{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:44:06Z","timestamp":1788929046859,"version":"build-2803163510"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2018,1,1]]},"abstract":"<jats:p>\n                    Most drugs that act on the central nervous system (CNS) require dose titration to avoid withdrawal syndrome. Tizanidine withdrawal syndrome is caused by adrenergic discharge due to its \u03b1\n                    <jats:sub>2<\/jats:sub>\n                    -agonist mechanism and is characterized by hypertension, reflex tachycardia, hypertonicity, and anxiety. Although tizanidine withdrawal syndrome is mentioned as a potential side effect of cessation, it is not common and there have been few reports. We present the case of a 31-year-old woman with tizanidine withdrawal syndrome after discontinuing medication prescribed for a muscle contracture (tizanidine). She showed high adrenergic activity with nausea, vomiting, generalized tremor, dysthermia, hypertension, and tachycardia. Symptoms were reversed and successful reweaning was achieved by restarting tizanidine followed by slow downward titration. Withdrawal syndrome should be considered when drugs targeting the CNS are suddenly stopped. Weaning regimens should be closely monitored for acute withdrawal reactions.\n                  <\/jats:p>","DOI":"10.1177\/1179547618758022","type":"journal-article","created":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T01:50:03Z","timestamp":1518573003000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Management of Tizanidine Withdrawal Syndrome: A Case Report"],"prefix":"10.1177","volume":"11","author":[{"given":"A","family":"Su\u00e1rez-Lled\u00f3","sequence":"first","affiliation":[{"name":"Pharmacy Department, IDIBELL and Hospital Universitario de Bellvitge, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Padull\u00e9s","sequence":"additional","affiliation":[{"name":"Pharmacy Department, IDIBELL and Hospital Universitario de Bellvitge, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Lozano","sequence":"additional","affiliation":[{"name":"Pharmacy Department, IDIBELL and Hospital Universitario de Bellvitge, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Cobo-Sacrist\u00e1n","sequence":"additional","affiliation":[{"name":"Pharmacy Department, IDIBELL and Hospital Universitario de Bellvitge, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Colls","sequence":"additional","affiliation":[{"name":"Pharmacy Department, IDIBELL and Hospital Universitario de Bellvitge, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"J\u00f3dar","sequence":"additional","affiliation":[{"name":"Pharmacy Department, IDIBELL and Hospital Universitario de Bellvitge, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,2,13]]},"reference":[{"key":"bibr1-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1254\/jphs.FP0050520"},{"key":"bibr2-1179547618758022","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1055\/s-0034-1399167","volume":"83","author":"M\u00f6rkl S","year":"2015","journal-title":"Fortschr Neurol Psychiatr"},{"key":"bibr3-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2010.10.003"},{"key":"bibr4-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.9.12.2209"},{"key":"bibr5-1179547618758022","unstructured":"Tizanidine Hydrochloride (Zanaflex\n                      \u00ae\n                      ). Drug label FDA approved labeling dated, October 4; 2013. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2013\/021447s011_020397s026lbl.pdf."},{"key":"bibr6-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.57.11.1355"},{"key":"bibr7-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2007.01660.x"},{"key":"bibr8-1179547618758022","first-page":"1","volume":"2","author":"Shaw M","year":"2015","journal-title":"BMJ Case Rep"},{"key":"bibr9-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1177\/2045125315612334"},{"key":"bibr10-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-013-0079-5"},{"key":"bibr11-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.46.6.503"},{"key":"bibr12-1179547618758022","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.189.3.213"},{"key":"bibr13-1179547618758022","first-page":"1","volume":"22","author":"Azparren A","year":"2014","journal-title":"Drug Ther Bull Navarre"},{"key":"bibr14-1179547618758022","first-page":"27","volume":"67","author":"Schatzberg AF","year":"2006","journal-title":"J Clin Psychiatry"}],"container-title":["Clinical Medicine Insights: Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1179547618758022","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1179547618758022","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1179547618758022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:13:33Z","timestamp":1777454013000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1179547618758022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,1]]},"references-count":14,"alternative-id":["10.1177\/1179547618758022"],"URL":"https:\/\/doi.org\/10.1177\/1179547618758022","relation":{},"ISSN":["1179-5476","1179-5476"],"issn-type":[{"value":"1179-5476","type":"print"},{"value":"1179-5476","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,1]]},"article-number":"1179547618758022"}}