Mexiletine for muscle cramps in amyotrophic lateral sclerosis: A randomized, double-blind crossover trial
- Author(s): Oskarsson, Björn
- Moore, Dan
- Mozaffar, Tahseen
- Ravits, John
- Wiedau-Pazos, Martina
- Parziale, Nicholas
- Joyce, Nanette C
- Mandeville, Ross
- Goyal, Namita
- Cudkowicz, Merit E
- Weiss, Michael
- Miller, Robert G
- McDonald, Craig M
- et al.
Published Web Locationhttps://doi.org/10.1002/mus.26117
More than 90% of amyotrophic lateral sclerosis (ALS) patients have muscle cramps, but evidence-based treatments have not been available.
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.
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.
Mexiletine is a well tolerated and effective medication for controlling the symptom of muscle cramps in ALS.
Many UC-authored scholarly publications are freely available on this site because of the UC Academic Senate's Open Access Policy. Let us know how this access is important for you.