Oral baclofen and clonidine for treatment of spasticity in children

J Child Neurol. 2006 Dec;21(12):1090-2. doi: 10.1177/7010.2006.00134.

Abstract

Few data exist in the literature to support the use of high dosages of oral baclofen and clonidine that are frequently required to treat children with spasticity. This study was a retrospective chart review of baclofen and clonidine dosages used in children diagnosed with cerebral palsy or traumatic brain injury. The primary objective was to calculate the mean dosages of baclofen and clonidine based on the duration of spasticity postinjury. Secondary objectives included determining correlations between dosage and age, injury type, location of spasticity, comorbid seizures, or concomitant antispasticity medications. Eighty-seven children receiving baclofen and/or clonidine were included in this study. Mean dosages of 40 mg/day (n = 86) and 0.4 mg/day (n = 31) were required for baclofen and clonidine, respectively. The maximum dosage was 240 mg/day for baclofen and 3.6 mg/day for clonidine. Duration postinjury, age, and concomitant antispasticity medications were the most predictive variables for baclofen dosage as a model (r = .522; P = .000). Duration postinjury and location of spasticity were the most predictive variables for clonidine dosage as a model (r = .523; P = .000). The average dosages of baclofen and clonidine used in this population of children with cerebral palsy or traumatic brain injury were similar to those reported in the literature, with higher maximum dosages found in this investigation.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adrenergic alpha-Agonists / administration & dosage
  • Adrenergic alpha-Agonists / adverse effects
  • Adult
  • Age Factors
  • Baclofen / administration & dosage*
  • Baclofen / adverse effects
  • Brain Injuries / drug therapy
  • Brain Injuries / physiopathology
  • Central Nervous System / drug effects*
  • Central Nervous System / physiopathology
  • Cerebral Palsy / drug therapy
  • Cerebral Palsy / physiopathology
  • Child
  • Child, Preschool
  • Clonidine / administration & dosage*
  • Clonidine / adverse effects
  • Dose-Response Relationship, Drug
  • Drug Synergism
  • Drug Therapy, Combination
  • Female
  • GABA Agonists / administration & dosage
  • GABA Agonists / adverse effects
  • Humans
  • Infant
  • Male
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / etiology
  • Muscle Spasticity / physiopathology
  • Muscle, Skeletal / drug effects*
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / physiopathology
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Adrenergic alpha-Agonists
  • GABA Agonists
  • Baclofen
  • Clonidine