Tizanidine

<p>From: Reviving the Broken Marionette: Treatments for CFS/ME and Fibromyalgia

Tizanidine is an antagonist of the imidazoline receptors and agonist of the alpha2 adrenergic receptors. It can be used to relieve and prevent muscle aches and cramps, muscle weakness and headaches. Tizanidine is particularly useful in treating the spasticity caused by multiple sclerosis, but it also helps many patients with CFS/ME and fibromyalgia. It reduces the levels of substance P in patients with FM while improving sleep, pain and functionality.58

A trial that compared low doses of tizanidine (1–2 mg, when normally 4 mg is used) to cyclobenzaprine in the treatment of fibromyalgia found that both drugs helped pain, stiffness, tiredness, anxiety and depression.59 Tizanidine improved the functionality of the patients even more than the more commonly used cyclobenzaprine. Another fibromyalgia study found tizanidine helpful for pain, sleep, fatigue and functionality.60 The number of tender points was also markedly reduced.

One study found tizanidine effective in the prevention of chronic daily headaches.61 It can also help with restless legs and neuropathic pain.62 Fibromyalgia specialist Richard Podell notes that tizanidine is useful not only in fibromyalgia, but also for menopausal hot flashes.63

Tizanidine has shown excellent efficacy in the treatment of myofascial pain.64 89% of the patients with MPS rated it as a good treatment.

In many patients tizanidine causes marked sedation and thus can only be used at bedtime. On the other hand, some paradoxically experience insomnia. Dizziness, dry mouth, stomach upset, orthostatic hypotension and muscle weakness are common side effects. Some patients who suffer from urinary frequency have reported that tizanidine has worsened the problem for up to a week or two after just one dose.

Tizanidine should not be combined with alcohol and concomitant use with blood pressure medications or fluvoxamine can cause a major drop in blood pressure. Oral contraceptives can significantly elevate blood levels of the drug. Some doctors recommend regular monitoring of liver enzymes if tizanidine is used in the long term.

Tizanidine is available in the United States, the United Kingdom, Canada and some other countries, but not in Australia. It is fairly expensive in continuous use.</p>