Baclofen versus diazepam for the treatment of spasticity and long-term follow-up of baclofen therapy.

Baclofen (25 to 60 mg per day) and diazepam (10 to 40 mg per day) were evaluated for spasticity reduction in a double-blind, crossover study in 13 patients over a period of 19 weeks. Both drugs produced overall improvement and there was no significant difference in preference for one or other treatment. Side-effects, especially excessive daytime sedation, were more common in the diazepam group. In a companion baclofen long-term study, 18 spastic patients were treated with baclofen for an average of 4 years. Baclofen discontinuation in this group resulted in a worsening of spastic signs and symptoms in 16 patients, with no evidence of drug tolerance even after many years of baclofen therapy.