Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new cyclobenzaprine research articles will be listed here shortly after becoming available to us.
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Medical research on cyclobenzaprine
Pharmacotherapy. 2008 Feb; 28(2): 207-13
See S, Ginzburg R
Health care providers prescribe skeletal muscle relaxants for a variety of indications. However, the comparative efficacy of these drugs is not well known. Skeletal muscle relaxants consist of both antispasticity and antispasmodic agents, a distinction prescribers often overlook. The antispasticity agents-baclofen, tizanidine, dantrolene, and diazepam-aid in improving muscle hypertonicity and involuntary jerks. Antispasmodic agents, such as cyclobenzaprine, are primarily used to treat musculoskeletal conditions. Much of the evidence from clinical trials regarding skeletal muscle relaxants is limited because of poor methodologic design, insensitive assessment methods, and small numbers of patients. Although trial results seem to support the use of these agents for their respective indications, efficacy data from comparator trials did not particularly favor one skeletal muscle relaxant over another. Therefore, the choice of a skeletal muscle relaxant should be based on its adverse-effect profile, tolerability, and cost.
Extended-release cyclobenzaprine (Amrix).
Med Lett Drugs Ther. 2007 Dec 17; 49(1276): 102-3
Inappropriate prescribing in an older ED population.
Am J Emerg Med. 2007 Sep; 25(7): 804-7
Hustey FM, Wallis N, Miller J
The objective of this study was to determine the prevalence of potentially inappropriate medication (PIMs) use in older emergency department (ED) patients based on the updated 2002 Beers criteria. This was a retrospective analysis of 352 consecutive ED visits by patients aged 65 years and older. The mean number of medications taken was 8.4 per patient. In the study population, 111 (32%; 95% confidence interval [CI], 27-36) of 352 patients were taking at least 1 PIM at ED presentation. Propoxyphene/acetaminophen (24/352, 7%; 95% CI, 4-10), muscle relaxants (14/352, 4%; 95% CI, 2-7), and antihistamines (12/352, 3%; 95% CI, 2-6) were the most common PIMs. Among 101 of 193 patients discharged home from the ED with a new prescription, 13 (13%; 95% CI, 6-19) were also given PIMs. The most common PIMs were propoxyphene/acetaminophen (3/101; 95% CI, 1-8), diazepam (3/101; 95% CI, 1-8), cyclobenzaprine (2/101, 2%; 95% CI, 0-7), and diphenhydramine (2/101, 2%; 95% CI, 0-7). Outpatient PIM use in older ED patients is highly prevalent. Further education is needed regarding prescribing practices in this population group.
Pharmeur Sci Notes. 2005 Aug; 2005(1): 15-20
Dixon SP, Lodi A, Miller JH, Skellern GG
An isocratic reversed-phase liquid chromatographic method is described using a hybrid column for the control of synthetic impurities potentially found in amitriptyline hydrochloride. The method has been validated and is capable of controlling impurities to 0.1 per cent.
J Anal Toxicol. 2007 Jun; 31(5): 270-5
Melanson SE, Lewandrowski EL, Griggs DA, Flood JG
Patients taking tricyclic antidepressants (TCA) can experience toxicity or severe side effects. As a rapid and less technically demanding alternative to quantitative serum analysis, most laboratories offer qualitative immunoassays to assist in the evaluation of a suspected TCA overdose. However, the relationship between quantitative serum and qualitative urine levels of TCA-related compounds and their metabolites has not been comprehensively studied. Serum high-performance liquid chromatography results were compared to the qualitative urine results using the Syva Rapid Test and the Biosite Triage. Serum concentrations of amitriptyline, desipramine, doxepin, imipramine, and nortriptyline ranging from subtherapeutic to toxic triggered a positive response on both urine immunoassay devices. On the other hand, neither immunoassay uniformly detected clomipramine, even at serum levels greater than the therapeutic range. False positives due to cyclobenzaprine were more common with the Biosite assay. For virtually all positive urine TCA findings, it was not possible to determine whether the positive results corresponded to subtherapeutic, therapeutic, supratherapeutic, or toxic serum concentrations. Because urine immunoassays are the only option for many laboratories analyzing specimens for TCAs (especially in an emergency setting), clinicians must understand the limitations and interpret results in conjunction with clinical findings and/or quantitation of serum levels.
An internet survey of 2,596 people with fibromyalgia.
