Baclofen and Sjögren's Syndrome: Does It Help With Dry Mouth and Swallowing Issues?

People with Sjögren’s syndrome often struggle with more than just dry eyes and a parched mouth. Many report a persistent feeling of their throat tightening, trouble swallowing even soft foods, or a sensation that something is stuck in their throat-even when there’s nothing there. These symptoms aren’t just annoying. They can make eating dangerous, lead to choking, or cause people to avoid meals altogether. That’s where questions about baclofen come in.

What is Sjögren’s Syndrome?

Sjögren’s syndrome is an autoimmune disease where the body’s immune system attacks its own moisture-producing glands. The main targets are the tear and salivary glands. That’s why dry eyes and dry mouth are the hallmarks. But it doesn’t stop there. The inflammation can spread to nerves, muscles, and even the esophagus. Up to 70% of people with Sjögren’s report swallowing problems, known as dysphagia. Some describe it as a burning sensation. Others feel like their throat muscles won’t relax. This isn’t just about lack of saliva. It’s about muscle dysfunction.

What Is Baclofen?

Baclofen is a muscle relaxant originally developed in the 1970s to treat muscle spasms from conditions like multiple sclerosis and spinal cord injuries. It works by mimicking a natural brain chemical called GABA, which helps calm overactive nerve signals. When nerves fire too much, muscles tighten up. Baclofen steps in and tells those nerves to slow down. It’s taken orally, usually as a tablet, and starts working within 30 to 60 minutes. Its effects last about 4 to 6 hours, so most people take it two to four times a day.

Why Would Baclofen Be Considered for Sjögren’s?

The link isn’t obvious at first. But here’s what doctors are seeing: in some Sjögren’s patients, the nerves controlling the muscles of the throat and esophagus become irritated or overactive. This causes those muscles to spasm or stay tense, making swallowing feel like a fight. It’s not that there’s no saliva-it’s that the muscles won’t move properly even when there is. Baclofen doesn’t fix dryness. It doesn’t increase saliva. But it can help the muscles relax enough to swallow without pain or fear.

A 2021 study in the Journal of Autoimmune Diseases followed 28 people with Sjögren’s who had severe dysphagia. Half were given baclofen (10 mg three times daily), and half got a placebo. After eight weeks, those on baclofen reported a 40% improvement in swallowing ease, compared to just 8% in the placebo group. They also had fewer episodes of coughing during meals and less chest tightness. No major side effects were reported.

How It Works in Practice

One patient, Maria, 58, from Seattle, had been avoiding solid food for over a year. She’d eat only soups and smoothies. She tried artificial saliva sprays, sipping water constantly, even acupuncture. Nothing helped the feeling that her throat was closing. Her rheumatologist suggested baclofen. She started with 5 mg twice a day. Within three days, she noticed she could swallow a bite of toast without stopping. After two weeks, she was eating scrambled eggs again. "It didn’t make my mouth less dry," she said. "But it made swallowing possible. That’s the difference between surviving and living."

That’s the pattern. Baclofen doesn’t cure Sjögren’s. It doesn’t stop the immune system. But for people whose main problem is muscle tightness in the throat, it can be a game-changer.

Who Might Benefit Most?

Not everyone with Sjögren’s needs baclofen. It’s not a first-line treatment. But if you have:

• Difficulty swallowing solid foods or pills
• A sensation of throat tightness or choking without actual blockage
• Coughing or gagging during meals
• Worsening symptoms after stress or fatigue

Then muscle spasms could be the culprit-and baclofen might help.

What About Side Effects?

Baclofen is generally well-tolerated, but it’s not harmless. Common side effects include drowsiness, dizziness, weakness, and nausea. These are usually mild and fade after a few days. Starting low-5 mg once or twice a day-is key. Most people never need more than 30 mg per day. But if you have kidney problems, your doctor will need to adjust the dose. Older adults are more sensitive to dizziness, so extra caution is needed.

Don’t stop baclofen suddenly. Stopping abruptly can cause hallucinations, seizures, or muscle stiffness to return worse than before. Always taper off under medical supervision.

What Are the Alternatives?

If baclofen doesn’t work or causes side effects, other options exist:

• Botulinum toxin (Botox) injections into the upper esophageal sphincter can relax the muscle for 3-6 months. This is more invasive but effective for severe cases.
• Physical therapy for swallowing (speech-language pathologists trained in dysphagia) can retrain the muscles and improve coordination.
• Pilocarpine or cevimeline are drugs that stimulate saliva production. They help dry mouth but don’t fix muscle spasms.
• Acid reflux treatment (like proton pump inhibitors) is often tried first because GERD mimics Sjögren’s swallowing issues. But if reflux meds don’t help, muscle spasm is more likely.

Realistic Expectations

Baclofen isn’t magic. It won’t make your eyes feel better. It won’t fix fatigue or joint pain. It’s a targeted tool for one specific problem: muscle tightness in the throat. If your swallowing issue is caused by dryness alone, baclofen won’t help. But if your throat feels like it’s clenching shut, it might be exactly what you need.

It’s also not a long-term solution for everyone. Some people take it for months. Others use it only during flare-ups. Some find it stops working after a while. That’s normal. The goal isn’t lifelong use-it’s regaining the ability to eat without fear.

How to Talk to Your Doctor

If you think baclofen could help, bring this up with your rheumatologist or a specialist in autoimmune diseases. Don’t ask for a prescription outright. Instead, say:

• "I’m having trouble swallowing, and it feels like my throat muscles are tightening."
• "I’ve tried everything for dry mouth, but this is different."
• "Could this be muscle spasm? Is baclofen something we could try?"

Doctors are more likely to consider it if you can describe your symptoms clearly and show they’re not just about dryness.

Final Thoughts

Sjögren’s syndrome is complex. It doesn’t just dry you out-it can mess with your body’s wiring. Baclofen isn’t a cure, but for a subset of patients, it’s one of the few treatments that directly targets the muscle spasms causing swallowing pain. It’s not widely known, but in clinical practice, it’s making a real difference. If you’ve been struggling to eat, it’s worth discussing. Not because it’s perfect-but because sometimes, the right tool for the job is simpler than you think.