A DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL OF TIZANIDINE IN THE TREATMENT OF SPASTICITY CAUSED BY MULTIPLE-SCLEROSIS

Tizanidine was evaluated in a prospective, double-blind, randomized, p lacebo-controlled trial in 187 patients with MS. Taken orally for 9 we eks and preceded by a titration phase for a period of 3 weeks starting at 2 mg daily, tizanidine produced a significant reduction in spastic muscle tone compared with placebo treatment. Within the effective dos e range of 24 to 36 mg given daily in three doses, tizanidine achieved a 20% mean reduction in muscle tone. Approximately 75% of patients, w ith all degrees of spasticity, reported subjective improvement without an increase in muscle weakness, but there was no improvement in activ ities of daily:living depending on movement. Tizanidine achieved its m aximum effect on spasticity within 1 week of the start of treatment; t he benefit was maintained for at least 1 week after discontinuation of therapy. A variety of adverse events was recorded by patients taking tizanidine, but these were minor and reversible, and rarely limited tr eatment. Tizanidine is a well-tolerated and effective drug for symptom atic treatment of spasticity.