Can you get high on cyclobenzaprine. Cyclobenzaprine Abuse: Understanding Flexeril Addiction and Its Dangers
Can cyclobenzaprine cause a high. What are the risks of abusing Flexeril. How does cyclobenzaprine interact with other substances. What are the side effects of misusing this muscle relaxant. How to recognize and treat cyclobenzaprine addiction.
The Mechanism of Action: How Cyclobenzaprine Works
Cyclobenzaprine, commonly known by its brand name Flexeril, is a muscle relaxant prescribed for short-term relief of muscle pain and spasms. Unlike some muscle relaxants that directly affect muscle tissue, cyclobenzaprine operates by influencing the central nervous system (CNS).
How does cyclobenzaprine achieve its pain-relieving effects. The medication works by blocking pain signals sent from nerves to the brain. This interaction with the CNS explains why cyclobenzaprine can have wide-ranging effects on various bodily functions, including respiratory, cardiovascular, and gastrointestinal systems.
- Onset of action: 20-40 minutes after ingestion
- Duration of effects: 4-6 hours for immediate-release tablets
- Extended-release tablets: Effects can last up to 24 hours
Why is cyclobenzaprine only recommended for short-term use. The medication has a long half-life, which means it can accumulate in the body over time. This accumulation increases the risk of toxic buildup and potential habituation, making it unsuitable for extended periods of use.
The Potential for Cyclobenzaprine Abuse: Can It Get You High?
While cyclobenzaprine is not classified as a controlled substance by the DEA, it still carries a risk of abuse. The question arises: can cyclobenzaprine produce a high. When used as prescribed, the medication has minimal risks. However, misuse can lead to a cyclobenzaprine high characterized by sedation and mild euphoria.
What constitutes misuse of cyclobenzaprine:
- Taking higher doses than prescribed
- Crushing or chewing tablets instead of swallowing them whole
- Using the medication without a prescription
The sedative properties of cyclobenzaprine contribute to its potential for abuse. Users may seek out these effects, leading to a pattern of misuse that can escalate to addiction. It’s important to note that the dangers of cyclobenzaprine increase significantly when combined with other substances, particularly CNS depressants.
Dangerous Interactions: Cyclobenzaprine and Other Substances
The risks associated with cyclobenzaprine use escalate dramatically when the drug is combined with other substances. These interactions can lead to severe health consequences and increase the likelihood of overdose.
Cyclobenzaprine and CNS Depressants
When cyclobenzaprine is mixed with central nervous system depressants, the effects of both substances are amplified. This combination can result in severe impairment of cognitive function, consciousness, and vital bodily processes.
Common CNS depressants that dangerously interact with cyclobenzaprine include:
- Alcohol
- Benzodiazepines
- Barbiturates
How does the combination of cyclobenzaprine and depressants increase overdose risk. The synergistic effect of these substances can lead to extreme drowsiness and profound CNS depression, potentially resulting in respiratory failure or other life-threatening complications.
Cyclobenzaprine and Stimulants
Contrary to what one might expect, combining cyclobenzaprine with stimulants can also be hazardous. This combination can lead to unpredictable effects and increase the strain on the cardiovascular system.
Cyclobenzaprine and Antidepressants
The interaction between cyclobenzaprine and certain antidepressants, particularly those affecting serotonin levels, can be particularly dangerous. This combination can lead to a condition known as serotonin syndrome.
What is serotonin syndrome. It’s a potentially life-threatening condition caused by an excess of serotonin in the body. Symptoms can range from mild to severe and may include:
- Agitation
- Confusion
- Rapid heart rate
- High blood pressure
- Dilated pupils
- Muscle rigidity
- Seizures
In severe cases, serotonin syndrome can lead to coma or death. The onset of symptoms can occur within hours of taking the interacting medications.
Recognizing Cyclobenzaprine Abuse: Signs and Symptoms
Identifying cyclobenzaprine abuse can be challenging, as some of the effects may mimic the drug’s intended therapeutic action. However, certain signs and symptoms may indicate misuse or addiction.
