Baclofen

Baclofen is a muscle relaxant that works on the central nervous system. In neuro-ophthalmology, it's used to treat certain types of nystagmus, blepharospasm, and muscle spasms.

How It Works

Baclofen activates GABA-B receptors in the spinal cord and brain, reducing muscle tone and spasms. It may also affect neural pathways involved in eye movements.

Common Uses

• Periodic alternating nystagmus
• Some types of acquired nystagmus
• Blepharospasm—adjunctive treatment
• Hemifacial spasm—sometimes tried
• Muscle spasticity

Dosing

• Start low (5mg three times daily)
• Increase gradually
• Typical dose: 10-20mg three times daily
• Higher doses may be needed

Side Effects

Common

• Drowsiness
• Dizziness
• Weakness
• Nausea
• Confusion (especially in elderly)

With Sudden Discontinuation

Tips for Taking Baclofen

• Start low to minimize drowsiness
• Take with food if GI upset occurs
• Avoid alcohol (increases sedation)
• Don't stop suddenly—taper

Frequently Asked Questions

Will it make me sleepy?

Drowsiness is common, especially initially. It often improves as your body adjusts. Taking doses at bedtime may help.

Can I drive?

Be cautious initially—don't drive until you know how baclofen affects you. Once stable on a dose, many people can drive safely.

How do I know if it's working?

For nystagmus, you may notice improved vision stability. For spasms, reduced frequency or intensity. Effects may take weeks to assess fully.