Tone reduction: Oral medications

The goal of treatment with oral medications (those taken by mouth) is to achieve generalized tone reduction. There are several oral medications physicians may prescribe to reduce spasticity, including:

  • Baclofen
  • Diazepam
  • Dantrolene sodium
  • Tizanidine

These medications act at different sites within the body, with different effects on the muscles, brain, or spinal cord. They may have different brand names in different countries. The challenge of treatment with oral medications is managing their side effects, and their efficacy is greater in some people than in others. They are sometimes used in combination or in conjunction with focal spasticity reduction measures such as botulinum neurotoxin A (BoNT-A). They can also sometimes be used to reduce muscle spasms, particularly after orthopedic surgery.

Novak and colleagues (2013) found strong evidence supporting the use of diazepam but recommended that the use of dantrolene, oral baclofen, and tizanidine be accompanied by a sensitive outcome measure to monitor progress. Physicians must weigh the risk-benefit ratio of each medication alongside the patient’s medical history, issues, and needs.

The above is an extract from Spastic Diplegia–Bilateral Cerebral Palsy available here.