medication advice-muscle relaxant

[shelley2]

As you guys know i went through terrible withdrawals from baclofen. impleased to say im back working full time and have a handful of symptoms which ive been told will go.

However the reason for why i was put on baclofen may or may nor return ie my ear muscles went into spasm. i already have a torticollis but my ear muscles spasmed and causes pain inside both ears. i may need to be put on another muscle relaxant for life if there is no other treatment. this scares me so much as Im only 39. Are there any muscle relaxants that anuy one would suggest and has been on for years with hardly any probs? are all these drugs addictive? what happens when you hit tolerance on these drugs. any advise apprecaited and happy new year to you all. Love shelley

[Diandra]

Hi Shelley,
I have been on Soma on and off for years and am very happy with the results. I have tried many muscle relaxers and this has been the best one for me. It works well with no side effects other than causing sleepiness when taken sporatically. I do notice when I take it for weeks at a time on a scheduled dose, I don't have the sleepiness. In years, I have gone from needing to take 1/2 a tab to a full tab and I am talking about being on it, on and off for 15 years.

Best of luck in your search for a med that works best for you.
Diandra

[Boxerlover]

Shelly, hi, I had been on flexeril for years and it worked great then just stopped working. Then I was out on zanaflex and it was way to strong, I started doing things in my sleep! My husband caught me putting my make-up on in the middle of the night and I had no idea what I was doing! So then they put me on skelaxin and it doesn't do anything for me so at the moment I am looking for one as well. I have never used soma.

If you find one, let me know!
Melissa

[Mark N]

Shelley, I have been on Soma for over 12 years with no real problems. I know it is an older muscle relaxer and many PMs would choose a different muscle relaxer that is newer but I have liked Soma and see no reason to change.

[Kira]

I take Baclofen and don't have problems with it, but I know you don't want to take that one!

I have tried others--Flexeril, Robaxin, Skelaxin--but they didn't work for my particular problems. I had some success with Klonopin, though it wasn't actually prescribed for me as a muscle relaxant.

I think everyone is different, based on what is causing their spasms and also based on their individual body chemistry, how well they tolerate meds, and so on.

What about things like physical therapy, stretching, massage, heat, etc? Those are all great things for spasmy muscles, even if you do start taking a muscle relaxant.

I hope you are able to find something that works for you.

[slipnslide]

Shelley,

When I was taking Soma (at night only), I definitely was able to sleep longer, but I didn't notice any relief from the nerve pain, and as a result I also didn't notice it relaxing any muscles either....so, for me, it was a good "sleep aid". Before my surgery, I was on both Skelaxin and Flexeril (not at the same time) and honestly couldn't tell if they were having any affect. To be fair, nothing helped much because I had too much swelling and cord compression. I was pretty much just "drugged up" on muscle relaxers, anti-inflamatories, narcotics/opiates to the point where I was "one big cloud of brain-fog". Before then, if I took one Tylenol tablet a year, that was alot for me!:o

Everyone is just so different that you may have to try different Rx's until you find what works best for you.

Good luck,

Kim

[lobelsteve]

Pain docs are generally against the use of Soma owing to several things wrong with the medication.

1. Carisoprodol is the prodrug of Meprobamate (Miltown). Miltown was the mild tranquilizer of choice before Xanax and Valium.

2. Pharmacodynamics: Carisoprodol is a centrally acting skeletal muscle relaxant that does not directly relax skeletal muscles. A metabolite of carisoprodol, meprobamate, has anxiolytic and sedative properties. The degree to which these properties of meprobamate contribute to the safety and efficacy of SOMA is unknown.

3. Street value. No other muscle relaxant has street value like Soma. I do not include Benzo's as muscle relaxants as their well defined mechanism of action is in relaxing the brain.

[Kira]

Steve,

Which muscle relaxants do you prefer to use?

[shelley2]

Thankyou everyone for your advise. I really appreciate it. Its made me realise that im not the only one. I was fine on baclofen to be honest and when i was on it had no probs and felt better. its when i came off the drug that the problems started. i wish i had never come off it now sometimes because i feel like im back to square one again ie I was put on baclofen because my ear muscles spasmed, then told to come off it and now Im recovering from the horrific withdrawal feel like the ear spasms are returning . Im pleased my withdrawals are slowly recovering but upset that my ear problems are returning. This time however im going to be knowledgeable going on these drugs and am trying to find the best solution for me so I can live a better life.

