Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis

P. W. Nance, William Sheremata, S. G. Lynch, T. Vollmer, S. Hudson, G. S. Francis, P. O'Connor, J. A. Cohen, R. T. Schapiro, R. Wliitham, M. K. Mass, J. W. Lindsey, K. Shelknberger

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background: Spasticity is a serious problem in multiple sclerosis (MS) and many patients do not achieve a satisfactory response to currently available oral antispasticity drugs. Tizanidine hydrochloride, an α2- noradrenergic agonist, has been shown to have an antispasticity effect in single center trials of patients with MS. Objective: To compare plasma concentrations of tizanidine with objective measures of muscle tone in patients with MS with moderate to severe spasticity. Setting: Ten centers, all tertiary referral centers for the specialized treatment of patients with MS, in the United States and Canada. Design: A randomized, double-blind, placebo-controlled, dose-response study of tizanidine hydrochloride (8 or 16 mg). Patients: One hundred forty-two patients with spastic MS who were not taking any interfering medication, such as an antispasticity drug or other α-noradrenergic agonist, entered the trial. Results: Tizanidine treatment reduced muscle tone significantly, as shown by improved Ashworth scores and increased knee swing amplitude recorded by the pendulum test, both of which correlated significantly with plasma concentration. Placebo had no significant effect on muscle tone. Dizziness, drowsiness, dry mouth, and fatigue were reported most often in the group treated with tizanidine at peak plasma concentration. Conclusions: Tizanidine reduces spasticity in MS, and both therapeutic effects and side effects are related to the plasma drug levels.

Original languageEnglish
Pages (from-to)731-736
Number of pages6
JournalArchives of Neurology
Volume54
Issue number6
StatePublished - Jun 30 1997
Externally publishedYes

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Multiple Sclerosis
Muscles
Placebos
Pharmaceutical Preparations
Muscle Spasticity
Sleep Stages
Dizziness
Therapeutic Uses
Tertiary Care Centers
Canada
Fatigue
Mouth
tizanidine
Plasma
Knee
Therapeutics
Drugs
Placebo

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Nance, P. W., Sheremata, W., Lynch, S. G., Vollmer, T., Hudson, S., Francis, G. S., ... Shelknberger, K. (1997). Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis. Archives of Neurology, 54(6), 731-736.

Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis. / Nance, P. W.; Sheremata, William; Lynch, S. G.; Vollmer, T.; Hudson, S.; Francis, G. S.; O'Connor, P.; Cohen, J. A.; Schapiro, R. T.; Wliitham, R.; Mass, M. K.; Lindsey, J. W.; Shelknberger, K.

In: Archives of Neurology, Vol. 54, No. 6, 30.06.1997, p. 731-736.

Research output: Contribution to journalArticle

Nance, PW, Sheremata, W, Lynch, SG, Vollmer, T, Hudson, S, Francis, GS, O'Connor, P, Cohen, JA, Schapiro, RT, Wliitham, R, Mass, MK, Lindsey, JW & Shelknberger, K 1997, 'Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis', Archives of Neurology, vol. 54, no. 6, pp. 731-736.
Nance PW, Sheremata W, Lynch SG, Vollmer T, Hudson S, Francis GS et al. Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis. Archives of Neurology. 1997 Jun 30;54(6):731-736.
Nance, P. W. ; Sheremata, William ; Lynch, S. G. ; Vollmer, T. ; Hudson, S. ; Francis, G. S. ; O'Connor, P. ; Cohen, J. A. ; Schapiro, R. T. ; Wliitham, R. ; Mass, M. K. ; Lindsey, J. W. ; Shelknberger, K. / Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis. In: Archives of Neurology. 1997 ; Vol. 54, No. 6. pp. 731-736.
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