Baclofen for narcolepsy: Is it effective? 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Sellers, BS Pharmacy, PharmD — By Rachel Ann Tee-Melegrito on June 29, 2022Baclofen is a muscle relaxant that offers promising results in improving daytime wakefulness, sleeping patterns, and cataplexy in people with narcolepsy. However, more research is needed to assess its effectiveness as a treatment. Narcolepsy is a disabling neurological disorder that causes excessive daytime sleepiness and fragmented sleep. According to the Narcolepsy Network, it affects around 1 in 2,000 Americans. There is no cure for narcolepsy. Treatment, which includes medications and lifestyle changes, is aimed at managing symptoms such as cataplexy, sleep fragmentation, and excessive daytime sleepiness. Recent studies suggest that baclofen may have benefits and can improve sleep and treat narcolepsy symptoms. This article explores the benefits and effectiveness of using baclofen in treating narcolepsy. It also discusses the potential risk of using it and other alternative treatments for narcolepsy. What is baclofen Share on PinterestFG Trade/Getty ImagesBaclofen is a muscle relaxant. Doctors mainly prescribe it to relieve painful muscle spasms and reduce spasticity caused by various conditions. These include cerebral palsy, multiple sclerosis, trigeminal neuralgia, and spinal cord injuries. Baclofen is a gamma-amino-butyric acid (GABA) agonist and blocks the signals from the central nervous system (CNS) that tell muscles to spasm. GABA is a crucial neurotransmitter in the CNS. This neurotransmitter is responsible for inhibiting neurons. Baclofen specifically acts at GABA-B receptors. GABA-B is a type of GABA receptor that blocks the release of neurotransmitters or prevents the neuron from receiving another stimulus. Due to its central role in neurobiology, GABA-B seems involved in several neurological and psychiatric disorders, including sleep disorders, stress, spasticity, neuropathic pain, depression, and anxiety. Is it effective for treating narcolepsy A 2014 mice study found that giving R-baclofen (R-BAC) 2.8 milligram per kilogram twice nightly — the same dosing regimen given to people with narcolepsy — suppressed cataplexy to a greater extent than gamma-hydroxybutyrate (GHB). GHB has Food and Drug Administration (FDA) approval to treat narcolepsy. Cataplexy is a sudden, brief loss of muscle control triggered by strong emotions. Some people with narcolepsy experience cataplexy. Learn more about narcolepsy. However, the studies only reflected positive results in mice with narcolepsy. Further studies on humans with the condition are needed. A 2015 report found that using baclofen led to an almost complete resolution of cataplexy in two people with narcolepsy and cataplexy who were experiencing multiple daily cataplexy episodes. A 2019 study described five individuals with narcolepsy with excessive daytime sleepiness who reported subjective improvement in their sleep maintenance without excessive daytime sleepiness and fragmentation. Benefits People experiencing minimal benefits or side effects with the initial or first-line of treatment for narcolepsy may respond to baclofen, similar to the 2019 study mentioned above. A 2016 study also found that baclofen used with benzodiazepines can effectively treat GHB withdrawal. It has many other uses and benefits besides its primary role as an antispasticity and spasmodic medication. Some doctors use it as an off-label prescription in treating alcohol use disorder. A 2020 study also found that GABAB receptor agonists reduce depression and cocaine addiction in rats. A 2021 study suggested that a novel combination of the antidepressant opipramol and baclofen can potentially treat people with substance use disorder with comorbid mood or anxiety disorders. Dosage for narcolepsy While the FDA has approved baclofen for use in managing reversible spasticity in various conditions and is known to be safe for humans, it is not yet approved to treat narcolepsy. There is no approved dose for baclofen for treating narcolepsy. Moreover, the dose that may be effective for spasticity may differ from the dose needed for narcolepsy. Risks As with any other medication, baclofen may cause side effects. The most common include:muscle weaknessvertigoconfusionnauseatiredness Less common side effects include:constipationdifficulty falling