Im scared of hitting tolerance on these drugs or being on high dosages that can affect other parts of the body...am I worrying too much?

[Mark N]

We go through a learning process with our meds as each of our bodies react differently to each med. Now you know how your body responds to baclofen and the results when you are off of it. The longer you deal with this the more you will know about the best combination of meds for you.

As Steve pointed out many doctors don't want to prescribe Soma any more. I have had good results with it the past 19 years and don't want to change a good thing as my combo of meds works well for me.

[shelley2]

Thankyou mark for you advise it is much appreciated. I am beginning to understand that it will be a case of managing the side effects should they occur and having a good neurologist to support me with any drug im on. I will probably only need to take one. thanks for your support everyone.

[lobelsteve]

Steve,

Which muscle relaxants do you prefer to use?

As a paid consultant for Acorda Pharmaceuticals, I can recommend Zanaflex Capsules, 2, 4, or 6mg capsules taken three times per day WITH FOOD. :D

I signed up because I like the molecule. Plus it is an anti-spasticity drug more than a muscle relaxer. Known mechanism of action in the brain and spinal cord. Downside is the cost (generic is not AB rated (ask Pharm Steve)), and the sedation is still present.

For just muscle spasms, they are all the same (or at least that what the literature says). Wen folks get to me they have already tried Flexeril and Soma and most of the folks with tobacco abuse and other risk factors for drug misuse rave about Soma and say that nothing else works. FOlks who do not like taking any meds efuse Soma. I like everything else including Parafon, Baclofen, Norflex, Robaxin, tizanidine tablets, Amryx, Skelaxin. I do not believe in the use of benzos as muscle relaxants and do not prescribe them for any reason for any chronic condition.

[Mark N]

Steve, just to add to your knowledge I hate taking meds and took none, including the times I was in recovery from surgery, until a year after my 360 lumbar fusion. I think your lumping everyone that takes Soma into the group of people that like to take med is wrong and sorry to see your bias put into a response on this board. Sorry to be taking your comment personally but you were pretty nasty with the comment even though it wasn't directed at any of us specifically.

[Kira]

Steve,

Funny about the Zanaflex rec, but hey... you did announce your affiliation...

I know this is Shelley's post but I did have a question for you (sort of related).

We are thinking that the "spasms" in my left leg are more of a neuro/spasticity thing than plain old muscle spasms.

Weirdly, I have intermittent funky reflexes -- L Babinski, bilat Hoffmans, diffuse hyperreflexia, occas ankle clonus -- that have been documented by multiple docs (neuros, PM&R, metabolic/genetics, internal medicine). In fact, in med school, they always picked me to demonstrate reflexes in Physical Exam Skills because my hyperreflexia made them easy to see. The hyperreflexia is pretty much always there, but every so often I have normal Babinskis & Hoffmans. "They" think the fluctuating thing is mito's fault, like all of my other stuff that fluctuates... nothing works normally when I am metabolically screwed up, but things get a bit better between flares. (My other stuff that fluctuates: metabolic acidosis, proximal renal tubule dysfunction, myopathy symptoms, autonomic dysfunction symptoms, GI motility, etc).

I do have other weird neuro issues -- which fluctuate, too -- but nothing as directly related to spasticity as my funky reflexes. In 2000, before my mito dx, I had what we now strongly suspect was a mito "Stroke-Like Episode" (the "S" in MELAS). At the time, they thought I was nuts... but, in retrospect, I had all of my typical mito exacerbation symptoms along with left-sided neuro sx that no one could explain. These days, my complex migraines cause left-sided sx, too. My other neuro-ish things are autonomic issues (HR, temp, BP, etc) & predictable episodes of agitation/mental status stuff with severe mito exacerbations that resolve when the mito flare ends. Lately, I also have a LOT of fasiculations & some rhythmic muscle twitching... though that could just be my muscle disease b/c I get lots of muscle shaking with fatigue.

