A Case of Tizanidine Withdrawal Syndrome: Features and Management in the Emergency Department

Abstract

Anxiety medications, muscle relaxants, and sleeping pills have the potential to cause complications, side effects, and withdrawal symptoms if not prescribed and managed appropriately. Tizanidine, a short-acting muscle relaxant, acts on central alpha-2-adrenergic receptors to reduce spasticity. However, abrupt withdrawal of tizanidine can lead to symptoms such as hypertension, reflex tachycardia, hypertonicity, and anxiety as a result of high adrenergic activity. Few cases have been reported on tizanidine withdrawal syndrome. Here, we are presenting a rare occurrence of tizanidine withdrawal syndrome in a patient presenting to the emergency department with vomiting, generalized tremor, dysthermia, hypertension, and tachycardia. We discuss the management approach used to stabilize the patient and successfully control the symptoms by reintroducing a low therapeutic dose of tizanidine.