100 Migraine Drugs, A to Z: baclofen
Baclofen (Lioresal) is one of several muscle relaxants that have been tested for the treatment of migraine headaches. The testing was not very rigorous – baclofen was subjected only to one open label trial. The trial done by an Israeli neurologist, Dr. Rachel Hering-Hanit involved 54 patients. After a 4-week baseline assessment period, patients were given baclofen for 12 weeks. The drug was given three times a day with the dose ranging from 15 to 40 mg.
What was impressive about this study is that not only 86% of patients improved by at least 50%, but also that 51 out of 54 patients completed the study. It is very likely that many would have dropped out if the treatment was ineffective or had a high rate of side effects. Only 3 patients dropped out because of side effects.
Dr. Hering-Hanit also tested baclofen in 9 cluster headache sufferers with six improving within a week on doses ranging from of 15 to 30 mg.
The main side effect of this drug is drowsiness. Some patients may not need to take it three times a day – one nightly dose may suffice. I start with 10 mg nightly and gradually increase the dose. However, another muscle relaxant, tizanidine has been shown to relieve chronic migraine in double-blind studies and I tend to use it much more frequently than baclofen. Tizanidine has the same main side effect – sedation.
The dose of Baclofen for the treatment of spasticity goes up to 60 mg a day and even higher, so yes, I would ask your doctor about increasing the dose. As far as Botox, it may take a second treatment to really see if it is going to provide lasting benefit. There is no negative interaction between Botox and Baclofen.
Hi Doctor, My neurologist has me on Baclofen (10mg) 3x daily as a a migraine preventative. I have severe daily migraine headaches and I think it has benefited me along with my Botox treatments which i just started 4 weeks ago. Recently however my migraine headaches intensity (and frequency) has started to increase. I am not sure if the Botox is starting to wear off but is it possible to increase the baclofen daily dosage to counteract the headache intensity and frequency? Thank you for starting this blog!