Treatments

Baclofen

In this section:

Key points | Benefits and Harms | Comment

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Key points

  • For GRADE evaluation of interventions for Trigeminal neuralgia, see table.
  • We found no sufficient evidence to judge the effectiveness of baclofen.
  • There is consensus that baclofen may be useful for people with multiple sclerosis who develop trigeminal neuralgia.
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Benefits and harms

Baclofen versus placebo:

We found one systematic review (search date 2011), which identified one controlled trial (double-blind crossover, 10 people, 4 using carbamazepine or phenytoin, not clearly randomised).[41] The review excluded the study owing to its crossover design and insufficient washout period (7 days before crossover).

Baclofen versus carbamazepine:

We found one systematic review (search date 2011), which identified one randomised, double-blind, parallel-group trial comparing carbamazepine, baclofen, and combinations of both.[41] The review excluded the study as it lasted only 10 days and the washout period was insufficient.

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Comment

As Clinical Evidence was unable to perform a second appraisal of results retrieved by the contributor's search, we may have missed studies that could affect our overall assessment of this intervention.

Clinical guide:

We found no good evidence of benefit for baclofen from any RCTs. Consensus has suggested that it may be useful in people with multiple sclerosis who develop trigeminal neuralgia. This group of people are often taking baclofen already, and may achieve control of symptoms without having to add carbamazepine. Only one research group to date has carried out trials on L-baclofen and has now ceased to do so.

Baclofen is associated with transient sedation and loss of muscle tone. Abrupt discontinuation may cause seizures and hallucinations.