Cyclobenzaprine (Flexeril) Abuse and Withdrawal

Cyclobenzaprine, commonly known by the brand name Flexeril, is a potent pain reliever and muscle relaxant used to treat injuries or sprains. Its sedative properties contribute to its potential for abuse. In addition to improper use, people may experience symptoms of withdrawal when cyclobenzaprine is discontinued abruptly.

Cyclobenzaprine Withdrawal Symptoms

Cyclobenzaprine withdrawal can be relatively mild with the potential for severe withdrawal depending on the dose, length of time used, and whether other drugs and substances are used concurrently with Flexeril1. Common withdrawal symptoms include2:

  • Headache
  • Fever
  • Malaise
  • Fatigue

Additional symptoms may be present during withdrawal if cyclobenzaprine was used in conjunction with other drugs like opiates or alcohol.

How long do cyclobenzaprine withdrawal symptoms last?

Cyclobenzaprine Withdrawal Timeline

Since withdrawal symptoms can vary from person to person, there is no established timeline for how long cyclobenzaprine withdrawal will last. The likelihood of severe withdrawal from discontinuation of cyclobenzaprine alone is low3. Those that experience withdrawal generally report onset of symptoms a day or two after discontinuing the medication. Withdrawal from cyclobenzaprine has the potential to last one to two weeks4, with symptoms peaking 3-4 days after the drug is discontinued. 

The Addictive Potential of Cyclobenzaprine

Cyclobenzaprine is not currently listed as a controlled substance by the US government, indicating it has a low potential for addiction. Nonetheless, addiction and abuse is possible, particularly when combined with other substances. Addiction is characterized by intense cravings for the drug as well as withdrawal symptoms when drug use is discontinued.
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Signs of Abuse

General signs of Cyclobenzaprine abuse or addiction may indicate problematic use of cyclobenzaprine. These include:

  • Taking cyclobenzaprine without a prescription
  • Taking cyclobenzaprine more frequently or for longer than prescribed
  • Mixing cyclobenzaprine with other substances like alcohol or opiates
  • Loss of interest in other activities
  • Withdrawal from family and friends
  • Neglect of personal responsibilities including home and work obligations
  • Inability to stop using cyclobenzaprine even when harmful side effects are present

Cyclobenzaprine Detox and Withdrawal

Persistent symptoms of withdrawal that are alleviated by continued drug use after attempting to discontinue cyclobenzaprine can be a sign of addiction. Though the detox period can be marked by withdrawal symptoms, they are unlikely to be harmful or deadly. To help with these withdrawal symptoms, individuals may choose to seek out help during the detox period. 

Medical detox provides individuals with necessary care to treat the uncomfortable withdrawal symptoms as well as professional treatment as part of individual or group therapy. Professional and medical support during the detox period can reduce the risk of relapse.

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Treatment for Cyclobenzaprine Addiction

Treatment for cyclobenzaprine may be tailored to individuals depending on whether other drugs are also being abused. This can make withdrawal symptoms more severe and thus treatment more difficult. As a result, treatment can be tailored to address addiction severity. 

Inpatient treatment may be required for individuals who have more severe addiction and may need medically assisted detox to treat cyclobenzaprine and other associated withdrawal symptoms. Since this plan provides round-the-clock care, individuals can get support when needed to reduce the risk of relapse. This treatment option may also be ideal for removing individuals from toxic environments where remaining sober can be difficult. 

Therapy or support groups may be part of inpatient treatment programs or can be sought externally as part of the recovery process. Therapy for abuse and addiction typically seeks to identify triggers and patterns that lead to problematic drug use. Other therapeutic interventions or support groups may focus on vocational training or occupational therapy in order to help the individual reintegrate into life after recovery. 

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References:
  1. S. Department of Health and Human Services; U.S. Food and Drug Administration (FDA)—FDA Approved Drug Products. (2013). FLEXERIL (CYCLOBENZAPRINE HCL) TABLETS.
  2. Drug Enforcement Administration—Diversion Control Division. (2019). Cyclobenzaprine.
  3. Kaye A.D., Daste L.E. (2015) Muscle Relaxants and Antispasticity Medications. In: Sackheim K. (eds) Pain Management and Palliative Care. Springer, New York, NY. 
  4.  https://americanaddictioncenters.org/prescription-drugs/side-effects-of-muscle-relaxers