{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:10:34Z","timestamp":1792195834779,"version":"4.4.0"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T00:00:00Z","timestamp":1716336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropediatrics"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Spasticity and dystonia are movement impairments that can occur in childhood-onset neurological disorders. Severely affected individuals can be treated with intrathecal baclofen (ITB). Concomitant use of ITB and opioids has been associated with central nervous system (CNS) depression. This study aims to describe the clinical management of this interaction, based on a case series and review of literature.<\/jats:p><jats:p>\n          Methods\u2003Four individuals with childhood-onset CNS disorders (age 8\u201324) and CNS-depressant overdose symptoms after the concomitant use of ITB and opioids are described. The Drug Interaction Probability Scale (DIPS) was calculated to assess the cause-relationship (doubtful &lt;2, possible 2\u20134, probable 5\u20138, and highly probable &gt;8) of the potential drug\u2013drug interaction. A literature review of similar previously reported cases and the possible pharmacological mechanisms of opioid\u2013baclofen interaction is provided.<\/jats:p><jats:p>\n          Results\u2003After ITB and opioid co-administration, three out of four patients had decreased consciousness, and three developed respiratory depression. DIPS scores indicated a possible cause-relationship in one patient (DIPS: 4) and a probable cause-relationship in the others (DIPS: 6, 6, and 8). Discontinuation or adjusting ITB or opioid dosages resulted in clinical recovery. All patients recovered completely. In the literature, two articles describing nine unique cases were found.<\/jats:p><jats:p>\n          Conclusion\u2003Although the opioid\u2013ITB interaction is incompletely understood, concomitant use may enhance the risk of symptoms of CNS-depressant overdose, which are potentially life-threatening. If concomitant use is desirable, we strongly recommend to closely monitor these patients to detect interaction symptoms early. Awareness and monitoring of the potential opioid\u2013ITB interaction is essential to reduce the risk of severe complications.<\/jats:p>","DOI":"10.1055\/s-0044-1787103","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T23:08:26Z","timestamp":1716419306000},"page":"294-302","source":"Crossref","is-referenced-by-count":3,"title":["Potentially Life-Threatening Interaction between Opioids and Intrathecal Baclofen in Individuals with a Childhood-Onset Neurological Disorder: A Case Series and Review of the Literature"],"prefix":"10.1055","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5578-6354","authenticated-orcid":false,"given":"Liza M.M.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Location Vrije Universiteit, Amsterdam, the Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelies","family":"van Zwol","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5662-2843","authenticated-orcid":false,"given":"Annemieke I.","family":"Buizer","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Location Vrije Universiteit, Amsterdam, the Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands"},{"name":"Emma Children's Hospital, Amsterdam University Medical Centers, Location University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"van de Pol","sequence":"additional","affiliation":[{"name":"Department of Child Neurology, Amsterdam University Medical Centers, Location Vrije Universiteit, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Mariam","family":"Slot","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Amsterdam University Medical Centers, Location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Brain Tumor Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia N.","family":"de Wildt","sequence":"additional","affiliation":[{"name":"Division of Pharmacology and Toxicology, Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands"},{"name":"Department of Neonatal and Pediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Bonouvri\u00e9","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Location Vrije Universiteit, Amsterdam, the 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