Carisoprodol ( Soma ): a drug of continuing abuse.

Carisoprodol ( Soma ) is a noncontrolled, skeletal-muscle relaxant whose activemetabolite is meprobamate. Despite previous indications that the drug may beabused, it continues to be widely prescribed for musculoskeletal conditionsinvolving muscle spasm. Presented here are three cases demonstrating patterns ofCarisoprodol ( Soma ) abuse not previously reported. Carisoprodol ( Soma ) usage should be limitedto short-term treatment. Patients for whom Carisoprodol ( Soma ) is prescribed are atrisk for meprobamate dependence.

Recent trends of drug abuse and drug-associated deaths in Korea.

Low back pain is a leading reason for primary care visits. Manytreatment options are available, but some lack scientific support. OBJECTIVE:The aim of this review was to discuss the etiology of low back pain and therelative risks and benefits of muscle relaxants commonly prescribed for themanagement of back pain. METHODS: We searched Intercontinental MarketingServices data for January 2003 through January 2004 to determine the mostcommonly prescribed agents for the management of musculoskeletal pain.Carisoprodol ( Soma ), cyclobenzaprine hydrochloride, and metaxalone represented >45% ofall such prescriptions. Cochrane Library, MEDLINE, and EMBASE databases weresearched (time frame: 1960 through January 2004; search terms: back pain,Carisoprodol ( Soma ), cyclobenzaprine, metaxalone, muscle relaxants, andpharmacotherapy) and reference lists of identified articles were hand-searched.RESULTS: Three trials of Carisoprodol ( Soma ) (N = 197) were located in the CochraneLibrary database. Two double-blind, randomized, placebo-controlled trialsevaluating the safety and efficacy of cyclobenzaprine hydrochloride (N = 1405)were identified in the literature. Three double-blind, placebo-controlled trialswere identified for metaxalone (N = 428) in 2 reports. The types of adverseevents seen with these agents involved the central nervous system, includingdrowsiness/sedation, fatigue, and dizziness. However, the efficacy ofcyclobenzaprine hydrochloride was shown to be independent of its sedativeeffects, which were dose related. The potential for abuse with Carisoprodol ( Soma ) isof growing concern. CONCLUSIONS: Analgesic pain management for low back pain dueto muscle spasm may be combined with a muscle relaxant. Cyclobenzaprinehydrochloride has the most recent and largest clinical trials demonstrating itsbenefit, but Carisoprodol ( Soma ) and metaxalone also appear to be effective. However,Carisoprodol ( Soma )'s usefulness is mitigated by its potential for abuse.

Dantrium in the treatment of increased muscle tonus in patients with multiplesclerosis

In 19 patients with multiple sclerosis and 1 with subacute sclerosingpanencephalitis the mean increase in muscle tonus was found to be 3.1 (range1--4 according to Burke-Ashwort). In 10 controls with multiple sclerosis themean spasticity was 2.4. Dantrium was given in doses up to 800 mg for 14--16days and it caused a greater reduction of spasticity than placebo (p less than0.05). In 12 patients (60%) varying degrees of muscle tonus reduction wasobserved. In 11 patients the efect of Dantrium was compared with that of otherdrugs (Clonazepam, Tetradiazepam, Carisoprodol ( Soma ) and Lyoresal). In 6 casesDantrium was a more effective drug than other muscle relaxants and in 5 cases nodifference was observed or other drugs were superior to Dantrium.

Gas chromatographic determination of Carisoprodol ( Soma ) in human plasma.Kucharczyk N, Segelman FH, Kelton E, Summers J, Sofia RD, Mahrous H, Heath R.