Mismatch in Cerebral Palsy Medications for Adults Raises Concerns

Managing pain and symptoms effectively is crucial for adults with cerebral palsy (CP), yet many are prescribed medications that do not address their specific needs. This discrepancy can lead to unnecessary drug use, which may not only fail to alleviate symptoms but could also lead to additional health complications.

A recent study from the University of Michigan, published in the Mayo Clinic Proceedings: Innovations, Quality & Outcomes, explored the medication and therapy treatment patterns for adults with cerebral palsy. Dr. Mark Peterson, a professor specializing in physical medicine and rehabilitation, investigated whether there are variations in medication prescriptions based on pain types or associated neurodevelopmental disorders.

The research revealed a list of the most frequently prescribed medications for pain and symptom management among this population. The medications, ranked from most to least prescribed, include antiepileptics, antidepressants, benzodiazepines, nonsteroidal anti-inflammatories (NSAIDs), non-operative opioids, antipsychotics, muscle relaxants, and others.

Interestingly, despite the emphasis on physical and occupational therapy as primary interventions for children with CP, only 41% of adult participants in this study received these therapies. This gap in treatment may contribute to adverse reactions and ineffective symptom management.

One significant finding highlighted by the research is the concerning trend among adults with mixed pain phenotypes. Those individuals exhibited a strikingly high prescription rate, with up to 80% receiving non-operative opioids and 60% prescribed muscle relaxants. This pattern raises alarms about the potential for over-reliance on medications that may not be suitable for their specific conditions.

Dr. Peterson emphasized the necessity of employing proper screening tools to accurately identify the nature and source of pain experienced by individuals with CP. Understanding the comprehensive impact of pain is vital, particularly regarding potential connections between opioid use and prevalent comorbidities such as respiratory, psychiatric, and bowel disorders, as well as issues related to fractures.

To address these concerns, Dr. Peterson and his team have developed a set of recommendations for improving pain management strategies tailored for adults with cerebral palsy. These guidelines are part of a broader international initiative aimed at establishing the first comprehensive clinical practice guidelines for adults with the condition.

As research continues in this critical area, the focus remains on enhancing treatment modalities and ensuring that medication prescriptions align more closely with the actual needs of adults living with cerebral palsy.