Which medication is delivered intrathecally for spinal cord injury–related spasticity?

Which medication is delivered intrathecally for spinal cord injury–related spasticity?

• A. Baclofen
• B. Diazepam
• C. Cyclobenzaprine
• D. Carisoprodol

Answer: (A)

Delivering medication into the intrathecal space targets the spinal cord directly, allowing high concentrations where the spastic reflexes are generated while minimizing systemic side effects. Baclofen is a GABA-B receptor agonist; when infused intrathecally, it dampens the hyperactive stretch reflexes that drive spinal cord injury–related spasticity, making it particularly effective for severe cases that don’t respond well to oral meds. The other drugs listed are typically given orally and act through different mechanisms or receptors (for example, diazepam is a GABA-A agonist, while cyclobenzaprine and carisoprodol are central muscle relaxants) and are not standard intrathecal therapies for SCI spasticity. Intrathecal baclofen therapy uses a pump to deliver the drug and carries risks such as infection, catheter issues, and withdrawal if delivery is interrupted.

Delivering medication into the intrathecal space targets the spinal cord directly, allowing high concentrations where the spastic reflexes are generated while minimizing systemic side effects. Baclofen is a GABA-B receptor agonist; when infused intrathecally, it dampens the hyperactive stretch reflexes that drive spinal cord injury–related spasticity, making it particularly effective for severe cases that don’t respond well to oral meds. The other drugs listed are typically given orally and act through different mechanisms or receptors (for example, diazepam is a GABA-A agonist, while cyclobenzaprine and carisoprodol are central muscle relaxants) and are not standard intrathecal therapies for SCI spasticity. Intrathecal baclofen therapy uses a pump to deliver the drug and carries risks such as infection, catheter issues, and withdrawal if delivery is interrupted.