Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new carisoprodol research articles will be listed here shortly after becoming available to us.
Related Sponsors
Medical research on carisoprodol
Is it time for carisoprodol to become a controlled substance at the federal level?
South Med J. 2008 Feb; 101(2): 127-8
Reeves RR, Burke RS
Acute intoxications with carisoprodol.
Clin Toxicol (Phila). 2008 Apr; 46(4): 307-9
Høiseth G, Sørlid HK, Bramness J
Carisoprodol is a drug frequently prescribed for lower back pain. Several case reports on the toxic potential have been published. Larger autopsy materials have supported the high toxicity of the drug, but have also shown that carisoprodol most often appears in mixed intoxications. The present study reports on contacts concerning possible intoxications with carisoprodol to the Norwegian Poisons Information Department. From 1992 to 2003, the number of contacts concerning carisoprodol rose heavily, also when adjusting for increasing total number of contacts. There was a relationship between the whole sales figure of carisoprodol and the number of contacts. Of the cases classified as "serious intoxications", carisoprodol was the second most frequent drug, only surpassed by acetaminophen (paracetamol). Despite the potential weaknesses of the present material, this study gave an additional indication of a high toxicity of carisoprodol.
Curr Med Res Opin. 2008 Feb; 24(2): 551-8
Ralph L, Look M, Wheeler W, Sacks H
PURPOSE: The objective of this placebo-controlled trial was to determine the efficacy and safety of carisoprodol (Soma, MedPointe Pharmaceuticals, Somerset, NJ, USA), a centrally acting skeletal muscle relaxant used to treat acute, painful musculoskeletal conditions, at a dosage of 250 mg three times daily and at bedtime in patients with acute, painful muscle spasm of the lower back. METHODS: This was a 7-day, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Qualified patients were randomly assigned to treatment with carisoprodol 250-mg tablets (n = 277) or matching placebo tablets (n = 285). The coprimary efficacy endpoints were patient-rated global impression of change and patient-rated relief from starting backache scored on a 5-point rating scale. The primary analysis was on study Day 3. Four secondary endpoints were also assessed: (1) the Roland-Morris Disability Questionnaire (RMDQ), (2) time to symptom improvement, (3) patient-rated medication helpfulness, and (4) physician assessment of range of motion. RESULTS: Carisoprodol was significantly more effective than placebo for patient-rated global impression of change (2.24 vs. 1.70; p < 0.0001) and patient-rated relief from starting backache (1.83 vs. 1.12; p < 0.0001). Patients experienced clinical improvement with or without sedation. Onset of moderate or marked improvement was 3 days with carisoprodol compared to 6 days with placebo (p < 0.0001). No patient discontinued treatment with carisoprodol because of drowsiness, and there were no serious adverse events or clinically significant effects on laboratory values or vital signs. CONCLUSIONS: In this study, patients with acute muscle spasm of the lower back had significantly greater and more rapid relief from starting backache, and had improved functional status, as measured by the RMDQ, during treatment with carisoprodol 250-mg tablets compared to placebo. Patients experienced clinical improvement with or without sedation.
[Toxicological screening of medicines and drugs of abuse in emergency cases]
Tidsskr Nor Laegeforen. 2008 Jan 3; 128(1): 42-5
Helland A, Espnes KA, Reimers A, Aamo T, Zahlsen K, Rygnestad T, Spigset O
BACKGROUND: In some situations, and particularly when intoxications are suspected, it would be advantageous if medicines and drugs of abuse could be swiftly detected in serum or urine. MATERIAL AND METHODS: The Department of Clinical Pharmacology at St. Olav University Hospital has since 2004 been developing a comprehensive toxicology service (at all hours 7-days/week) for immediate quantitative analysis of between 80 and 90 substances. We here present the service in further detail and evaluate its usefulness during its first full year, 2005. Two case reports are presented to further illustrate the possible benefits of this service. RESULTS: Urgent testing was requested for a total of 390 samples; 351 serum and 39 urine samples. The most common indications for requesting such analyses were suspected acute intoxication (46%) and suspected therapeutic failure/adverse drug reaction (31%). 88% of the serum samples obtained for acute intoxications were positive, and 48 different substances were detected. The substances most often found were various benzodiazepines, various antiepileptic drugs, ethanol, carisoprodol, lithium, and other psychotropic drugs. In urine, amphetamine and zopiclone were the substances most often detected. INTERPRETATION: The service seems to be used according to its intentions, and the high number of samples received indicate that clinicians consider the service to be useful. An early and continuous dialogue between the clinician and the laboratory physician is a prerequisite for rational use of the service.
