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Baclofen, sold under the brand name Lioresal among others, is a medication used to treat muscle spasticity, such as from a spinal cord injury or multiple sclerosis. [8] [9] It may also be used for hiccups and muscle spasms near the end of life, [9] and off-label to treat alcohol use disorder [10] [11] or opioid withdrawal symptoms. [12]
Cyclobenzaprine was approved for medical use in the United States in 1977. [5] It is available by prescription as a generic medication. [5] In 2022, it was the 45th most commonly prescribed medication in the United States, with more than 13 million prescriptions. [8] [9] It was not available in the United Kingdom as of 2012. [10]
There is evidence, albeit limited, of the clinical effectiveness of baclofen, [168] dantrolene, [169] diazepam, [170] and tizanidine. [171] [172] [173] In the most complicated cases intrathecal injections of baclofen can be used. [174] There are also palliative measures like castings, splints or customized seatings. [93]
Cyclobenzaprine produces confusion and lethargy, as well as anticholinergic side effects. When taken in excess or in combination with other substances, it may also be toxic . While the body adjusts to this medication, it is possible for patients to experience dry mouth , fatigue , lightheadedness, constipation or blurred vision .
Effectiveness has not been clearly shown for metaxalone, methocarbamol, chlorzoxazone, baclofen, or dantrolene. [7] Applicable conditions include acute back [8] or neck pain, or pain after an injury. Long-term use of muscle relaxants in such cases is poorly supported. [8]
Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
Effectiveness appears similar to baclofen or diazepam. [4] It is taken by mouth. [5] Common side effects of tizanidine include dry mouth, sleepiness, weakness, and dizziness. [5] Serious side effects may include low blood pressure, liver problems, psychosis, and QT prolongation. [5] It is unclear if use in pregnancy and breastfeeding is safe. [6]
Side effects of thiocolchicoside can include nausea, allergy and vasovagal reactions. [15] Liver injury, pancreatitis, seizures, blood cell disorders, severe cutaneous disorders, rhabdomyolysis, and reproductive disorders have all been recorded in the French and European pharmacovigilance databases and in the periodic updates that the companies concerned submit to regulatory agencies.