IV Baclofen for Treating Migraines Accompanied by Severe Muscle Spasm in Outpatient Setting (P03.235)

Abstract

Objective: IV baclofen was used to treat refractory migraines/daily headaches associated with muscle spasm of neck muscles in an outpatient headache clinic. Background IV baclofen is not available in the USA, although an oral preparation is widely available. A sterile preparation of baclofen (2.5mg/ml, pH 6.6) was made with a compounding pharmacist, and studied to reduce refractory muscle spasm accompanied by migraine headaches. Design/Methods: 56 patients were treated in the clinic with pulse oximetry monitoring. 5-10 mg of IV baclofen given at intervals of 10-15 minutes with rating of muscle spasm and headache/migraine by patients every 15 minutes. A 0-10 scale was used to monitor muscle spasm and migraine severity. Results: Average initial refractory headaches were rated 8.1/10; muscle spasm was rated 9.1/10 by patients. Patients were treated (up to 6 times) with IV baclofen; half were treated once. Headache severity diminished to 3.0/10 (p Conclusions: IV baclofen is a safe and efficacious treatment for refractory migraines/headaches associated with muscle spasm in an outpatient setting with pulse oximetry monitoring. This is a new and unique approach to treatment, where active treatment is provided. Side effects were minimal; double-blind studies for this medication are definitely warranted, given the impressive initial open-label results. Type B GABA receptor activity may be altered or reduced in the maintenance of migraines and muscle spasm and baclofen is postulated to play a modulatory role in this system. Supported by: This is an investigator initiated study - NOT supported by any pharmaceutical company. Disclosure: Dr. Krusz has nothing to disclose. Dr. Cagle has nothing to disclose.