Cyclobenzaprine and RLS?

[Guitarpickin]

Has anyone else had good luck with cyclobenzaprine alleviating RLS symptoms? I have a prescription because of back problems but very rarely feel the need to take a muscle relaxer (my prescription is 7 years old and each pill is 10mg). However, I needed one last night and because I don’t know if it is safe to mix with anything, the only other pill I ingested was magnesium. I bit the pill in half so I only had around 5 mg, give or take. When I awoke this morning after 8 solid hours of sleep, I realized the cyclobenzaprine may have worked as well as gabapentin does (gabapentin is also something I try to use sparingly because I don’t want to build a tolerance). I’m wondering if the amazing night of sleep was coincidental or if muscle relaxers are a good thing to add to the arsenal of potential things to help someone with RLS get through the night. I’d be curious to know if anyone else has tried this as a treatment?

[Guitarpickin]

I forgot to mention that based on another member’s suggestion to use THC oil rubbed on the legs, I tried that last night. That’s a huge oversight/omission as it may be the reason I slept so well (or a combination of the two). Sorry for leaving that out.

[Hidden]

It's possible that the muscle relaxant worked for you.

It's possible the oil worked for you.

Since you used both at the same time it's impossible to tell.

Further if you took the magnesium at the same time as the muscle relaxant, then it's possible the magnesium interfered with the absorption of the muscle relaxant.

I suggest you try just the oil for a few nights and if it works stick with that.

If it doesn't then try the relaxant but take it 2 hours before or after the magnesium.

You really need a new prescription for the relaxant, which will also mean your doctor's aware you're taking it.

[Guitarpickin in reply to Hidden]

Thank you, Manerva. Your responses are always so thoughtful and informed. This online community is lucky to have you as a participant. My doctors are already aware of the muscle relaxers but have said the medicine still has efficacy despite its age (I’m told the expiration dates on most medicine is arbitrary-at least in the US), and I consistently decline a new prescription because I still have pills left. However, my doctors seem to be remiss in not discussing the interaction between certain drugs and the over-the-counter supplements I take. The magnesium can be stopped as I’m unsure how much it helps anyway. I mostly take it out of habit. I know for certain muscle relaxers make me sleep really, really well. But I posted because last night was the first time I remember taking one when my RLS is flaring (I don’t even know if RLS can flare but I don’t know what other reason explains why I can sometimes go for days or weeks without a problem and then it hits hard and becomes debilitating). I don’t know if the flexeril stops the involuntary movements and cramping, or just makes me sleep through them. Anyway, because of how well I slept last night, I was wondering if any other people had any experience with cyclobenzaprine and RLS...even if my own night involved flexeril and a topical oil. I’m just curious. A google search this morning showed others have had success with it, but I trust the people in this forum more than google. I don’t mind experimenting and will be glad to try only the oil tonight, but don’t have the ability to go for more than one night without sleep and still be able to function at work. So most of my “experiments” are woefully inadequate and short lived with unclear results because I often try many things at once out of desperation and/or fear.

[Hidden in reply to Guitarpickin]

OK about the prescription.

I can appreciate your desperation, but it would be good to.identify what is and what isn't working, if you can.

As your RLS comes and goes, flares as you say. I wonder if there's something triggering it.

Have you had blood tests for ferritin, vitamin B12 and vitamin D?

I suggest a diary of what you eat and drink each day and what your sleep is like. You may be able to see a pattern.

[Guitarpickin in reply to Hidden]

Thank you again, Manerva. I am frequently overwhelmed by your kindness and willingness to share your knowledge and energy helping others. I have learned a lot from reading things you have told other sufferers on this site and have tried to put what I can into practice. Finding this community is the first time I haven’t felt entirely helpless. I love that I now have options! They may not work, but at least they give me hope for now!

Thanks to this forum I am in my second week of approaching this strategically. I DO have a diary where I record my food (thanks to a post of yours I read when I initially found this group)!! I also record the things I ingest to try to help alleviate symptoms (vitamins, teas, alcohol, cannabis, or actual medicine), and activities I do. And of course, how the night went.

