Baclofen is a medication commonly prescribed to treat muscle spasms, cramps, and tightness associated with multiple sclerosis (MS) and other conditions. Spasticity, characterized by stiff or tight muscles and involuntary muscle spasms that can be painful and hinder movement, is a common and often challenging symptom of multiple sclerosis (MS). MS causes lesions (damage) in the central nervous system (CNS), which includes the brain, optic nerves, and spinal cord. These lesions lead to symptoms such as spasticity. More than 17,000 MyMSTeam members have reported experiencing spasticity.
Baclofen, approved by the Food and Drug Administration (FDA), may also relieve pain and improve muscle control in people with MS-related spasticity. Baclofen is available under brand names including Fleqsuvy, Lioresal, Lyvispah, and Ozobax. Oral baclofen is taken as a tablet or liquid solution. For severe spasticity, a doctor may recommend an intrathecal pump, also known as intrathecal baclofen therapy. In this procedure, a surgically implanted pump and catheter deliver baclofen directly into the spinal canal for continuous relief.
Although baclofen may offer relief, some individuals have expressed concerns about potential weight gain. While weight gain is not typically listed as a common side effect of baclofen, various MS-related factors and, in some cases, the medication itself can influence weight, either increasing or decreasing it. Understanding what to expect when taking baclofen can help you feel more prepared to manage potential side effects.
Weight Gain and Baclofen: What the Evidence Says
According to Mayo Clinic, weight gain is an uncommon or even rare side effect of taking baclofen. MedlinePlus doesn’t list weight gain as a side effect at all. Additionally, there is no evidence that baclofen causes water retention. Within the MyMSTeam community, weight gain related to baclofen use does not appear to be a common experience. When one member asked others about weight gain while taking baclofen, many reported that they did not experience it: “I don’t recall any major side effects. I didn’t experience any weight gain.” “I take it nightly for back/leg spasms. … No weight gain but some nausea.” “I have been taking baclofen for about 14 years. The only side effect I had at first was tiredness.” Another team member said, “I’ve noticed some weight gain. But it could be from something else.”
Although baclofen is unlikely to cause weight gain, concerns about weight changes are common with MS medications. Talk with your doctor if you’re concerned about your weight or the possible side effects of your medications.
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However, some research indicates that baclofen can reduce fat intake when access to food is limited to brief periods under non-food-deprived conditions. Baclofen can reduce the size of a fat binge as induced by limited access. Another study concluded that weight loss is a possible side effect of baclofen. The researchers noted that baclofen suppresses cravings for pure fat but does not help regulate binge eating of foods high in sugar.
Common Side Effects of Baclofen
While baclofen does not typically cause weight gain, other side effects are possible, including:
- Dizziness
- Confusion
- Weakness
- Nausea
- Headache
- Fatigue or drowsiness
- Constipation
- Sleep problems
- Frequent urination
It’s important to talk to your doctor or neurologist if you experience any of these side effects, especially if they persist, worsen, or interfere with your daily life. Avoid stopping baclofen suddenly, even if side effects are bothersome, and always seek medical advice first. Abruptly stopping baclofen can lead to severe withdrawal effects, including increased muscle stiffness, fever, confusion, seizures, or hallucinations. If you and your doctor decide to discontinue baclofen, they will provide guidance on gradually and safely reducing the dose.
While baclofen may help you with spasticity, it doesn’t work for everyone. Research shows that a significant number of people stop taking baclofen due to side effects or lack of effectiveness. Always inform your doctor of any unpleasant side effects, and ask if other treatments for spasticity might be worth considering.
How Baclofen Side Effects Might Indirectly Influence Weight
Some common side effects of baclofen may indirectly impact weight by reducing physical activity. For instance, dizziness can cause balance issues that make it challenging to exercise safely. Fatigue and weakness, also common with baclofen, may make physical activity more difficult to manage.
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Interestingly, research shows that physical activity may actually help reduce MS-related fatigue. Although it can feel difficult to get moving when you’re tired, gentle exercise may help boost your energy and decrease fatigue. Many people with MS find that low-impact activities like water exercise, yoga, and Pilates improve cardiovascular fitness, strength, and flexibility.
The Impact of MS Symptoms on Exercise and Weight
Muscle weakness and spasticity are common MS symptoms that can make exercise challenging. Medications like baclofen may help relieve spasticity, potentially making physical activity more comfortable.
