Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 6:10.1002/mus.26117.
doi: 10.1002/mus.26117. Online ahead of print.

Mexiletine for muscle cramps in amyotrophic lateral sclerosis: A randomized, double-blind crossover trial

Björn Oskarsson  1 , Dan Moore  2 , Tahseen Mozaffar  3 , John Ravits  4 , Martina Wiedau-Pazos  5 , Nicholas Parziale  5 , Nanette C Joyce  1 , Ross Mandeville  4 , Namita Goyal  3 , Merit E Cudkowicz  6 , Michael Weiss  7 , Robert G Miller  2 , Craig M McDonald  1
Affiliations

Mexiletine for muscle cramps in amyotrophic lateral sclerosis: A randomized, double-blind crossover trial

Björn Oskarsson et al. Muscle Nerve. .

Abstract

Introduction: 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, 2018.

Keywords: Muscle cramp; amyotrophic lateral sclerosis; fasciculations; neuromuscular; quality of life.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow Diagram of Patient Study Participation.
Figure 2
Figure 2
Number of Cramps by Patient and Treatment. Mean observed numbers of cramps over 24 hours during mexiletine and placebo treatments by patient.
Figure 3
Figure 3
Average Muscle Cramp Severity by Patient and Treatment. VAS indicates visual analog scale (range, 1-100).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Caress JB, Ciarlone SL, Sullivan EA, Griffin LP, Cartwright MS. Natural history of muscle cramps in amyotrophic lateral sclerosis. Muscle Nerve. 2016 Apr;53(4):513–7. - PMC - PubMed
    1. Stephens HE, Joyce NC, Oskarsson B. National study of muscle cramps in ALS in the USA. Amyotroph Lateral Scler Frontotemporal Degener. 2017 Feb;18(1-2):32–36. - PMC - PubMed
    1. Miller TM, Layzer RB. Muscle cramps. Muscle Nerve. 2005 Oct;32(4):431–42. - PubMed
    1. Matzner O, Devor M. Hyperexcitability at sites of nerve injury depends on voltage-sensitive Na+ channels. J Neurophysiol. 1994 Jul;72(1):349–59. - PubMed
    1. Tamura N, Kuwabara S, Misawa S, Kanai K, Nakata M, Sawai S, et al. Increased nodal persistent Na+ currents in human neuropathy and motor neuron disease estimated by latent addition. Clin Neurophysiol. 2006 Nov;117(11):2451–8. Epub 2006 Sep 25. - PubMed