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Muscle relaxants are a heterogeneous group of drugs. As a class, which are structurally and pharmacologically different. Muscle relaxants are used to treat two different types of basic conditions:

• spasticity syndromes of upper motor neurons
• muscle pain or spasms of peripheral musculoskeletal conditions

Although muscle relaxants have been classified by the convention as a group, the Administration Food and Drug Administration (FDA) has approved only a few drugs in this class for the treatment of spasticity. The rest are approved for the treatment of conditions musculoskeletal.

Drugs are classified as muscle relaxants:

• baclofen (Lioresal)
• carisoprodol (Soma)
• (chlorzoxazone PARAFLEX)
• (Cyclobenzaprine Flexeril)
• dantrolene (Dantrium)
• metaxalone (Skelaxin)
• methocarbamol (Robaxin)
• (Orphenadrine Norflex)
• tizanidine (Zanaflex)

Muscle relaxants for the treatment of spasticity

Spasticity is a state of increased muscle tone with exaggeration of tendon reflexes. Some of the most common conditions associated with spasticity and requiring treatment include multiple sclerosis, spinal cord injury, traumatic brain injury, cerebral palsy, and syndrome Stroke. In many patients with these conditions, spasticity can be disabling and painful, with a marked effect on functional ability and quality of life.

The engine upper neuron syndrome is a cluster of signs and symptoms that may be associated with exaggerated cutaneous reflexes, autonomic hyperreflexia, dystonia, contractures, paralysis, lack of skill, and fatigue. The syndrome of spastic upper motor neuron may result from a variety of conditions affecting the cortex or spinal cord.

Dantrolene only baclofen and tizanidine are approved for the treatment of spasticity. There is sufficient evidence that baclofen and tizanidine are roughly equivalent efficacy in patients with spasticity, but insufficient evidence to determine the efficacy of dantrolene compared to baclofen or tizanidine. Tizanidine is associated with more dry mouth and baclofen with more weakness.

Muscle relaxants for the treatment of disturbed conditions

Muscle spasm is defined as a sudden involuntary contraction of one or more muscle groups and is usually an acute condition associated with muscle tension (partial rupture of a muscle tear) or sprain (partial or complete ligament). Common musculoskeletal conditions causing pain and muscle spasms include fibromyalgia, tension headaches, myofascial pain syndrome, and mechanical low back pain or neck pain. If muscle spasm is present in these conditions, is related to local factors involving the affected muscle groups.

The muscle relaxants carisoprodol, chlorzoxazone, cyclobenzaprine, metaxalone, methocarbamol and orphenadrine are approved for the treatment of musculoskeletal disorders.

Clinical studies show that cyclobenzaprine, carisoprodol, orphenadrine, and tizanidine are effective compared with placebo in patients with musculoskeletal disorders (primarily acute back or neck pain). Cyclobenzaprine has been evaluated in most clinical trials and has always proven effective.

Effectiveness

Most studies have demonstrated the relaxants muscle to be more effective than placebo in treating acute disorders of musculoskeletal pain and muscle spasm, while the efficacy was less consistent in the treatment of chronic conditions. Muscle relaxants when used alone, which were consistently higher than simple analgesics to relieve pain. When muscle relaxants were used in combination with analgesics, pain relief is superior to either agent used alone. Studies have suggested that these drugs are effective, have tolerable side effects and can be complementary in the treatment of musculoskeletal conditions associated with muscle spasms.

No studies have documented superior efficacy of a muscle relaxant over another.

Side effects and adverse reactions

• All muscle relaxants may cause sedation (drowsiness, dizziness).
• Baclofen may cause serious central nervous system depression with cardiovascular collapse and respiratory failure.
• Dantrolene has a potential for hepatotoxicity. Is hepatitis was observed more frequently between the third and twelfth in the therapy. The risk of liver damage appears to be greater in women, in patients over 35 years of age and in patients taking other medications in addition to dantrolene.
• Carisoprodol has some potential for dependence and withdrawal symptoms.
• Cyclobenzaprine, closely related tricyclic antidepressants, causes the expected lethargy and anticholinergic side effects and may have some toxicity in overdose and in combination with other substances.
• The Tizanidine may cause low blood pressure, but this can be controlled by starting with a low dose and gradually increase. The drug can cause liver damage.
• Methocarbamol and chlorzoxazone may cause harmless color changes in urine – orange or red-purple with chlorzoxazone and purple, brown or green with methocarbamol. The urine becomes to its normal color when the patient stops taking the drug.

Yury Bayarski is the author of Price-RX.com – prescription drug price comparison website. Please follow this link if you would like to read more about muscle relaxers