# A Case of Tizanidine Withdrawal and Road to Recovery

## TL;DR

A 68-year-old woman experienced tizanidine withdrawal symptoms and was successfully managed with phenobarbital and transitioned to methocarbamol.

## Contribution

A unique approach using phenobarbital to manage tizanidine withdrawal symptoms is presented.

## Key findings

- The patient experienced hypertension and tachycardia during tizanidine withdrawal.
- Phenobarbital helped resolve hemodynamic instability and pain during withdrawal.
- Transitioning to methocarbamol provided successful long-term pain management.

## Abstract

This case report highlights the complexities of tizanidine withdrawal in a 68-year-old woman with chronic pain. Tizanidine, a widely used imidazole-derived muscle relaxant, poses challenges due to the absence of standardized withdrawal protocols. The patient's presentation included hypertension and tachycardia following a gradual reduction in her outpatient tizanidine dose.

During the de-escalation of tizanidine, the patient experienced withdrawal symptoms, including severe body aches, hypertension, and tachycardia. Management during withdrawal involved a unique approach using a one-time dose of phenobarbital, a measure that allowed the resolution of hemodynamic instability and pain with complete discontinuation of tizanidine. The ultimate decision to transition the patient to methocarbamol and stop taking tizanidine for pain control highlights the importance of individualized care. The patient has responded to this therapy upon follow-up.