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Drugs Used to Treat Spasticity

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Abstract

Spasticity is a common and disabling symptom for many patients with upper motor neuron dysfunction. It results from interruption of inhibitory descending spinal motor pathways, and although the pathophysiology of spasticity is poorly understood, the final common pathway is overactivity of the alpha motor neuron. Therapy for spasticity is symptomatic with the aim of increasing functional capacity and relieving discomfort. Any approach to treatment should be multi-disciplinary, including physical therapy, and possibly surgery, as well as pharmacotherapy. It is important that treatment be tailored to the individual patient, and that both patient and care giver have realistic expectations. Pharmacotherapy is generally initiated at low dosages and then gradually increased in an attempt to avoid adverse effects. Optimal therapy is the lowest effective dosage. Baclofen, diazepam, tizanidine and dantrolene are currently approved for use in patients with spasticity. In addition, clonidine (usually as combination therapy), gabapentin and botulinum toxin have shown efficacy, however, more studies are required to confirm their place in therapy. Intrathecal baclofen, via a surgically implanted pump and reservoir, may provide relief in patients with refractory severe spasticity.

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  1. Department of Neurology, University of California at San Francisco, School of Medicine UCSF/Mt Zion Multiple Sclerosis Center, 1701 Divisadero Suite 480, San Francisco, California, 94115-1642, USA

    Mariko Kita & Donald E. Goodkin

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  1. Mariko Kita
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Correspondence to Mariko Kita.

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Kita, M., Goodkin, D.E. Drugs Used to Treat Spasticity. Drugs 59, 487–495 (2000). https://doi.org/10.2165/00003495-200059030-00006

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