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Published Online, 17 October 2006, www.theannals.com, DOI 10.1345/aph.1H202.
 The Annals of Pharmacotherapy: Vol. 40, No. 11, pp. 2071-2073. DOI 10.1345/aph.1H202
© 2006 Harvey Whitney Books Company.
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Baclofen-Induced Psychosis

Jatinder Mohan Chawla, MBBS

Junior Resident, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India

Ravindra Rao, MD

Senior Resident, Department of Psychiatry, All India Institute of Medical Sciences

Rajesh Sagar, MD

Associate Professor, Department of Psychiatry, All India Institute of Medical Sciences

Reprints: Dr. Ravindra Rao, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi 110 029, India, fax 91-11-26588663, drrvrao{at}yahoo.com

OBJECTIVE: To report a case of psychosis induced by therapeutic doses of baclofen.

CASE SUMMARY: A 32-year-old Hindu man was prescribed oral baclofen 10 mg twice daily for relief of muscular spasms secondary to tetanus. After 4 weeks of baclofen use, he presented to the psychiatry emergency facility with a 4 day history of third-person auditory hallucinations and persecutory and referential delusions without underlying mood symptoms. These symptoms resolved within 1 week of discontinuing baclofen. Rechallenge with baclofen resulted in reemergence of psychotic symptoms, which disappeared after discontinuing baclofen.

DISCUSSION: Reemergence of psychotic symptoms after rechallenge with baclofen suggests baclofen-induced psychosis. Use of the Naranjo probability scale indicates a probable association of baclofen with this patient's psychosis. The absence of underlying mood disorder makes this case different from previously reported ones.

CONCLUSIONS: Baclofen may be associated with the occurrence of psychosis. Clinicians should consider baclofen-induced psychosis as a differential diagnosis in patients presenting with psychosis during treatment with this drug.

Key Words: baclofen, psychosis

Published Online, October 17, 2006. www.theannals.com, DOI 10.1345/aph.1H202




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