act via the facilitation of gamma-aminobutyric acid (GABA) neurotransmission at various supraspinal levels and in the spinal cord
there is evidence from small randomised, double-blind, placebo-controlled trials that diazepam reduced painful muscle spasms and led to a partial resolution of spasticity - however there was no improvement in muscle power (1,2)
the sedative effects of diazepam last for less time than the its antispasmodic effects - therefore diazepam (in the treatment of spasticity) is best administered as a single dose at night
Reference:
(1) Wilson LA, McKechnie AA (1966). Oral diazepam in the treatment of spasticity in paraplegia. A double-blind trial and subsequent impressions. Scott Med J, 11, 46-51.
(2) Corbett M, Frankel HL, Michaelis L (1972). A double-blind, cross-over trial of valium in the treatment of spasticity. Paraplegia, 10, 19-22.
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