Cyclobenzaprine/Flexeril

Discussion in 'Treatments' started by joe, May 29, 2012.

tinnitus forum
    1. joe

      joe Member

      Location:
      UK
      Tinnitus Since:
      October 2011
      • Optimistic Optimistic x 1
    2. Charmaine

      Charmaine Guest

      I am keen to know about this as well ... Does it work ?!!
       
    3. joe

      joe Member

      Location:
      UK
      Tinnitus Since:
      October 2011
      Hi Charmaine, according to the study, it lowered T compared to most? I am Hoping Marku might chime in he knows alot about these experimental drugs, this one does seem to have low side effects, but not recomended for the elderly or people with muscle weaknesses ;)
       
    4. BOB3000

      BOB3000 Member

      Tinnitus Since:
      2002
      What are the sideeffects to be precise?
       
    5. joe

      joe Member

      Location:
      UK
      Tinnitus Since:
      October 2011
      Side Effects
      Meta-analysis studies have found significantly increased rates of drowsiness (38% of patients), dry mouth (24%), dizziness (10%), and adverse events of any kind in patients taking cyclobenzaprine versus placebo.[13] Drowsiness and dry mouth appear to intensify with increasing dose.[18]
      Other side effects are not significantly more common than they are in patients taking placebo. Some of these include blurred vision, fatigue, nausea, and headache.[18] The sedative effects of cyclobenzaprine are likely due to its antagonistic effect on histamine, serotonin, and muscarinic receptors. Agitation is a common side effect observed especially in the elderly. In general, the NCQA recommends avoiding the use of cyclobenzaprine in the elderly because of the potential for more severe side effects.[19] There is one case report of overdose causing rhabdomyolysis (muscle breakdown).[20]Treatment protocols and support should follow the same as for any structurally-related tricyclic, such as tricyclic antidepressants.[20]
       
    6. BOB3000

      BOB3000 Member

      Tinnitus Since:
      2002
      Do you only have to take it for 12 weeks and then be fine or is it something that needs to be taken daily? If so the sideeffects of drowsiness dont sound too good. Thanks for the reply joe.
       
    7. joe

      joe Member

      Location:
      UK
      Tinnitus Since:
      October 2011
      According to the study they stated
      "12-week period. High-dose cyclobenzaprine resulted in a significant reduction in the Tinnitus"
      you can take a cough mixture and it causes drowsiness, it all depends how drowsy this can make a person?
       
    8. erik
      Breezy

      erik Manager Staff Benefactor

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012
      Cause of Tinnitus:
      Most likely hearing loss
      I wonder how significant since they don't really give in THI numbers. It is great to see they are testing all these current drugs and combos for treating T but it seems like it would be hard to get prescribed most of them for T.
       
    9. joe

      joe Member

      Location:
      UK
      Tinnitus Since:
      October 2011
      Yes I agree its difficult to get that drug specifically for T as its used as a muscle relaxant
       
    10. joe

      joe Member

      Location:
      UK
      Tinnitus Since:
      October 2011
      However its still one other possible drug treatments for T for now
       
    11. erik
      Breezy

      erik Manager Staff Benefactor

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012
      Cause of Tinnitus:
      Most likely hearing loss
      yes as long as they keep researching existing drugs and new ones, there's some hope
       
    12. daedalus

      daedalus Member

      Location:
      Brussels
      Tinnitus Since:
      04/2007
      I have tried it. Prescribed by Prof. Dirk De Ridder at brai2n at Antwerp. No effect on my tinnitus. It relaxed my jaw muscles pretty well though. I think it was a low dose but i am not sure.
       
    13. erik
      Breezy

      erik Manager Staff Benefactor

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012
      Cause of Tinnitus:
      Most likely hearing loss
      There was a small study that showed flexeril a muscle relaxant successful in treating tinnitus though I heard it makes you into a zombie for a while....

      http://content.karger.com/ProdukteD...ikelNr=335657&Ausgabe=256667&ProduktNr=224213

      Tinnitus, the phantom perception of sounds, is a highly prevalent disorder. Although a wide variety of drugs have been investigated off label for the treatment of tinnitus, there is no approved pharmacotherapy. We report an open-label exploratory pilot study to assess the effect of muscle relaxants acting on the central nervous system on tinnitus patients. Cyclobenzaprine at high (30 mg) and low doses (10 mg), orphenadrine (100 mg), tizanidine (24 mg) and eperisone (50 mg) were administered to a maximum of 20 patients per group over a 12-week period. High-dose cyclobenzaprine resulted in a significant reduction in the Tinnitus Handicap Inventory (THI) score between baseline and week 12 in the intention-to-treat sample. On the other hand, other treatments were not effective. These results were confirmed in an explorative analysis where baseline corrected THI and Clinical Global Impression scores at week 12 were compared between groups. The present open trial presents a new promising pharmacotherapy for tinnitus that should be validated in placebo-controlled double-blind trials.
       
    14. Fish
      Balanced

      Fish Member Benefactor

      Location:
      Poland
      Tinnitus Since:
      July 2012
      Now this is a coincidence erik. I visited a dentist to do something about teeth grinding at night and he wants me to try flexeril.
       