Physical Signs of Cyclobenzaprine Abuse
- Excessive drowsiness or sedation
- Slurred speech
- Impaired coordination
- Dilated pupils
- Dry mouth
- Constipation
- Rapid or irregular heartbeat
Behavioral Signs of Cyclobenzaprine Abuse
- Doctor shopping (seeking prescriptions from multiple healthcare providers)
- Requesting early refills
- Claiming to have lost prescriptions
- Social withdrawal
- Neglecting responsibilities
- Mood swings
- Secretive behavior
How can you differentiate between therapeutic use and abuse of cyclobenzaprine. Look for patterns of escalating use, attempts to obtain the drug through illegitimate means, and continued use despite negative consequences. If you suspect someone is abusing cyclobenzaprine, it’s crucial to seek professional help.
The Dangers of Cyclobenzaprine Overdose
While cyclobenzaprine is generally considered to have a low risk of overdose when used alone, the danger increases significantly when the drug is misused or combined with other substances. Understanding the signs of a cyclobenzaprine overdose can be life-saving.
Symptoms of Cyclobenzaprine Overdose
- Severe drowsiness
- Confusion or disorientation
- Hallucinations
- Rapid, pounding heartbeat
- High blood pressure
- Tremors or seizures
- Nausea and vomiting
- Difficulty breathing
- Loss of consciousness
What should you do if you suspect a cyclobenzaprine overdose. Immediate medical attention is crucial. Call emergency services right away and provide as much information as possible about the amount of cyclobenzaprine taken and any other substances involved.
Treatment for cyclobenzaprine overdose may include:
- Activated charcoal to absorb the drug
- Intravenous fluids
- Respiratory support
- Monitoring of vital signs
- In severe cases, specific medications to counteract the effects
Long-Term Effects of Cyclobenzaprine Abuse
While cyclobenzaprine is intended for short-term use, prolonged misuse can lead to various long-term health consequences. Understanding these risks is crucial for anyone considering or currently misusing this medication.
Physical Health Consequences
- Liver damage: Chronic use can strain the liver, potentially leading to hepatotoxicity.
- Cardiovascular issues: Long-term abuse may contribute to heart rhythm abnormalities and hypertension.
- Gastrointestinal problems: Prolonged use can cause chronic constipation and other digestive issues.
- Cognitive impairment: Consistent abuse may lead to memory problems and decreased cognitive function.
Mental Health Impact
How does long-term cyclobenzaprine abuse affect mental health. Chronic misuse can exacerbate or trigger various mental health issues, including:
- Depression
- Anxiety disorders
- Mood swings
- Sleep disturbances
Moreover, the development of tolerance and dependence can lead to a cycle of escalating use, further compounding these mental health risks.
Social and Occupational Consequences
The impact of cyclobenzaprine abuse extends beyond physical and mental health. Long-term misuse can significantly affect an individual’s social life and professional performance:
- Strained relationships due to mood changes and drug-seeking behavior
- Decreased work performance and potential job loss
- Financial difficulties from purchasing drugs or lost income
- Legal issues related to obtaining or using the drug illegally
Treatment Options for Cyclobenzaprine Addiction
Overcoming cyclobenzaprine addiction requires a comprehensive approach tailored to the individual’s needs. While the drug itself may not cause severe physical dependence like opioids, psychological dependence can be significant.
Medical Detoxification
What is the first step in treating cyclobenzaprine addiction. Typically, the process begins with medical detoxification. During this phase, healthcare professionals monitor the individual as they discontinue cyclobenzaprine use, managing any withdrawal symptoms that may arise.
Common withdrawal symptoms may include:
- Nausea
- Headache
- Fatigue
- Anxiety
- Sleep disturbances
Inpatient Rehabilitation
For individuals with severe addiction or those who have been unsuccessful with outpatient treatment, inpatient rehabilitation may be recommended. This intensive approach provides:
- 24/7 medical supervision
- Structured environment free from triggers
- Individual and group therapy sessions
- Holistic treatments such as yoga or meditation
- Education on addiction and coping strategies
Outpatient Treatment Programs
For those with less severe addiction or strong support systems at home, outpatient treatment can be effective. These programs allow individuals to maintain their daily responsibilities while receiving treatment. Outpatient options include:
- Intensive Outpatient Programs (IOP)
- Partial Hospitalization Programs (PHP)
- Regular outpatient counseling
Behavioral Therapies
Various forms of behavioral therapy play a crucial role in treating cyclobenzaprine addiction. These may include:
- Cognitive-Behavioral Therapy (CBT): Helps identify and change negative thought patterns and behaviors
- Motivational Interviewing: Enhances motivation for change
- Contingency Management: Provides tangible rewards for maintaining sobriety
- Family Therapy: Addresses family dynamics that may contribute to or be affected by addiction
Support Groups
Participation in support groups can be a valuable component of long-term recovery. These groups provide peer support, accountability, and a sense of community. Options include:
- Narcotics Anonymous (NA)
- SMART Recovery
- LifeRing Secular Recovery
How do support groups complement professional treatment. They offer ongoing support and reinforcement of recovery principles, helping individuals maintain their sobriety long after formal treatment has ended.
