Information ⬇
- Spasticity may respond to physical therapy, baclofen (20-120 mg/d), diazepam (2-40 mg/d), tizanidine (8-32 mg/d), dantrolene (25-400 mg/d), and cyclobenzaprine hydrochloride (10-60 mg/d).
- Dysesthesia may respond to carbamazepine (100-1000 mg/d in divided doses), phenytoin (300-600 mg/d), gabapentin (300-3600 mg/d), pregabalin (50-300 mg/d), or amitriptyline (25-150 mg/d).
- Treatment of bladder symptoms is based on the underlying pathophysiology investigated with urodynamic testing: bladder hyperreflexia is treated with evening fluid restriction and frequent voiding; if this fails, anticholinergics such as oxybutynin (5-15 mg/d) may be tried; hyporeflexia is treated with the cholinergic drug bethanechol (30-150 mg a day), and dyssynergia due to loss of coordination between bladder wall and sphincter muscles is treated with anticholinergics and intermittent catheterization.
- Depression should be treated aggressively.
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