Intoxicación por baclofeno: ¿uso terapéutico o recreativo? Reporte de caso y revisión de la literatura: Baclofen poisoning: therapeutic or recreational use? A case report and literature review

Neyra Cedeño Caballero; Andrés Agrazales; Zuleyka Chen; Eduardo  Guinard

doi:10.59722/rmcu.v3i2.1234

Authors

Neyra Cedeño Caballero Caja de Seguro Social|Unidad Local de Salud y Seguridad Ocupacional| Hospital Dionisio Arrocha| Barú| Panamá https://orcid.org/0000-0001-9558-2178
Andrés Agrazales Caja de Seguro Social| Unidad Local de Salud y Seguridad Ocupacional| Hospital Raúl Dávila Mena| Changuinola|Panamá https://orcid.org/0009-0004-3180-3372
Zuleyka Chen Caja de Seguro Social|Unidad Local de Salud y Seguridad Ocupacional| Ciudad de la Salud| Panamá https://orcid.org/0009-0007-0800-0637
Eduardo Guinard Ministerio de Salud|Dirección Nacional de Salud Ocupacional|Panamá https://orcid.org/0009-0001-4450-2999

DOI:

https://doi.org/10.59722/rmcu.v3i2.1234

Keywords:

Key Words: Baclofen; Intoxication; Coma.

Abstract

Abstract

Introduction: Baclofen is a fat-soluble derivative of the neurotransmitter gamma-aminobutyric acid used as an approved medical treatment for spasticity related to multiple sclerosis and other spinal cord pathologies. In 2020, according to statistics, baclofen was reported as the only agent associated with overdose, with 2,112 cases of intentional use, 700 unintentional exposures, and 110 cases of adverse drug reactions, resulting in 2 to 12 deaths per year.

Clinical Case: A 32-year-old male patient who was admitted to the Emergency Department of the Dr. Juan Fernández Acute Care Hospital in the Autonomous City of Buenos Aires. The patient was found in a public area with decreased level of consciousness and episodes of apnea. Empty containers of baclofen and benzodiazepines were found in his possession, which initially suggested a possible suicide attempt by ingestion of these drugs.

In the initial management at the emergency department, he required mechanical respiratory support and was subsequently transferred to the critical care unit, where he remained hospitalized for 7 days. Afterwards, he continued follow-up in the toxicology ward for comprehensive care.

Conclusion: Baclofen intoxication is an increasing clinical problem, more frequently reported in North America and Europe, but also present in Latin America, often associated with recreational drug use. These cases may require advanced ICU management, including prolonged mechanical ventilation. The reported case highlights the importance of early airway intervention and intensive monitoring to support recovery. It also emphasizes the inappropriate use of baclofen for low back pain without clear indication, underscoring the need for strict prescription and follow-up. Finally, the potential concomitant use of other substances should always be considered as part of a comprehensive evaluation in such intoxications.

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