Common Brand Names: Rela, Soma, Soma Compound (with aspirin), Sopridol, Soridol, Vanadom
Carisoprodol is believed to possess a centrally acting skeletal muscle relaxant effect as opposed to acting directly on the skeletal muscles. Research also shows that carisoprodol can cause changes in the interaction of neurons in multiple areas of the body, including the spinal cord and brain, which can lead to muscle relaxation. Its metabolite, meprobamate, apparently affects the GABA receptors, which produces its therapeutic effects.
Under the federal drug scheduling system, carisoprodol is listed as a Schedule IV drug. This means that it is accepted for medical use in the United States, although it possesses an abuse potential, and chronic use of it can lead to limited physical or psychological dependence.
Carisoprodol is prescribed—along with physical therapy, rest and other measures—to relieve acute musculoskeletal pain in individuals aged 17 and older.
Those with acute intermittent porphyria and hypersensitivity reactions to carbamates (e.g., meprobamate) are advised against using carisoprodol. The drug is also contraindicated in patients with impaired renal function, as well as in the elderly.
How Is Carisoprodol Abused?
According to data from the 2012 National Survey on Drug Use and Health (NSDUH), more than 3.69 million people aged 12 or older have used carisoprodol for non-medical reasons.
Carisoprodol tablets are often taken together with other CNS depressants to boost its effects or to self-manage opiate withdrawal. It is also sometimes mixed in alcohol and with date rape drugs to potentiate its effects.
Additionally, the combination of carisoprodol with opioid analgesics and benzodiazepine drugs has been referred to by recreational users as “the Holy Trinity,” pertaining to the kind of “high” that they get when using these drugs together.
Relationship of Carisoprodol Use to Meprobamate Toxicity
Carisoprodol, along with its primary metabolite meprobamate, are listed as Schedule IV drugs under the scheduling system described by the Controlled Substances Act. Meprobamate, in particular, has been classified in the schedule as early as 1970 for being a known drug of abuse and dependence.
However, it’s metabolite meprobamate has a high risk of abuse and dependence. Meprobamate also has a prolonged elimination half-life of about 10 hours, which is much longer than carisoprodol’s 1.7 to 2 hours at 250 mg and 350 mg respectively. This increases the risk of bio-accumulation of meprobamate in the body if carisoprodol is used for extended periods.
Drugs That Interact With Carisoprodol
There are various kinds of drugs that may affect how carisoprodol works in the human body. These include the following:
- CNS depressants. Alcohol, benzodiazepines, and opioids may lead to extremely potent effects of carisoprodol. If you are taking any of these mentioned substances, tell your doctor so you can be monitored accordingly.
- CYP2C19 inhibitors and inducers. Carisoprodol is metabolized in the liver by CYP2C19, a kind of enzyme protein. This process forms meprobamate, which acts like a benzodiazepine. CYP2C19 inhibitors can decrease the exposure of meprobamate, reducing carisoprodol’s anxiolytic and sedative properties. CYP2C19 inducers, on the other hand, may produce the opposite effect.
The Side Effects of Carisoprodol
Some of the most immediate side effects of carisoprodol include:
- Nausea, vomiting
Long-Term Effects of Carisoprodol
Prolonged use of carisoprodol can produce deleterious effects on the body, including:
- Withdrawal symptoms similar to those of barbiturate withdrawal
- Withdrawal symptoms similar to those of alcohol withdrawal
- Long-term memory loss
- Chronic insomnia or sleep disorder
- Anxiety and depression
Symptoms of Carisoprodol Overdose
An overdose of carisoprodol can manifest through the following symptoms:
- Direct cardiac toxicity
- Central nervous system depression
- Respiratory depression
- Dystonic reactions (involuntary contractions all over the body)
- Muscular incoordination
- Mydriasis (dilated pupils)
- Blurred vision
- Nystagmus (involuntary eye movements)
The recommended interventions in case of carisoprodol overdose include:
- Gastric lavage (suctioning of gastrointestinal contents) within one hour of overdose
- Circulatory system support with volume infusion and vasopressor agents
- Benzodiazepine and phenobarbital treatment for seizures
- Tracheal intubation to protect the airway
- Oral or nasogastric administration of activated charcoal for meprobamate overdose
- Forced diuresis
- Peritoneal dialysis
Carisoprodol overdose can result in death. If you suspect an overdose in yourself or another individual, contact 911 or your local emergency services immediately.
