Is Cyclobenzaprine Addictive? What to Know About Dependence, Misuse, and Warning Signs

Is Cyclobenzaprine Addictive?

Cyclobenzaprine is not a controlled substance [1] under the Drug Enforcement Administration’s (DEA) Controlled Substances Act and, therefore, has a lower potential for addiction compared to opioids and benzodiazepines. Despite this, the potential for misuse of cyclobenzaprine does exist, and using cyclobenzaprine [2] over extended periods or taking higher doses than prescribed may lead to dependence.

The majority of people who take cyclobenzaprine specifically to relieve muscle pain for a short term probably will not develop an addiction to the drug; however, problematic usage [1] exists, especially with extended use and when taken in combination with other substances.

What Is Cyclobenzaprine?

What is it Used For?

Cyclobenzaprine, an oral tablet, has been primarily prescribed [3] as a muscle relaxant for the reduction of acute muscle spasms associated with musculoskeletal disorders; it is typically used with physical therapy and rest rather than alone.

How Cyclobenzaprine Works

Cyclobenzaprine decreases the transmission of nerve signals in your body’s central nervous system [4] (CNS), which includes both your brain and spinal cord, leading to decreased muscle spasms and muscle tension. Since cyclobenzaprine affects the CNS, it can often also create feelings of sedation or drowsiness [5].

Why Cyclobenzaprine is Usually Used Short-term

Prescribing sources recommend that cyclobenzaprine [2] be prescribed for short usage periods (typically up to two or three weeks). There is limited evidence to suggest it is safe or effective for long-term use, which could lead to a greater incidence of side effects and a higher risk of misuse.

Is Cyclobenzaprine Addictive? Understanding the Real Risk

Addiction, Dependence, and Tolerance Defined

While addiction, physical dependence, and tolerance are frequently confused for one another, they do clearly delineate three distinct processes [6] and categories of risks, according to the American Academy of Pediatrics:

• Addiction refers to compulsively using a drug despite awareness of negative impacts on health or relationships.
• Physical Dependence is defined as adaptation to a degree such that the body cannot function normally in the absence of the drug, which is associated with withdrawal symptoms upon stopping the drug.
• Tolerance is when more of a drug is needed to attain the same level of effect as before.

Is Cyclobenzaprine listed as a Controlled Substance?

The DEA does not list [1] cyclobenzaprine in any of its drug schedule categories, ranging from I-V, indicating its lower risk for abuse in comparison with controlled medications, but it does not mean that it cannot be used for problematic purposes.

Why do People Misuse Cyclobenzaprine?

According to the Mayo Clinic, for many individuals, cyclobenzaprine is misused to obtain the sedating or calming effects [5]. When cyclobenzaprine is combined with alcohol, opioids, or benzodiazepines, this use of cyclobenzaprine [3] puts an individual at risk for serious health problems, including impairment or suppressed breathing.

Risk Factors

• Taking cyclobenzaprine for a more extended period than recommended.
• Taking higher doses [2] than prescribed.
• History of substance use disorder.
• Taking cyclobenzaprine for sleep purposes and/or using cyclobenzaprine to manage anxiety.

Who Can Become Addicted to Cyclobenzaprine?

Evidence-Based Answer

Most individuals who take cyclobenzaprine as prescribed for a short term should not be at risk of developing addictive behavior related to cyclobenzaprine; most clinical literature [4] supports the conclusion that an individual’s risk of developing an addiction to cyclobenzaprine is low when managed appropriately. However, there are patterns of abuse [6] that develop in some individuals who misuse cyclobenzaprine, such as taking larger amounts or for longer durations than prescribed, and in conjunction with alcohol, opioids, and benzodiazepines.

What Would an Addict Look Like?

People engaging in problematic use of cyclobenzaprine may be placing a substantial focus on obtaining and/or taking the medication, be unable to reduce dosage or stop using cyclobenzaprine, and continue to use cyclobenzaprine even when experiencing negative effects [3]. Many of these behaviors may overlap with other warning signs previously mentioned in this article.

Red Flags That Require Immediate Medical Assistance

If you are using cyclobenzaprine with alcohol or other CNS depressants, driving while overly sedated [5], or experiencing repeated episodes of being overly sedated, you should seek medical advice as soon as possible.

Cyclobenzaprine Withdrawal: Stopping Safely

Does stopping cyclobenzaprine cause withdrawal symptoms?

A person may experience withdrawal symptoms [4] from abruptly stopping cyclobenzaprine, especially after using it for a long period of time. For this reason, you should not stop or alter the dosage without consulting your doctor.

Common Withdrawal Symptoms

Withdrawal symptoms are highly variable [6]. Some users may experience them and some may not:

Common symptoms include:

• Headaches
• Nausea
• Fatigue
• Sleep deprivation
• Anxiety

When to Call Your Doctor

If you have taken cyclobenzaprine for more than a few weeks, are taking more than the prescribed amount, have mixed substances, or have a history of alcohol or drug problems, talk to your healthcare professional for help.

Risks of Overdose and Safety when Mixing Substances with Cyclobenzaprine

Combining cyclobenzaprine with alcohol, opioids, or benzodiazepines increases the effects of CNS depression [3]; cognitive function, respiratory rate, blood pressure, and oxygen levels are all negatively affected.

Seek emergency attention if a person appears lethargic, unresponsive,/falling asleep, has difficulty breathing, experiences palpitations, or cannot be awakened.

Concerned About Treatment or Support?

Start by discussing your concerns with your prescribing physician; oftentimes, a simple discussion of proper use [2], dosing, duration, and possible interactions with other substances will significantly reduce the risk.

Care for Substance Use Disorder

If the assessment of a substance use disorder is confirmed, care may include outpatient counseling, intensive outpatient programs, residential/inpatient addiction treatment, or medical detox. Medical detox uses medications and other interventions with healthcare providers to manage withdrawal symptoms [4] safely.

Family and Friends Support

Gentle compassion and interest from family [5] or loved ones, rather than judging the user about their situation, and supporting their well-being while they search for professional support will help maintain their trust.