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- W2034669544 abstract "Tizanidine, an Alpha-2 Agonist with antinociceptive properties, has been effective prophylactic therapy for Chronic Migraines. Based on multiple studies, high dose Tizanidine (24 milligrams daily) has shown to decrease the number of episodes, intensity, and duration of headaches. Although the most common adverse effects have included somnolence, dizziness, and dry mouth, reports of hallucinations and bradycardia have been noted. We report on a case of a healthy 40 year old caucasian female with intractable migraines. The patient was started on Tizanidine with slow titration from 2 to 8 milligrams three times a day over a 4 week period with improvements in her headache pain, Patient Health Questionnaire, and Midas Scores. She was continued on this therapy for over 4 months, when she suddenly began having hallucinations and dizziness. Emergency department evaluation noted visual hallucinations and bradycardia (35-45 BPM). She was slowly weaned off Tizanidine with resolution of her hallucinations and bradycardia once her daily dose was reduced to below 18 milligrams daily. No further sequela was noted and she was transitioned to an alternative therapy for her headaches. Although Tizanidine is a relatively safe medication, dose dependent hallucinations and bradycardia are known adverse effects based on previous reports, and more commonly with daily doses above 20 milligrams. We advise caution in prescribing high doses of Tizanidine, especially in patients that may be at risk of complications secondary to severe bradycardia. Additionally, Tizanidine is an Alpha-2 Agonist, similar to Clonidine, thus abrupt withdrawal should be avoided due to the risk of severe hypertension. (Saper, J Headache, 2002.)" @default.
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- W2034669544 date "2012-04-01" @default.
- W2034669544 modified "2023-09-23" @default.
- W2034669544 title "Tizanidine for the management of chronic migraines" @default.
- W2034669544 doi "https://doi.org/10.1016/j.jpain.2012.01.295" @default.
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