More MS news articles for January 2003

Muscle Relaxants for MS-Associated Painful Muscle Spasms

http://www.medscape.com/viewarticle/448407

01/27/2003
Medscape Neurology & Neurosurgery 5(1), 2003.

Question

What drugs are useful for painful muscle spasms in patients with multiple sclerosis if regular muscle relaxants and analgesia are no longer effective?

Thandi Kumalo, MB, ChB

Response
from Omar Khan, MD, 01/28/2003

I assume the term "regular" muscle relaxants and analgesia implies that drugs such as baclofen, tizanidine, cyclobenzaprine, and diazepam have been used. Other agents that can help relieve painful muscle spasms include carbamazepine, gabapentin, tiagabine, carisoprodol, and dantrolene. Of these, carbamazepine may be the most effective, or some of the newer epilepsy drugs that have a structure similar to carbamazepine. The use of these latter drugs for treating muscle spasms would be considered "off-label."

Suggested Readings
Schapiro RT. Management of spasticity, pain, and paroxysmal phenomena in multiple sclerosis. Curr Neurol Neurosci Rep. 2001;1:299-302.

About the Panel Members
Omar Khan, MD, Associate Professor of Neurology and Medical Director, Multiple Sclerosis Clinic, Wayne State University, Detroit, Michigan