Mexiletine usage in a chronic pain clinic
A. Romman, MD; J. Salama-Hanna, MD; S. Dwivedi, DO
Department of Anesthesiology and Pain Medicine, Henry Ford Health System
We reviewed patient records that were prescribed mexiletine in a multi-physician, three location chronic pain practice. All patients who were written for a mexiletine prescription during the period from August 2015 - August 2016 were queried. Each patient’s chart was then reviewed to collect demographic data, diagnosis, QTc changes, reason for stoppage, and length of use. Patients examined for length of use excluded those who never started it, or those who were already on mexiletine at the start of the study period. Chart review occurred in August 2017 to ensure at least one year had passed for all queried patients.
There were 74 patients identified in our the chronic pain management clinics as receiving a mexiletine prescription over the one-year time period. The demographics of these patients are shown in Table 1. Thirteen of these patients never actually started the mexiletine. Neuropathic pain was the most common diagnosis (64%). QTc change on EKG did not appear clinically significant with an average change of -0.1ms and median change of 1.5ms. Figure 1 shows the Kaplan Meier curve for length of treatment of mexiletine. At six months, approximately 30% of patients remained on therapy, and 28% at one year.