Spasticity: revisiting the role and the individual value of several pharmacological treatments.
Though in the last few decades only a few new drugs have come available for the treatment of spasticity, new insights may revise the role and individual value of several pharmacological treatments. Diazepam, baclofen and tizanidine are the most prescribed drugs for the treatment of spasticity. Intrathecal baclofen and local infiltration of botulin toxin are added values in selective patients. Gabapentin is a novelty, and the working mechanism of cannabis has been elucidated. Dantrolene sodium appears to owe its selectivity from the recently discovered ryanodine receptor, with a peripheral effect in muscles. In this review the pathophysiology and epidemiology of spasticity, pharmacology, clinical efficacy and unwanted effects of the different drugs for spasticity are updated.
Lapeyre
Eric
E
Department of Physical Medicine and Rehabilitation, Hôpital de Percy, Val-de-Grâce, France.
Kuks
Jan B M
JB
Meijler
Willem J
WJ
D000588:Amines / Q000494:pharmacology / Q000627:therapeutic use; D001418:Baclofen / Q000494:pharmacology / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000494:pharmacology / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use; D003000:Clonidine / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000494:pharmacology / Q000627:therapeutic use; D003620:Dantrolene / Q000494:pharmacology / Q000627:therapeutic use; D003975:Diazepam / Q000494:pharmacology / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D009125:Muscle Relaxants, Central / Q000494:pharmacology* / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D020127:Recovery of Function / Q000187:drug effects*; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000494:pharmacology / Q000627:therapeutic use
D000588:Amines; D002121:Calcium Channel Blockers; D003509:Cyclohexanecarboxylic Acids; D009125:Muscle Relaxants, Central; D005680:gamma-Aminobutyric Acid; C023754:tizanidine; D000077206:Gabapentin; D001905:Botulinum Toxins; D003620:Dantrolene; D001418:Baclofen; D003000:Clonidine; D003975:Diazepam