Medication for spasticity

[debbie52]

I have spastic paraplegia (incomplete) from a T-7 injury caused by a nitrogen bubble resulting from a severe case of decompression illness (DCS II) suffered while scuba diving five years ago. I spent 11 days in and out of a hyperbaric oxygen chamber being "recompressed," followed by months of physical therapy. I recovered a significant strength and range of motion on my left side, although my right side remained fairly paralyzed. The spasticity (and pain) was bilateral -- pretty much the same on both sides. I had been taking 400 mg/4 X a day of Neurontin (gapabentin) and 40 mg/4 X day of 4-Aminopyridine (4-AP), but no anti-spasmodic like Baclofen.

In the past 6 months I have had serious deterioration on my left side, and no-one can figure out why. I have had MRIs, but they don't really show anything new. The spasticity is much worse, and the muscles on my left side have gotten weaker. I have tried increasing the gabapentin dosage to 600 mg/4 X day, but that didn't seem to do much. I have tried Zanaflex (tizanidine), but that made me woozy and slightly weaker.

I'd be very interested in anyone's experience with these drugs, and dosages, and also any comparisons between gabapentin and Lyrica, and also Baclofen.

Thanks.

[Catucci]

Hi Debbie

My hubby, Nico, is T6 complete for nearly 2 years now.  He suffers from spasms a lot and is going to have a Baclofen pump fitted in the next few weeks.  He's taken Baclofen from the beginning really, started off on a small dose and the spasms just got more and more severe.  Now they are so strong they are dislocating his hips!  He takes Gabapentin, Tazanidine and Amitryptaline too, I'm not sure of the dosage without checking.  He also takes Diazepam which is supposed to suppress the spasms a little.

You mention your left side is deteriorating most.  Nico had more injuries on his left side but it is his right side that is spasaming more.  His Consultant said sometimes one side will spasm more to compensate for the other side not being able to.  I would think your Consultant will try you with Baclofen or similar, have you asked specifically about that drug or other anti-spasmodic?

Good luck.

xx Cat xx

[gzarnke]

hi debbie,

my son was on 3 types of anti-spasm medication at one time including neurotin and baclofen i can not remember the other medication. he did go to just baclofen and neurotin and he was taking 800mg 3 x a day of the neurotin.

my son did not like taking all the meds as it made his head fuzzy and his mouth very dry but they did help, at this time he is not on any meds at all.

gzarnke

[BarbaraS]

Hi there
I have just come off Gabapentin - I was on 1800mg per day. I have now been put on Lyrica (PREGABALIN) and am currently on 150mg per day, and seems to be a miracle pill (althought the gabapentin was when  I was first on it). Baclefen did not work at all for me, they have had to put me on clonazepam. The spasm's I get are when I lie down, and virtually start body popping, each time causing pressure on the cord!

I am seeing my consultant again in a week or so, but so far, being on the lyrica has been good. (I also take tramadol and amytriptaline). My dr wants me off the amytriptaline. I have been on it for nearly ten years for pain management now. However, two of the many side effects is an increased heart beat, and weight gain. I had a look at the lyrica info, and that too increases the heart rate. So no doubt, in a few months I'll be on something else.

Basically, lyrica is "the son of" gabapentin (so my dr explains) and its primary purpose is for pain and secondary for seizures, wheras the gabapentin is the other way around. He also told me that you need to take less. It is another one that you have to build up in dosage month by month, but the first week of me being on it, I worked full time for the whole week. Something that I have not been able to do in a long long time.

Hope this has helped. I have 2 cervical fusions c4/5 and c6/7 and have had two laminectomies too. Also, have a protruding disc at T4. The weakness returned about 5 months ago, and the spasms started soon after.
Barbara

[Andy]

hi barbara,

I cant help with these medications but welcome to the forums

Andy

[darrel]

hello, my name is darrel I have an incomplete C3-C6 for almost 2 years (I fell off a ladder), I'm new to this sight but not to the pills. I have been maxxed out on the dosage of baclofen, and combined with zanaflex, I had my Dr. take me off of the baclofen for 2 reasons, 1) it can couse damage to your liver in some cases and 2) I did not like the drowsiness it caused. I am now only taking dantrolene but still having the spasms, my Dr. is pushing the baclofen pump toward me, it is implanted at the waist line and a small tube is ran upto the spinal colom, they say that there is less side affects with this than the pill form. I would talk with your Dr. good luck, darrel.

[wheels5894]

I agree with Darrel as far as the pump is concerned - it sounds the best you'll get.

As far as your medication in concerned I am puzzled with your taking Lyrica. The 'Drug Bible' in the Uk BNF says: -

PREGABALIN
Indications peripheral and central neuropathic pain; adjunctive therapy for partial seizures with or without secondary generalisation; generalised anxiety disorder

Nothing is mentioned about controlling spasms. There is also the note; -

The Scottish Medicines Consortium has advised (August 2006) that Lyrica® is not recommended for the treatment of peripheral neuropathic pain

which seems to limit its use.

I have been on gabapentin for nueropathic pain for a while and it is very effective. Just interested