Oral medications are usually a first line of treatment, along with physical therapy. Your doctor may prescribe oral medication to treat stiffness and spasms that interfere with your daily activities or sleep.
There are several medications that are used to manage spasticity. Your healthcare professional will decide which one is right for you. Sometimes, two or more drugs or a combination of oral medications with another type of treatment – like chemodenervation or intrathecal medication – may be needed.
One medication for spasticity is a muscle relaxer called baclofen, which acts on the central nervous system to relax muscles. It decreases stretch reflexes, rate of muscle spasms and clonus, pain, and tightness and improves range of motion. Its actions on the central nervous system may cause some of the medicine’s side effects, which may include sedation, drowsiness, weakness, decreased muscle tone, confusion, fatigue, nausea, dizziness, and more difficulty in controlling seizures in people with epilepsy. Suddenly stopping baclofen may cause seizures, hallucinations, and rebound spasticity.1
Benzodiazepines (such as Valium*)
Benzodiazepines act on the central nervous system to relax muscles, temporarily decreasing spasticity. Because of their sedative effects, benzodiazepines are given most often at night. Additional side effects may include low blood pressure, nausea, difficulty thinking clearly. Benzodiazepines may be addictive, and, with long-term use, withdrawal symptoms may occur if the drug is stopped too quickly.2
Dantrolene Sodium (Dantrium*)
Dantrolene does not act at the level of the central nervous system like oral baclofen and benzodiazepines. Instead it blocks the signals to the muscles that cause them to contract. Dantrolene decreases muscle tone, clonus, and spasms and may cause fewer problems with clouded thinking or confusion than oral baclofen and benzodiazepines. Muscle fibers may change when dantrolene is used over a long period of time and become more rapidly fatigued. Additional side effects may include diarrhea, mild sleepiness, weakness, nausea, or liver damage.3
Imidazolines (such as Tizanidine)
Tizanidine (Zanaflex*) is a imidazoline that reduces spasticity through its action on the central nervous system. Imidazolines typically cause less muscle weakness than do oral baclofen and benzodiazepines, which may help retain strength. Tizanidine is often used in controlling spasticity due to MS or stoke; it can also be used in patients with traumatic brain injury. The most common side effect of the imidazolines is sedation. Additional side effects include low blood pressure, dry mouth, dizziness, and hallucinations. People who have liver problems should usually not take tizanidine.4
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800- FDA-1088.
*Valium® is a registered trademark of Roche Pharmaceuticals, inc.
Dantrium® is a registered trademark of JHP Pharmaceuticals, LLC
Zanaflex Capsules® is a registered trademark of Acorda Therapeutics
- Baclofen. We Move. http://www.wemove.org/spa/spa_bac.html. Accessed January 25, 2012.
- Benzodiazepines. We Move. http://www.wemove.org/spa/spa_benz.html. Accessed January 25, 2012.
- Dantrolene sodium. We Move. http://www.wemove.org/spa/spa_dant.html. Accessed January 25,2012.
- Imidazolines. We Move. http://www.wemove.org/spa/spa_imid.html. Accessed Janaury 25, 2012.