Writer's Cramp Medication
- Author: Jonathan B Strober, MD; Chief Editor: Selim R Benbadis, MD more...
Medication Summary
Several classes of drugs have been used in patients with writer's cramp. Anticholinergics have had conflicting results. Beta-blockers have helped the tremor in a few patients. Botulinum toxin injections seem to have the best results.
Anticholinergic
Class Summary
Blocking cholinergic innervation of the basal ganglia is hypothesized to increase the dopaminergic effect, thereby reducing dystonia.
Trihexyphenidyl (Artane)
Substituted piperidine that inhibits parasympathetic system. Available as 2 mg tab or 2 mg/5 cc elixir.
Beta-adrenergic blockers
Class Summary
These agents help reduce the tremor.
Propranolol (Inderal, Betachron E-R)
Class II antiarrhythmic, nonselective, beta-adrenergic, receptor blocker with membrane-stabilizing activity that decreases automaticity of contractions. Available as 10 mg, 20 mg, 40 mg, and 80 mg tablets and 60 mg, 80 mg, 120 mg, and 160 mg long-acting tablets (Inderal LA)
Neurotoxins
Class Summary
Neurotoxin complex blocks neuromuscular conduction by binding to receptor sites on motor nerve terminals, entering the nerve terminals, and inhibiting the release of acetylcholine. When injected intramuscularly, it produces a localized chemical denervation muscle paralysis.
OnabotulinumtoxinA (BOTOX®)
Local intramuscular injections weaken overactive muscles, reducing dystonic symptoms.
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