I had a ridiculously expensive series of tests when all of these symptoms first started. The tests showed I was low in D (I am now a little too high), but the doctor was surprised my B12 was where it should be. Iron too, though I know from reading your posts (and other’s too) that the test may not have looked at what it needed to for RLS. I have recently bought ferrous bisglycinate (again thanks to this community) and take 27mg on an empty stomach a couple hours before bed, with Vitamin C, two days a week. This may not be be often enough to do anything but i figured I could start small and increase later, if needed. Or stop all together if I start to feel weird (like the poor person who thought her feet felt like glass from too much iron). I only take it twice a week because I only have an empty stomach at night two days a week (I am trying intermittent fasting). Anyway, that’s probably way too much info. But I am now trying to keep track of what is happening and why, in hopes of figuring this out.

Do other people’s symptoms not wax and wane?

[Hidden in reply to Guitarpickin]

I believe some peoples symptoms wax and wane. I don't recall that mine ever did.

[ArtHanger]

Gabapentin is a potentiator for many drugs. I use tapentadol 100mg to prevent Mirapex augmentation and keep it at low dosages. I replace the mirapex with gabapentin when I sense my impulse control decreasing and the combination of the two works better than either one individually.

[Guitarpickin]

As a follow up to anyone who may do a search for cyclobezaprene/flexeril...I do still find it to work miraculously, providing at least 8 hours of sleep (more if I somehow have the time). But I have never taken it with any regularity. Only when things are very bad (which thankfully is not often, lately). However, after my initial posting asking if others had the same experience, I was able to meet with my GP to ask about it. She said she has never heard of it being used this way but that it makes sense it could help. However, importantly, she said it is not a drug they recommend for long term use. I was a little confused by what she was saying (because I can’t understand why mirapex and the like would ever be considered okay for long term use but somehow a muscle relaxer wouldn’t). But the main takeaway was that there are long term, negative implications for your brain with chronic cyclobenzaprene use. She didn’t explain what those were and I didn’t keep asking because I began to feel she may think I was drug seeking. Anyway, if anyone should ever stumble upon this post and have their own experience with muscle relaxers helping (or hurting) their RLS/PLMD, please share. Thank you.

[daughter-Advocate in reply to Guitarpickin]

Hi! So happy to see you've found relief and ability to sleep soundly - are you still taking Cyclobenzaprine? Or have had any bad episodes? I found Cyclobenzaprine as a suggested muscle relaxer for Myofacial pain. How is the Cyclobenzaprine different from other muscle relaxers you tried? Which provider prescribes the Cyclobenzaprine? I'd like to ask about it as an option for my dad

[ircam2112]

Hi Guitarpickein,

I did “stumble” onto this post from one of your more recent posts I hope things are well with you these days. I also have back problems for which I take Cyclobenzaprine and would like to give you my impression on a couple of questions you have asked.

When I first began taking Cyclobenzaprine, it helped quite a bit as far a daytime fatigue/feeling rested. I video taped my sleep at the time and noticed a definite difference, not in the frequency but, in the intensity of the PLMS. So, my thinking is that it does more to prevent arousals to lighter stages of sleep (as a CNS depressant) rather than have an impact on the frequency of the PLMS.

Since, I’ve had to take the Cyclobenzaprine 6-8 nights/month for chronic back pain that flairs with activity (all we need right?). I do find that it does help daytime fatigue less now, likely due to tolerance. The other possibility is that rather than tolerance (or in addition to it) the benefits of Cyclobenzaprine on PLMS intensity are </= to the negative effects of the back pain on sleep quality. So, my guess is that it’s probably not a effective medication for regular use but effective as a PRN/as needed medication when things are quite bad….maybe 3-4 nights/month and, that it’s effectiveness is dependent on the severity of your back pain.

BTW, for years I used ice to treat my back strains/spasms with limited success but since I installed a bath….wow! Heat, for me, is so much better often being back to regular activities the next day rather than being out for 3-4 days.

You also asked about waxing and waning of symptoms. Early on, my symptoms fluctuated from severe to moderate quite often and I was determined to find out why. Through a lot of trial and error, I found that a big part of the reason for the waxing and waning has been in finding effective medications but, I’ve also found a large component has been eliminating food additives from my diet. I know this through elimination and re-introduction of these additives from/to my diet and tracking PLMS at night/during the day and daytime energy.

