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DG DISPATCH - STROKE: Zanaflex Reduces Spasticity Resulting From Stroke By Cameron Johnston Special to DG News NEW ORLEANS, LA -- February 14, 2000 -- Zanaflex (tizanidine hydrochloride), which is currently used in the treatment of multiple sclerosis, has been found useful in treating patients who develop spastic limbs as a result of an acute cerebral infarct. The findings from a small study were presented at the American Stroke Association's 25th International Stroke Conference, being held Feb. 10-12 in New Orleans, LA. The American Stroke Association is a division of the American Heart Association. Approximately one-third of all stroke patients experience some degree of spasticity, invariably on one side rather than on both sides of the body, and frequently in an arm more so than in a leg, explained Dr. David Gelber, an associate professor of neurology at the Southern Illinois University School of Medicine, in Springfield. Forty-seven patients who had had strokes were treated with Zanaflex by Dr. Gelber and colleagues, at a dose beginning at 2 mg/day, which was then titrated upward by an additional 2 mg/day until the patient reached a final daily dose of 20 mg/day at the end of a 16-week period. Seventeen of the patients reached doses to a maximum of 36 mg/day. The degree of spasticity the patients experienced was graded on a Modified Ashworh Scale, which rates the spasticity subjectively: 0 = no stiffness, and 4 = total rigidity in the affected limb. Four muscles in each arm were evaluated, so in the most extreme cases, a patient could rate 16 points per limb. In this study, the mean change in Ashworth scores for all patients was 2.80 after 16 weeks of therapy. Sixty-four per cent of the patients experienced at least some improvement, while 31 percent experienced an improvement of at least four points. The effects of the drug are short-lived; two weeks after discontinuing the drug, the mean score change had fallen to 1.59. While Zanaflex has been used for some time in patients with multiple sclerosis, Dr. Gelber said what is noteworthy here, is that the average age of MS patients who use the drug is between 30 to 35, whereas the average age of the patients in this study was just over 60. Dr. Gelber added that there is no reason why some patients could not receive the drug within a week of having a stroke although, in this study, the mean time since the stroke was more than 29 months for each patient. This was done, he said, to ensure that the patients were past the point of spontaneous improvement. Also, he said, by the 29-month mark, the patients would probably have achieved whatever improvement from physiotherapy and other forms of rehabilitation that they were likely to see. During the course of the study, the patients were not allowed to take any other form of medication that might affect their spasticity or that might potentiate the effects of Zanaflex. Related Link: Zanaflex (tizanidine hydrochloride). E-mail this page to a friend or colleague! To print, use this version