Efficacy and safety of oral baclofen in the management of spasticity: A rationale for intrathecal baclofen
Per Ertzgaard, Claudia Campo, Alessandra Calabrese
Department of Rehabilitation Medicine, Linköping University Hospital , SE-581 85 Linköping, Sweden. E-mail: per.ertzgaard@liu.se
DOI: 10.2340/16501977-2211
Lay Abstract
Oral baclofen for the treatment of spasticity: when it works, and when intrathecal administration should be considered
Spasticity is characterized by overactivity of the muscles and increased muscle tone. Treatment of spasticity is necessary when the condition begins to interfere with daily activities. First-line treatment comprises orally-administered anti-spasmodic agents, with baclofen being used most frequently. This review of available clinical studies shows that baclofen given orally is effective in decreasing spasticity. However, side effects such as muscle weakness, nausea and somnolence are often experienced by patients, thus limiting the quantity of medication that can be administered. The infusion of baclofen directly into the intrathecal space of the spine should be considered as an alternative. This mode of delivery allows baclofen to be administered close to the site of action, and is known to provide effectiveness at much smaller doses. Intrathecal baclofen can be an option for patients who experience intolerable side effects or who do not achieve adequate spasticity relief with the maximum recommended dosage of oral baclofen.
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