    15. daedalus

      daedalus Member

      Location:
      Brussels
      Tinnitus Since:
      04/2007
      I tried cyclobenzeprine for tinnitus. No effect on the tinnitus itself but very good for relaxing the muscles of the jaw. It didn't turn me into a zombie or anything.
       
    16. sansa

      sansa Guest

    17. wxintel

      wxintel Member

      Tinnitus Since:
      03/2008
      I have taken flexeril 'on and off' over the last 30 years for back muscle spasms. Initially, flexeril will make most people quite sleepy - but repeated use almost always results in very few negative side effects. (I've had sleep 'triggered' tinnitus for 5 years now - one day I wake up with very bad 'T'- almost debilitating - 2nd day it tends to be 'livable', and by the thirdor 4th day, it usually is incredibly quiet. This 'Cycle' then repeats - but not always as just described). Last year I tried taking flexeril (2, 10mg tabs a couple hrs before bed) on an especially bad day - slept very well, and awoke to total silence. I was elated. I quickly found out it doesn't work by taking it every day. It does, however, seem to work by using it on a very bad day just before bed, almost insuring a very quiet day after.
       
      • Informative Informative x 1
    18. Petloy
      Happy

      Petloy Member Benefactor

      Location:
      Canada
      Tinnitus Since:
      08/2012
      I take Flexeril 5 mg because I would have episodes of inner ear twitching (Objective Tinnitus), I noticed that after taking it the next day or days my T would be very low.
       
    19. Golly
      Bookworm

      Golly Member Benefactor Team Awareness Team Research

      Location:
      New York City
      Tinnitus Since:
      01/2011
      I tried Cyclobenzaprine (Flexeril) at the low dose of 5mg. It resulted in no significant difference in the pattern of my tinnitus. Of course, the study recommends 30mg at a time. I should note that a friend of mine tried this high dose protocol and did notice some benefits. But like me, he has intermittent tinnitus, and we suspect that the sedating effect was the key to any improvements. I have since taken the odd 5mg dose (when muscles were sore) and awoken to find my tinnitus gone. But again, this is almost certainly because the drug made me really tired.

      Of interest is that Flexeril is a close cousin (chemically speaking) to Elavil (Amitripyline): a tricyclic antidepressant that is often prescribed for individuals with tinnitus!

      -Golly
       
    20. erik
      Breezy

      erik Manager Staff Benefactor

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012
      Cause of Tinnitus:
      Most likely hearing loss
      Despite some positive studies on these drugs, most of which have been around for decades and I think if they significantly made any difference with T we would all know about it.
       
    21. aka

      aka Member

      Tinnitus Since:
      12/2011
      I've seen Flexeril mentioned as a potential treatment of Tonic Tensor Tympani Syndrome (which I have in addition to the tinnitus - but I have not asked for a scrip for it because when I first looked into it I thought I saw something about potential heart problems, etc.
       
    22. Tami
      Amused

      Tami Member

      Location:
      Portland Or
      Tinnitus Since:
      04/2014
      Cause of Tinnitus:
      Unknown
      I have a bad neck/back due to Degetive Disc Desease, and stopped taking it Flexeril over a year ago. When I got T this last April, I had a hard time sleeping, so one night I took a flexeril knowing it would help me sleep, and of course it did. I woke the next morning to find my T just about GONE! :) I had to struggle to try to hear the ringing! I was so excited to have found it works on my T, thinking it would just help me sleep. Yes I wake up feeling out of it but I have found having only two cups of coffee gets me going again. NOTE: That is all the caffeine I have for the day.
      I much rather wake up a little sluggish than have the horrible ringing in my head. Hope this helps. Talk to your Doctor about of course.
       
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    23. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      Thank you so much for this information!:) What dose do you take? And, if I'm right, you're only taking the Flexeril once a day. And is the the brand name or a generic? I know sometimes generic drugs will not effect the same results.

      I'm so happy for you! Congratulations! :D
       
    24. SoulStation
      No Mood

      SoulStation Member Ambassador Team Tech

      Location:
      New York
      Tinnitus Since:
      2012
      Cause of Tinnitus:
      Noise / Possible Medication
      I'm gonna see if I can get a Rx for this. It sounds promising. And may help me ween off the benzo I've been on for years.
       
    25. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      In 2010, five inventors filed a patent for a sustained-release version of Flexeril for tinnitus. Anyone interested in this drug should read the patent information. According to the inventors, better efficacy is obtainable through a sustained-release formulation of the drug.

      Here are some extracts from the patent application, published in 2013:

      Treatment of tinnitus and related auditory dysfunctions

      ABSTRACT

      The invention provides an extended-release dosage form of cyclobenzaprine for use in the treatment of tinnitus and related auditory dysfunctions by once-a-day oral administration, wherein the dosage form is a tablet or capsule comprising cyclobenzaprine as active agent in an amount from 10-80mg, preferably from 10- 60mg. The active agent is associated with a polymer coating or matrix that comprises a water-insoluble polymer, the polymer coating or matrix providing the dosage form with an extended release of the active agent over at least 12 hours and preferably over at least 16 hours when the dosage form is administered to a patient.