or staying asleepdepressionpainfrequent urinationlow blood pressureperipheral edema, swelling of lower legs or handsshortness of breathhypoventilationpneumoniaseizureagitationdiarrheaspeech alterationincontinenceimpotencetremorlazy eyeitchy skin or itchy rash on skin Baclofen toxicity can be life threatening with cardiac arrhythmia, respiratory failure, and hemodynamic instability, requiring ICU admission. Some signs of baclofen toxicity include:lethargyconfusiondrowsinessseizuresmetabolic encephalopathycoma What to avoid while taking baclofen It may not be safe for a pregnant individual to take baclofen. However, regarding breastfeeding or chestfeeding, the level of baclofen in breastmilk is very low and may have negligible effects on the infant. Baclofen may also interact with other medications. Before taking baclofen, a person should inform a doctor of their nonprescription and prescription medications. It is essential to mention any of the following:antidepressantsanxiety medicationsantipsychotic medicationsseizure medicationssedativessleeping pillstranquilizers Drinking alcohol or smoking can also worsen the side effects of baclofen. It is also essential for a person to inform the doctor if they have other comorbid conditions. These include:strokerheumatic diseaseParkinson’s diseasecerebral palsykidney diseaseschizophrenia Other treatments for narcolepsy There is no cure for narcolepsy. However, treatments and lifestyle changes are available to manage its symptoms. Behavior modifications and lifestyle changes A person can make specific lifestyle changes to help improve their sleep:following a regular sleep scheduletaking short, scheduled napsavoiding sleep deprivation and not skipping sleepasking for school and work accommodationsavoiding caffeine, alcohol, and smokingexercising dailyundergoing psychotherapy for some people Learn more about ways to improve sleep here. Medications Doctors may prescribe different drugs for narcolepsy. Below are the main types of medications that control various narcolepsy symptoms such as sleepiness, disturbed nighttime sleep, and cataplexy:Stimulants: Drugs such as modafinil and methylphenidate can improve alertness and reduce daytime sleepiness.Antidepressants: Medications such as tricyclic antidepressants, serotonin-specific reuptake inhibitors (SSRIs), and noradrenergic reuptake inhibitors (NARIs) can control cataplexy.Sodium oxybate or GHB: These medicines manage excessive daytime sleepiness and cataplexy when taken twice daily. When to speak with a doctor Narcolepsy is often diagnosed late or misdiagnosed. A person experiencing sleep issues and a powerful urge to sleep during the day should consult a doctor. A person not experiencing improvements with their current prescription and behavior management strategies should also ask the doctor about alternative management of their condition. Frequently asked questions Here are some answers to common questions about baclofen. Is baclofen a sleeping pill Baclofen is a muscle relaxant, not a sleeping pill. However, it acts on the CNS and has depressing properties that can cause mild sedation and sleepiness. What is the best drug for narcolepsy There is no one-size-fits-all drug for narcolepsy. A doctor will prescribe the right medication for a person with narcolepsy, depending on their symptoms and severity. Summary Baclofen is a widely known muscle relaxant that affects the CNS. Recent studies are exploring its effectiveness as a drug for narcolepsy. Research shows promising results and found that baclofen can improve sleep quality in individuals with narcolepsy by acting on GABA-B receptors. However, scientists need to conduct more clinical research into the ideal baclofen dosage for narcolepsy. Using baclofen may also cause risks and side effects. A person needs to consult a doctor before trying the drug. Last medically reviewed on June 29, 2022Clinical Trials / Drug TrialsNeurology / NeuroscienceSleep / Sleep Disorders / InsomniaMedically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD — By Rachel Ann Tee-Melegrito on June 29, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat to know about narcolepsyMedically reviewed by Raj Dasgupta, MD Narcolepsy is a chronic sleep disorder wherein the brain cannot regulate the body's sleep-wake cycles. A person may fall asleep unexpectedly. 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