Dystonia Association of Kentucky

• A color-coded list of oral meds to avoid if you have dystonia according to their use in clinical medicine. Further information about each agent can be found by clicking here to RxList.
• Drugs to be used with Caution (pdf format )

(courtesy of c4dystonia)

DRUGS THAT MAY CAUSE DYSTONIA

Drugs belonging to a class called "dopamine receptor blocking agents" (DRBAs) 
may cause dystonia.  The following is a list of such drugs that may cause dystonia.

     TREATMENT

Not all dystonia needs to be treated.  If you and your doctor agree that treatment is needed, your choices may include:

• Injection therapy with botulinum toxin type A (BOTOX®, www.allergan.com) or type B (MYOBLOC^{TM, www.myobloc.com}) is the most effective treatment for  focal dystonias; injections are typically limited to a specific region of the body.  It usually requires repeated treatments at about 3 month intervals and is associated with minor side effects.
• Physical therapy, bracing, relaxation, and learning techniques to accommodate the dystonia.  Stretching is important to prevent muscle shortening.  Bracing may be effective if it reduces the dystonia without being uncomfortable.  Techniques such as learning to write with the non-dystonic hand may also be beneficial.
• Oral medications may be very helpful in children with generalized dystonia, but are not usually completely effective in adults, and may cause reversible side effects that limit the doses.  These oral medications may include:  benzodiazepines such as diazepam (Valium®) and clonazepam (Klonopin®); the anti-spasmodic baclofen (Lioresal®); anticholinergics such as trihexyphenidyl (Artane®) or diphenhydramine (Benadryl®); or neuroleptic drugs such as clozapine (Clozaril®) or olanzapine (Zyprexa®).  A small group of patients with a specific childhood-onset dystonia (DRD) improve dramatically with levodopa.
• Intrathecal baclofen therapy (ITB Therapy^TM) may be most effective in those with dystonia and spasticity involving the lower body.  Surgery is required to implant a pump, which delivers anti-spasm medication directly into the space around the spinal cord.  Complications may occur and may be serious in some patients.
• Two different types of brain surgery have been tried--lesioning and deep brain stimulation.  During a lesioning surgery, a small selected area of the brain (thought to be involved in dystonia) is destroyed.  Deep brain stimulation (Activa^TM)  surgery can be performed for some forms of dystonia but is reserved for patients with more severe dystonia who do not benefit or have lost benefit from other types of treatment.  Deep brain stimulation (DBS) uses implanted electrodes to stimulate specific areas of the brain.  The electrical stimulation interferes with the abnormal activity, creating the same effect as a lesion.  The effect lasts as long as the stimulation continues, but ceases when it is shut off.  Complications are possible.  Support groups and other forms of psychological counseling are very important for psychological adjustment and maintaining or improving self-image.

Questions to Ask Your Doctor

• Are my symptoms likely to get worse or better over time?
• Will my symptoms spread to other parts of my body?
• Will my children get dystonia?
• What re the treatments that could help me and are there side effects?
• How can I contribute to research studies on dystonia?

If you would like more detailed information on treatment options or additional support (such as discussion forums and chat rooms), please visit  http://www.wemove.org or http://www.dystoniaassociation.org/thecoffeeshop.htm     

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