Reevaluating Medication Practices for Adults with Cerebral Palsy

Managing pain and symptoms effectively is crucial for adults living with cerebral palsy (CP). However, recent research indicates that the medications commonly prescribed to this population may not always align with the underlying causes of their symptoms. This mismatch can result in unnecessary drug use, potential health risks, and the possibility of worsening existing conditions.

A study conducted by Professor Mark Peterson from the University of Michigan explored medication patterns among adults with CP, focusing on whether treatments are appropriate for specific pain phenotypes and co-occurring neurodevelopmental disorders. Published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes, the research analyzed prescription data to identify prevalent pharmacological interventions.

The findings revealed that adults with mixed pain presentations tend to receive a higher number of prescriptions, including muscle relaxants and opioids, with up to 80% of patients being prescribed non-operative opioids. Common medications involved in pain management included antiepileptics, antidepressants, benzodiazepines, NSAIDs, muscle relaxants, antipsychotics, clonidine, anticholinergics, and botulinum toxin injections.

Interestingly, primary interventions like physical and occupational therapy were prescribed for only about 41% of adult participants, highlighting a potential gap in holistic treatment strategies. The study emphasizes the importance of using precise screening tools to understand the origin and severity of pain, which can guide more targeted and effective treatments.

Peterson warns of the risks linked to opioid exposure, particularly concerning respiratory issues, psychiatric conditions, bowel disorders, and fall-related injuries common among adults with CP. To address these concerns, his team has developed an overview of treatment recommendations, published alongside the research, aiming to improve pain management practices.

This ongoing research aligns with international efforts to establish clinical guidelines tailored specifically for adults with cerebral palsy, ultimately striving to optimize care and reduce inappropriate medication use. For more details, the study can be accessed in the latest issues of Mayo Clinic Proceedings and Developmental Medicine & Child Neurology.