ABSTRACT
This chapter discusses the orally administered drugs commonly used for spasticity and explores their modes of action, side-effect profiles, dosage schedules and evidence base. Education and support in self-management strategies, combined with ongoing evaluation of the evolving impact of spasticity, is necessary to enable ongoing assessment of change and thus aid in the optimisation of pharmacological intervention. Cognitive changes may be marked in the elderly or in those with organic brain disease. Occasionally, toxic symptoms of ataxia, vertigo, headache, gastrointestinal symptoms, behavioural disturbance, hypotension and coma can occur. Gabapentin was initially launched as an anticonvulsant for partial seizures in the early 1990s, but its main use over recent years has been for its effects on neuropathic pain. In addition, active, effective communication of these plans is paramount to the ongoing appropriate use of oral medication and, in the case of tizanidine or dantrolene, for essential blood monitoring.
