ABSTRACT
There are many medications available to treat spasticity, but the tolerability of medications is the main issue for choosing the best treatment. The objectives of this study were to compare the efficacy and adverse effects of tolperisone compared to baclofen among patients with spasticity associated with spinal cord injury. Patients received baclofen plus physical therapy (BAF+PT, n=135) or tolperisone plus physical therapy (TOL+PT, n=116), or physical therapy alone (PT, n=180). The modified Ashworth scale score, the modified Medical Research Council score, the Barthel Index score, and the Disability Assessment scale score were improved (P<0.05 for all) in all the patients at the end of 6 weeks compared to before interventions. After 6 weeks, the overall coefficient of efficacy of the intervention(s) in the BAF+PT, TOL+PT, and PT groups were 1.15, 0.45, and 0.05, respectively. The patients of the BAF+PT group reported asthenia, drowsiness, and sleepiness and those of the TOL+PT group reported dyspepsia and epigastric pain as adverse effects. When comparing drug interventions to physical therapy alone, both baclofen plus physical therapy and tolperisone plus physical therapy played a significant role in the improvement of daily activities of patients. Nonetheless, baclofen plus physical therapy was tentatively effective. Tolperisone plus physical therapy was slightly effective. In addition, baclofen caused adverse effects related to the sedative manifestation (Level of Evidence: III; Technical Efficacy Stage: 4).
Subject(s)
Humans , Spinal Cord Injuries/complications , Tolperisone , Muscle Relaxants, Central/adverse effects , Baclofen/adverse effects , China , Retrospective StudiesABSTRACT
Introdução: o baclofeno, uma droga agonista seletivo de GABA B, tem sido apontado como uma nova opção de tratamento do etilismo. Neste estudo avaliou-se o efeito do baclofeno no consumo etílico em ratos Wistar. Materiais e Métodos: o experimento ocorreu em quatro fases: exposição, abstinência, reexposição e tratamento. Os animais foram alocados em grupos: 1, 2, 3 e 4 (n=5 por grupo), expostos à água pura, solução hidroalcoólica (SHA) 5% e SHA 10%; grupo 5 (subdividido em A, B e C N =5 por subgrupo) e grupo 6 (n=5), ambos expostos a apenas água pura. A administração de baclofeno via intraperitoneal destinou aos grupos 1, 2, 3 e 5 em diferentes doses. Nos demais grupos, administrou-se placebo. Aferiu-se o consumo das soluções em todas as fases, para fins comparativos. Resultados: o baclofeno, na dose de 1mg/Kg, reduziu o consumo de SHA 10% no grupo 1, que apresentou maior consumo etílico durante o experimento. Os demais grupos apresentaram menor consumo das SHA ofertadas, sem redução da ingesta etílica após administração da droga nas doses de 2 e 3mg/Kg. Conclusão: baclofeno reduziu etilismo apenas em animais com maior consumo etílico prévio à sua administração. O peso dos animais não foi fator determinante na resposta à droga. A dose efetiva no tratamento dos efeitos da privação alcoólica foi a de menor concentração (1mg/kg).
Introduction: Baclofen, a GABA B agonist, has been pointed as a new drug on the alcohol consumption treatment. This study has evaluated baclofen Ìs effect on ethanol consumption in Wistar rats. Materials and Methods: four phases protocol: exposure, abstinence, re-exposure and treatment. Animals were allocated into groups: 1, 2, 3 and 4 (n=5 per group), exposed to pure water, 5% ethanol solution and 10% ethanol solution. Group 5 (subdivided into A, B and C, n=5 by subgroup) and group 6 (n=5), exposed to pure water. Baclofen intraperitoneal administration was destined to groups 1, 2, 3 and 5 (A, B and C) in different doses. The remaining groups received saline solution as control. Solutions consumption was assessed in all phases for comparative purposes. Results: Baclofen at 1mg/Kg reduced the 10% (vv) water-alcohol consumption in animals from Group 1, which also presented greater ethanol consumption during the experiment. The other groups showed a lower water - alcohol consumption and did not show an ethanol intake reduction after the drug administration in both 2 and 3mg/Kg doses. Conclusion: Baclofen only reduces alcoholism in animals with higher ethanol consumption. Animals weight is not a determining factor in ethanol consumption or in baclofen response. The effective baclofen dose in treating the deprivation alcohol effects was observed in the lowest concentration, corresponding to 1mg/Kg dose.
Subject(s)
Animals , Male , Baclofen/administration & dosage , Baclofen/adverse effects , Alcohol Drinking/adverse effects , Receptors, GABA-B/drug effects , Rats, Wistar , Models, AnimalABSTRACT
En un estudio realizado a doble ciego, randomizado, en que se comparó el efecto de tizanidina (TZ) con baclofén (BF), en 27 pacientes con espasticidad crónica de diferentes etiologías (grupo TZ n=14 y grupo BF n=13), se observó que ambas drogas produjeron ligeras mejorías en varios de los ítems estudiados. Aunque no se registraron diferencias significativas entre los resultados de un grupo comparado con el otro, se evidenció un efecto favorable de ambos fármacos (P<0,05) sobre el tono muscular, la eficiencia personal y la intensidad de los espasmos. En este último ítem en particular, fue algo más acentuada la tendencia a la mejoría observada con TZ. En la evaluación final, hecha por el médico, se consideró que la eficacia del tratamiento fue buena en 3 pacientes del grupo TZ y 1 del grupo BF, moderada en 6 pacientes del grupo TZ contra 7 del grupo BF y deficiente en 2 del grupo TZ contra 3 del BF. En la evaluación efectuada por los pacientes se consideró como buena la eficacia del tratamiento en 8 casos del grupo TZ, contra 6 del grupo BF. Si bien los efectos colaterales fueron en general moderados, 3 pacientes del grupo TZ y 2 del grupo BF debieron suspender el tratamiento a consecuencia de los mismos. En base a estos resultados puede concluirse que, en este tipo de pacientes particularmente difíciles de tratar, TZ resultó de una efectividad y tolerancia semejante o ligeramente superior a BF.