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• W2161175331 abstract "Over the last 3 years, we evaluated the efficacy of tizanidine (Zanaflex®, Elan Pharmaceuticals), a central alpha-2 agonist FDA-approved antispastic agent, in 430 patients (66% female, 34% male) with a variety of chronic pain syndromes (chronic daily headache-6%, complex regional pain syndrome 1–6%, failed back surgery syndrome-9%, fibromyalgia-7%, migraine headache-5%, myofascial pain-27%, non operated spine pathology-33%[discogenic disease-27%, spondylosis-6%], and osteoarthritis-7%). Tizanidine has shown a dose-dependent antinociceptive activity presumably due to decreased release of substance P and reduction in excitatory amino acid activity at the spinal level [1]. During the study, 652 patients were prescribed tizanidine, but only 430 patients' records were sufficiently complete for review or were reachable by telephone for questionnaire completion. Of the 430, 284 (66.1%) continue to use tizanidine noting at least a moderate effect in reducing their symptoms with 35%, 48%, and 55% of the 430 study patients feeling that tizanidine provided significant (greater than 70%) improvement in pain, associated muscle spasm or myofascial pain component, and associated sleep disturbance, respectively. Tizanidine appeared to be equally effective across all chronic pain conditions represented in the study sample. Nearly half of the patients use a single q.h.s. dose (2–8 mg) of tizanidine and almost all of the remainder take more than half of their daily dose at night (4–12 mg) with smaller day time doses to reduce sedation (ranges 6–24 mg/d). Sixty-two (14.4%) of the patients discontinued the drug due to side effects: sedation (31 patients-50%) nausea/cramps/gastrointestinal upset (9–14.5%), confusion (5–8%), irritableness (4–6.6%), headache (3–4.8%), dizziness (2–3.3%), insomnia (2–3.3%), and paresthesias, flushed sensation, urinary retention and itching (1 each-1.6%). The majority who discontinued the drug due to sedation were those in whom early daytime dose titrations were used. Discontinuation due to sedation became almost nonexistent using a dosing schedule starting at 2 mg q.h.s. and increasing in 2 mg increments every few days up to 8–12 mg at night before introducing lower daytime doses. Eighty-four patients (19.5%) felt that the drug was poorly effective (less than 20% improvement) in reducing their symptoms. Of these patients, almost all stopped the drug at a daily dose of 4–12 mg and were unwilling to continue on it due to perceived lack of effect (12.5%) or cost compared with benefit (7%)." @default.
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• W2161175331 date "2008-07-07" @default.
• W2161175331 modified "2023-09-23" @default.
• W2161175331 title "(223) Retrospective Study of Efficacy of Tizanidine in the Treatment of Chronic Pain" @default.
• W2161175331 doi "https://doi.org/10.1111/j.1526-4637.2001.pme01039-23.x" @default.
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