Numerous oral medications have been shown to improve dystonia.
No single drug works for everyone, and several trials of medications may be needed to determine which is most appropriate for you. It is essential to clearly communicate with your doctors about all medications you are taking. Changes to medication dosage should be done only under the guidance of a physician.
Categories of medications commonly used to treat dystonia include:
Anticholinergic drugs include Artane® (trihexyphenidyl), Cogentin® (benztropine), and Parsitan® (ethopropazine). These medications act by blocking a neurotransmitter chemical called acetylcholine, which plays an important role in muscle activation.
Benzodiazepines include Valium® (diazepam), Klonopin (clonazepam), and Ativan® (lorazepam). These drugs act on the neurotransmitter chemical GABA-A.
Baclofen (Lioresal®) stimulates the body’s ability to process a neurotransmitter called GABA-B. Baclofen can be taken orally or the medication can be continuously fed into the nervous system by a surgically implanted device, often called a baclofen pump.
Some patients with specific types of dystonia respond to drugs that increase the neurotransmitter dopamine. These drugs include Sinemet (levodopa) or Parlodel (bromocriptine). Drugs that block or deplete dopamine are generally discouraged from use in treating dystonia because of the risk of tardive syndromes which may worsen movement symptoms.
Tetrabenazine (Xenazine®) is a drug that decreases dopamine and is used to treat a variety of movement disorders.
Additional drugs are sometimes used for specific forms of dystonia. For example, muscle relaxers, anticonvulsants, and (in rare cases) dopamine-depleting agents, among many others.