Aftercare Planning
A comprehensive aftercare plan is crucial for maintaining long-term recovery. This may include:
- Ongoing therapy sessions
- Regular check-ins with a healthcare provider
- Continued participation in support groups
- Development of healthy coping mechanisms and lifestyle changes
Why is aftercare planning important in cyclobenzaprine addiction treatment. It helps individuals transition back to daily life while maintaining their recovery, reducing the risk of relapse and providing ongoing support as they navigate challenges.
Preventing Cyclobenzaprine Abuse: Education and Awareness
Prevention is a crucial aspect of addressing cyclobenzaprine abuse. Raising awareness about the risks associated with misuse and providing education on proper use can help reduce the incidence of addiction.
Healthcare Provider Education
Healthcare providers play a vital role in preventing cyclobenzaprine abuse. Key areas of focus include:
- Proper prescribing practices, emphasizing short-term use
- Screening patients for risk factors of substance abuse
- Educating patients on the risks of misuse and potential interactions
- Monitoring patients for signs of developing dependence
Patient Education
Patients prescribed cyclobenzaprine should receive comprehensive education about the medication, including:
- Proper dosage and administration
- Potential side effects and risks
- Importance of adhering to the prescribed duration of use
- Dangers of combining cyclobenzaprine with other substances
- Signs of dependence or addiction to watch for
Public Awareness Campaigns
Broader public education efforts can help raise awareness about the risks of prescription drug abuse, including cyclobenzaprine. These campaigns may focus on:
- Dispelling myths about the safety of prescription medications
- Providing information on safe storage and disposal of medications
- Encouraging open communication about substance abuse within families and communities
- Promoting awareness of available treatment options
How can public awareness campaigns effectively reach diverse populations. Utilizing various media channels, partnering with community organizations, and tailoring messages to specific demographic groups can enhance the reach and impact of these efforts.
School-Based Prevention Programs
Implementing drug education programs in schools can help prevent cyclobenzaprine abuse among young people. Effective programs often include:
- Age-appropriate information about prescription drug risks
- Development of refusal skills and healthy coping mechanisms
- Peer-led initiatives to promote drug-free lifestyles
- Resources for students to seek help if they or someone they know is struggling with substance abuse
Workplace Initiatives
Employers can play a role in preventing cyclobenzaprine abuse by implementing workplace wellness programs that include:
- Education on prescription drug safety
- Stress management techniques to reduce the likelihood of substance abuse
- Employee assistance programs that provide confidential support for substance abuse issues
- Clear policies on prescription drug use in the workplace
By implementing comprehensive prevention strategies across various sectors of society, we can work towards reducing the incidence of cyclobenzaprine abuse and its associated harms.
What Does A Cyclobenzaprine High Feel Like? Is It Dangerous?
Cyclobenzaprine, better known as the brand name medication Flexeril, is a muscle relaxant used to treat muscle-related pain such as tenderness and spasms from strains and other types of muscle injuries. Despite being deemed low to no-risk by the DEA (Flexeril is not a controlled substance) cyclobenzaprine abuse is a fairly regular occurrence that is at its most dangerous when it’s combined with other substances be they legal or illicit, depressant or stimulant.
How Does Cyclobenzaprine Work?
Cyclobenzaprine works by blocking the pain signals sent from nerves to the brain (two key components of the central nervous system), rather than impacting the muscles directly. Like any other drug that impacts the CNS, side effects are far-reaching and affect respiratory, cardiovascular, and even gastrointestinal function. Side effects can take place within 20 to 40 minutes of ingestion and last 4-6 hours for immediate-release tablets or up to 24 hours for extended-release tablets.
