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**COSGringo** · June 17, 2012, 06:18 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Hi MusiciansMallet,
I find the GABA B med for me blocks a lot of the effects of GABA A. The benzos still help with SE's and insomnia but I don't notice any kind of "high". I think it's fine. Fiorcet never did much for me when I wasn't on baclofen but everyone is different.
I can't imagine going to 200mg in a couple days. Where were you at before that? If you were at 0 I can't imagine how be the SE's would be. It would have been overwhelming for me and I would have been very ill. Are you still taking 200? If you want to titrate down I believe 20mg per week is the standard. You can then go up later say once you are down to 120 and SE's are better.
I would keep benzos around to deal with insomnia and SE's.
Also keep in mind baclofen is a muscle relaxant. Migraines usually require other meds from when I got them. Imitrex is effective. Codeine can help a bit. There are a lot of options but I've never heard of a low dose barb being helpful for those but I have not had a spot of those in years thankfully. I think you will lose any strong will to take that butalbital much while on baclofen and I think you will be fine. Maybe keep some benzos handy.

**MusiciansMallet** · June 17, 2012, 06:38 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Thanks for your reply Cos:
I initially went from 0 mg to 200 mg (in a 24 hour period, first time taking baclofen) -- I was fine the day of; but about 24 hours later I became dizzy, then violently ill for a full 24-36 hours! After the vomiting resolved itself, I resumed baclofen but at very VERY small doses- ~5mg or so i'd say two days ago; 8mg yesterday; & i'm going to try & take 15-20mg today. So far, i'm ok, no side effects. I do not have access to benzodiazepines, I have access to the butalbital (the barbiturate) & baclofen, that's it.

The butalbital--the barbiturate--is my main concern here; and its what i'm trying to reduce or hopefully eventually completely STOP taking (w/ the help of baclofen). The typical dose is 50 mg 3-5x a day (250mg/d); I've managed to titrate myself upwards to 1300mg-1500mg day due to tolerance. So, I was just noticing diminishing effects of butalbital after baclofen (perhaps, as you say, this is b/c of GABA-B agonists diminishing some of the effects of GABA-A drugs?)... I don't know if this is the intended effect of baclofen? To somewhat block the effects?

Any other information on mixing GABA-A & GABA-B drugs/ their impact on each other- whether anecdotal, scientific, etc.. is welcome!

(SIDE NOTE: I am prescribed suboxone (buprenorphine) for past opiate-dependency, 4 mg/daily... really not relevant here I suppose, BUT, I have noticed a decreased need to take this even at 10-15mg of baclofen.. that is a definite upside too! I'd love to get off this crap already.)

**Ne/Neva Eva** · June 17, 2012, 06:41 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Hey, MM.

I read your posts from the other board.

Is there any way that you can stabilize your whole body/mind back to normal before you do anything else? I can't imagine that 2 days of baclofen would have an effect for such a long time. (That said, in the doses you took, I am not really comfortable suggesting it doesn't at all.)

I have a friend who took low doses ativan for a couple of years and stopped cold turkey after she'd found indifference with baclofen. There were other unrelated circumstances, but the result was really, really bad.

What's the goal, by the way? And who the heck prescribed 200mg of baclofen for the purpose? (It doesn't really matter, btw, I'm just curious if there is actually someone in this country prescribing HDB...)

Take good care.

**Ne/Neva Eva** · June 17, 2012, 06:48 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

We cross posted.
Those are some big numbers.
We've had someone find indifference to heroin and post about it. But he wasn't using.
The couple of people who have posted about getting off of long term benzos really struggled, but they stopped cold turkey.

Titration for booze is about 20mg/week. Starting at about 10mg-30mg for the first 3 days to a week. If it works the same way, (and I bet it does, at least for the craving, not sure about the physical stuff) the transition is gradual. Unless you swallow it by the handful.

**moglor** · June 17, 2012, 07:48 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Taking 200mg in one whopping dose is a recipe for disaster. There's no "cross tolerance" that I'm aware of, and there's pretty minimal tolerance in general, but people do get used to the side effects over time.

