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Christopher F. Terrence, MD
Neurology Service Veterans Administration Medical Center Pittsburgh, PA 15240

Gerhard H. Fromm, MD
Department of Neurology University of Pittsburgh School of Medicine Pittsburgh, PA 15261

Matei Roussan, MD
Department of Rehabilitation Medicine Albert Einstein College of Medicine Bronx, NY 10461

Arch Neurol. 1984;41(2):134.

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In Reply.

—Dr Seyfert's thoughtful letter brings up an important point about previous individual case reports of baclofen and seizures, namely, that baclofen given in toxic doses is probably epileptogenic in both animals and humans. Such toxic overdose was certainly the case in the reports of Paulson,¹ Laplatte et al,² and Seyfert et al.³ In the more recent article by Seyfert and Straschill,⁴ the serum baclofen concentration was 850 ng/mL in a patient receiving long-term hemodialysis who was unable to excrete baclofen normally. Since a single 40-mg oral dose of baclofen will produce a peak transient baclofen blood level of about 650 ng/mL,⁵ attainment of a relatively constant serum concentration of 850 ng/mL in a patient with normal kidney function would take a daily dose of at least three to four times the manufacturer's recommended maximum daily dose of 80 mg. The common feature in these case . . . [Full Text PDF of this Article]

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