Baclofen-induced Delirium in a Patient with End-stage Renal Disease: A Case Report

A BSTRACT Baclofen is a centrally acting muscle relaxant primarily excreted through the kidneys. In patients with renal impairment, even therapeutic doses may lead to drug accumulation and neurotoxicity. We report a case of a 60-year-old male with end-stage renal disease on maintenance hemodialysis who developed acute delirium after ingesting a total dose of 30 mg of oral baclofen prescribed for intractable hiccups following blunt chest trauma. The patient presented with altered behavior, agitation, and drowsiness within hours of ingestion. Laboratory investigations and neuroimaging did not reveal any acute metabolic or structural cause. Baclofen toxicity was suspected, and the patient underwent hemodialysis with rapid clinical improvement after two sessions. This case highlights the importance of recognizing baclofen-induced neurotoxicity in patients with renal failure and avoiding its use or exercising extreme caution.