BMC Musculoskelet Disord. 2007; 8: 27
Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L
BACKGROUND: This study explored the feasibility of using an Internet survey of people with fibromyalgia (FM), with a view to providing information on demographics, sources of information, symptoms, functionality, perceived aggravating factors, perceived triggering events, health care utilization, management strategies, and medication use. METHODS: A survey questionnaire was developed by the National Fibromyalgia Association (NFA) in conjunction with a task force of "experts in the field". The questionnaire underwent several rounds of testing to improve its face validity, content validity, clarity and readability before it was mounted on the internet. The questionnaire consisted of 121 items and is available online at the website of the National Fibromyalgia Association. RESULTS: The questionnaire was completed by 2,569 people. Most were from the United States, with at least one respondent from each of the 50 states. Respondents were predominantly middle-aged Caucasian females, most of whom had FM symptoms for > or = 4 years. The most common problems were morning stiffness, fatigue, nonrestorative sleep, pain, concentration, and memory. Aggravating factors included: emotional distress, weather changes, insomnia, and strenuous activity. Respondents rated the most effective management modalities as rest, heat, pain medications, antidepressants, and hypnotics. The most commonly used medications were: acetaminophen, ibuprofen, naproxen, cyclobenzaprine, amitriptyline, and aspirin. The medications perceived to be the most effective were: hydrocodone preparations, aprazolam, oxycodone preparations, zolpidem, cyclobenzaprine, and clonazepam. CONCLUSION: This survey provides a snap-shot of FM at the end of 2005, as reported by a self-selected population of people. This descriptive data has a heuristic function, in that it identifies several issues for further research, such as the prescribing habits of FM health care providers, the role of emotional precipitants, the impact of obesity, the significance of low back pain and the nature of FM related stiffness.
Psychol Health Med. 2006 Nov; 11(4): 498-506
García J, Simón MA, Durán M, Canceller J, Aneiros FJ
Given that studies about the differential efficacy of existing treatments in fibromyalgia syndrome are scarce, the aim of this study was to compare the differential efficacy of a cognitive-behavioral and a pharmacological therapy on fibromyalgia. Using a randomized controlled clinical trial, 28 fibromyalgic patients were assigned to one of following experimental conditions: (a) pharmacological treatment (i.e., cyclobenzaprine), (b) cognitive-behavioral intervention (i.e., stress inoculation training), (c) combined pharmacological and cognitive-behavioral treatment and (d) no treatment. The results show the superiority of cognitive-behavioral intervention to reduce the severity of fibromyalgia both at the end of the treatment and at follow-up. We conclude that cognitive-behavioral interventions must be considered a primary treatment of fibromyalgia syndrome.
Serotonin syndrome from the interaction of cyclobenzaprine with other serotoninergic drugs.
Anesth Analg. 2006 Dec; 103(6): 1466-8
Keegan MT, Brown DR, Rabinstein AA
Serotonin syndrome is a potentially lethal adverse drug reaction that may occur in patients taking proserotoninergic medications. Drug interactions are often responsible for the causation of this syndrome. We report two cases of severe serotonin syndrome induced by the administration of cyclobenzaprine in postoperative patients already receiving another proserotoninergic drug (phenelzine in one case and duloxetine in the other). In both cases, symptoms of autonomic instability and severe agitation started within hours of initiation of cyclobenzaprine and fully resolved within 3 days after discontinuing the proserotoninergic drugs. We conclude that cyclobenzaprine should be used with extreme caution in patients receiving other serotonin-enhancing drugs; these patients should be closely monitored for manifestations of serotonin syndrome.
Rhabdomyolysis: a manifestation of cyclobenzaprine toxicity.
J Occup Med Toxicol. 2006; 1: 16
Chabria SB
A case of cyclobenzaprine (flexeril) overdose and the resultant rhabdomyolysis is presented. A review of the range of clinical toxicity, management of overdose is described. The similarity of cyclobenzaprine to the tricyclic antidepressant class is emphasized; this report attempts to disseminate related information on this commonly prescribed centrally acting muscle relaxant.
Top Stroke Rehabil. 2005; 12(4): 37-49
Zorowitz RD, Smout RJ, Gassaway JA, Horn SD
Pain remains one of the most common, yet most challenging, medical problems in health care today, and it is one of the most common complications that occurs after a stroke. Pain can affect the course of stroke rehabilitation adversely, and it occasionally may be a cause for transfer back to an acute care hospital. The Post-Stroke Rehabilitation Outcomes Project (PSROP) database was used to describe the incidence of pain by body location and trends in the use of different classifications of medications to treat pain. Of the 1,122 participants in the PSROP database, the most common locations of pain in stroke survivors were the head, leg, back, and shoulder. The most frequently prescribed classifications of pain medications were other analgesics (acetaminophen and tramadol), followed by narcotic analgesics, non-steroidal antiinflammatory drugs (NSAIDs), anticonvulsants, and tricyclic antidepressants. After acetaminophen, the most frequently prescribed medications in each classification, respectively, include hydrocodone APAP, cox-2 inhibitors, gabapentin, and amitriptyline. Other frequently prescribed pain medications included sumatriptan (migraine analgesic), cyclobenzaprine (muscle relaxant), and baclofen (antispasticity muscle relaxant). Medications should be chosen based upon the medical condition causing pain, the ability of the stroke survivor to comply with administration of the medication, and the cost of the medication. Appropriate and timely treatments of painful conditions result in maximum function and the ability to lead active lives and maintain an adequate quality of life.