ANYWAY... I have tried several muscle relaxants. Flexeril, Skelaxin, & Robaxin don't touch my "spasms." Then a shrink prescribed Klonopin short-term for agitation w/ mito exacerbations, and an unexpected side effect was that it worked really well for the "spasms." That was when my pain doc suggested baclofen, which I eventually tried... and it works pretty well.

I'm long-winded, I know, but here's my question... Since benzos & baclofen work but the others don't, is that more evidence in favor of it being spasticity more than "regular" muscle spasms?

(I also have very hard, tight muscles in my upper body where 10 of the 11 documented rhabdo attacks since 2005 have been... mid & upper back, neck, shoulders, chest, & to a lesser extent arms... but these don't respond at all to any meds & we think there is a good deal of scarring... fortunately we have recently had some success at loosening up some of those areas in PT)

[Kira]

I have another question, also a bit off-topic. In my post about central sleep apnea, you posted a link to an abstract & table from an article about CSA and different meds. It showed a small but statistically significant association between muscle relaxants & CSA. I didn't look up the rest of the article's text, and maybe it says in the Methods section or something... but do you know if there is a difference between muscle relaxants in terms of CSA risk? It looked like they lumped them all together in their analysis, though they did separate out benzos.

[shelley2]

Kira, i know that benzos cause more sleep problems ie there is a correlation than baclofen.

[lobelsteve]

Steve, just to add to your knowledge I hate taking meds and took none, including the times I was in recovery from surgery, until a year after my 360 lumbar fusion. I think your lumping everyone that takes Soma into the group of people that like to take med is wrong and sorry to see your bias put into a response on this board. Sorry to be taking your comment personally but you were pretty nasty with the comment even though it wasn't directed at any of us specifically.

Sorry,

Yes, everyone is different. Soma can be beneficial for some patiens.
I do have a handful of patients that have demonstrated benefit from this medication over other SMR's. I do not feel that it is reasonable to start new patients on this medication with the liability of this med compared to the lack of liability for the other SMR's.

[shelley2]

Thankyou every one for your advise

[mrsdoubtfyre]

As a paid consultant for Acorda Pharmaceuticals, I can recommend Zanaflex Capsules, 2, 4, or 6mg capsules taken three times per day WITH FOOD. :D

I signed up because I like the molecule. Plus it is an anti-spasticity drug more than a muscle relaxer. Known mechanism of action in the brain and spinal cord. Downside is the cost (generic is not AB rated (ask Pharm Steve)), and the sedation is still present.

For just muscle spasms, they are all the same (or at least that what the literature says). Wen folks get to me they have already tried Flexeril and Soma and most of the folks with tobacco abuse and other risk factors for drug misuse rave about Soma and say that nothing else works. FOlks who do not like taking any meds efuse Soma. I like everything else including Parafon, Baclofen, Norflex, Robaxin, tizanidine tablets, Amryx, Skelaxin. I do not believe in the use of benzos as muscle relaxants and do not prescribe them for any reason for any chronic condition.

Oh, blech!

[Jackstraw]

Howdy Folks,
Since I did not see where anyone mentioned these 2 facts, I will state them, direct from the New England Medical Journal and the 2008 review of the "Most abused Px Drugs", as per the DEA:
First, Valium has always been, still is, and probably always will be one of the best muscle relaxants ever made, for upper body neck and back spasms, thoracic, and lumbar areas.
Second, the DEA has listed Soma in the "Top 10" most abused drugs in the U.S. 8 out of the last 10 years.
Comments anyone ? (Mrs. D.,I see by your reply to the above post, that you are still keen with those feisty responses, albeit short and sweet, but very understandable,"Oh, Blech!",Hee-Haw!) Jackstraw

[debhun]

I have been on baclofen but I can't use it. I swell with it. I didn't have any trouble comeing off it. I was on it for 6 or so. I hope it help you.


Deb

[Shadowrose40]

My PM doc had me on valium as a muscle relaxant and it worked great. After a few weeks of the 'tired' from it, my body adjusted and it didn't make me sleepy any longer. I loved the way it worked so well. I have chronic muscle pain and it's been the only one that worked for any length of time. (I took it for over a year)