Skeletal muscle relaxants are prescription medications that are usually prescribed for short-term use after an injury, accident, or surgery. There are many different types of muscle relaxants, and all work to reduce muscular pain, spasms, and tension by slowing the activity of the central nervous system (CNS). This article will provide a comparative review of common muscle relaxants and their effects, efficacy, and risk profiles.
- Skeletal muscle relaxants are a class of medications used to treat acute muscular pain and spasms due to injuries, accidents, and sprains.
- Muscle relaxants are CNS depressants that have similar mechanisms of action, effectiveness, and safety and risk profiles.
- Individual responses to medications vary depending on a number of factors, and certain medications may work better for someone than others.
Common skeletal muscle relaxants compared
Skeletal muscle relaxants are a class of medication that act as CNS depressants to slow the activity of the nervous system to reduce muscular pain and spasms. Although most drugs in this class carry a low risk for abuse and dependence, they are usually indicated for short-term use. Typically, muscle relaxers are prescribed for a period of about two weeks or less, making them effective in addressing acute injuries, rather than more chronic conditions. [1]
While there has been research outlining slight differences between commonly prescribed medications in this class, most muscle relaxants have similar efficacy and safety profiles. [2][3] Still, individuals can respond differently to certain medications, so it may be necessary to try more than one type of muscle relaxant to find one that works best.
Here are some of the commonly prescribed skeletal muscle relaxants: [1][2][3]
| Medication | Therapeutic effects | Side effects and risks | Legality |
|---|---|---|---|
| Cyclobenzaprine(Flexeril, Amrix) |
|
| Not a controlled substance |
| Carisoprodol (Soma, Vanadom) |
|
| Controlled substance |
| Methocarbamol (Robaxin) |
|
| Not a controlled substance |
| Tizanidine (Zanaflex) |
|
| Not a controlled substance |
| Baclofen (Lioresal, Lyflex) |
|
| Not a controlled substance |
Effectiveness for pain and spasms
There is not a lot of research to suggest that one type of muscle relaxant is more effective than another, although different medications in this class may be prescribed to target specific issues or complaints. [2][3] For example, tizanidine and baclofen are more commonly prescribed to target muscle spasms, while cyclobenzaprine is more commonly used for pain. [2]
Certain medications have been studied more, resulting in stronger data and evidence to support their efficacy in treating muscular pain and spasms. For example, cyclobenzaprine is one of the most commonly prescribed muscle relaxants and has strong evidence to support that it is effective. Metaxolone, on the other hand, has less research to support its efficacy, which may result in this medication being prescribed less often. [2][3]
Risks & side effects comparison
All of the commonly prescribed skeletal muscle relaxants in this article have similar mechanisms of action and similar side effect profiles. Because these medications work to slow the activity of the CNS, fatigue and dizziness are among the most commonly reported side effects. Some people may experience stronger responses to muscle relaxants and may find that most medications in this class cause cognitive or motor impairment. Cyclobenzaprine and tizanidine are often more sedating than other medications in this class. [2][3]
Certain medications in this class carry risks for specific side effects, including some that are serious in nature. For example, cyclobenzaprine is considered more likely to cause sedation and drowsiness than other muscle relaxants, while carisoprodol carries a higher risk for abuse and addiction. [1][2] Tizanidine is more likely to result in dry mouth and also carries a higher risk for liver damage because of the way this medication is metabolized. [2]
Addiction and dependence risks
Most muscle relaxants are believed to carry a low risk for abuse, addiction, and dependence. The exception to this is carisoprodol (Soma), which is a controlled substance. For this reason, carisoprodol is less frequently prescribed than other muscle relaxants. [1][2]
Muscle relaxants are intended for short-term use only, and should not be taken long-term. [2] When these medications are abused and taken in higher doses or more often than prescribed, it is possible to form a dependence. When a dependence has formed, it can be more difficult to stop or control use of these medications, and withdrawal symptoms may be experienced.
When to seek professional help
It is possible for anyone to form an addiction to a substance, particularly when they are using it often, in high doses, or for a long period of time. When an addiction forms, it can be difficult to overcome on your own. There are many professional treatments available that can help individuals overcome an addiction. Knowing the signs and symptoms of addiction can help ensure that people get the help they need.
Here are some of the signs and symptoms that indicate someone is struggling with a substance use disorder: [4]
- Using a drug in higher doses or more often than intended.
- Excessive time spent trying to obtain, use, or recover from effects of a drug.
- Unsuccessful attempts to cut back or stop using.
- Strong urges or cravings to use a drug.
- Neglecting basic responsibilities at work or home.
- Using a drug in situations where it is risky or unsafe.
- Giving up important social or recreational activities to use a drug more.
- Negative impacts on important relationships.
- Negative impacts on physical or mental health.
- Developing a tolerance, needing to use more for the same effects.
- Physical or psychological withdrawal symptoms when stopping or cutting back on use.
Choosing the right muscle relaxant
If you are struggling with acute muscle pain or spasms due to an accident, injury, or surgery, your doctor may recommend muscle relaxants as part of your treatment. Muscle relaxants are typically only prescribed for short-term use and can be taken as needed for up to two weeks to help reduce pain and tension. These medications should always be taken as prescribed, and used as an adjunct to primary interventions and measures including rest and physical therapy. [2]
Talking with your doctor or prescriber is the best way to learn more about your options for different muscle relaxants, helping you decide which option is right for you. In some cases, it may be necessary to try more than one medication in this class to find one that works for you. When discussing medication options with prescribing professionals, be sure to provide this information:
- Information about any underlying medical issues or diagnoses.
- All other prescribed medications including dose and frequency.
- Alcohol or any other current or recent substances used.
- Any history of substance use disorders or addictions.
- Any known drug or medication allergies.
- Insurance status and ability to afford or access medications.
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