Baclofen with Trimipramine Interaction Details
Brand Names Associated with Baclofen
- Baclofen
- Kemstro®
- Lioresal®
- Ozobax®
Brand Names Associated with Trimipramine
- Surmontil®
- Trimipramine
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Mar 04, 2024
Interaction Effect
Memory loss, loss of muscle tone
Interaction Summary
Baclofen when administered with antidepressants, specifically imipramine, amitriptyline, and clomipramine, has induced short term memory loss. In addition, concomitant imipramine and baclofen may result in additive muscle relaxant effects[1][2].
Severity
Minor
Onset
Delayed
Evidence
Theoretical
How To Manage Interaction
Due to the additive effects of both drugs, monitor for excess anticholinergic activity and muscle relaxant effects with concomitant therapy.
Mechanism Of Interaction
Unknown
Literature Reports
A) Baclofen when administered with antidepressants, specifically imipramine, amitriptyline, and clomipramine, has induced short-term memory loss in three patients. Specifically, the patients could not remember names of persons or places familiar to them. The interaction is believed to be caused by baclofen enhancing the anticholinergic effects of antidepressants, which may be partially reversed by piracetam [2].
B) Concomitant imipramine and baclofen therapy has been reported to result in an additive muscle relaxant effect. A 54-year-old male with a 12-year history of multiple sclerosis and a 2-year history of depression was maintained on oral baclofen 10 mg four times daily. The patient experienced good relief of spasticity with this regimen and maintained sufficient muscle tone to stand. Nortriptyline 50 mg nightly was added to relieve depression. On the sixth day of therapy, the patient was no longer able to stand. Nortriptyline was withdrawn and muscle tone returned within 48 hours. Two weeks later, imipramine 75 mg daily was given to the patient for treatment of depression, however, the patient again experienced loss of muscle tone. Muscle tone returned within two days of imipramine discontinuation. The additive effect between baclofen and the tricyclic antidepressants is attributed to an interaction affecting the neurotransmitters at the presynaptic membrane [1].
References
1 ) Silverglat MJ: Baclofen and tricyclic antidepressants: possible interaction (letter)?. JAMA 1981; 246:1659.
2 ) Sandyk R & Gillman MA: Baclofen-induced memory impairment. Clin Neuropharmacol 1985; 8:294-295.
Baclofen Overview
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Baclofen is used to treat pain and certain types of spasticity (muscle stiffness and tightness) from multiple sclerosis, spinal cord injuries, or other spinal cord diseases. Baclofen is in a class of medications called skeletal muscle relaxants. Baclofen acts on the spinal cord nerves and decreases the number and severity of muscle spasms caused by multiple sclerosis or spinal cord conditions. It also relieves pain and improves muscle movement.
Trimipramine Overview
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Trimipramine is used to treat depression. Trimipramine is in a class of medications called tricyclic antidepressants. It works by increasing the amount of certain natural substances in the brain that are needed to maintain mental balance.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.