Flexeril is a type of muscle relaxant that is only available via prescription. It is typically given as a short-term treatment for muscle spasms to relax the muscle and reduce pain.

Whether it is truly addictive is debatable. Learn more about how this drug works, its effects, and other relevant details to determine if you might be abusing this medication. 

How Does Flexeril Affect the Body?

Flexeril, the brand name for cyclobenzaprine, works by blocking pain sensations from getting to the brain, according to RxList. However, its exact mechanism of action is not entirely understood.

It is known that it works on the central nervous system as a depressant. This causes a relaxing effect on the body and mind.

It is believed to act on the alpha and gamma neurons, altering their ability to fire to alleviate muscle spasms and tension.

The chemical structure of this drug is similar to tricyclic antidepressants. 

The usual starting dose for this drug is 5 mg (milligrams), according to the Drug Enforcement Administration. Doctors usually prescribe it three times a day. It is possible for a doctor to increase the dose if 5 milligrams do not adequately reduce a person’s pain. In most cases, this drug is given for up to three weeks.

Side Effects

This medicine comes in three dosage forms, including a tablet, capsule, and suspension. No matter the form a person takes, there is the potential for side effects.

Blurry vision, dry mouth, drowsiness, dizziness, and feeling lightheaded are the common side effects.

The side effects that are less common are:

  • Gas or bloating, vomiting or nausea
  • Nervousness or excitement
  • General feelings of illness or discomfort
  • Muscle twitching
  • Pounding heartbeat
  • Trembling
  • Abnormal or unpleasant taste in the mouth
  • Unusual tiredness
  • Diarrhea or constipation
  • Headache
  • Foot or hand tingling, weakness, numbness, or pain
  • Trouble speaking
  • Difficulty sleeping
  • Abnormal muscle weakness 

A doctor should evaluate any rare side effects right away. According to the Mayo Clinic, these include the following:

  • Unsteadiness or clumsiness
  • Fainting
  • Problems with urination
  • Skin hives, rash, or itching
  • Yellow skin or eyes
  • Confusion
  • Mental depression
  • Buzzing or ringing in the ears
  • Abnormal dreams or thoughts 

This drug is not approved for use in people younger than age 15.

Each capsule or pill must be taken whole. Crushing, breaking, opening, or chewing the pills or capsules can be dangerous. This is especially true with extended-release formulas.

Dependence and withdrawal are most often seen when someone is misusing or abusing Flexeril.

Is There Addiction Potential with Flexeril?

It has been debated for years whether Flexeril is addictive. There is some evidence showing that there is a potential for people to experience dependence on the medication. There are also cases where people go through withdrawal when they abruptly stop taking this medicine.

Flexeril is not addictive, according to RxList. This does not mean that there is not a potential for abuse and other associated issues. 

In 2011, the Drug Abuse Warning Network released a report that stated that there were 1.2 million emergency department visits by people who used medicines without a medical reason. Of these cases, 11,551 involved Flexeril, which was about 0.9 percent of cases.

DAWN statistics are focused on 24-hour emergency departments in non-federal hospitals. Select metropolitan areas are used for their research. 

Withdrawal and Overdose

When someone develops a dependence on this drug, withdrawal effects are possible. Withdrawal symptoms are typically only seen when someone abused the drug or took very high doses for an extended period.

According to information published in Pain Management, withdrawal symptoms may include:

  • Nausea
  • Malaise
  • Headache

Roughly eight to 37 hours is the estimated half-life range for Flexeril. This means that the drug will remain in the body for an average of four to five days. If someone uses alcohol and Flexeril together, this could prolong how long Flexeril stays in the body.

There is a chance of overdose with Flexeril. The symptoms of overdose, according to the Mayo Clinic, include the following:

  • Seizures
  • Hot, flushed, and dry skin
  • Hallucinations
  • Trouble breathing
  • Unusual restlessness and nervousness
  • Severe drowsiness
  • Irregular or fast heartbeat
  • Reduced or increased body temperature
  • Unexplained muscle stiffness
  • Vomiting 
  • Chest pain
  • Cardiac arrest
  • Muscle rigidity, fever, and altered mental state
  • Extremely low blood pressure

An overdose is a medical emergency. Immediate medical treatment is needed.

The exact dose that can cause an overdose will vary. However, in studies on rats and mice, giving them an acute oral LD50 dose of Flexeril cause overdose at 425 mg/kg (milligrams per kilogram) and 338 mg/kg, respectively. 

What are the Potential Signs of Abuse?

When someone is abusing or misusing Flexeril, the usual noticeable signs and symptoms are: 

  • The person has moods that change rapidly.
  • They are having problems at work or school.
  • They appear to be neglecting their hygiene.
  • They have noticeable slurred speech, motor ability impairment, and confusion.

