In patients who cannot tolerate high doses of spasticity medications, what method may be most effective?

Intrathecal administration of spasticity medications is often considered the most effective method for patients who cannot tolerate high doses of spasticity medications due to side effects or inefficacy at standard dosages. This method allows for the delivery of medication directly into the cerebrospinal fluid (CSF), which can achieve higher concentrations of the drug at the site of action in the spinal cord while minimizing systemic side effects.

By bypassing the body's normal absorption and distribution processes, intrathecal administration can provide effective relief from spasticity symptoms, allowing for lower overall doses of medication which are often better tolerated. This method is particularly useful for patients with severe spasticity who have not responded adequately to oral medications or who experience significant adverse effects when using higher doses.

Other methods such as physical therapy, behavioral therapy, and alternative medicine practices can certainly contribute to managing spasticity and improving function, but they typically do not provide the direct and potent relief achievable through intrathecal administration of spasticity medications. These alternatives often serve as complementary approaches rather than primary treatments in severe cases.