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Baclofen therapy is associated with potential complications, including life-threatening toxicity and withdrawal syndrome. These disorders require prompt recognition and a high index of suspicion. While these complications can develop following administration of either oral or intrathecal baclofen, the risk is greater with the intrathecal route. The management of baclofen toxicity is largely supportive while baclofen withdrawal syndrome is most effectively treated with re-initiation or supplementation of baclofen dosing. Administration of other pharmacologic adjuncts may be required to effectively treat associated withdrawal symptoms. This narrative review provides an overview of the historical and emerging uses of baclofen, offers practical dosing recommendations for both oral and intrathecal routes of administration, and reviews the diagnosis and management of both baclofen toxicity and withdrawal.<\/jats:p>","DOI":"10.1177\/20503121211022197","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T17:55:36Z","timestamp":1622742936000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":157,"title":["Baclofen therapeutics, toxicity, and withdrawal: A narrative review"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5011-9179","authenticated-orcid":false,"given":"Jia W","family":"Romito","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA"},{"name":"Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA"},{"name":"Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily R","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Rosener","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Landon","family":"Coldiron","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh","family":"Udipi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linsey","family":"Nohrn","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Tausiani","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7178-4613","authenticated-orcid":false,"given":"Bryan T","family":"Romito","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"key":"bibr1-20503121211022197","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-3589(10)58002-5"},{"key":"bibr2-20503121211022197","unstructured":"Entreprises Importfab Inc. 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