2. Duration of Therapy

For muscle spasm, centrally acting skeletal muscle relaxants have been evaluated for short-term use in managing acute pain associated with musculoskeletal conditions. Therefore, with the exception of carisoprodol and cyclobenzaprine, patient profiles documenting prolonged skeletal muscle relaxant use for greater than three months will be reviewed.

Cyclobenzaprine therapy for muscle spasm should not last longer than three weeks as efficacy beyond this time period has not been demonstrated1,2,5-7.

Limited information exists regarding carisoprodol therapy duration for muscle spasm. As carisoprodol has been evaluated only for use in the treatment of acute painful musculoskeletal conditions, patient profiles documenting prolonged carisoprodol or carisoprodol combination therapy use (greater than 21 days) will be reviewed. Cases of psychological dependence have been reported following carisoprodol administration.19,20 Therefore, carisoprodol should be administered cautiously, if at all, to patients with a history of drug or alcohol abuse and/or dependence.

There is no basis for limiting therapy duration for skeletal muscle relaxants prescribed for spasticity (e.g., baclofen, dantrolene, tizanidine) as spasticity due to upper motor neuron disorders (e.g., spinal cord injury, cerebral palsy, multiple sclerosis, stroke) is a chronic disorder.