Pain medication of any kind has a high potential to be habit-forming, but those with long half-lives such as cyclobenzaprine face a significant risk of doing so and causing toxic levels of medication build-up. As a result, this medication is only intended for short-term use or periods for a few weeks at a time.
Can Cyclobenzaprine Get You High?
On its own, cyclobenzaprine has minimal risks or long-term effects. However, it does have sedative properties, and misusing this drug (taking too much, crushing or chewing a capsule rather than swallowing, using it without a prescription) can result in a cyclobenzaprine high.
A cyclobenzaprine high causes feelings of sedation and mild euphoria. Those effects—and its dangers—are heightened when cyclobenzaprine is combined with other drugs, particularly central nervous system depressants such as alcohol, benzos, and barbiturates.
Wherever there are drug highs to be found, there are adverse effects including the risk of overdosing, developing an addiction, and even withdrawal effects.
In rare circumstances, cyclobenzaprine can even cause life-threatening complications.
Risks & Drug Interactions
The risk of adverse side effects becomes more serious in instances when cyclobenzaprine was combined with other drugs. When mixed with depressants, it can amplify the effects of those drugs to cause intense and debilitating consequences that affect cognition, consciousness, and basic bodily functions. It also significantly increases the likelihood of a cyclobenzaprine overdose which can result in extreme drowsiness and CNS depression.
However, cyclobenzaprine can also be harmful when combined with stimulants, antidepressants, or even simple over-the-counter migraine medication. The presence of cyclobenzaprine in the body can cause a condition called serotonin syndrome; when there’s too much serotonin being present in the body. These symptoms can take effect within hours of taking a medication, ranging from mild to severe, and yes, can even result in death.
Side Effects of Cyclobenzaprine Abuse
Common Side Effects
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Extreme fatigue
- Heartburn
- Headache
- Increased heart rate
- Nausea
Uncommon Side Effects
- Chest pain
- Difficulty breathing
- Fast or irregular heartbeat
- Hives or skin rash
- Swelling of tongue or face
Serious Side Effects
- Agitation
- Diarrhea
- Fast heartbeat
- Fever
- Hallucinations
- Loss of coordination
- Muscle stiffness
- Slurred speech
- Shivering
- Sweating
- Twitching
- Vomiting
Struggling With Prescription Painkillers?
If you are struggling with prescription painkillers, you’re not alone.
These drugs (including opioid analgesics) are the leading cause of addiction and overdose in the nation. Specialized addiction treatment centers can help individuals get through unpleasant withdrawal side effects and safely overcome any compulsive or inappropriate use of pain meds. Call today to learn more.
Sources:
https://www.drugs.com/tips/cyclobenzaprine-patient-tips
https://medlineplus.gov/druginfo/meds/a682514.html
Treatment for Recreational Use of Flexeril
A prescription-based medication, cyclobenzaprine (known by the brand names Flexeril and Amrix) is similar to tricyclic antidepressants and being both diverted and abused, Drug Enforcement Administration (DEA) reports.
Designed for the short-term relief of limited motion and pain that may be caused by muscle spasms, cyclobenzaprine is a central nervous system muscle relaxer that may stop hyperactive nerve firings that can cause muscles to spasm.
The DEA reports that there were more than 25 million prescriptions written for cyclobenzaprine in 2011, which may be a common medication prescribed for back pain.
Flexeril comes in tablet form in both immediate- and extended-release formations to be swallowed.
Who Abuses Flexeril and Why?
NIDA reports that young adults between the ages of 18 and 25 (according to 2014 data) abuse prescription drugs at the highest rates of any other age demographic. Young adults may use the Internet to access information on how to abuse Flexeril and the possible desirable effects that may come from the drug’s recreational use. Flexeril may be used to heighten the effects of alcohol or other drugs when used recreationally.
Prescription drugs are abused across almost all age, gender, race, cultural, and socioeconomic demographics, however. For example, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that prescription drug abuse is increasing for older adults in their 50s, which may be of particular concern due to the range of negative side effects that specifically impact this population group. Flexeril in particular is not even generally prescribed to the elderly population, according to the FDA, because of the high risk factors.
Additionally, individuals with a legitimate prescription to Flexeril may develop a tolerance to the drug, requiring them to take higher and more frequent doses to feel its effects. Drug dependence can develop wherein the brain becomes accustomed to the interaction of cyclobenzaprine and begins to rely on it in order to keep functioning the same way.
