Cyclobenzaprine is a prescription muscle relaxant that is indicated for the treatment of pain or injury in the musculoskeletal system. This medication is typically used as part of a treatment program that also includes physical therapy and rest. Cyclobenzaprine may also be used off–label for conditions like fibromyalgia.
In terms of its classification, the formulation of cyclobenzaprine is chemically close to the category of antidepressants known as tricyclic antidepressants. This medication works by stopping the passage of pain signals from nerves to the brain (i.e., it affects the central nervous system). As Mayo Clinic notes, cyclobenzaprine is the generic drug in the following branded drugs:
- Flexeril (first approved in 1977)
- FusePaq Tabradol
While cyclobenzaprine has noted therapeutic benefits, one downside to taking this drug is that it is potentially addiction-forming. As Everyday Health discusses, cyclobenzaprine confers a high when abused. The following are some facts in brief about cyclobenzaprine abuse:
- Anecdotal reports indicate that cyclobenzaprine can induce a narcotic-like high, with a significant feeling of drowsiness.
- At high doses, cyclobenzaprine can cause physical and cognitive impairments.
- At especially elevated doses, cyclobenzaprine can cause a condition known as ataxia, a neurologic condition that involves a person losing the ability to control muscle movements.
- Cyclobenzaprine abuse was brought to national attention after the death of world-famous singer Whitney Houston. Per the Los Angeles coroner’s report, Houston had five drugs in her body at the time of death, including cyclobenzaprine.
Individuals who are prescribed cyclobenzaprine as part of a medically supervised treatment plan face a low risk of developing an addiction to this drug, provided they follow the doctor’s orders for use. However, cyclobenzaprine abuse can occur in a prescribed user even if the person does not initially have an abuse intention. Sometimes, individuals will take more a drug, such as cyclobenzaprine, thinking that it will increase relief from the symptoms that it is prescribed to help. However, what really happens is that a new host of side effects emerge, including psychoactive ones, such as feeling high. Some individuals may experience a cyclobenzaprine high, recognize the danger, and work with their doctor to ensure they do not take too much of this drug ever again. In other instances, a person may be drawn to the cyclobenzaprine high and start abusing the drug for this reason. Recreational users (those who do not have a medical need for cyclobenzaprine) face a high risk of addiction, as an abuse intention exists from the start and there is no medical oversight of the use.
Cyclobenzaprine Use Disorder
While the US is not facing a muscle relaxant abuse epidemic, at the individual level, an addiction to this type of drug can harm one’s health, mind, spirit, family life, work, school, and social life. For this reason, it is helpful to understand the symptoms and signs of cyclobenzaprine abuse.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) outlines criteria that a clinician can use to guide the process of diagnosing a substance use disorder, including disorders in which cyclobenzaprine is the drug of abuse. The following is a list of the criteria, as applied to cyclobenzaprine abuse:
- Consuming higher doses of cyclobenzaprine than prescribed
- Having a desire to stop using cyclobenzaprine, or to reduce the familiar amount, but not being able to do so
- Spending a disproportionately large amount of time obtaining cyclobenzaprine, taking it, or recovering from its side effects
- Experiencing cravings to use cyclobenzaprine
- Due to the cyclobenzaprine use, not being able to fulfill obligations at work, home, school, or as part of any social activities, such as membership on a sports team or club
- Continuing to use cyclobenzaprine even though doing so is causing problems in relationships
- Due to the cyclobenzaprine abuse, not engaging in important work, family, or social events and activities
- Continuing to use cyclobenzaprine even though doing so is putting one in dangerous situations, such as driving while high
- Ongoing use of cyclobenzaprine despite the fact that it is causing or exacerbating a psychological or physical problem
- Showing tolerance (This natural biological process is part of physical dependence. Due to building a tolerance to cyclobenzaprine, a person will need more of this drug over time in order to get the desired psychoactive effects, such as a high.)
- Going into withdrawal if use of cyclobenzaprine is stopped
It is helpful to have a basic understanding of the physical, psychological, and behavioral components of a cyclobenzaprine use disorder to recognize them in oneself or another person. Denial of substance abuse is often a component of addiction. For this reason, self-education is critical for a person who is concerned about their use, or another’s use, of cyclobenzaprine.
Physical and Psychological Symptoms of Cyclobenzaprine Abuse
Taking a high dose of cyclobenzaprine can lead to the onset of more severe side effects compared to regular use of this medication in accordance with a doctor’s instructions. The following are some of the known serious side effects:
- Severe drowsiness
- Rapid heart rate
- Fluttering in chest
- Pounding heartbeat
- Poor coordination
- Overacting reflexes
Common side effects may include but are not limited to:
- Trouble concentrating
- Blurred vision
- Changes in taste
- Dry mouth
- Dry throat
- Upset stomach
As noted earlier, cyclobenzaprine is similar in chemical structure to antidepressants known as tricyclic antidepressants. For this reason, withdrawal from cyclobenzaprine is going to be similar to that of tricyclic antidepressants. Withdrawal symptoms may include:
- Muscle aches
- Trouble sleeping
- Flu symptoms
From a neurobiological perspective, a main concern about cyclobenzaprine abuse is that this drug, like all others, can act unpredictably at high doses. The severity of side effects depends on a range of factors, including whether alcohol or any other drugs have been consumed, physiological factors, and the volume and frequency of the abuse. For this reason, the earlier intervention occurs, the better.
Treatment for Cyclobenzaprine Abuse
Treatment for cyclobenzaprine abuse is divided into two main approaches: medical detox and comprehensive therapy for addiction. Medical detox involves supervision and assistance from a medically trained staff members. Professionals safely manage the withdrawal process to ensure that severe symptoms do not emerge. Medical detox can also serve as a relapse prevention tool should cravings or uncomfortable symptoms appear. There is a general advisement that anyone who is ready to stop taking cyclobenzaprine do so within a medical detox program.
As the National Institute of Drug Abuse impresses on the public, detox is only a step in treatment. Alone, it is not enough to treat addiction. For this reason, immediately after medical detox, a person in recovery from cyclobenzaprine abuse at a drug rehab center will start therapy in both individual and group sessions. Typically, rehab centers will rely on research-based therapies, such as Cognitive Behavioral Therapy, to help a person discover the thoughts and emotions underlying the cyclobenzaprine addiction. This identification process can help a person to then develop drug-free behaviors and set in place strategies to cope with drug use cues.
While therapy is a main component of treatment during the primary care phase, there are a host of supportive therapies that a rehab center may provide. The following is a list of some possibilities:
- Peer support group meetings (a staple of the rehab process)
- Art and music therapy
- Time on the daily agenda for exercise
- Drug education
- Wellness-oriented services, such as nutritional counseling, yoga, massage, and acupuncture
- Family therapy
- Family days and other social activities
The road to recovery is full of helping hands. In addition to proving clients with research-based treatments for addiction, rehab centers are staffed with addiction professionals who can deliver compassion care. Participating in a rehab program can help a person to develop skills, strategies, and numerous tools that can be used to maintain recovery.