Benzodiazepines vs. Cyclobenzaprine

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

Facts on benzodiazepines vs. cyclobenzaprine

What are benzodiazepines? What is cyclobenzaprine?

Benzodiazepines are central nervous system depressants are used to treat anxiety and panic disorders, seizures, nervousness, muscle spasms, insomnia, alcohol withdrawal, status epilepticus, premenstrual syndrome, and as sedation during surgery. Benzodiazepines are believed to work by boosting the effects of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. Seizures, anxiety, and other illnesses may be caused by increased activity of nerves in the brain. GABA reduces this nerve activity in the brain.

Cyclobenzaprine is a muscle relaxant used to relieve muscle spasm when the spasm is due to problems in the muscle itself and not in the nerves controlling the muscles. Cyclobenzaprine is thought to work through a complex mechanism within the nervous system, probably in the brainstem. Cyclobenzaprine is used along with rest and physical therapy for short-term relief of muscle spasms associated with acute painful muscle and skeletal conditions. It is only for short-term use, up to two or three weeks.

PTSD Quiz: Test Your IQ of Posttraumatic Stress Disorder

What are the side effects of benzodiazepines and cyclobenzaprine?

Benzodiazepines

Common side effects include:

  • Lightheadedness
  • Drowsiness
  • Confusion
  • Sedation
  • Memory impairment
  • Improper body balance
  • Increase or decrease in appetite
  • Nausea
  • Vomiting
  • Constipation
  • Weight gain
  • Dry mouth
  • Reduced libido
  • Fatigue

Serious side effects include:

Cyclobenzaprine

The most common side effects of cyclobenzaprine include:

Other reported side effects include:

Possible serious side effects include:

What is the dosage of benzodiazepines and cyclobenzaprine?

Benzodiazepines

Dosage depends on the type of benzodiazepine prescribed. All oral benzodiazepines are available in tablet forms.

  • Alprazolam and clorazepate are available as extended-release tablets.
  • Alprazolam, clobazam, diazepam, and lorazepam are available in oral liquid form.
  • Alprazolam and clonazepam are available in orally dissolving tablets.
  • Chlordiazepoxide, oxazepam, and temazepam are available in capsule form.
  • Diazepam also is available as a rectal gel.

Some benzodiazepines are available for injection.

Cyclobenzaprine

  • The recommended dose of cyclobenzaprine dose is 5 or 10 mg three times daily using immediate release tablets or 15 or 30 mg once daily using extended release tablets.

Can you get addicted to benzodiazepines and cyclobenzaprine?

Benzodiazepines

Benzodiazepines or benzos are habit forming and you can become addicted to them - even if you take them as your doctor or health care professional has prescribed. People who have a history of drug or alcohol abuse are more likely to develop an addiction to these drugs. If you use these drugs over a long period of time you can develop a tolerance for them. This means that you will need higher doses of the drug to treat your health condition or disease because you've become tolerant of the weaker formulations of the drug. These drugs may be very effective for the treatment of several conditions, for example, anxiety and insomnia; but be careful because you can become addicted to them.

The street names for benzodiazepine drugs are "Benzos" and "Downers." Drug addicts abuse these drugs to get "high." They can cause addiction similar to opioids (narcotic drugs like oxycodone, morphine, hydrocodone, and fentanyl), cannabinoids (marijuana), and the club drug GHB (gamma-hydroxybutyrate).

They are commonly abused by young adolescents and young adults who crush it up and snort it, or take the tablet to get high. If you abuse this medication you may have adverse effects with symptoms include:

  • Disturbing or vivid dreams
  • Irritability
  • Hostility
  • Amnesia

Signs and symptoms that you might be addicted include:

  • Problems sleeping
  • Diarrhea
  • Vomiting
  • Nausea
  • Goose bumps
  • Uncontrollable leg movements
  • Bone and muscle pain

It is very difficult to recover from benzodiazepine addiction because these drugs change the chemistry of the brain. Contact a drug addiction treatment center if you or a loved one are suffering from a addiction. Quitting cold turkey is not likely to be successful and can be dangerous because of symptoms of withdrawal. Doctors and other health care professionals that treat addiction will formulate a taper schedule to slowly wean off the medication to reduce the severity of withdrawal symptoms during treatment.

