Tizanidine withdrawal symptoms in stress cardiomyopathy

• Published in: Fortschritte der Neurologie-Psychiatrie Vol. 83; no. 3; p. 170
• Main Authors: Mörkl, S, Bengesser, S A, Schöggl, H, Bayer, D, Kapfhammer, H P
• Format: Journal Article
• Language: German
• Published: Germany 01.03.2015
• Subjects: Adrenergic alpha-2 Receptor Agonists - adverse effects; Adrenergic alpha-2 Receptor Agonists - therapeutic use; Clonidine - adverse effects; Clonidine - analogs & derivatives; Clonidine - therapeutic use; Electrocardiography; Humans; Male; Middle Aged; Muscle Relaxants, Central - adverse effects; Muscle Relaxants, Central - therapeutic use; Substance Withdrawal Syndrome - physiopathology; Substance Withdrawal Syndrome - psychology; Takotsubo Cardiomyopathy - complications; Takotsubo Cardiomyopathy - drug therapy
• ISSN: 1439-3522
• DOI: 10.1055/s-0034-1399167

An acute discontinuation of tizanidine, an alpha-2-agonistic muscle relaxant, is associated with reflex tachycardia, hypertension, tremor, hypertonicity and anxiety. We describe a 53-year-old patient with broken-heart syndrome, who developed serious tizanidine withdrawal symptoms after high-dosed long-term treatment within the framework of stress cardiomyopathy. Central muscle relaxants like tizanidine might have an impact on the development of delirium. Tizanidine withdrawal should be considered in patients who manifest signs and symptoms of withdrawal from medications. The drug should be gradually reduced in dosage under observation by a psychiatrist. When prescribing tizanidine, the possible pharmacological side effects and interactions should be taken into careful account.