Complex Motor Disorders

Uses

Side Effects

Handling

Uses

What is Complex Motor Disorders for?

Medicine	How does the medicine work?
Antispasmodics e.g. Baclofen	Helps muscles to relax. This will help your child to move, and make it easier and less painful to move them. It may also help to reduce muscle pain.
Anticholinergics e.g. Benzhexol	In children with dystonia, the muscles have contracted too much and are too tight. The head, arms or legs are held in awkward or uncomfortable positions. Benzhexol blocks the effects of a chemical messenger called acetylcholine that is released from the nerves to make the muscle contract. It helps the muscles to relax. This should allow a better range of movement in the affected part of the body and reduce painful spasms.
Benzodiazepines e.g. diazepam, nitrazepam, clonazepam	Helps to reduce symptoms of spasticity, and other movement disorders such as dystonia, and myoclonus. It modifies the chemical transmission in the brain. It helps your child’s muscles to relax. This should also help to reduce muscle pain.
Chloral Hydrate	Helps to reduce symptoms of dystonia by modifying the chemical transmission in the brain. It is also used in children with sleep-onset disorder (difficulty getting to sleep), muscle spasm/dystonia and agitation.
Clonidine	Helps to reduce symptoms of dystonia by modifying the chemical transmission in the brain. It is also used in children with Tourette’s syndrome, attention-deficit hyperactivity disorder (ADHD) and sleep-onset disorder (difficulty getting to sleep).
Gabapentin	Helps to reduce symptoms of dystonia by modifying the chemical transmission in the brain. It also helps to reduce muscle pain and neuropathic pain (nerve pain).
Levodopa e.g. Madopar	Levodopa is absorbed by the brain cells and turned into the chemical dopamine, which is used to transmit messages between the parts of the brain and nerves that control movement. Increasing the levels of dopamine helps to improve movement problems.

How should I take or use Complex Motor Disorders?

Your doctor will instruct you on how much and how often your child should take the medicine. Do not take more of the medicine or take it more often than what the doctor tells your child to. Most medicines can be taken with or without food. Give the medicine at the same time each day.

The medicine starts to work straight away. However, because the dose is usually increased gradually, it may take some weeks before the full effects can be seen.

Do not stop taking the medicine without first checking with the doctor.

What should I do if I forget to take or use Complex Motor Disorders?

If your child misses a dose, give it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for the missed dose.

Side Effects

What are some common side effects of Complex Motor Disorders?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Medicine	Rare but serious side effects Seek medical attention immediately if your child has any of these side effects:	Common side effects If your child has problems with these less serious side effects, talk with your doctor/ pharmacist
Antispasmodics e.g. Baclofen	Seizure (also called a fit or convulsion) Excessive sleepiness or difficulty in waking up Breathing difficulties	Drowsy (sleepy), dizzy Confusion Trouble sleeping or nightmares Constipation Nausea (feeling sick) Difficulty with passing urine If your child’s muscles become too floppy (hypotonic) Emotional, anxious or overactive or may have problems with their memory
Anticholinergics e.g. Benzhexol	Excessive sleepiness or difficulty in waking up Difficulty with passing urine, or unable to pass urine	Drowsy (sleepy), dizzy Blurred vision Constipation, nausea, vomiting Dry mouth Emotional, anxious or overactive or may have problems with their memory.
Benzodiazepaines, e.g. Diazepam, Nitrazepam, Clonazepam	Excessive sleepiness or difficulty in waking up Breathing difficulties Skin rash Yellowing of skin or eyes Hallucinations	Drowsy (sleepy), dizzy If your child's muscles become too floppy (hypotonic) Difficulty controlling their movements (ataxia) or walking Difficulty talking Salivary drooling Emotional, anxious or overactive or may have problems with their memory
Chloral Hydrate	Excessive sleepiness or difficulty in waking up Breathing difficulties	Drowsy (sleepy), dizzy Nausea, vomiting Stomach upset/heartburn
Clonidine	Excessive sleepiness or difficulty in waking up	Drowsy (sleepy) or dizzy Dry mouth Constipation Nausea, vomiting Headaches Agitation or restlessness at night
Gabapentin	Excessive sleepiness or difficulty in waking up	Drowsy (sleepy), dizzy Unsteadiness Changes in appetite Nausea, vomiting Diarrhoea/constipation, wind, indigestion Dry mouth Emotional, anxious or overactive or may have problems with their memory
Levodopa e.g. Madopar	Excessive sleepiness or difficulty in waking up	Drowsy (sleepy), dizzy Nausea or vomiting Stomach upset Dry mouth Emotional, anxious or overactive or may have problems with their memory Chorea (abnormal involuntary movements)

There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, please contact your doctor or pharmacist.

Handling

How should I store Complex Motor Disorders?

Keep away from children
Keep in a cool, dry place, away from direct sunlight

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System, and SingHealth), community pharmacies (Guardian, Unity, and Watsons), and the Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.