Is baclofen the least worst option for spasticity management in children?

Baclofen is often considered a first-line treatment option for spasticity management in children. However, adverse effects, administration, and dosing can be barriers to effectiveness. In my practice, other medications for spasticity management are often used prior to initiating baclofen. In this article, baclofen use for spasticity management in children is briefly reviewed along with discussion of approaches using other medications as first-line treatment options. I will present a rationale for medication selection for spasticity management and discuss the approaches I take in medication selection that incorporate spasticity severity, patient goals, and medication side effect profiles.