I'll occasionally double up a 50mg dose and I've been on bac for several years. I'll get quite ill as you described. I suspect your experience is more due to acute baclofen intoxication and/or withdrawal than anything else. I've never experienced baclofen "blocking" the effects of anything, including a variety of therapeutic and recreational psychotropics.

My guess is you took too much, too fast, then stopped taking it, and threw your entire neurochemistry balance into a tailspin.

It sounds like you did quite a bit of homework, but like anything that changes your neurochemistry, it takes weeks of slow titration to achieve therapeutic effects. If your psychiatrist was "aware" of your plan to slam 200mg of baclofen and abruptly stop, yet did nothing to intervene, your psychiatrist's license should be revoked. Either way, you should seek care from someone else.

**COSGringo** · June 18, 2012, 09:39 AM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

200 mg that quick much too fast. I can't believe a doc would prescribe that. That's more than some folks even need to hit their "switch"
I had read some articles on HDB being such a strong GABA B agonist that a low dose of a GABA A agonist has much less of an effect than it normally would. I don't have time to look it up as I was on a company sponsored event in Vegas last week. Catching up with work now.
Be careful and good luck.

**MusiciansMallet** · June 18, 2012, 07:51 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

FIRST: Thank you VERY much for everyone's replies... I cannot tell you how much I appreciate it! :thanks:

Ne/Neva Eva wrote: What's the goal, by the way? And who the heck prescribed 200mg of baclofen for the purpose? Goal is to eventually get off the butalbital, or at least slowly titrate down to typical doses at 250mg/day give or take (since I’ve been unable to do it on my own, w/ JUST the butalbital). This is why I tried the baclofen. I was prescribed it via online consultation, 90mg for $89 total (a. b/c i have no insurance & currently unemployed, and; b. because my doctor, who i primarily see for suboxone & opiate addiction which i kicked 12/22/07, is hesitant to prescribe anything for the butalbital, which he is ALSO aware of, which i ALSO must acquire via online consultations 180 pills for $130-$140). And to your comment “I’m sure they act in the same area of the brain” – yes barbiturates (such as butalbital) act in the same area of the brain as alcohol does; although it is more prone to cause general delirium *AND* delirium tremens (somewhat like benzodiazepines, but w/ even more tendency to cause DTs than them)

moglor wrote:

I'll occasionally double up a 50mg dose and I've been on bac for several years. I'll get quite ill as you described. I suspect your experience is more due to acute baclofen intoxication and/or withdrawal…….If your psychiatrist was "aware" of your plan to slam 200mg of baclofen and abruptly stop yet did nothing to intervene, your psychiatrist's license should be revoked.

He was aware I was planning to start the baclofen (although at slightly lower doses than the 200mg I ended up taking over 1.5 days), & he wasn't aware I was going to immediately stop. And I haven’t seen him during this period either, I will be seeing him tomorrow. And I only used the baclofen for 24-36ish hours in a row (more answers in post below).. So I don’t think it was a result of baclofen withdrawal, but more so of butalbital withdrawal since my intake was greatly reduced (again, more below on this…). And yes, in regards to your statement to find a different doctor, I would love too.. but in my area there are only 4 licensed suboxone doctors (which i take, 4mg a day, for opiate/opioid maintenance).. not to mention the initial "assessment" for a new doctor who will be prescribing you suboxone (buprenorphine, sublingual) costs around ~$150-$300!!! & this is JUST for the assessment, you do not get medication until your next appointment, usually 3-4 weeks later! (although, these regulations may have been relaxed given recent Federal relaxations of suboxone prescribing practices) ....at least I got the heroin/opiate addiction shit kicked, since Dec 2007! Although GABAergic drug-withdrawal (such as the butalbital... is much more scary than ANY opiate withdrawal!)

****ANYWAY: please, both of you, read my post below for more answers to your questions!******

**MusiciansMallet** · June 18, 2012, 07:52 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

OK, to generally answer everyone's questions/comments........

1) I took 200 mg over 24-36ish hour period; I felt the horrible effects about 48-60 hours (if i'm remembering correctly) AFTER my first baclofen dose. And yes, it did completely seem to block *most* of the effects of butalbital (the barbiturate I take, that i'd like to eventually get off, and/or get back to the originally prescribed dose).

2) And yes, i have NO DOUBT it completely through my neurophysiology off (and blocking, or at least interfering w/ the GABA-A agonist, butalbital). I'm attributing my experience (i was a pre-pharmacology major for one & a half years here in the US) to a combination of: A. hangover/intoxication of high dose of baclofen and; B. the first day & a half of baclofen use (before severe effects were noticed) I was able to drop my butalbital intake to 1/2-2/3 my typical dose; BUT then the severe vomiting came in, & I couldn't keep down my butalbital, thus precipitating withdrawal (& being unable, due to severe anxiety & general sickness, to secure funds for my next Rx of butalbital--I am unemployed).

[3) However, I haven't taken the baclofen now in ~24 hours; & i'm somewhat stabilized & the butalbital is somewhat working & feeling better, although I'm having to take slightly higher doses (a little over 1500 mg/day—again, typical dose for a non-tolerant person is 250 mg/d max; although, higher doses are not unusual w/ this barbiturate with long term use; but usually 1500 mg is the ceiling amount). But, its slowly gaining its efficacy, so I will plan to go back down to my typical dose I was somewhat stabilized on: 1350mg to 1500mg (max) w/in the next few days.. & then again slowly reintroduce the baclofen again; starting at 20mg MAX w/in 24 hours, then wait a few days... make sure i'm ok, see how I feel with the butalbital, & then go from there.

4) And, I haven't really heard of GABA-B agonist drugs causing a "blockade" effect with GABA-A agonists, neither in my short stint as a pre-pharm major or with my personal hobby of pharmacology that I still maintain (& not to mention, other GABA-B agonists like GHB & related drugs don't block—but actually INCREASE the effects of GABA-A agonist drugs, although, GHB & related drugs are less selective, & I suspect have less affinity & selectivity as a whole than baclofen).. but, this is more or less as a result of the fact that big PHRMA (and all the pharmaceutical companies here in the US) unwilling to pursue any double-blind studies on baclofen use (& pharmacology/interactions), since they can't make any money off this generic, non-patentable drug! Its a sad state of affairs when healthcare in this f***ing country is a BUSINESS more than a damn treatment!! (sorry, don't know if swearing is allowed or not?) ...But I guess the "free market" US-healthcare system is more concerned with profit than it is with the hippocratic oath!!!

...

I cannot stress enough my thanks for your reaching out guys & girls! I know this forum is primarily for alcohol dependency... but i barely use alcohol , nor am I dependent upon it- however, butalbital & most barbiturates have VERY similar side effects; and the withdrawal is very similar; & it is *much* more likely to cause delirium tremens- so i'd figure I'd take a shot here.

**Greg** · June 18, 2012, 08:14 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Just a personal opinion here....I would never try baclofen for either barbiturate or alcohol withdrawal, or benzo withdrawal for that matter. They simply work too differently.

If I were on a barbiturate to the extent of having to withdraw from it, my first instinct would be to ask a doctor if the long-acting phenobarbital could be used as a substitute, which could then be gradually withdrawn. I say this because a standard way of getting off short/medium-acting benzodiazepines is to substitute diazepam for the existing benzo, and then slowly taper that down. Diazepam itself could also possibly be used to get off your barbiturate, but I am only guessing there (due to it being a GABA-A agonist and also being the detox treatment of choice for alcohol withdrawal).

The best idea would be to speak to a doctor who deals with addiction treatment, or maybe even see an emergency department at a hospital about this. You are pretty much in the same situation as anyone who is physically dependent on alcohol and who is needing to get off it, which usually means medical detoxification. As I said, I would NEVER use baclofen for this, no matter what anyone here or anywhere else told me. Its GABA-B agonist action is too different to GABA-A agonists in my humble opinion.

