AAN Releases Guidelines on Treating Muscle Cramps

Although quinine derivatives are "likely effective" for treating muscle cramps, they should not be used routinely because of the potential for adverse events, according to new guidelines from the American Academy of Neurology (AAN).

The guidelines, published in Neurology, specify that quinines should be considered only when cramps are very severe, when other agents haven't helped, and when there can be ongoing monitoring for adverse effects (e.g., hematologic abnormalities, headache).

Among the AAN's other conclusions:

• Vitamin B complex and the calcium channel blocker diltiazem are "possibly effective" and may be considered as treatment.

• Studies of gabapentin (1 trial) and magnesium (2 trials) found no treatment benefit.

• There are no clinical trials evaluating baclofen, carbamazepine, or oxcarbazepine for managing muscle cramps, despite their frequent use for this indication.

• Data are insufficient to recommend for or against calf stretching.