title: Alpha adrenergic and serotonergic agents in the treatment of spastic hypertonia.
abstract: In the treatment of patients with problematic spasticity, it is important to consider the following steps: 1. Establish the functional impact of the spasticity. 2. Identify the functional goal to be achieved by treatment. 3. Eliminate any remediable spasticity aggravating factors. 4. Evaluate the effects of previous antispasticity treatments. 5. Consider nonpharmacologic and pharmacologic treatments. 6. Initiate therapy with a low dosage, and titrate judiciously. 7. Stop the titration when functional goal is achieved. 8. If goal is not achieved or if side effects are intolerable, consider a second medication.
authors.affiliation: Comprehensive Rehabilitation, VA Long Beach Healthcare System, Long Beach, California, USA.
authors.forename: P W
authors.initials: PW
authors.lastname: Nance
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use*; D003000:Clonidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003533:Cyproheptadine / Q000627:therapeutic use; D006801:Humans; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000503:physiopathology; D010276:Parasympatholytics / Q000627:therapeutic use; D011941:Receptors, Adrenergic / Q000502:physiology; D012702:Serotonin Antagonists / Q000627:therapeutic use; D013116:Spinal Cord / Q000502:physiology; D013565:Sympatholytics / Q000627:therapeutic use
chemical_list: D000316:Adrenergic alpha-Agonists; D000927:Anticonvulsants; D010276:Parasympatholytics; D011941:Receptors, Adrenergic; D012702:Serotonin Antagonists; D013565:Sympatholytics; D003533:Cyproheptadine; C023754:tizanidine; D003000:Clonidine