Carisoprodol abuse in Texas, 1998-2003.
J Med Toxicol. 2006 Mar; 2(1): 8-13
Forrester MB
INTRODUCTION: Texas poison centers identified carisoprodol as a skeletal muscle relaxant that is subject to abuse, and this investigation explores the abuse reported by Texas poison centers. METHODS: This study used data from six Texas poison centers to describe the epidemiology of carisoprodol abuse and drug identification (ID) calls from 1998 to 2003. RESULTS: Drug ID and abuse calls were 217% higher in 2003 than in 1998. Although eastern and central Texas contains 43% of the state's population, this region reported 77% of all drug ID calls and 64% of abuse calls. For male patients, 51% of the calls were abuse calls and 37% were other human carisoprodol exposure calls. Patients from 13 to 19 years of age accounted for 17% of abuse calls and 9% of other human exposure calls. Among those human exposure calls with a known medical outcome, a higher percentage of abuse calls involved minor effects while a greater proportion of other human exposure calls involved outcomes that ranged from moderate effects to death. CONCLUSIONS: Carisoprodol abuse is increasing in Texas and is substantially more common in the eastern part of the state. Carisoprodol abuse is much more likely, than other types of adverse carisoprodol exposures, to involve males and adolescents; and it less likely to involve adverse medical outcomes.
Clin Ther. 2007 Oct; 29(10): 2222-5
Owens C, Pugmire B, Salness T, Culbertson V, Force R, Cady P, Steiner J
BACKGROUND: Carisoprodol is a muscle relaxant indicated as adjunctive therapy in acute, painful musculoskeletal conditions. Case reports of drug-seeking behavior and utilization of carisoprodol in combination with opioids have suggested abuse potential. OBJECTIVES: We undertook a retrospective review of claims data to identify and characterize potential indicators of abuse in long-term users of carisoprodol and to determine any continued use of the drug by former long-term users following prior authorization implementation. METHODS: The Idaho Medicaid pharmacy and medical claims database was queried from January 1 to December 31, 2005, to identify long-term users of muscle relaxants. Use of concomitant opioids and coded diagnoses relating to past drug abuse were analyzed and compared between patients who used carisoprodol and patients who used other muscle relaxants. Data from 11 of 30 surveys mailed to pharmacies filling prescriptions for long-term users of carisoprodol were also collected to determine the frequency of self-pay-continued use after Medicaid coverage of the drug was discontinued. RESULTS: Long-term users of carisoprodol (n = 340) and other skeletal muscle relaxants (SMRs) (n = 453) were identified from among 130,000 individuals in the Idaho Medicaid pharmacy and medical claims database in calendar year 2005. Patients in both groups were similar in terms of mean age (~47 years) and sex (71.5% female). Patients using carisoprodol used concomitant opioids more frequently (81.5% vs 59.8%; P < 0.01), more commonly had past diagnoses indicating other drug abuse (34.1% vs 21.4%; P < 0.01), and in 80% of reported cases, continued to pay out of pocket for carisoprodol when third-party coverage was discontinued. Taken together, these findings are consistent with published case reports suggesting the abuse potential of carisoprodol. CONCLUSIONS: The results from this review suggest that, compared with long-term users of other SMRs, carisoprodol patients utilized concomitant opioids more frequently and concomitant NSAIDs less frequently, more commonly had past diagnoses indicating other drug dependence or abuse, and continued to pay out of pocket for carisoprodol when third-party coverage was discontinued. While none of these issues alone may be direct indicators of abuse, collectively they suggest that patients who used carisoprodol long term displayed abuse potential characteristics more frequently than long-term users of other agents.
