Novel Use of Clonidine Patch to Treat Tizanidine Withdrawal.
Publication/Presentation Date
2-1-2024
Abstract
Tizanidine is commonly prescribed for muscle spasticity and pain. Yet, withdrawal is rarely reported. Tizanidine stimulates presynaptic α-2 adrenergic and imidazoline receptors decreasing norepinephrine release. Abrupt cessation can cause withdrawal. Current treatment strategies include tapering oral tizanidine or substituting oral clonidine. A 52-year-old male with a history of hypertension, diabetes, coronary artery disease, and chronic back pain presented with altered mental status, agitation, hypertensive emergency (blood pressure: 250/145 mmHg), and tachycardia. The patient had been prescribed tizanidine for chronic back pain for two years and had recently run out with suspicion of misuse. Tizanidine withdrawal was diagnosed, and he improved with 0.1 mg oral clonidine three times daily weaned over five days while hospitalized. One month later the patient was admitted for persistent hypertension, tachycardia, diaphoresis, and anxiety. Alpha-2 agonist withdrawal was again diagnosed. Utilizing a clonidine patch taper may offer a reasonable approach in patients with tizanidine withdrawal.
Volume
16
Issue
2
First Page
54831
Last Page
54831
ISSN
2168-8184
Published In/Presented At
Deutsch, A. B., Hartman, C. F., Flaherty, C. P., Ebeling-Koning, N. E., Beauchamp, G. A., & Katz, K. D. (2024). Novel Use of Clonidine Patch to Treat Tizanidine Withdrawal. Cureus, 16(2), e54831. https://doi.org/10.7759/cureus.54831
Disciplines
Medicine and Health Sciences
PubMedID
38529428
Department(s)
Department of Emergency Medicine, Department of Emergency Medicine Faculty, Department of Emergency Medicine Residents, Toxicology Division, Fellows and Residents
Document Type
Article