Muscle Spasticity & Baclofen:
Baclofen and Zanaflex are two medications prescribed every day for muscle spasticity or spasms and tremors. They both can relieve this frustrating MS symptom but long term use can cause the muscles to weaken and become flaccid.
Baclofen is a muscle relaxant that works by inhibiting the reflexes at the spinal cord level. It is not selective for just hyperactive reflexes, however. It inhibits or depresses many aspects of the central nervous system. As a result, it can be effective at reducing severe muscle spasticity, but it also produces common side effects such as drowsiness, dizziness, slurred speech, and confusion. New, long-term side effects revealed by several studies are muscle weakness and fatigue.
Use of baclofen with other drugs that also depress the function of nerves may lead to additional reduction in brain function. In addition to the risk of depressing brain function, the use of baclofen and tricyclic antidepressants ( amitriptyline ,Elavil, Endep, doxepin Sinequan, Adapin together causes muscle weakness. Low blood pressure is another side effect to consider even short term.
Diabetics will need to make adjustments in their glucose control as baclofen can substantially raise blood glucose levels.
Baclofen may cause drowsiness, weakness, dizziness, headache, seizures, nausea, vomiting, low blood pressure, constipation, confusion, respiratory depression, inability to sleep, and increased urinary frequency or urinary retention. It is well known that too much anti-spasmadics can lead to muscle atrophy. One recent study showed that 27% of patients who used baclofen for over 1 year developed muscle atrophy , primarily in the calves and thighs.
There are safer alternatives. Magnesium is an OTC supplement that can reduce muscle spasms. Magnesium has been used widely for clinical manifestation of muscle cramps, with good success. Research has shown that it is not just deficient individuals that benefit from supplementation, rather it has been hypothesized that everyone can benefit from its ability to stabilize cellular membranes. Magnesium is critical to cellular functioning in terms of energy production, cell reproduction, and protein formation. It is essential for energy production. A blood test is needed to determine the blood magnesium level before starting magnesium supplements. If the blood level is low or even normal, then body magnesium stores may be low. Unfortunately, a normal blood level does not ensure that body magnesium stores are adequate. The RDA is below what the body needs to relieve spasticity. Too much can cause diarrhea. For people taking medications to relieve MS symptoms, that could actually be a plus as many of them cause constipation.
Because of the effectiveness of magnesia and muscle cramps it is often given in the doctor’s office intravenously.
Magnesium is an important element in the body because it activates or is involved in many basic processes or functions, like:
1. Cofactor for over 300 enzymes;
2. Oxidation of fatty acids;
3. Activation of amino acids;
4. Synthesis and breakdown of DNA;
6. Immune function;
7. Interactions with other nutrients, including potassium, vitamin B6, and boron.
500 mg three times a day is a reasonable dosage, however the blood testing should be done first.
CAUTION: Abrupt discontinuation of oral baclofen may cause seizures and hallucinations. Abrupt discontinuation of intrathecal baclofen may result in high fever, rebound spasticity, muscle rigidity, and muscle breakdown that can progress to failure of several organs, including the kidney, and even death. If you are taking Baclofen regularly you have to taper off not try to do it cold turkey. In the meantime, the magnesium can be stared before you discontinue baclofen.
In a recent study analyzing the diet of 564 adult Americans, both male and female, the average intake of magnesium was less than two-thirds of the RDA for men and less than 50% of the RDA for women. This means that men, on average, are getting under 200 mg. magnesium daily and women get under 150 mg. per day. When you take into consideration the current RDA is less than half of the probable adequate amount of magnesium you begin to see the scope of the deficiency problem.
How to Take Magnesium and What Kind of Magnesium to Take:
SPECIAL NOTE ON CALCIUM- High calcium intake may block uptake and utilization of magnesium. Current available research seems to indicate that calcium intake be twice than or equal to magnesium intake. In spite of publicized research proclaiming high calcium intake as a positive health factor, in-depth review of research shows that high calcium intake contributes to many degenerative diseases and is a health risk factor.
IMO magnesium chelates as the only reliable sources to replete magnesium. Magnesium is available in chelated (bound to) combinations such as alpha-ketogluconate, aspartate, glycinate, lysinate, orotate, taurate and others. Inorganic or ionic magnesiums include sulphate, oxide, citrate, carbonate, bicarbonate and chloride. Some supplement companies make so-called chelated magnesiums but the chelate (bound to) is partial and the raw material contains some percentage of ionized, unbound or inorganic magnesium. Ionized magnesium may cause diarrhea in many users and, therefore, not correct a cellular magnesium deficiency. Diarrhea, or soft stools, caused by any form of magnesium can make a magnesium deficiency worse.
The best food sources of magnesium are chocolate, nuts, seeds, and deep, dark, leafy greens.
Magnesium should be taken with your other supplements and/or food. Split your supplemental intake into 2 or more doses daily. Some magnesium supplements can be energizing and in some persons may have a negative impact on getting to sleep and staying asleep when taken near bedtime. If taken in the correct dose and early enough in the day magnesium often corrects insomnia. Taking magnesium late in the day is not a problem if it does not adversely affect your sleep.