**Ne/Neva Eva** · June 18, 2012, 08:50 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

MusiciansMallet;1337036 wrote:
4) And, I haven't really heard of GABA-B agonist drugs causing a "blockade" effect with GABA-A agonists, neither in my short stint as a pre-pharm major or with my personal hobby of pharmacology that I still maintain (& not to mention, other GABA-B agonists like GHB & related drugs don't block—but actually INCREASE the effects of GABA-A agonist drugs, although, GHB & related drugs are less selective, & I suspect have less affinity & selectivity as a whole than baclofen)..
...

You make me grin a little bit. I've read some stuff on bluelight (or whatever that website is?) about bac both intensifying and numbing effects of various things. I wouldn't be surprised if it's dose dependent. I also wouldn't be surprised if there were rat studies (at the very least) that you might be able to pull up related to bac and benzo and/or barbiturates.

And your summary of the whole experience makes sense. (And that's the part that makes me grin a bit. If you were a drunk (okay, I'll just speak for myself,) if you were like me...that whole thing would have been very, very disturbing. As it is, I think the people who have more experience with pharmaceuticals have an easier go of it with bac.

Not that it wasn't awful, and I really am glad you're feeling better.

It'll work. Take your time. I wonder if you'll just wake up one day, after a period of time of lowering your use without really caring, and find you don't want or need any? That's what happens 'round here, if you take enough baclofen.

oh, and btw, that is WAY too much money to spend on baclofen. Depending on which country you're in, you can order it online for much less. No bull shit doctor sign off necessary. I'll bump one of the old threads.

Check back in with the results, will you? And updates would be even better. I could be wrong, and then a lot of people would be spared my suggestion that they try it.

Which brings me to this: Congratulations. That is a really dreadful addiction. I've been watching a friend of a friend descend into opiate addiction. She's taking suboxone now, which she's buying on the street. I cannot believe that feckin' racket. I can't even read about it without getting physically ill. Anyway. I'm glad you made it to the other side, and I hope the bac works for you.
Are you thinking that it will alter your suboxone use? It works for heroin. Or worked for at least one person that we know of.

Greg;1337050 wrote: Just a personal opinion here....I would never try baclofen for either barbiturate or alcohol withdrawal, or benzo withdrawal for that matter. They simply work too differently.

Greg, your point is well taken, but there is a study that shows that baclofen is effective for managing alcohol withdrawal. And another one, maybe, that shows that it lessens the amount of benzo needed. (I read about that one here, I didn't read the actual research.)

Caveat here: It's been ages since I've read anything about any of this stuff! The peeps who normally fact check me are apparently busy. Just wanted to throw that out there so that no one thinks I know something about medicine. I don't.

**MusiciansMallet** · June 18, 2012, 09:23 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Greg wrote: If I were on a barbiturate to the extent of having to withdraw from it, my first instinct would be to ask a doctor if the long-acting phenobarbital could be used as a substitute, which could then be gradually withdrawn. I say this because a standard way of getting off short/medium-acting benzodiazepines is to substitute diazepam for the existing benzo, and then slowly taper that down. Diazepam itself could also possibly be used to get off your barbiturate, but I am only guessing there (due to it being a GABA-A agonist and also being the detox treatment of choice for alcohol withdrawal).

The best idea would be to speak to a doctor who deals with addiction treatment, or maybe even see an emergency department at a hospital about this.

First, thanks for your response Greg... But, benzodiazepines are very ineffective for barbiturate withdrawal, unless used at ABSURD dosages. Which isn't an option for me, nor my psychiatrist (who is an addiction specialist, & is aware of my butalbital/barbiturate use, although not aware of my doses currently; but doesn't seem to care... i see him mainly for suboxone, for my past opiate addiction; he will not prescribe phenobarbital or even small amounts of benzodiazepines). I cannot afford to see anyone else, seek treatment, etc- i'm in the US, unemployed, no insurance.. and OF COURSE, no universal healthcare like that of Canada, Australia, UK, Japan, & most of Europe. I've tried ER's, no meds, they'll keep you for roughly 3-6 hours (in utter pain & exasperated w/d's), until you insist upon checking yourself out. Tried at least 5 times.

