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) 222-1222.
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.
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
Works to reduce muscle contraction, may cause liver damage. Brand names: Dantrium, Dantrium IV
Other treatments used for spasticity
Chemodenervation by injections of botulinum toxin type A (BTX-A) directly into the muscle, lasts about six months. Brand name: Botox (chemodenervation) Product site
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.