Cyclobenzaprine Withdrawal

Cyclobenzaprine is a type of muscle relaxant usually prescribed for short-term pain management from muscle injury including strains, sprains and spasms. It is more commonly known by the brand name Flexeril. Though the medication Flexeril is no longer available, many people still refer to this type of muscle relaxant medication as such. It is one of the most commonly prescribed medications used to treat musculoskeletal pain.

A light colored yellow pill of cyclobenzaprine on a blue background represents cyclobenzaprine withdrawal.

Cyclobenzaprine is FDA-approved to relieve muscle pain when it is caused by the muscle itself and not the nerves controlling the muscles. It is typically prescribed as a short-term treatment and part of an overall health plan that includes physical therapy and other medical treatments. The recommended dose of cyclobenzaprine is between 5mg to 10mg for the immediate-release formulation. For those taking the extended relief formulation, the recommended dose is between 15mg to 30mg.

According to the National Institute on Drug Abuse, more than 50 million American adults have abused prescription drugs like cyclobenzaprine at least once in their lives. And in 2011, physicians wrote an estimated 25 million prescriptions for medications that contain cyclobenzaprine. Cyclobenzaprine is a centrally-acting muscle relaxant that is structurally similar to tricyclic antidepressants. It works as a central nervous system depressant by reducing muscle hyperactivity.

The short-term use of this medication is recommended because muscle spasms and sprains are usually short-term and temporary conditions. When taken for several weeks or longer, the muscle relaxant can produce a mild euphoria, causing physical dependence and can lead to the development of cyclobenzaprine withdrawal symptoms.

How does Cyclobenzaprine work?

Cyclobenzaprine works by blocking pain sensations in the central nervous system. The complex mechanism works through the brainstem. It helps to relieve muscle pain and spasms without physically interfering with muscle function. The drug does not interact directly with the skeletal muscle or neuromuscular junction. However, the pain-blocking mechanism of cyclobenzaprine is what helps to alleviate pain and can contribute to the misuse of the drug.

Cyclobenzaprine is not considered to be an addictive substance. It is a long-acting drug that can remain in the body for several days. This can be effective in improving muscle spasms, reducing pain and tenderness and helping to increase range of motion from painful musculoskeletal conditions. Despite the benefits of the muscle relaxant, many people seeking pain relief can begin to take more than prescribed, misusing the prescription medication and becoming dependent on the drug.

Infograph sharing the side effects and withdrawal symptoms of cyclobenzaprine.

Cyclobenzaprine Withdrawal

Withdrawal from any type of addictive substance can be uncomfortable. Cyclobenzaprine withdrawal isn’t necessarily dangerous but can result in uncomfortable symptoms. Users are most likely to experience withdrawal within a few days after last taking the muscle relaxant. This is because the drug is long-acting and can stay in the system for a while before it is processed. In general, withdrawal can last a few weeks. The symptoms and severity can vary depending on individual sensitivity to the drug, frequency of dose, duration of overall drug use, misuse of other drugs, metabolic rate and overall body composition.

  

Cyclobenzaprine Withdrawal Symptoms

  • Difficulty sleeping – insomnia can occur while the body tries to readjust to functioning without drugs
  • Chills and sweating – common symptoms of general withdrawal from any addictive substance
  • Nausea and vomiting – mild to moderate nausea with an upset stomach and digestive issues
  • Flu-like symptoms
  • Body and muscle pain – can occur due to abrupt cessation of muscle pain relief provided by a muscle relaxant
  • Headaches – tension headaches or migraines as the body is readapting and adjusting to functioning without substances
  • Lethargy
  • Agitation and irritability
  • Anxiety – heightened anxiety can occur as the body and system readjust

During the first couple of days of initial cyclobenzaprine withdrawal, users will experience mild flu-like symptoms followed by drowsiness and other discomfort. The symptoms will usually peak and subside within 1-2 days. If withdrawal symptoms linger and last for longer than a month, the user can develop what is called post-acute withdrawal syndrome (PAWS). However, in cases with cyclobenzaprine withdrawal, it is not common.

Withdrawal from muscle relaxants is much less dangerous than withdrawal from other substances such as alcohol, street drugs, benzos and opioids. However, it can be dangerous if the user has a history of polydrug use. Using other mind-altering substances in conjunction with muscle relaxants can intensify the withdrawal side effects.

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Effective Treatment for Cyclobenzaprine Dependence and Withdrawal

Detoxing from Muscle Relaxants

The best way to treat dependence and possibly an addiction to muscle relaxants is to medically detox from the drug. For people who have taken the drug regularly for a long period of time, for people who take high doses, for people who have a history of drug use, and for people who use it in combination with alcohol, it is recommended to detox in a professional setting. Detoxing with a medical provider under supervision and care can ensure the safety and well-being throughout the process.

Detoxing can occur over the course of a few weeks and can lead to the development of withdrawal symptoms. Muscle relaxants can lead to abuse and dependence despite not producing the same effects or intensity of euphoria compared to other central nervous system-effecting drugs. Professional medical detox can offer 24-hour care, behavioral support, medicinal treatment for painful or uncomfortable withdrawal symptoms, pain management and treatment referrals that might be needed during detox.

Inpatient Residential Treatment

Those who use muscle relaxants for pain-relieving prosperities unrelated to muscle pain are more likely to misuse and abuse the medication. Developing a dependence on the drug is a physical response while developing an addiction to the drug is a psychologically driven condition. Users who continue to abuse the drug and become addicted may have underlying co-occurring mental health conditions that drive their drug abuse. Residential programs can offer clinical support with medication management and behavioral therapies.

Outpatient Treatment

For those who have a less severe addiction to cyclobenzaprine or other muscle relaxants, outpatient treatment can be beneficial. Patients can focus on behavioral health and mental health treatments addressing the root cause of their addiction. Individual counseling and group sessions can also provide greater insight into the patient and how they can learn to heal and cope with distressing thoughts and emotions associated with their addiction.

Reach out to Hotel California by the Sea

We specialize in treating addiction and other co-occurring disorders, such as PTSD. Our Admissions specialists are available to walk you through the best options for treating your addiction.

Hotel California by the Sea is a professional behavioral health treatment program with specialties in substance use disorder, alcohol use disorder and co-occurring mental health disorders. We offer comprehensive treatment at all levels of care including detox, residential, PHP and IOP. We utilize evidence-proven treatment methods such as cognitive behavioral therapy, dialectical behavioral therapy, group therapy, marriage and family therapy as well as EMDR therapy. Hotel California by the Sea provides clients in all stages of recovery the support, tools and resources needed to overcome their addiction.

References:

https://www.medicinenet.com/benzodiazepines_vs_cyclobenzaprine/drug-vs.htm
https://www.addictionresource.net/treatment/detox/prescription-drugs/flexeril/
https://usrehab.org/addiction/flexeril-withdrawal/
https://californiadetox.com/cyclobenzaprine-withdrawal
https://www.ncbi.nlm.nih.gov/books/NBK513362
https://www.addictioncenter.com/antidepressants/flexeril