Medications for spasticity and tremors caused by multiple sclerosis

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Medications for spasticity and tremors caused by multiple sclerosis

Spasticity

Several medications may be used to treat muscle stiffness (spasticity) caused by multiple sclerosis (MS).

Baclofen (Lioresal) is the drug of choice for spasticity. It is available in tablets or by delivery through a pump implanted in the lower spinal area. Pump delivery is effective for those with severe spasticity.
Tizanidine (Zanaflex) is a drug similar to baclofen. It is available in tablet form.
Dantrolene (Dantrium) is also effective. However, it may cause muscle weakness, which limits the number of people who can use it. Other side effects may include nausea, vomiting, lack of hunger (anorexia), and, with high dosages or prolonged use, liver damage.
Gabapentin (Neurontin) may help relieve pain as well as spasticity. It is usually very well tolerated and causes few side effects.
Diazepam (Valium) and clonazepam (Klonopin) relieve both spasticity and anxiety but may cause side effects such as dizziness, drowsiness, and confusion.

Often a combination of these medications given in small doses is better tolerated and more effective than a larger dose of a single medication.

Some people try alternative therapy. One study found that 97% of people who used marijuana reported improvement in spasticity and tremor. In some cases, injection of botulinum toxin (Botox) may provide relief.¹

Tremor

Carbamazepine (Tegretol), which is a seizure medication, benzodiazepines such as diazepam (Valium) and clonazepam (Klonopin), and beta-blockers, especially propranolol (Inderal), may have some benefit in treating tremors caused by MS.

Severe tremors are very hard to treat. If they do not respond to medication, surgery may be needed.

References

Citations
Krupp LB, Rizvi SA (2002). Symptomatic therapy for underrecognized manifestations of multiple sclerosis. Neurology: Practical Issues in the Management of Multiple Sclerosis, 58(Suppl 4): S32–S39.

Credits

Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Michele Cronen
Associate Editor	Pat Truman
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Barrie J. Hurwitz, MD - Neurology
Last Updated	March 23, 2006

Last updated:	March 23, 2006
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	Kathleen Romito, MD - Family Medicine, Barrie J. Hurwitz, MD - Neurology
Editors:	Kathleen M. Ariss, MS, Pat Truman

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