Effect of Alprazolam in Spasticity: A Pilot Study

Background: Alprazolam, given in 0.5 mg dose for some other reason (like anxiety), showed reduction in spasticity and spasm lasting for a few hours. On searching the literature we did not come across any study to authenticate this effect of alprazolam. Hence, this study was planned. Methodology: This was a prospective pilot study. 38 cases suffering from spasticity of any origin were included. 0.5 mg (for 15 days) followed by 1mg (for another 15 days) of Alprazolam once daily 1⁄2 hour before bed time was given to every patient and repeat evaluations were done at day 15 (0.5mg) and 1 month (1mg). Spasticity were assessed by MAS, PSFS, Peak torque at 30o, 60o, and 90o/sec, time taken for ADL drinking, dressing, hand activity), and FIM motor score. Results: 34 completed the 1 month period of study. Significant improvement was observed in MAS score, PSFS at each time, peak torque at 30o /sec velocity (only with 1mg), peak torque at 60o and 90o /sec, FIM score, drinking activity (only with 1mg), dressing activity and hand activity. Conclusion: Alprazolam is a safe and effective drug for the treatment of spasticity as well as spasms, that is, both the phasic and tonic part of stretch reflexes responds to alprazolam when used up to 1 mg for 1 month. Performance of ADL improved favorably with 0.5 and 1 mg alprazolam. Further studies are required in this area regarding the long term safety and efficacy and effective dose for spasticity.