Dependence on cyclobenzaprine is recognized by the onset of withdrawal symptoms when the drug leaves the bloodstream. These may include fatigue, nausea, headache, and general malaise.
Understanding Drug Dependence and Addiction
The terms drug dependence and addiction are often used interchangeably; however, they are not the same thing. A dependence on a drug can occur independently of addiction. It is a physical reaction to the brain needing a particular drug to remain balanced. Drug dependence can form even when a drug is taken for medical reasons and used exactly as prescribed. Narcotic drugs, like opioids, and sedatives, like benzodiazepines and tricyclic antidepressants (which are similar in structure to cyclobenzaprine), can cause physical dependence.
Medical help is needed to stop taking a drug after a person has become dependent on it, as withdrawal symptoms and drug cravings may be significant. Instead of stopping the drug suddenly, these drugs can be tapered off slowly, or their dosage slowly reduced over a period of time to minimize withdrawal. This should only be done under medical supervision. Significant dependence, often created by the nonmedical use of drugs, is best treated with medical detox where medications may be used and medical supervision is available around the clock.
Addiction is not just physical but also behavioral. Addiction is classified as a disease by the American Society of Addiction Medicine (ASAM) that is related to changes in brain structure and chemical makeup as the result of substance abuse. The main indicator of drug addiction is a loss of control over drug use. An individual battling addiction may make multiple attempts to stop using the drug, may take more than intended at one time, or may take the drug for longer than initially desired.
Individuals suffering from addiction may use drugs in situations that could potentially be hazardous and continue abusing them even when negative consequences are clear.
Signs of a Cyclobenzaprine Overdose
A drug overdose occurs when a toxin is unable to be successfully metabolized and removed from the body, and certain bodily functions are negatively affected. In the case of cyclobenzaprine, the Journal of Occupational Medicine and Toxicology reports that more than 100 mg of the drug taken in one dose can cause a toxic overdose.
The FDA publishes the following as potential overdose signs of Flexural:
- Drowsiness
- Rapid heart rate (tachycardia)
- High blood pressure (hypertension)
- Tremors
- Slurred speech
- Agitation
- Confusion
- Dizziness
- Nausea
- Vomiting
- Hallucinations
- Loss of muscle control (ataxia)
- Coma
Less common and more serious symptoms of a Flexeril overdose, according to the drug’s prescription information published by the FDA, include:
- Chest pain
- Seizures
- Extremely low blood pressure (hypotension)
- The heart stops beating (cardiac arrest)
- Irregular heart rate (cardiac dysrhythmia)
- Fever, muscle rigidity, and altered mental state (neuroleptic malignant syndrome)
A toxic overdose necessitates immediate medical attention.
The DEA reported that in 2010, there were over 10,000 mentions of cyclobenzaprine in calls to the American Association of Poison Control Centers. The Drug Abuse Warning Network (DAWN) published that in 2011, more than 11,000 people sought emergency department (ED) treatment for abuse of cyclobenzaprine.
Recovery Is Possible
If an overdose on cyclobenzaprine is suspected, call 911. Immediate medical attention is always needed in cases of overdose.
If you, or someone you love, have been struggling with Flexeril abuse, treatment is needed. With medical detox and comprehensive addiction treatment, you can leave such abuse in your past and embrace a happier, healthier future without substance abuse of any kind.
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antidepressants
Last Updated on Nov 16, 2022
Rec. drug interaction Included in preparations: Pharmacological actionCyclobenzaprine is a centrally acting muscle relaxant. Indications of the active substance |
INN| M40-M54 | Dorsopathies (M40-M54) |
| M54 | Dorsalgia |
| M54.2 | Cervicalgia |
| M54.3 | Sciatica |
M54. 4 | Lumbago with sciatica |
| M54.6 | Pain in the thoracic spine |
| R25.2 | Convulsions and spasm |
Dosing regimen
Int. The recommended dose for adults is 15 mg/day. If necessary, the dose can be increased to 22.5-30 mg / day.
Elderly patients, patients with mild hepatic impairment require dose adjustment. The use of cyclobenzaprine in patients with moderate to severe hepatic impairment is not recommended.