Ask your health care team for personalized recommendations to help you stay active within your abilities. Physical activity can support healthy weight management and improve both your physical and mental well-being. Always talk to a health care professional before beginning a new exercise program. Let them know whether you are experiencing side effects from medications, including baclofen. Your doctor can give you a referral to a physical therapist who can help you with an exercise routine that is appropriate for you.
Other Factors Contributing to Weight Gain in MS
Weight gain is a common concern among people with MS, and many people wonder if the condition is to blame. There are many reasons someone with MS might gain weight. As one MyMSTeam member put it, “To be honest, I take so many prescription medications, I’m not sure which one would have helped with my weight gain. Of course, not being as physically active had something to do with it too.”
There may be several factors at play. Common causes of weight gain in MS include:
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- Stress, anxiety, and depression
- Symptoms like spasticity, which can limit mobility and activity
- Medications (e.g., steroids) that treat MS relapses
If you’re experiencing unwanted side effects such as weight gain from one of your other MS medications, consider speaking with your doctor about switching treatments. More than 23,000 MyMSTeam members have said they experience depression, which could bring on weight gain or weight loss. Be sure to talk to your doctor if you need help managing depression or other mood changes. They may refer you for mental health evaluation or counseling.
If you would like guidance on maintaining a healthy weight, consider asking your doctor about a referral to a registered dietitian. Additionally, if you are pregnant or breastfeeding, consult your doctor before taking baclofen.
Baclofen and Weight Loss: Exploring the Potential Link
While weight gain is often the primary concern, some studies suggest that baclofen may be associated with weight loss in certain situations. Baclofen has been shown to cause weight loss through several mechanisms potentially. Research indicates that baclofen can reduce fat intake when access to food is limited to brief periods under non-food-deprived conditions. Baclofen can reduce the size of a fat binge as induced by limited access. Another study concluded that weight loss is a possible side effect of baclofen. The researchers noted that baclofen suppresses cravings for pure fat but does not help regulate binge eating of foods high in sugar.
One study involving women and men with a body mass index in the obese range showed that administration of baclofen for 12 weeks significantly decreased both body weight and waist circumference. Serum leptin levels, which possibly reflect the amount of adipose stores, were also decreased significantly by the treatment. On the other hand, there were no significant changes in the blood pressure or metabolism of glucose and lipid.
It's important to note that more research is needed to fully understand the mechanisms and conditions under which baclofen may contribute to weight loss.
Intrathecal Baclofen Therapy and Body Composition
Intrathecal baclofen (ITB) therapy, where baclofen is delivered directly into the spinal canal, is used for severe spasticity. A study assessing changes in body composition after initiation of ITB therapy found an increase in fat body mass and a decrease in lean body mass during the first year after commencement of ITB therapy. The study indicated that unfavourable changes in body composition might occur after intrathecal baclofen therapy. Since obesity and increased fat body mass contribute to an increased cardiovascular risk, these findings may indicate a need for initiation of countermeasures, e.g. increased physical activity and/or dietary measures, in conjunction with intrathecal baclofen therapy. Further studies, including larger study samples and control groups, are needed to corroborate these findings.
The researchers suggested that the changes in body composition were primarily due to a decrease in activity-related/activity-triggered spasticity, rather than due to any changes in resting-state spasticity. This highlights the importance of maintaining physical activity even when spasticity is reduced through medication.
Important Considerations When Taking Baclofen
- Consult your doctor: It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.
- Do not stop suddenly: Do not suddenly stop using this medicine without checking first with your doctor. You may need to slowly decrease your dose before stopping it completely. Unwanted side effects (eg, hallucinations, seizures, high fever, rhabdomyolysis) may occur if baclofen is stopped suddenly.
- Avoid alcohol and other CNS depressants: This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, other muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using baclofen.
- Be aware of potential side effects: This medicine may cause dizziness, drowsiness, vision problems, or clumsiness or unsteadiness in some people. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert, well-coordinated, and able to see well.
- Monitor blood sugar levels: This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.
- Pregnancy and breastfeeding: Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has shakiness or tremors, seizures, or increased muscle tone. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
- Drug interactions: Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
- Geriatric considerations: Elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution for patients receiving this medicine. Side effects such as hallucinations, confusion or mental depression, other mood or mental changes, and severe drowsiness may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of this medicine. Avoid use in elderly patients with kidney disease because of increased risk of serious brain problems (eg, encephalopathy).