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Cerebral Palsy Message Board


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Bulkhead, did your friend tell you why is Baclofen contraindicated for CP?

I took it at 12 and 16 for about 2 months and it did nothing at the time (I did not have my quadriceps as tight as they are now). Now at 30 I started to take it again a couple of months ago for my tight quads and it helps a bit to decrease the spasticity in them.

Kat
OK, I found this:

"Benzodiazepines such as diazepam are the oldest and most frequently used oral agents for spasticity related to spinal cord injury, cerebral palsy, and cerebral vascular accident. The clinical effects of diazem include improved passive range of motion and reduction in hyperreflexia as well as painful spasms. These agents also cause sedation and improve anxiety (5).

Baclofen has been widely used for spasticity since 1967. Most studies indicate that it improves clonus, spasm frequency and joint range of motion resulting in improved functional status for the patient. Side effects are predominantly from central depressant properties including sedation, ataxia, weakness and fatigue. Tolerance to the medication may develop. Baclofen must be slowly weaned to prevent withdrawal effects such as seizures, hallucinations and increased spasticity. When this medication is used in combination with tizanidine or benzodiazepines the patient should be monitored for unwanted depressant effects(5).

Patients with cerebral palsy and traumatic brain injury respond best with dantrolene sodium. It is less likely that the other agents to cause drowsiness, confusion and other central effects because of its mechanism of action. Dantrolene sodium has been shown to decrease muscle tone, clonus and muscle spasm. The action of this agent is not selective for spastic muscles and it may cause generalized weakness, including weakness of the respiratory muscles. The side effects include drowsiness, dizziness, weakness, fatigue and diarrhea (5).

Tizanidine is used for the treatment of spasticity caused by multiple sclerosis and spinal cord injury. It differs from other antispasticity agents, enabling the avoidance of certain drug dependence, intolerance and interactions. Objective measures of muscle strength demonstrate no adverse effects from tizanidine. Patients report less muscle weakness from tizanidine than baclofen or diazepam. When combined with baclofen, tizanidine presents the opportunity to maximize side effects by reducing the dosage of both drugs. If tizanidine is prescribed in conjunction with baclofen or benzodiazepines, the patient will experience possible additive effects, including sedation (6).

One treatment method that has consistently produced positive results for spasticity patients is the injection of Botulinum toxin, or BOTOX. BOTOX is injected directly into the spastic muscle with the person receiving a dose according to body weight. A small needle is used to administer the BOTOX and there is only minor discomfort associated with the brief treatment. BOTOX can be given without anesthesia and few complications have been reported from it other than the fact it can cause localized weakness, which is actually its desired response. Range of motion exercises and other spasticity-reducing techniques can be used immediately following injection. This form of treatment generally lasts about 12 weeks, then another dose can be administered. If enough tissue lengthening has occurred through stretching and splinting, a permanent effect of increased range of motion can be realized(7)."

[url]http://serendip.brynmawr.edu/bb/neuro/neuro99/web3/Byrd.html[/url]

Diazepam=Valium

Yeah so based on that, I think the meds used for CP really just depend on what your particular doctor likes to use/thinks will work. :)
[QUOTE=Bulkhead]I have a few friends who are Pharmacists. They've told me that Baclofen is contraindicated for CP.[/QUOTE]

For [i]some[/i] people with CP, baclofen is good; for others it is not.

What I have heard is that some people with CP can only walk, because of their spastic muscles. So if you take away the spasticity (with baclofen in this case) the person is no longer able to walk and that puts them in a less able position. So, the baclofen, kind of did something not so great...

Maybe this is what those doctors/pharmasists mean?
Hey guys!

I am 42 with spastic L hemiplegia. I get BOTOX shots to relieve spasticity, and I take ti****dine (zanaflex), which works rather well for me. I was offered baclofen but they (docs) decided that the sedative effects would be more of a negative effect than the good the drug would do for the spasticity.

I wasn't sure that the zanaflex was actually doing anything after taking it for a year. I went off of it and quickly found out that yes it was infact controlling my muscle spasms. I went right back on it. I take it at night and don't get too many problems with the sedative effect. I would say that side effect isn't really there for me.

But like the other posts have stated not all drugs are for everyone as each case of CP is very unique.

Lastramy





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