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As shown in this slide, antispasticity drugs (ASDs) can be divided into primary and secondary groups of medications. Primary ASDs are the first-line agents in the treatment of spasticity.
Patients with resistant or refractory spasticity, or who develop adverse reactions to primary agents, may respond to a secondary ASD. The mechanisms and anatomic sites of actions of the ASDs are not completely understood.
However, they are believed to either alter the function of neurotransmitters or modulators in the central and/or peripheral nervous system. The CNS actions could include suppression of excitation via glutamate, enhancement of inhibition via GABA or glycine, or both.