...SIGH...

**MusiciansMallet** · June 18, 2012, 09:23 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Ne/Neva Eva wrote: I've read some stuff on bluelight (or whatever that website is?) about bac both intensifying and numbing effects of various things. I wouldn't be surprised if it's dose dependent. I also wouldn't be surprised if there were rat studies (at the very least) that you might be able to pull up related to bac and benzo and/or barbiturates.

And I grin too.. haha... I've been a member of bluelight for almost 10 years. I just started posting here b/c there wasn't much response over there. And bluelight is more "harm reduction" orientated, rather than expertise in withdrawal (especially w/ GABAergic drugs/substances like alcohol, barbiturates, benzodiazepines, etc)... & i've pretty much exhausted all the studies on baclofen & rat studies already (mostly only abstracts are available anyway--they want a couple few hundred dollars to gain access to the full study).

EDIT 6/19/11: morning, update:
...Although, the blocking effects definitely do seem dose-dependent; but that's sort of hindering me here in utilizing baclofen. : BUT, i took a bit over my 1500mg/day butalbital dosage yesterday (had to); started to respond to normal doses of 300-400mg by evening.. took only 5 mg of baclofen at night- slept better ok. Mentally feel better, far less anxiety, more mentally lucid.

**MusiciansMallet** · June 18, 2012, 09:43 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Ne/Neva Eva wrote: It'll work. Take your time. I wonder if you'll just wake up one day, after a period of time of lowering your use without really caring, and find you don't want or need any? That's what happens 'round here, if you take enough baclofen. I hope so! Hope it'll work! I'm sorta in a drawn out "waking up period" where I want to quit.. which is why i sought out the baclofen for a try, i just think i overdid it!

Ne/Neva Eva wrote: oh, and btw, that is WAY too much money to spend on baclofen. Depending on which country you're in, you can order it online for much less. No bull shit doctor sign off necessary. I'll bump one of the old threads.

I am in the US; & due to my financial situation (and credit history)... I can only afford COD via online pharmacies; so it makes international shipments out of the question. But i'm still willing to take a look at your thread, most definitely.

Ne/Neva Eva wrote: Check back in with the results, will you? And updates would be even better.

I most certainly will keep updating you guys & checking back in. I really really appreciate everyone's interest & feedback so far! Today- I just got my butalbital Rx refilled which should last 5-7 days (I can only afford this much at a time); & i am definitely back to thinking clearly, almost my normal self. Once i'm stabilized, i'll reintroduce

**Greg** · June 18, 2012, 11:23 PM

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

MusiciansMallet;1337141 wrote: First, thanks for your response Greg... But, benzodiazepines are very ineffective for barbiturate withdrawal, unless used at ABSURD dosages. Which isn't an option for me, nor my psychiatrist (who is an addiction specialist, & is aware of my butalbital/barbiturate use, although not aware of my doses currently; but doesn't seem to care... i see him mainly for suboxone, for my past opiate addiction; he will not prescribe phenobarbital or even small amounts of benzodiazepines). I cannot afford to see anyone else, seek treatment, etc- i'm in the US, unemployed, no insurance.. and OF COURSE, no universal healthcare like that of Canada, Australia, UK, Japan, & most of Europe. I've tried ER's, no meds, they'll keep you for roughly 3-6 hours (in utter pain & exasperated w/d's), until you insist upon checking yourself out. Tried at least 5 times.

...SIGH...

Talk about being in a predicament. I thought something like Valium may have helped, due to it working for alcohol withdrawal, but barbiturate withdrawal must be far worse. I do remember reading that they are the most dangerous withdrawal symptoms. Yes we are lucky here in Australia to have decent health care, which some people still whinge about..they have no idea what it must be like in the US. I don't know if it would be worth mentioning your exact situation, including dosage, to your doctor. He could possibly agree to supervised short-term phenobarbital to get you off the butalbital. There's probably no point in me suggesting any sort of clinic either, as I imagine they would all be expensive and you would not get any financial help in your situation. Maybe someone else in the US can suggest something??

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