Effectiveness of Tizanidine in Neuropathic Pain: An Open-Label Study

Semenchuk, Marilyn R.; Sherman, Scott J.

doi:10.1054/jpai.2000.9435

Cited by 52 publications

(14 citation statements)

References 27 publications

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“…124 In fact epidural administration of tizanidine (5-500 mg) produced a dose-dependent antinociceptive effect (IC 50 ¼ 48.2 nM) which is well correlated with its binding affinity to spinal a 2 -adrenoceptor (IC 50 ¼ 96.8 nM). Studies reporting about the effectiveness of tizanidine in neuropatic pain in animal models [125][126][127] and with patients in openlabel trials 128 are in agreement, asserting that tizanidine may be useful in the treatment of this pathology. In a study performed by Hord and coworkers 125 in rats with surgically induced neuropathic pain, it was displayed that tizanidine is able to reduce sensitivity to heat, measured by withdrawal latency, without sedation as secondary effect.…”

Section: Tizanidinementioning

confidence: 77%

α₂‐Agonists as analgesic agents

Giovannoni¹,

Ghelardini²,

Vergelli³

et al. 2008

Medicinal Research Reviews

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It is well known that norepinephrine is involved in the control of pain by modulating pain-related responses through various pathways. alpha(2)-Adrenergic agonists have a well-established analgesic profile and, in the recent years, have found a wider application, in particular as adjunct to anesthetics and analgesics in perioperative settings. This review analyzes the alpha(2)-agonists currently in clinical use, starting from the prototype Clonidine, as well as the most promising and studied molecules. In addition, an overview of the imidazoles, imidazolines, and hydroxyethyl-thioureas derivatives published in both the open and patented literature is presented, providing chemical description and pharmacological data. Finally, the most commonly alpha(2)-agonists used in veterinary medicine are described.

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Section: Tizanidinementioning

confidence: 77%

α₂‐Agonists as analgesic agents

Giovannoni¹,

Ghelardini²,

Vergelli³

et al. 2008

Medicinal Research Reviews

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“…[31] Tizanidine has a narrow therapeutic range and the concentration-effect relationship is somewhat steep with respect to its effects on BP and psychomotor function. [49] There is no specific information in the prescribing information concerning the tolerability of tizanidine in pediatric patients. In adults, tizanidine has been investigated and used offlabel for the treatment of various conditions, such as chronic daily headache, [41][42][43] acute or chronic back pain, [44][45][46] myofascial pain, [47,48] and neuropathic pain.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Safety of Tizanidine

Henney

Chez

2009

Pediatric Drugs

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The overall safety of tizanidine in the pediatric group appeared good; however, the adverse event profile differed from that in adults. This difference most likely reflects the off-label use of tizanidine as adjunctive treatment for attention disorders and autism. The frequency and nature of adverse events in adults were consistent with the tizanidine prescribing information as reported for its approved indication, i.e. management of spasticity.

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“…These agents include cannabinoid receptor antagonists, a2-adrenergic agonists, NMDA receptor antagonists, lysine B antagonists, NR2B-selective agents, glycine antagonists, nicotinic receptor agonists, NK1 receptor antagonists, bradykinin B1 receptor antagonists, vanilloid VR1 receptor antagonists, cholocystokinin antagonists, oral TNF antagonists, interleukin antagonists, neuroimmunomodulators and many others. 85,101,102 Completely new drug classes, which derived from exotic animal sources like conotoxins from a marine snail family and epitadine from a species of frog, seem to modulate neuronal transmission in pain pathways. 103 Innovative pathways in therapeutic aspects include development of gammaaminobutyric acid (GABA) and serotonin secreting neuron grafts for spinal cord injury pain and the use of herpes simplex or HIV-like viruses as drug or gene vectors to transport therapeutic agents into the dorsal root ganglion or dorsal horn.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Pharmacological Treatment of Neuropathic Cancer Pain: A Comprehensive Review of the Current Literature

et al. 2011

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Neuropathic cancer pain (NCP), commonly encountered in clinical practice, may be cancer-related, namely resulting from nervous system tumor invasion, surgical nerve damage during tumor removal, radiation-induced nerve damage and chemotherapy-related neuropathy, or may be of benign origin, unrelated to cancer. A neuropathic component is evident in about 1/3 of cancer pain cases.Although from a pathophysiological perspective NCP may differ from chronic neuropathic pain (NP), such as noncancer-related pain, clinical practice, and limited publications have shown that these two pain entities may share some treatment modalities. For example, co-analgesics have been well integrated into cancer pain-management strategies and are often used as First-Line options for the treatment of NCP. These drugs, including antidepressants and anticonvulsants, are recommended by evidence-based guidelines, whereas, others such as lidocaine patch 5%, are supported by randomized, controlled, clinical data and are included in guidelines for restricted conditions treatment. The vast majority of these drugs have already been proven useful in the management of benign NP syndromes. Treatment decisions for patients with NP can be difficult. The intrinsic difficulties in performing randomized controlled trials in cancer pain have traditionally justified the acceptance of drugs already known to be effective in benign NP for the management of malignant NP, despite the lack of relevant high quality data. Interest in NCP mechanisms and pharmacotherapy has increased, resulting in significant mechanism-based treatment advances for the future. In this comprehensive review, we present the latest knowledge regarding NCP pharmacological management. n INTRODUCTIONFollowing EFIC's (European Federation of IASP Chapters) declaration in 2001, pain is not a symptom but a disease in its own right, necessitating appropriate treatment. The word pain usually refers to a discrete sensory experience, triggered by an identifiable set of ''painful'' stimuli, acting on a unique or stable ''pain'' pathway and eliciting an invariant sensation. However, pain, and particularly neuropathic pain (NP) can also exist as a diverse group of complex phenomena of unpleasant and distressing nature. NP encloses numerous complicated neurobiologic constituents and reflects potentially dynamic mechanisms, interacting at multiple neuraxial sites. 1Modern neurobiological techniques have led to tremendous progress in the exploration of pain pathogenetic mechanisms. [2][3][4] Research indicates that pain can be produced in multiple ways, at different locations, co-existing between and across various pathological conditions. 5,6 Novel therapeutic targets have been discovered and are used by the pharmaceutical industry for the construction of highly specific molecules, acting as potential innovative analgesics. Recent targets' application, specific to precise NP mechanisms, will very soon enable treatment to be focused at particular mechanisms, introducing a mechanism-based therap...

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Effectiveness of Tizanidine in Neuropathic Pain: An Open-Label Study

Cited by 52 publications

References 27 publications

α₂‐Agonists as analgesic agents

α₂‐Agonists as analgesic agents

Pediatric Safety of Tizanidine

Pharmacological Treatment of Neuropathic Cancer Pain: A Comprehensive Review of the Current Literature

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Effectiveness of Tizanidine in Neuropathic Pain: An Open-Label Study

Cited by 52 publications

References 27 publications

α2‐Agonists as analgesic agents

α2‐Agonists as analgesic agents

Pediatric Safety of Tizanidine

Pharmacological Treatment of Neuropathic Cancer Pain: A Comprehensive Review of the Current Literature

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Product

Resources

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α₂‐Agonists as analgesic agents

α₂‐Agonists as analgesic agents