Randomized placebo-controlled study of baclofen in the treatment of muscle cramps in patients with liver cirrhosis

Abstract

Baclofen was well tolerated, safe, and effective in the treatment of muscle cramps in patients with liver cirrhosis.

Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis

“…Muscle cramps affect many aspects of quality of life in cirrhotic patients including sleep, physical functioning and mobility, general health, mental health, energy levels, and social isolation with no available highly effective treatment. [1][2][3][4] However, despite the obvious association of muscle cramps with liver disease, there is a paucity of information regarding pathogenesis and treatment in these patients. 5 Until now the mechanism of muscle cramp occurrence in cirrhosis has remained unclear.…”

“…Several agents including vitamin E, human albumin, zinc, taurine, eperisone hydrochloride, and branched-chain amino acids targeting the postulated mechanisms have been used to treat these cramps and have shown some benefit in small uncontrolled studies, although large randomized controlled trials are lacking. 2 Orphenadrine is an anti-cholinergic drug that has been used to treat painful muscle spasms due to its potent central nervous system (CNS) and peripheral actions. 7 The combination of anticholinergic effects and CNS penetration make orphenadrine useful for pain of all etiologies, including pain from radiculopathy, muscles, and headaches.…”

Pharmacological Therapy of Ascites

“…Other complications of diuretic therapy include hepatic encephalopathy, electrolyte disorders, gynaecomastia, and muscle cramps [13, [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. If cramps are severe, diuretic dose should be decreased or stopped, and albumin infusion [37], baclofen, and l-carnitine may relieve symptoms [23][24][25][26][27]37].…”

Randomised clinical trial: oral taurine supplementation versus placebo reduces muscle cramps in patients with chronic liver disease

“…Further studies have investigated specific treatments for muscle cramps in patients with cirrhosis. They include the antispasmodic agent, baclofen, an anticholinergic drug, orphenadrine and the amino acid, carnitine . Baclofen was safe and well tolerated over the 3‐month intervention period with mild side effects of dizziness, nausea, and constipation reported which were alleviated by gradual dose titration .…”

“…They include the antispasmodic agent, baclofen, an anticholinergic drug, orphenadrine and the amino acid, carnitine . Baclofen was safe and well tolerated over the 3‐month intervention period with mild side effects of dizziness, nausea, and constipation reported which were alleviated by gradual dose titration . Orphenadrine was associated with a reduction in frequency, duration, and intensity of muscle cramps during treatment with minimal side effects .…”