Muscle relaxers or muscle relaxants are medications used to treat acute muscle pain and discomfort caused by muscle spasms. Muscle spasms are involuntary contractions that cause excessive strain in muscles and are often associated with conditions such as lower back pain and neck pain.
Medications used as muscle relaxers can differ in their chemical structures and the way they work in the brain. In general, muscle relaxers act as central nervous system depressants and cause a sedative effect or prevent your nerves from sending pain signals to your brain. The onset of action is rapid and effects typically last from 4-6 hours.
Muscle Relaxants for Muscle Spasms
Muscle spasms are painful and may restrict mobility, which can limit your ability to perform even basic activities. Painful, tight muscles can also interfere with getting a good night’s sleep.
Muscle relaxants may help reduce pain, and improve movement and range of motion, but your doctor will likely recommend that you first try acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). In some cases, these over-the-counter medications will be enough to help alleviate your pain.
If your muscle pain persists, your doctor may prescribe a muscle relaxant in addition to your pain medication. Below are common muscle relaxants (the generic names are listed first, with a brand name example in parentheses):
- Baclofen (Lioresal)
- Carisoprodol (Soma)
- Cyclobenzaprine (Amrix)
- Metaxalone (Skelaxin)
- Methocarbamol (Robaxin)
When You Might Need a Muscle Relaxer
Your doctor might first suggest you try an over-the-counter medicine like acetaminophen (Tylenol) or ibuprofen (Advil) to treat your pain. But if those don’t work, or you can’t take them because you have another issue like liver problems or ulcers, you may need to try a muscle relaxant.
Muscle relaxants are ideally prescribed for acute rather than chronic pain. They may be an option if pain is preventing you from getting enough sleep. Because muscle relaxants cause drowsiness, they can help you get rest when you take them at night.
Some of the common side effects of muscle relaxers include:
- Dry mouth
- Decreased blood pressure
The most commonly prescribed muscle relaxers are carisoprodol (Soma) and cyclobenzaprine (Flexeril). According to data from IMS Health, there were 4.2 million prescriptions of Soma and 28.4 million prescriptions of Flexeril dispensed in the United States in 2017.
What Are Side Effects of Flexeril?
Common side effects of Flexeril include:
- dry mouth or throat
- blurred vision
- loss of appetite
- stomach pain
- gas, or
- muscle weakness.
Dosage for Flexeril – For most patients, the recommended dose of Flexeril is 5 mg three times a day.
You shouldn’t drink alcohol while taking muscle relaxants. These medications make it hard to think and function normally, even if you take a low dose, so combining them with alcohol can increase your risk of an accident.
You also shouldn’t drive or operate heavy machinery while taking muscle relaxants. Some muscle relaxers start working within 30 minutes of taking them, and the effects can last anywhere from 4 to 6 hours
Muscle Relaxant Abuse
Muscle relaxers have a potential for abuse and addiction. Prolonged use can lead to increased tolerance and physical dependence, especially with Soma.3 For this reason, muscle relaxers are intended as a short-term treatment not to be prescribed for more than 2-3 weeks.
Unfortunately, many individuals take muscle relaxers alone or in combination with other illicit drugs for nonmedical reasons, such as to produce or enhance feelings of euphoria and dissociation. According to the Drug Enforcement Administration, Soma is one of the most commonly diverted drugs in the United States.2 Evidence also indicates prevalent misuse of Flexeril. In 2010 there were over 12,000 emergency room visits associated with Flexeril, and in 2016 over 10,000 calls to the Poison Control Centers had involved Flexeril.1
Muscle relaxer abuse can lead to serious dangers such as an increased risk of overdose, which can result in:
- respiratory depression
- cardiac arrest
Alcohol and Muscle Relaxers
Like muscle relaxers, alcohol also depresses the central nervous system. When alcohol is consumed with muscle relaxers the side effects are exacerbated. This can be very dangerous, leading to symptoms like:
- Blurred vision
- Urine retention
- Extreme dizziness
- Extreme drowsiness
- Low blood pressure
- Memory problems
- Liver damage
- Increased risk of overdose
It is recommended to not drive or operate heavy machinery when under the influence of muscle relaxers. It is especially important to avoid drinking, as combining muscle relaxers with alcohol greatly increases your risk of an accident.
Withdrawal and Treatment
Regular use of muscle relaxers causes the brain to become used to its effects. If you attempt to suddenly stop using muscle relaxers you may experience withdrawal symptoms. Depending on the specific drug and how long you have been using it, there are various treatment options available to help you overcome your addiction.
For many people, Flexeril withdrawal causes mild symptoms such as nausea, headache, drowsiness, malaise, and discomfort. Symptoms tend to peak about 2-4 days after you last took the Flexeril, although in some people withdrawal symptoms may last for up to 1-2 weeks. For many people Flexeril detox can be done at home. However, if Flexeril addiction is accompanied by alcohol or opioid abuse the withdrawal symptoms from these other substances can be severe. In these situations, it may be best to undergo professional medical detox.
Soma withdrawal is usually more severe and can include symptoms like hallucinations and seizures. For your safety and comfort, it is often best to find an inpatient treatment program that includes a detox program to manage withdrawal symptoms. After detox patients can transition into the actual treatment phase of the program. Some people may not require a supervised detox program and will be able to undergo treatment on an outpatient basis.
Most inpatient and outpatient rehab programs include cognitive behavioral therapy that will help you learn the coping skills needed for long-term recovery.
- Drug Enforcement Administration. (2019). Cyclobenzaprine.
- Drug Enforcement Administration. (2019). Carisoprodol.
- Gonzalez, L.A., Gatch, M.B., Forster, M.J., & Dillon, G.H. (2009). Abuse Potential of Soma: the GABA(A) Receptor as a Target. Molecular and Cellular Pharmacology, 1(4), 180-186.