Signs and symptoms of overdose include:

Benzodiazepine withdrawal symptoms and signs

If you stop taking these medications abruptly you may experience withdrawal symptoms that include:

  • Problems concentrating
  • Sleep problems
  • Irritability
  • Increased anxiety and tension
  • Panic attacks
  • Hand tremors
  • Dry heaving and vomiting
  • Palpitations
  • Headache
  • Muscle pain and stiffness
  • A host of perceptual changes

The severity of the withdrawal symptoms depends on amount and duration of benzodiazepine use. Withdrawal symptoms can be deadly.
These medications are classified by the Drug Enforcement Administration (DEA) as Schedule IV drugs. This means that they have a lower potential and risk of dependence than other more powerful drugs like codeine, testosterone, anabolic steroids, Vicodin (hydrocodone and acetaminophen), OxyContin (oxycodone), Adderall (amphetamine and dextroamphetamine), and Ritalin (methylphenidate).

Cyclobenzaprine

Abrupt cessation after prolonged therapy may cause withdrawal symptoms such as headaches, nausea, and weakness.

What drugs interact with benzodiazepines and cyclobenzaprine?

Benzodiazepines

Combining alcohol with a benzodiazepine is very dangerous. People who drink alcohol while taking this medicine will feel the effects of alcohol faster. It's not safe to drink alcohol or take other drugs that have similar effects on the central nervous system (CNS) at the same time because these drugs or substances interact with oral benzodiazepines by causing additional depression of the brain and respiratory depression. Respiratory depression can lead to breathing that's inadequate for supplying oxygen to the body. This can cause death. Examples of these drugs and products that increase sedative side effects or the risk of respiratory depression from benzodiazepines include:

Pain medications called opioids that also cause respiratory depression, for example:

Sedatives (for example, insomnia medicine) and other medicine that cause sedation, for example:

Cyclobenzaprine

  • Cyclobenzaprine is chemically related to the tricyclic class of antidepressants, for example, amitriptyline (Elavil, Endep), nortriptyline Pamelor). As such, it should not be taken with or within two weeks of any monoamine oxidase (MAO) inhibitor, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). High fever, convulsions, and even death can occur when these drugs are used together.
  • Cyclobenzaprine interacts with other medications and drugs that slow the brain's processes, such as
    • alcohol,
    • barbiturates,
    • benzodiazepines, for example, diazepam (Valium), lorazepam (Ativan), and
    • narcotics.

Are benzodiazepines and cyclobenzaprine safe to use while pregnant and breastfeeding?

Benzodiazepines

  • The FDA classifies benzodiazepines as pregnancy category D, which means that benzodiazepines can potentially cause fetal harm if administered to pregnant women. If benzodiazepines have to be used in pregnant women or if the patient may become pregnant while taking benzodiazepines, the patients must be informed of potential risks to the fetus.
  • Benzodiazepines enter breast milk and can cause lethargy and weight loss in the newborn. Therefore, they should not be used in nursing mothers.

Cyclobenzaprine

  • There are no adequate studies of cyclobenzaprine in pregnant women. However, studies in animals suggest no important effects on the fetus. Cyclobenzaprine therefore can be used in pregnancy if the physician feels that it is necessary.
  • It is not known whether cyclobenzaprine is secreted in milk. However, since it is related to the tricyclic antidepressants, some of which are excreted in breast milk, caution is advised in using this medication in women who are breastfeeding.

Summary

Benzodiazepines and cyclobenzaprine are used to treat muscle spasms. Benzodiazepines are also used to treat insomnia, seizures, anxiety disorders, nervousness, panic disorders, alcohol withdrawal, status epilepticus, premenstrual syndrome, and as sedation during surgery. Benzodiazepines are central nervous system depressants that cause drowsiness and cyclobenzaprine is a muscle relaxant.

Treatment & Diagnosis

Medications & Supplements

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Medically Reviewed on 8/20/2018
References
REFERENCES:

FDA Prescribing Information

https://www.dea.gov/factsheets/benzodiazepines

Health Solutions From Our Sponsors