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Mexiletine for muscle cramps in amyotrophic lateral sclerosis: A randomized, double‐blind crossover trial
Author(s) -
Oskarsson Björn,
Moore Dan,
Mozaffar Tahseen,
Ravits John,
WiedauPazos Martina,
Parziale Nicholas,
Joyce Nanette C.,
Mandeville Ross,
Goyal Namita,
Cudkowicz Merit E.,
Weiss Michael,
Miller Robert G.,
McDonald Craig M.
Publication year - 2018
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26117
Subject(s) - medicine , muscle cramp , mexiletine , fasciculation , crossover study , placebo , amyotrophic lateral sclerosis , anesthesia , adverse effect , physical therapy , alternative medicine , disease , pathology
: More than 90% of amyotrophic lateral sclerosis (ALS) patients have muscle cramps, but evidence‐based treatments have not been available. Methods : A multicenter, double‐blind, placebo‐controlled crossover trial of mexiletine 150 mg twice daily was conducted in ALS patients requesting treatment of symptomatic muscle cramps. Results : Muscle cramp frequency was reduced in 18 of 20 patients; 13 reductions were attributed to treatment ( P < 0.05). The average reduction, based on t tests, was 1.8 cramps per day (a reduction from 5.3 with placebo to 3.5 with mexiletine). The estimated reduction of cramp severity was 15 units on a 100‐unit scale ( P = 0.01) from a baseline average of 46. No effect on fasciculations was noted. One patient discontinued the study because of dizziness, and another patient discontinued the study to start open‐label mexiletine therapy. No serious adverse event occurred. Discussion : Mexiletine is a well tolerated and effective medication for controlling the symptom of muscle cramps in ALS. Muscle Nerve 58 : 42–48, 2018