Introduction Withdrawal hallucinations and muscles becoming There are a number of medications that You should not stop taking these drugs very stiff, very quickly with high fever, can be used for the treatment of suddenly as you can get serious side which can be potentially fatal. spasticity (muscle stiffnes). This effects. Always consult your GP or information leaflet looks at the most consultant. Reduce the dose gradually as Tizanidine common medications used. prescribed by your doctor. Tizanidine is an anti-spastic medication which works by blocking the pain nerve Before starting any medication the risks The effects of these medications will impulses that are sent to the brain. Its and benefits should be discussed with initially be monitored by the professionals effects are short lasting so it can be used you by the prescribing doctor. in the spasticity clinic. when needed. For example at night with fewer effects in the day. However, it Side effects Baclofen needs to be taken at regular intervals Drowsiness, sleepiness and weakness Baclofen is a common medication used throughout the day for all day effects. It is can be side effects of all these drugs to a to treat spasticity, spasms and pain well absorbed when taken by mouth and varying degree, depending on the associated with spasticity. It is rapidly it has been shown to be effective in the medication and dosage. In general the and extensively absorbed, when taken by treatment of spasticity following multiple side effects tend to be dose dependent mouth. It works by depressing the sclerosis, spinal cord injury, stroke and and can be managed by building the central nervous system. It may start to head injury. dose up slowly. Avoid drinking alcohol work within 2-6 hours. Common side effects include dry mouth, when taking these drugs as it tends to Common side effects include sedation sleepiness, low blood pressure and slow increase the side effects. Caution should (sleepiness), weakness of non-affected heart beat. Rare side effects include be taken when operating machinery or muscles, dizziness, fatigue, nausea, visual hallucinations, psychotic-like driving when taking these drugs, you vomiting, tremor, headaches, symptoms and liver damage. Before should discuss this with the doctor hypotension (low blood pressure), starting to take Tizanidine, blood testing prescribing the drugs. More specific side confusion and hallucination. It may is required for assessment of liver effects will be described for each cause breathing difficulties with function as this can be affected by medication. narrowing of the airways. It should Tizanidine. The blood test should be therefore be avoided in patients with repeated once a month for 4 months and Dose asthma. It is best avoided in patients at regular intervals after this. You should start on a low dose and with poorly controlled epilepsy, as it may increase gradually, to the optimum dose cause a problem with controlling fits. It Dantrolene sodium (Dantrium) for you, as advised by your doctor. may cause kidney disease or renal Dantrolene is a muscle relaxant that acts You should take these drugs daily at impairment. You need to inform your directly on the muscles rather than the regular intervals to get the maximum doctor if you have any of these brain or spinal cord to reduce the force of benefits from them. conditions. contraction and so has less side effects If you suddenly stop taking Baclofen you including drowsiness. It weakens both can experience fits, confusion, stiff and normal muscles. It has been shown to be effective in spasticity due to usefulness in treating neuropathic (nerve stroke, spinal cord injury, multiple damage) pain. sclerosis and cerebral palsy. Side effects include drowsiness, Common side effects generalised muscle dizziness, ataxia, fatigue, anxiety, sleep weakness, fatigue, diarrhoea, lethargy, disturbances, diarrhoea, nausea, impaired thinking/reactions and impaired vomiting, headaches, high blood swallow. A serious side effect can be pressure. liver damage, therefore blood testing to check liver function should be done Diazepam during treatment with Dantrolene as with Diazepam is commonly used for Tizanidine. It may take a few weeks to conditions such as anxiety however West Midlands start to work. because it slows the firing of all nerve cells in the brain it leads to muscle Rehabilitation Centre Clonazepam relaxation. Although there are no recent Clonazepam is closely related to studies of the effects of diazepam in the Diazepam. It is used more commonly in treatment of spasticity, it has been shown seizure disorders. It can be used to to be effective in spasticity in spinal cord Patient Information suppress jerky movement disorders and injury, cerebral palsy and multiple night time spasms. Sedation is a major sclerosis. It is generally unsuitable in problem so it should be taken at night, patients with stroke and brain injury. It Oral Medication Used In however this can be used to aid sleep. causes more sedation than the other Other common side effects are dizziness, anti-spastic medications and should The Treatment Of muscle weakness, co-ordination therefore be used as a last resort. Spasticity disturbances, poor concentration, Other side effects include memory confusion, amnesia and restlessness. problems, ataxia (clumsy movements), You can become dependent on difficulty passing urine and development Clonazepam and should therefore of tolerance. Long-term side effects For more information, please contact: reduce the dose gradually when stopping include paradoxical insomnia (sleeping Clinic Co-ordinator for Spasticity this medication under your Drs advice. during the day, awake at night), anxiety Tel 0121 466 3229 and irritability. Gabapentin You can also become dependent on Gabapentin is an anti-epileptic drug but Diazepam and should therefore reduce recent research has investigated its dose gradually when stopping this potential for anti-spasticity. It has been medication under your Drs advice. shown to reduce muscle tone in patients with MS and spinal cord injury. The other advantage of Gabapentin is its Updated February 2011