When a person is improperly using or abusing Flexeril, the following are possible, according to the U.S. Food and Drug Administration:

  • Nausea
  • Dizziness
  • Headache
  • Impaired cognitive function
  • Elevated heart rate
  • Excessive drowsiness
  • Dry mouth
  • Confusion
  • Physiological dependence

The possible adverse effects of this muscle relaxer increase when someone combines this drug with alcohol. Both alcohol and Flexeril are depressants.

The following are possible when a person uses Flexeril and alcohol together, according to the National Institute on Alcohol Abuse and Alcoholism:

  • Increased dizziness or drowsiness
  • Labored, slow breathing
  • Abnormal behavior
  • Poor cognitive function and motor skills
  • Memory loss
  • Seizures
  • Increased risk of Flexeril overdose or alcohol poisoning

What are the Long-Term Effects of Flexeril Use?

When using Flexeril long term, especially at high doses, there is the risk for serotonin syndrome and severe anticholinergic effects.

Serotonin syndrome is potentially life-threatening, according to research published in the Ochsner Journal. This issue can occur with Flexeril when someone takes high doses or mixes the drug with other substances that may contribute to serotonin syndrome. Examples include LSD, amphetamines, ecstasy, and cocaine. 

The symptoms of serotonin syndrome sometimes start within minutes of the condition happening, but sometimes, it takes hours. According to MedlinePlus, the symptoms may include:

  • Rapid blood pressure changes
  • Vomiting and nausea
  • Increased body temperature
  • High blood pressure
  • Abnormal eye movements
  • Rapid heartbeat
  • Restlessness or agitation
  • Diarrhea
  • Hallucinations
  • Loss of coordination
  • Overactive reflexes

Anticholinergic effects are possible when this drug disrupts neurotransmitter activity in the brain. This can have mental and physical manifestations. These effects may include, according to research published in the Journal of Clinical Psychiatry:

  • Reduced salivation
  • Increased pupil size
  • Increased heart rate
  • Reduced gastrointestinal motility
  • Decreased bronchial secretions
  • Reduced sweating
  • Trouble urinating
  • Impaired attention and concentration
  • Confusion
  • Problems with memory 

Other possible effects of Flexeril, especially with long-term abuse, may include:

  • Inappropriate ADH syndrome. The body produces too much ADH, which can cause vomiting and nausea, mental changes, headache, balance issues, seizures, and coma. 
  • Leukopenia. This condition is characterized by a reduced white blood cell count. 
  • Thrombocytopenia. This involves not having enough platelets in the body. It can cause symptoms, such as easy bruising or bleeding, fatigue, jaundice, heavy menstrual flow, and an enlarged spleen. 
  • Paralytic ileus. This condition can impact any area of the intestine. There is not a physical blockage, but the symptoms are similar to a blockage, which may include appetite loss, vomiting, abdominal swelling, crampy abdominal pain, constipation, and not being able to pass stool.
  • Bone marrow suppression. This involves reduced blood cells as a result of decreased bone marrow activity. Shortness of breath, fatigue, and dizziness are common. 
  • Eosinophilia. Too many eosinophil white blood cells are present. 

In addition, delusions or paranoia, weight loss or gain, muscle pain, purpura (purple blotches, caused by bleeding under the skin), and fluctuating blood sugar levels are possible with long-term abuse.

How is Flexeril Abuse Treated?

People who experience withdrawal symptoms may want to consider entering a medically supervised detox program. This will help to reduce the withdrawal symptoms so that this part of the process is less uncomfortable. It may also reduce the risk of relapse. 

If someone was using alcohol or other drugs with Flexeril, it is often recommended that they undergo detox. This can help to alleviate the symptoms of withdrawal from any other drugs they might have developed a dependence on. 

Once someone completes detox, they will usually go to inpatient or outpatient treatment. This treatment often involves a combination of different counseling types. According to the National Institute on Drug Abuse, these therapies may include:

  • Cognitive behavioral therapy (CBT). CBT helps people to avoid, cope with, and recognize situations that are likely to cause them to use drugs.
  • Motivational interviewing (MI). This therapy helps people to work on their readiness to enter a treatment program and change their behavior.
  • Multidimensional family therapy. This therapy will get the person’s loved ones involved. It can be used for people of all ages, but it is most often focused on adolescent clients. It helps people to work with their family to identify drug abuse patterns while allowing for improved family functioning.
  • Motivational incentives. This therapy encourages a person to remain abstinent by using positive reinforcement, such as rewards.

The therapies used will depend on the person, what they respond to, and the facility they choose. It is possible to try several types of therapy to determine which ones are the most effective. Most people will have more than one type of therapy as part of their treatment plan.

If someone has more than one substance use disorder or a co-occurring mental health disorder, the facility they choose should be able to accommodate all of their issues.

Assess the costs of the facility. Determine if the program takes medical insurance and if they accept the insurance in question. If they don’t, explore any payment plans they offer. Many facilities give the option of paying off the cost of care on a monthly basis once treatment is complete.

Those who think they may be abusing Flexeril should not hesitate to seek treatment. The sooner treatment is received, the more long-term effects of continued abuse can be mitigated.

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