Baclofen/risperidone

Reactions 1463, p12 - 3 Aug 2013

★ SBaclofen/risperidone

Increased blood triglycerides (first report withbaclofen): case report

A 39-year-old man developed an increased level of bloodtriglycerides while receiving baclofen and risperidone [routesnot stated].

The man started baclofen 20 mg/day for alcoholdependence, which was gradually increased to 180 mg/dayafter 5 weeks. He had been receiving lithium for bipolardisorder; however, he presented with signs of lithiumoverdose 7 weeks after starting treatment. Lithium wasswitched to risperidone 1 mg/day. One week later, hisrisperidone dosage was increased to 2 mg/day and hisbaclofen dosage was gradually increased to 240 mg/day. Onemonth later, tests revealed a serum triglyceride level of6.56 g/L and a total cholesterol level of 1.78 g/L. A few dayslater, he stopped drinking. Due to persistence of manicsymptoms, his risperidone dosage was increased to 4 mg/day2 months later. After a further 1.5 months, his risperidonedosage was increased to 6 mg/day. One week later, testsrevealed a serum triglyceride level of 41 g/L and a totalcholesterol level of 7.81 g/L, which induced hyponatraemia.Over the past month, his weight had increased by 10kg.

Risperidone and baclofen were withdrawn, and he receivedcarbamazepine. His triglyceride level decreased to 2 g/L after15 days. Three months later, he had no mood symptoms andremained abstinent, while triglyceride levels were normal.

Author comment: "In conclusion, this case suggests theexistence of a correlation between the severe increase in thetriglycerides level and risperidone in association with [high-dose baclofen]."Clarisse H, et al. Baclofen and risperidone association increases dramaticallytriglycerides level. Alcohol and Alcoholism 48: 515-516, No. 4, Jul-Aug 2013.Available from: URL: http://dx.doi.org/10.1093/alcalc/agt033 - France 803090724

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of bloodtriglycerides increased or hypertriglyceridaemia associated withbaclofen. The WHO ADR database contained no reports ofblood triglycerides increased or hypertriglyceridaemia associatedwith baclofen.

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Reactions 3 Aug 2013 No. 14630114-9954/13/1463-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved