Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case review
BackgroundBaclofen, a γ-aminobutyric acid (GABA) derivative, and Pregabalin, a GABA analogue, are widely prescribed for muscle spasm and neuropathic pain. This first-reported case demonstrates synergistic central nervous system (CNS) depression of Baclofen (30 mg/day) and Pregabalin (300 mg/day) in...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1598971/full |
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| author | Yitong Xie Yitong Xie Danwei Wu Peihao Jin Lu Mao Jiancun Zhen Wei Zhang |
| author_facet | Yitong Xie Yitong Xie Danwei Wu Peihao Jin Lu Mao Jiancun Zhen Wei Zhang |
| author_sort | Yitong Xie |
| collection | DOAJ |
| description | BackgroundBaclofen, a γ-aminobutyric acid (GABA) derivative, and Pregabalin, a GABA analogue, are widely prescribed for muscle spasm and neuropathic pain. This first-reported case demonstrates synergistic central nervous system (CNS) depression of Baclofen (30 mg/day) and Pregabalin (300 mg/day) in a patient with mild renal impairment [estimated glomerular filtration rate, (eGFR) = 77.26 mL/min].Case PresentationA 68-year-old female with renal impairment developed progressive CNS depression (somnolence, coma) following combined Baclofen (30 mg/day) and Pregabalin (300 mg/day) therapy after spinal fusion surgery. CNS depression was completely resolved 48 h after drug discontinuation.ConclusionClinicians should exercise heightened caution when combining Baclofen and Pregabalin in renal impairment. Dose adjustments based on creatinine clearance (CLcr) are strongly recommended. Particular attention should be given to initiating therapy with reduced starting doses in patients at elevated risk of CNS depression. |
| format | Article |
| id | doaj-art-d7bb2c8ac77448e8aff144c98b9f5259 |
| institution | OA Journals |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj-art-d7bb2c8ac77448e8aff144c98b9f52592025-08-20T02:32:27ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-06-011610.3389/fphar.2025.15989711598971Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case reviewYitong Xie0Yitong Xie1Danwei Wu2Peihao Jin3Lu Mao4Jiancun Zhen5Wei Zhang6School of Pharmaceutical Sciences, Capital Medical University, Beijing, ChinaDepartment of Pharmacy, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pharmacy, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Spine Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pharmacy, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pharmacy, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pharmacy, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaBackgroundBaclofen, a γ-aminobutyric acid (GABA) derivative, and Pregabalin, a GABA analogue, are widely prescribed for muscle spasm and neuropathic pain. This first-reported case demonstrates synergistic central nervous system (CNS) depression of Baclofen (30 mg/day) and Pregabalin (300 mg/day) in a patient with mild renal impairment [estimated glomerular filtration rate, (eGFR) = 77.26 mL/min].Case PresentationA 68-year-old female with renal impairment developed progressive CNS depression (somnolence, coma) following combined Baclofen (30 mg/day) and Pregabalin (300 mg/day) therapy after spinal fusion surgery. CNS depression was completely resolved 48 h after drug discontinuation.ConclusionClinicians should exercise heightened caution when combining Baclofen and Pregabalin in renal impairment. Dose adjustments based on creatinine clearance (CLcr) are strongly recommended. Particular attention should be given to initiating therapy with reduced starting doses in patients at elevated risk of CNS depression.https://www.frontiersin.org/articles/10.3389/fphar.2025.1598971/fullbaclofenpregabalindrug-induced CNS depressionrenal impairmentsynergistic toxicity |
| spellingShingle | Yitong Xie Yitong Xie Danwei Wu Peihao Jin Lu Mao Jiancun Zhen Wei Zhang Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case review Frontiers in Pharmacology baclofen pregabalin drug-induced CNS depression renal impairment synergistic toxicity |
| title | Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case review |
| title_full | Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case review |
| title_fullStr | Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case review |
| title_full_unstemmed | Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case review |
| title_short | Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case review |
| title_sort | case report synergistic central nervous system depression of baclofen and pregabalin clinical pharmacist driven case analysis and case review |
| topic | baclofen pregabalin drug-induced CNS depression renal impairment synergistic toxicity |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1598971/full |
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