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. 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.

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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

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