Tizanidine有助於治療慢性經常性頭痛

治療偏頭風,偏頭痛或者緊張性頭痛,效果相同

  2002年4月23日─在美國科羅拉多州多佛舉行的美國神經病學研究院年會上報導的一次雙盲安慰劑對照試驗的結果顯示,採用治療包括偏頭風、偏頭痛以及緊張性頭痛在內的慢性經常性頭痛(Chronic daily headaches, CDH)有效。

  來自美國密歇根州安阿伯的Alvin E. Lake III及其同事寫道:「Tizanidine是一種alpha2-腎上腺素拮抗劑,它可以抑制脊髓與脊髓上水平(locus ceruleus)的去甲腎上腺素釋放,從而產生與內源性鴉片系統無關的抗疼痛效果。」

  進行為期4周的基線單盲鎮定劑治療的200位患者中,有124人符合CDH的診斷標準而隨機接受tizanidine或者鎮定劑治療。其中有92人接受了8周以上的治療,有85人完成此次為期12周的研究。

  接受治療的患者,各項頭痛舒緩的指標,包括頭痛指數,嚴重程度與總頭痛天數,頭痛峰強度與平均強度以及頭痛的持續時間,都好於採用鎮定劑治療者。偏頭風,偏頭痛與緊張性頭痛患者,治療結果一致。採用治療的患者所報導的不良反應多是輕至中度的,其中47%報導嗜睡,24%報導頭昏眼花,23%報導口臭,19%報導感覺無力。有13位患者因為不良反應而終止治療,有兩名患者發生LFTs升高,停止干預後恢復正常。

  作者寫道:「Tizanidine治療慢性經常性頭痛(偏頭風,偏頭痛與慢性緊張性頭痛),效果優於鎮定劑。」

  Elan藥業為此次研究提供贊助

Tizanidine Helpful in Chronic Daily Headache

Migraine, Migrainous, or Tension-Type Responded Equally

By Laurie Barclay, MD
WebMD Medical News

Reviewed by Gary D. Vogin, MD

Apr 23, 2002 -- Chronic daily headaches (CDH) of migraine, migrainous, or tension type responded to tizanidine (Zanaflex) in a double-blind, placebo-controlled trial reported at the American Academy of Neurology annual meeting in Denver, Colorado.

"Tizanidine is an alpha2-adrenergic agonist that inhibits the release of norepinephrine at both spinal and supraspinal levels (locus ceruleus), with antinociceptive effects that are independent of the endogenous opioid system," write Alvin E. Lake III, and colleagues from Ann Arbor, Michigan.

Of 200 patients completing a 4-week single-blind placebo baseline, 134 met criteria for CDH and were randomized to tizanidine or placebo, 92 completed at least 8 weeks of treatment, and 85 completed the 12-week study.

Reduction in headache measures in patients on tizanidine were all significant relative to placebo, including headache index, severe and total headache days, peak and average intensity, and headache duration. Outcome was similar in patients with migraine, migrainous, or tension-type headache. Adverse events reported by patients on tizandine were generally mild to moderate, and included somnolence in 47%, dizziness in 24%, dry mouth in 23%, and asthenia in 19%. Adverse events led to treatment discontinuation in 13 patients, and two patients had elevated LFTs that returned to normal without intervention.

"Tizanidine showed superior efficacy over placebo for chronic daily headache (migraine, migrainous, and chronic tension-type headache)," the authors write.

Elan Pharmaceuticals supported this study.

© 2002 WebMD Inc. All rights reserved.

    
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