Index Support Center Forums Treating Narcolepsy Muscle spasms treatment

  • This topic has 7 replies, 4 voices, and was last updated 3 years, 1 month ago by Jason. This post has been viewed 1259 times
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  • #2489
    JasonJason
    Keymaster

    Does anyone take medication for spasticity and have N? I’ve been struggling to find something that works but isn’t massively sedating. I’ve tried pretty much everything besides something like soma or valium and dantrolene. Tizanidine is somewhat effective but more sedating than a hypnotic so it doesn’t really work for me. Temazepam, a hypnotic benzo works by far the best of the things I’ve tried but obviously isn’t ideal.

    Any input would be appreciated!

    #2718
    AvatarJesse
    Participant

    Most medications for muscle spasms are all going to be sedating.

    Temazepam (Restoril), Lorazepam (Ativan), Diazepam (Valium), or any other benzodiazepene are all going to cause quite a bit of sedation so they are probably not going to be ideal.

    You mentioned that you have tried pretty much everything, which have you tried exactly? Off the top of my head, the common options are baclofen, carisoprodol, cyclobenzaprine, metaxalone, methocarbamol, tizanidine, and chloroxazone.

    Dantrolene is rarely used outpatient but I have seen it once in my career for extremely severe muscle spasms. I wouldn’t recommend Dantrolene unless you have tried and failed every other option.

    Maybe an NSAID like meloxicam or diclofenac plus a low dose muscle relaxer would be an option?

    #2720
    JasonJason
    Keymaster

    I’ve tried tizanidine, methocarbamol, cyclobenzaprine, metaxalone, baclofen, umm. I may be forgetting a couple.

    I wasn’t really taking baclofen for muscle issues but rather as an off label hypnotic. Tizanidine works a little but the level of sedation is massive for me. It’s more sedating than temazepam for me. It also makes me feel very weak. The others haven’t done much. I haven’t tried carisoprodol. I wasn’t sure if it is generally more or less sedating than a benzodiazapine.

    I figured dantrolene was an unusual one due to the risks but from what I read, it’s primary action isn’t central so I thought maybe it’d be less sedating. Although I’ve also read it’s sedating as well. I feel like I’m going to be treated like a drug seeker if I request something controlled. Nsaids haven’t been much help. I’m not entirely sure what’s causing the spasticity if that matters for drug selection.

    I’m sort of hoping with an effective muscle relaxer and 2-4 weeks of PT, the issue will correct itself. I’ve done PT alone but the range of motion caused by the spasms seems to limit the effectiveness.

    I’ll inquire about carisoprodol since it’s one of the few I haven’t tried. Thanks for the reply!

    #2724
    TheRabbitKingTheRabbitKing
    Keymaster

    I would if an anti-muscarinic would be helpful. In the course of studying NAv1.7 and SCN9A mutations for pain relief, they’ve discovered they work on some forms of chronic pain.

    My current jam: Anathema - Springfield

    #2726
    AvatarJesse
    Participant

    Dantrolene actually isn’t scheduled as a controlled substance while Soma (carisoprodol) is. I don’t think your Doctor would treat you like a drug seeker since they can see your medical history and you have failed virtually every muscle relaxer. In addition if you have appointments with a Physical Therapist and you are showing an active effort to try to get better, 99% of practitioners will at least give you the benefit of the doubt. The only thing to keep in mind with Soma is that it is highly ridiculed if it is prescribed in a cocktail commonly known as “the holy trinity” consisting of Soma, a benzodiazepine, and a pain med (typically some form of hydrocodone/oxycodone). Any decent pharmacist and doctor will run a PDMP (monitoring system for controlled substance) and address the issue if there is one.

    If you still feel Soma isn’t a good option, maybe Norflex? I don’t typically recommend Norflex since it only comes as extended release and it is hard to know how much sedation it can cause and may take you out of commission for the day.

    Cyclobenzaprine is actually an anti-muscarinics (also know as anti-cholinergics). If you wanted a pure anti-muscarinic drug; they have a huge adverse reaction profile where it isn’t worth it unless you have exhausted every other option.

    #2772
    JasonJason
    Keymaster

    I’m going to ask about trying a low dose of Soma. The holy trinity sounds like a euthanasia cocktail. Opioids seem pretty scary as a long term treatment, especially combined with other depressants. I’m not sure if our brains are wired differently but I really can’t see the appeal behind muscle relaxers/hypnotics except as a medical treatment. A beer seems much more rewarding to me. I don’t have much of any experience with opioids but I kind of figured they must be involved with it.

    It’s an unfortunate epidemic, at least from what I’ve seen.

    #2773
    FerretFerret
    Moderator

    Have you tried Robax Gold? I take one a night for spasms in my lower back. It works for me as a preventative since I’ve had the problem since I was 12. Yeah, I grew 12 inches in 18 months but something’s not balanced. And yeah, I’m not balanced in the head either 😉

    #2846
    JasonJason
    Keymaster

    I’ve tried it without luck! No clue why so few things work for me. I’m wondering if I could just get the muscle injected with Botox at this point to avoid anything sedating.

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