Baclofen-Induced dystonia and tremors in a patient with alcohol dependence syndrome

Abstract

Baclofen is primarily a gamma-aminobutyric acid-B receptor agonist. It is used in patients with dystonia and to reduce spasticity in neuromuscular disorders. It has dopaminergic antagonist properties that reduce craving in alcohol dependence. Somnolence, dizziness, and fatigue are common side effects. Rarely paresthesia, rigidity, dystonia, dysarthria, or seizures are reported. We hereby report a rare case of baclofen-induced dystonia and tremors in a patient with alcohol dependence. An alcohol-dependent patient was admitted and withdrawal symptoms were managed. Twenty mg baclofen was advised to reduce craving. He developed dystonia and tremors within a few hours of the first dose. On evaluation, magnetic resonance imaging of brain revealed non-specific changes and electroencephalography was normal. To our knowledge, this is one of the first case reports of drug-induced dystonia attributable to baclofen. The underlying pathophysiological processes involved remain unclear. Baclofen decreases pre-synaptic dopamine release in the nigrostriatal pathway, which may be the possible mechanism for dystonia.