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

Bjorn E Oskarsson, Dan Moore, Tahseen Mozaffar, John Ravits, Martina Wiedau-Pazos, Nicholas Parziale, Nanette Joyce, Ross Mandeville, Namita Goyal, Merit E. Cudkowicz, Michael Weiss, Robert G. Miller, Craig M McDonald

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 150mg 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.

Original languageEnglish (US)
JournalMuscle and Nerve
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Mexiletine
Muscle Cramp
Amyotrophic Lateral Sclerosis
Cross-Over Studies
Placebos
Fasciculation
Dizziness
Therapeutics

Keywords

  • Amyotrophic lateral sclerosis
  • Fasciculations
  • Muscle cramp
  • Neuromuscular
  • Quality of life

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

Cite this

Mexiletine for muscle cramps in amyotrophic lateral sclerosis : A randomized, double-blind crossover trial. / Oskarsson, Bjorn E; Moore, Dan; Mozaffar, Tahseen; Ravits, John; Wiedau-Pazos, Martina; Parziale, Nicholas; Joyce, Nanette; Mandeville, Ross; Goyal, Namita; Cudkowicz, Merit E.; Weiss, Michael; Miller, Robert G.; McDonald, Craig M.

In: Muscle and Nerve, 01.01.2018.

Research output: Contribution to journalArticle

Oskarsson, BE, Moore, D, Mozaffar, T, Ravits, J, Wiedau-Pazos, M, Parziale, N, Joyce, N, Mandeville, R, Goyal, N, Cudkowicz, ME, Weiss, M, Miller, RG & McDonald, CM 2018, 'Mexiletine for muscle cramps in amyotrophic lateral sclerosis: A randomized, double-blind crossover trial', Muscle and Nerve. https://doi.org/10.1002/mus.26117
Oskarsson, Bjorn E ; Moore, Dan ; Mozaffar, Tahseen ; Ravits, John ; Wiedau-Pazos, Martina ; Parziale, Nicholas ; Joyce, Nanette ; Mandeville, Ross ; Goyal, Namita ; Cudkowicz, Merit E. ; Weiss, Michael ; Miller, Robert G. ; McDonald, Craig M. / Mexiletine for muscle cramps in amyotrophic lateral sclerosis : A randomized, double-blind crossover trial. In: Muscle and Nerve. 2018.
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