Forensic Sci Int. 2008 Mar 21; 176(1): 47-50
Moore C, Marinetti L, Coulter C, Crompton K
This article discusses the immunoassay screening of pain management drugs, and the mass spectrometric confirmation of fentanyl in human hair. Hair specimens were screened for fentanyl, opiates (including oxycodone), tramadol, propoxyphene, carisoprodol, methadone, and benzodiazepines and any positive results were confirmed using gas chromatography or liquid chromatography with mass spectral detection. The specific focus of the work was the determination of fentanyl in hair, since autopsy specimens were also available for comparison with hair concentrations. Using two-dimensional gas chromatography with electron impact mass spectrometric detection, fentanyl was confirmed in four of nine hair specimens collected at autopsy. The accuracy of the assay at 10 pg/mg was 95.17% and the inter-day and intra-day precision was 5.04 and 13.24%, respectively (n=5). The assay was linear over the range 5-200 pg/mg with a correlation of r(2)>0.99. The equation of the calibration curve forced through the origin was y=0.0053x and the limit of quantitation of the assay was 5 pg/mg. The fentanyl concentrations detected were 12, 17, 490, and 1930 pg/mg and the results were compared with toxicology from routine post-mortem analysis. The screening of pain management drugs in hair is useful in cases where other matrices may not be available, and in routine testing of hair for abused drugs.
Is the frequency of carisoprodol withdrawal syndrome increasing?
Pharmacotherapy. 2007 Oct; 27(10): 1462-6
Reeves RR, Hammer JS, Pendarvis RO
Carisoprodol is a commonly used centrally acting muscle relaxant. A number of case reports have suggested that the drug may have abuse potential, presumably because it is metabolized to the anxiolytic drug, meprobamate, which is a controlled substance at the federal level. Two recent case reports described symptoms of withdrawal after the cessation of carisoprodol. We present two additional cases that support the concept of a withdrawal syndrome with this drug. Symptoms of carisoprodol withdrawal include anxiety, tremulousness, insomnia, jitteriness, muscle twitching, and hallucinations. These symptoms are most likely caused by withdrawal from the meprobamate that accumulates after large amounts of carisoprodol are ingested. Although carisoprodol is not a controlled substance at the federal level, clinicians should be aware of its significant potential for abuse.
The risk of traffic accidents after prescriptions of carisoprodol.
Accid Anal Prev. 2007 Sep; 39(5): 1050-5
Bramness JG, Skurtveit S, Mørland J, Engeland A
OBJECTIVE: Carisoprodol, a drug used for acute lower back pain, may cause psychomotor impairment. We wanted to investigate if patients using carisoprodol had increased risk of being involved in a traffic accident. METHODS: Data were retrieved from three population-based registries for the period April 2004-September 2005. The Norwegian Prescription Database contained individual information on all dispensed drugs at all pharmacies outside hospitals. The Norwegian Road Accident Registry contained information on all drivers involved in motor vehicle accidents with person injury. The Norwegian Central Population Registry was used to control for emigration or death. The accident incidence among carisoprodol exposed and unexposed subjects was compared by standardized incidence ratio. RESULTS: Having a prescription for carisoprodol dispensed increased the standardized incidence ratio for being involved in an accident with person injury to 3.7 (95% CI 2.9-4.8) the first week after the date of dispensing. This was similar to diazepam (2.8; 2.2-3.6), but higher than for salbutamol (1.1; 0.6-1.8). CONCLUSIONS: Patients receiving carisoprodol seem to have an increased risk of being involved in traffic accidents involving person injury. The study gives support to earlier work published on the impairing effects of carisoprodol.
Tidsskr Nor Laegeforen. 2007 May 17; 127(10): 1397
Buajordet I, Madsen S