      ...

      Cyclobenzaprine is a skeletal muscle relaxant. The exact mechanism of action for cyclobenzaprine is unknown. Current research appears to indicate that cyclobenzaprine acts on the locus coeruleus where it results in increased norepinephrine release, potentially through the gamma fibers which innervate and inhibit the alpha motor neurons in the ventral horn of the spinal cord. Decreased firing of the alpha motor neuron results in decreased muscular tone. Cyclobenzaprine is a muscle relaxant acting primarily on the central nervous system. It is structurally similar to Amitriptyline, differing by only one double bond. Cyclobenzaprine is typically prescribed to relieve pain and muscle spasms. Typically, muscle spasms occur in an injury to stabilize the affected body part and prevent further damage. Whereas this is beneficial in acute injury, muscle spasm frequently persists over time, becomes dysfunctional and can increase the pain level. It is believed that by decreasing muscular spasm, pain is diminished. A common application would be that of a whiplash injury in a car accident. Cyclobenzaprine has also been studied in the treatment of fibromyalgia. In a study of 120 fibromyalgia patients, those receiving Cyclobenzaprine (10 to 40 mg) over a 12 week period had significantly improved quality of sleep and pain score. Interestingly, there was also a reduction in the total number of tender points and muscle tightness. It is also prescribed off-label as a sleeping-aid.

      ...

      As-yet unpublished PCT patent application PCT/IB2010/051373, filed 30 March 2010, relates to cyclobenzaprine for use in the treatment of tinnitus and related auditory dysfunctions by oral administration or by parenteral administration through intramuscular, intravenous, subcutaneous or intrathecal injection or infusion, and presents data demonstrating the efficacy of cyclobenzaprine for these treatments. This unpublished PCT patent application mentions the use of extended release cyclobenzaprine for tinnitus by once-a-day administration but does not provide any details thereupon, neither of the means for providing extended release, nor any other details. Background art on extended-release drug formulations.

      ...

      As shown by the tests reported below, which are taken over from the above- mentioned PCT patent application PCT/IB2010/051373, cyclobenzaprine has a positive effect on tinnitus severity and on tinnitus loudness in the tested subjects, it is safe to administer and though common side effects (like constipation and dry mouth) may be experienced, it is tolerated well by most subjects. Similar results are expected for associated auditory dysfunctions. Generally, according to the invention, the described extended release form of cyclobenzaprine is effective for the treatment of an auditory dysfunction selected from tinnitus, hyperacusis, auditory hallucinations, misophonia, phonophobia and central auditory processing disorders. General aspects of extended-release cyclobenzaprine for treating tinnitus

      For many chronic conditions such as chronic pain, management guidelines recommend the use of long-acting, extended-release formulations. Guidelines for pharmacological treatment of tinnitus however have not been established, although tinnitus is a chronic condition. As such, the goal of pharmacological therapy for tinnitus is to provide sustained relief. The use of long-acting, extended-release formulations for tinnitus is desirable because they provide prolonged, more consistent plasma concentrations of drug compared with short-acting agents, thus minimizing fluctuations that could contribute to end-of-dose breakthrough tinnitus. In this regard, a randomized, open-label, two-period crossover, single-centre study, has demonstrated that single-dose pharmacokinetics of once-daily cyclobenzaprine extended release 30 mg versus cyclobenzaprine immediate release 10 mg three times daily in healthy young adults, provides a controlled release of cyclobenzaprine with sustained plasma concentrations, in contrast to the fluctuating profile of cyclobenzaprine immediate release with comparable systemic exposures.

      Better efficacy and fewer side effects

      [emphases added]

      Reference: http://www.google.com/patents/EP2621475A1?cl=en

      Here's a summary of the patent's history:

      Screen Shot 2014-06-18 at 10.07.15 PM.png

      If anyone takes this new formulation, please let us know!
       
      • Like Like x 2
    26. SoulStation
      No Mood

      SoulStation Member Ambassador Team Tech

      Location:
      New York
      Tinnitus Since:
      2012
      Cause of Tinnitus:
      Noise / Possible Medication
      Took 20 mg of regular generic flexeril last night. I definitely notice a reduction of harshness in my T. Volume is a bit lower too. Will continue a 10 mg dose at bed and monitor the results.
       
      • Like Like x 2
    27. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      I'm glad you're getting results.:) Keep us posted! It may take several weeks before you get the full effect.
       
    28. SoulStation
      No Mood

      SoulStation Member Ambassador Team Tech

      Location:
      New York
      Tinnitus Since:
      2012
      Cause of Tinnitus:
      Noise / Possible Medication
      Thanks jazz - I will for sure.
       
    29. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      @SoulStation

      Has the Flexeril helped? Are you still taking it?
       
    30. SoulStation
      No Mood

      SoulStation Member Ambassador Team Tech

      Location:
      New York
      Tinnitus Since:
      2012
      Cause of Tinnitus:
      Noise / Possible Medication
      Hey still on 10mg. Its been about a week plus 2 days I feel like its helping a bit. But its hard for me to say. I'll check in after this week with a conclusive desicion.
       
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