An antispasmodic (synonym: spasmolytic) is a
pharmaceutical drug or other agent that suppresses muscle
spasm
A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ such as the bladder.
A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a muscle ...
s.
Smooth muscle spasm
One type of antispasmodics is used for
smooth muscle
Smooth muscle is an involuntary non-striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit mus ...
relaxation, especially in tubular organs of the
gastrointestinal tract
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organ (biology), organs of the digestive syste ...
. The effect is to prevent
spasm
A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ such as the bladder.
A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a muscle ...
s of the
stomach,
intestine
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...
or
urinary bladder.
Both
dicyclomine and
hyoscyamine
Hyoscyamine (also known as daturine or duboisine) is a naturally occurring tropane alkaloid and plant toxin. It is a secondary metabolite found in certain plants of the family Solanaceae, including henbane, mandrake, angel's trumpets, jimsonweed ...
are antispasmodic due to their
anticholinergic action. Both of these drugs have general side effects and can worsen
gastroesophageal reflux disease.
Mebeverine
Mebeverine is a drug used to alleviate some of the symptoms of irritable bowel syndrome. It works by relaxing the muscles in and around the gut.
Medical use
Mebeverine is used to alleviate some of the symptoms of irritable bowel syndrome (IBS) ...
is a musculotropic spasmolytic with a strong and selective action on the smooth muscle spasm of the gastrointestinal tract, particularly of the colon. It does not have the acetylcholine side effect commonly seen in an anticholinergic antispasmodic.
Papaverine is an
opium
Opium (or poppy tears, scientific name: ''Lachryma papaveris'') is dried latex obtained from the seed capsules of the opium poppy ''Papaver somniferum''. Approximately 12 percent of opium is made up of the analgesic alkaloid morphine, which i ...
alkaloid
Alkaloids are a class of basic
BASIC (Beginners' All-purpose Symbolic Instruction Code) is a family of general-purpose, high-level programming languages designed for ease of use. The original version was created by John G. Kemeny and Th ...
used to treat
visceral spasm
A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ such as the bladder.
A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a muscle ...
s,
erectile dysfunction
Erectile dysfunction (ED), also called impotence, is the type of sexual dysfunction in which the penis fails to become or stay erect during sexual activity. It is the most common sexual problem in men.Cunningham GR, Rosen RC. Overview of male ...
and investigated as
antipsychotic
Antipsychotics, also known as neuroleptics, are a class of psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia but also in a range o ...
drug due to its potency to inhibit
phosphodiesterase PDE10A.
Peppermint oil has been traditionally used as an antispasmodic, and a review of studies on the topic found that it "could be efficacious for symptom relief in
IBS"
(as an antispasmodic) although more carefully controlled studies are needed. A later study showed it is an effective antispasmodic when test-applied topically to the intestine during
endoscopy.
Bamboo shoots have been used for gastrointestinal and antispasmodic symptoms.
Anisotropine,
atropine,
clidinium bromide are also the most commonly used modern antispasmodics.
Skeletal muscle spasm
Pharmacotherapy may be used for
acute musculoskeletal conditions when
physical therapy
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient ...
is unavailable or has not been fully successful. Another class of antispasmodics for such treatment includes
cyclobenzaprine,
carisoprodol,
diazepam,
orphenadrine
Orphenadrine (sold under many brand names) is an anticholinergic drug of the ethanolamine antihistamine class; it is closely related to diphenhydramine. It is a muscle relaxant that is used to treat muscle pain and to help with motor control in Pa ...
, and
tizanidine.
Meprobamate is another effective antispasmodic which was first introduced for clinical usage in 1955 mainly as an
anxiolytic and soon afterward became a blockbuster psychotropic drug. While clinical usage of meprobamate has largely become obsolete since the development of
benzodiazepines due to its liability for developing physical
dependence and severe toxicity during instances of acute
overdose, it is still manufactured and available by prescription. Carisoprodol is similar to meprobamate as they both belong to the
carbamate drug class and meprobamate is a clinically significant
active metabolite of carisoprodol, although carisoprodol itself possesses additional antispasmodic properties which are distinct from its metabolites. Effectiveness has not been clearly shown for
metaxalone,
methocarbamol,
chlorzoxazone,
baclofen, or
dantrolene.
Applicable conditions include acute back or neck pain, or pain after an injury.
Spasm may also be seen in movement disorders featuring
spasticity in neurologic conditions such as
cerebral palsy,
multiple sclerosis
Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This d ...
, and
spinal cord disease. Medications are commonly used for spastic movement disorders, but research has not shown functional benefit for some drugs.
[Shakespeare D, Boggild M, Young CA. Anti-spasticity agents for multiple sclerosis. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD001332. .] Some studies have shown that medications have been effective in decreasing spasticity, but that this has not been accompanied by functional benefits.
Medications such as
baclofen,
tizanidine, and
dantrolene have been used.
See also
*
Muscarinic antagonist
*
Parasympatholytic A parasympatholytic agent is a substance or activity that reduces the activity of the parasympathetic nervous system. (The parasympathetic nervous system is often colloquially described as the "Feed and Breed" or "Rest and Digest" portion of the aut ...
*
Phloroglucinol
*
Spasticity
References
External links
*
{{Irritable bowel syndrome
Drugs acting on the gastrointestinal system and metabolism