Drug Treatment – Muscle Spasticity


The most commonly used drugs to help ease spasticity include oral and intrathecal Baclofen and Tizanidine, Diazepam and Clonazepam, and Dantrolene. Individuals report various levels of improvement in spasticity levels of leg, arm, and bulbar (speech/swallowing) muscles. In extreme cases of spasticity, some individuals benefit by botulinum toxin, which is injected directly into the muscle. This also has shown helpfulness in leg, arm, and bulbar (speech/swallowing) muscles.

Possible side effects for these drugs include drowsiness, dizziness, weakness, confusion and upset stomach. For information regarding drugs, contraindications and side effects, consult your doctor or pharmacist. Note: In case of emergency/ overdose the local poison control center can be reached at 1 (800) 222-1212.

  • Baclofen

    The most commonly used medication to help relax muscles or reduce tone. Brand name: Lioresal. Outside the United States: Alpha-Baclofen, Baclon, Baclosal, Baclospas, Baklofen, Clofen, Lebic, Mulax, Pacifen, Spinax

    To be effective, the dose must be large enough to cross the blood/brain barrier and reach the spinal cord (The blood/brain barrier is the body’s way of keeping chemicals from getting to the brain and spinal cord). If the high dosage results in too much sedation, the intrathecal Baclofen pump can be considered.

    The Baclofen pump is surgically implanted in the abdomen and delivers small, continuous doses of medication directly to the spinal canal. This can result in better performance with minimal side effects. Surgery is required to implant the pump under the skin of the abdomen and a catheter connects it to the spine. The pump can be programmed to release a specific amount of medicine at select times, which can be adjusted without surgery. The pump needs to be refilled every one to three months. See Medtronic.

    Talk to others that have the baclofen pump by joining the Yahoo group Pumpsters.

  • Tizanidine

    A short acting drug useful for treating nocturnal spasms and for intermittent management of spasticity. Brand name: Zanaflex. Outside the United States: Sirdalud, Sirdalud MR, Sirdalud Retard, Ternelax, Ternelin

  • Diazepam and Clonazepam

    Sedatives that slow the central nervous system, side effects are common. Klonopin

  • Dantrolene Sodium

    Works to reduce muscle contraction, may cause liver damage. Brand names: Dantrium, Dantrium IV

    Other treatments used for spasticity

  • Botulinum toxin

    Chemodenervation by injections of botulinum toxin type A (BTX-A) directly into the muscle, lasts about six months. Brand name: Botox (chemodenervation) Product site

  • Gabapentin

    Widely used to treat seizures and neuropathic pain, may be useful in reducing spasticity. Brand name: Neurontin

  • Fish oil and quinine

    Individuals have reported benefit from fish oil, which blocks activity of the sodium channels used to contract muscles and quinine. Quinine is found in tonic water.

Editor’s Note: A member, a primary care physician with HSP, provides an article on pain management in pain treatment.

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