Side effects
Mental disorders: very often – drowsiness; often – irritability, anxiety; infrequently – psychosis, agitation, abnormal thoughts and dreams, hallucinations, disorientation, depression, insomnia.
From the side of the central nervous system: often – headache, dizziness, fatigue; infrequently – fainting, convulsions, ataxia, dysarthria, tremor, convulsions, muscle hypertonicity, serotonin syndrome, paresthesia, tinnitus, diplopia, taste disturbances.
From the immune system: infrequently – severe allergic reactions (anaphylactic reactions, angioedema), swelling of the face, swelling of the tongue, itching, rash, urticaria.
From the urinary system: infrequently – increased frequency of urination, urinary retention.
From the respiratory system: often – pharyngitis, infections of the upper respiratory tract.
From the digestive system: very often – dry mouth; often – abdominal pain, gastroesophageal reflux, constipation, diarrhea, nausea; infrequently – vomiting, anorexia, gastritis, thirst, bloating, jaundice, hepatitis, cholestasis, increased ALT activity.
From the side of the cardiovascular system: infrequently – tachycardia, arrhythmia, palpitations, hypotension, vasodilation.
On the part of the body as a whole: infrequently – increased sweating, weakness in certain muscle groups, malaise.
Contraindications for use
Hypersensitivity to cyclobenzaprine; the simultaneous use of drugs from the group of MAO inhibitors or the end of the course of treatment with MAO inhibitors less than 14 days before the start of therapy with cyclobenzaprine; recovery period after acute myocardial infarction; cardiac arrhythmia and conduction disorders, including blockade of the conduction system of the heart; congestive heart failure; hyperthyroidism; age up to 18 years.
Pregnancy and lactation
Contraindicated during pregnancy and during breastfeeding.
Use in hepatic impairment
Patients with mild hepatic impairment require dose adjustment. The use of cyclobenzaprine in patients with moderate to severe hepatic impairment is not recommended
Use in children
Use is contraindicated in children and adolescents under 18 years of age.
Elderly use
Cyclobenzaprine should be used in elderly patients only if absolutely necessary, dose adjustment is required.
Precautions
Cyclobenzaprine should only be used for a short period (up to 2-3 weeks) as there is insufficient evidence of efficacy over a longer period of time. The use of the drug cyclobenzaprine has not been shown to be effective in the treatment of muscle spasm associated with diseases of the brain or spinal cord, or with cerebral palsy.
In the elderly, the concentration of cyclobenzaprine in blood plasma increases.
Also, in elderly patients, the risk of adverse reactions from the central nervous system and from the cardiovascular system, as well as the risk of developing drug interactions and the effect of the drug on concomitant diseases, may be increased. In this regard, cyclobenzaprine should be used in elderly patients only if clearly needed.
The concentration of cyclobenzaprine in patients with impaired liver function is increased. Cyclobenzaprine should be used with caution in patients with mild hepatic impairment. The use of cyclobenzaprine in patients with moderate to severe hepatic impairment is not recommended due to insufficient data on the use.
Sudden discontinuation of the drug after prolonged use may in rare cases cause nausea, headache and malaise. These symptoms do not indicate the development of addiction.
Influence on the ability to drive vehicles and mechanisms
increased concentration of attention and speed of psychomotor reactions.
Drug interactions
The development of a potentially life-threatening condition – serotonin syndrome has been reported with the use of cyclobenzaprine in combination with the following drugs: selective serotonin reuptake inhibitors, selective serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, tramadol, buprop ion, meperidine , verapamil or MAO inhibitors.
If the development of symptoms of serotonin syndrome is noted, it is necessary to immediately stop taking cyclobenzaprine and any concomitant serotonergic agents and start symptomatic treatment.
If concomitant treatment with cyclobenzaprine and other serotonergic drugs is clinically warranted, careful monitoring of the patient is recommended, especially at the start of treatment or when the dose is increased.
Cyclobenzaprine is structurally similar to tricyclic antidepressants. Against the background of the use of tricyclic antidepressants, cases of arrhythmia, sinus tachycardia, intracardiac conduction disturbances, which can cause the development of myocardial infarction and stroke, have been reported.
Some of the more serious CNS reactions associated with tricyclic antidepressants have been observed in short-term studies with cyclobenzaprine for indications other than skeletal muscle spasm for musculoskeletal disorders, mostly at higher than recommended doses.