I have a LOT of experience with baclofen. I took baclofen orally for 4 years trying to get to a dose that would control the spasticity that I have in every extremity in my body, but most severely in my right leg, which is my most effected area from my MS. It was mostly paralyzed for a while, necessitating the wheelchair. While on the baclofen, I required botox injections into my right leg to calm some of the spasticity down. None of this was controlling the spasticity well enough though. It interfered with sleep and with PT and was painful for me. Last July, I had a baclofen pump places. It's a small pump that holds 40ml of concentrated baclofen with a catheter that threads around and enters my spinal cord up to the T5 level and delivers a constant flow of baclofen to control spasticity. When I start having more spasticity, I go into the rehab doctor and he increases the dose. If I have muscle weakness, then he decreases the dose. I have more spasticity at night, so I have a higher dose going at night. I currently get 330 mcg per day infused into my spinal column. That keeps my spasticity to a minimum although my muscle tone to both legs and my right arm is still higher than normal.
The 2 biggest problem I had with the oral baclofen were the sleepiness and dry mouth. I could tell as soon as the medicine would kick in because my mouth would dry out. I take other meds that cause dry mouth, so it was very pronounced for me. It may not be as much with someone not taking other meds. I have to constantly have fluids with me. My mouth gets so dry I can't talk. I am really suseptible to sleepiness with medicines. I could take 20 mg at night, but only 10mg during the day. Many people with MS will take much more than that. That is part of why I got the pump.
Let me know if I can answer any questions. Like I said, I know lots about baclofen. It actually was not my first medication for muscle spasms. If you have trouble with the baclofen, you might want to ask about zanaflex. I take that now in addition to the baclofen pump to help with my arms and neck spasms since the pump only goes to T5. It didn't make me as sleepy as baclofen and seemed to help about the same. The name brand is more expensive, but has fewer side effects. I could take 4 mg of the name brand during the day, which was an ideal dose for me, but I can't take that much of the generic or it makes me sleepy.