The primary substance of concern for me is “free glutamate” - glutamate that has been added to and/or, drawn-out of the food through stewing, fermentation, etc. This glutamate is unattached to a protein, as in meats or wheat products and, as such, can directly act as a CNS stimulant - can cross the blood-brain barrier and act directly on neurons (Glutamate is the most abundant stimulating neurotransmitter, GABA (as in “Gabapentin and Pregabalin for RLS) is the most abundant neuromodulator (calmer)).

Also, through fermentation and producing food additives (high temps usually), the glutamate changes “hands” or “chirality” i.e.) the protein is naturally in a “left-handed” state but these processes produce a higher percentage “right-handed” proteins (an amino-acid in this case) and as such, act differently in digestive transport mechanisms to the brain and at receptor sites (such as motor neurons). I’ve read research that suggests that this difference results in negative changes in the behavior of the CNS i.e.) firing neurons repeatedly until they are damaged or killed resulting in involuntary movements, neurodegenerative diseases like Parkinson’s. Some motor neurons are inhibitory, in that they inhibit other motor neurons from firing. If they are damaged or killed, they can no longer modulate the downstream neurons, which fire at regular intervals unless inhibited. Another important point is that these “excitotoxins” (check Wiki), when consumed and, at least for me, create worse symptoms for 3-4 days. Therefore, if someone is in taking them daily, symptoms are continuous/non-stop.

At this point, having eliminated most sources of free-glutamic acid and other excitotoxins (Aspartame, MSG - in all it’s many forms in processed foods, diphenhydramine, caffeine, undistilled and/or fermented alcohols - anything with color (that’s the glutamate), etc.) my symptoms are pretty consistently “moderate” rather than severe. I no longer have daytime symptoms and most likely take fewer and less medication than I would otherwise.

Well, ok….this turned into a Tolstoyic message but I hope it is somewhat helpful and that this finds you well. Feel free to message me anytime.

[Guitarpickin in reply to ircam2112]

Hi ircam2112! Thanks so much for the feedback! It’s very helpful to hear another person’s experience with cyclobenzaprine. And it is interesting that your videos of sleep confirmed that it didn’t stop the movement disorder as much as it just allowed you to sleep through it.

Congratulations on your new bath and all the joys that go along with it!! It’s great the warm water helps your back and associated symptoms. I live in a desert and the anxiety/guilt of a bath would probably give me back spasms (lol), but maybe I’ll try a heating pad next time! Thanks for the idea.

Thank you also for taking the time to try and explain your dietary discoveries and for keeping it as simple as possible (it was a lot of complex information you relayed, but you explained it in a way I think I understood). It’s disheartening to learn something we eat could potentially impact us for days (that makes me feel I won’t ever fully be able to figure out if something I’m ingesting is the cause of worsening symptoms). It’s also frightening to think our diets may contribute to more serious movement disorders (like Parkinson’s disease), but I guess it makes sense.

I’m glad to read you’ve managed to get your symptoms to go from severe to moderate, but “moderate” is still a lot to deal with. Here’s to hoping our amazing bodies want to heal themselves and one day will, if given the opportunity. Thank you again for your time and feedback. It means a lot to me. Oh, and I happen to love Tolstoy. :))

[ircam2112]

You’re very welcome! Meant to write sooner. Yes, a hot bath in the desert heat doesn’t sound very comfortable and glad to hear you’re “water conscious”. Wish we could send some of the rain here to you there - it’s been almost non-stop.

As far as the diet, focusing on the top 3-4 foods (stewed tomatoes, Parmesan. Cheese, etc. and 3-4 top additives (Aspartame, Soy Leichitin (sp?), anything malted of fermented, etc, can make a difference. I’ve found it’s impossible to avoid all foods and additives. There’s likely a website that lists the foods and additives highest in free glutamic acid. And there’s medications also - antihistamines, anti-nausea medication and SSRI/some atypical anti-depressants.

I’ve learned so much about that period in history in listening to Tolstoy, Dostoevsky, Dickens and Pasternak. Never knew that Napoleon occupied Moscow and that the aristocracy spoke fluid French often. Crazy world we live in.