Signs of Carisoprodol Addiction
Anyone who has been chronically using carisoprodol must be monitored for signs of addiction. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists 11 criteria for substance use disorders, including those that may be attributable to carisoprodol abuse. These include the following:
- Taking carisoprodol in higher amounts or for much longer than intended
- Wanting to stop or lessen the use of carisoprodol, yet being unsuccessful
- Spending a lot of time acquiring, using, or recovering from use of carisoprodol
- Getting intense cravings or urges to use carisoprodol
- Using carisoprodol results in inability to manage obligations
- Continuing to use carisoprodol despite it causing interpersonal or relationship problems
- Using carisoprodol results in giving up on important activities
- Continuing to use carisoprodol even when it puts you in danger
- Continuing to use carisoprodol despite it causing or worsening existing physical and psychological problems
- Tolerance to the drug, which means needing higher and higher doses of carisoprodol to achieve its desired effects
- Development of withdrawal symptoms after the abrupt cessation of taking carisoprodol
Symptoms Carisoprodol Withdrawal
Abrupt cessation following chronic carisoprodol use can also cause the patient to experience withdrawal symptoms such as the following:
- Social Withdrawal
- Tremors and muscle twitching
- Ataxia, which presents as difficulty in balance and walking
Moreover, the severity of symptoms appears to be much worse in individuals who already have a history of substance abuse, as well as in individuals who are using carisoprodol with sedatives, benzodiazepines, and opioids.
Take note that it is possible to develop dependence on carisoprodol and then to experience withdrawal symptoms, even if you are taking the drug as prescribed. However, it’s important to remember that dependence doesn’t equate to addiction. It only means that your body may have become used to the presence of the drug.
If you want to stop using carisoprodol safely, don’t do it abruptly and on your own. Go to your doctor or consult a medical professional at a detox facility, who can create a tapering schedule for you. This way, you’ll be able to wean yourself off the drug in a safe manner.
The safest way to manage carisoprodol withdrawal symptoms and to completely stop using it is to undergo carisoprodol detoxification. This primarily involves the gradual reduction of carisoprodol doses that you take until such a time when you can manage without it. At a medical detox facility, professionals will oversee your care, and you may be:
- Given symptomatic medications to manage the associated negative effects of withdrawal.
- Given additional remedies, including IV fluids and nutritional supplements to restore your health.
- Provided with round-the-clock support and monitoring so you can stay safe and comfortable throughout the detoxification program.
Rehabilitation and Treatment for Carisoprodol Addiction
If you want to overcome carisoprodol addiction, the best thing to do is to seek professional help. Doctors and rehabilitation specialists can give you the medical attention and psychological support you need to beat substance use disorder.
Depending on the severity of your condition, you may be recommended to undergo either inpatient or outpatient treatment.
- Inpatient carisoprodol addiction treatment: Inpatient addiction treatment is the best option if you or your loved one has severe addiction. It’s also recommended for those who have a history of low or non-compliance to treatment protocols. With inpatient addiction treatment, you will stay in the rehabilitation facility until the program is completed. You may receive a variety of treatment modalities, including counseling, drug education, family therapy, and other forms of psychological therapy. Inpatient addiction treatment will also provide round-the-clock supervision from medical professionals, ensuring your safety and comfort through the entire program.
- Outpatient carisoprodol addiction treatment: If you have a milder addiction case and can guarantee treatment compliance outside of a facility, outpatient treatment may be the better option. It’s also recommended if you have a strong support system at home or in your community. With this addiction treatment option, you can continue living in your own home, go to work or school, and essentially keep your everyday routine. However, you’ll need to go to your assigned rehab facility to receive treatment on days when your sessions are scheduled.
Find the Treatment You Need
Take the first step towards a drug-free life: get in touch with Better Addiction Care at 1-800-429-7690 today. Once you get over the initial hurdle of acknowledging that you need help to overcome addiction, our recovery support advisors can put you in touch with our partner treatment centers and find the best treatment program for your needs.
If you want to verify insurance, you’ll be pleased to know that your policy may already have coverage for drug addiction treatment. If you don’t have insurance, our advisors can help you find alternative financing options. We can also help you find suitable treatment facilities.
History of Carisoprodol
Carisoprodol was first discovered in 1959. Interestingly, its metabolite meprobamate was discovered first. Because meprobamate had both sedating and muscle relaxant properties, researchers made small modifications to the molecule, which yielded carisoprodol.
As a Schedule IV drug, carisoprodol is only available via prescription, and its popularity as a treatment modality has declined significantly in recent years.
Carisoprodol is still commonly prescribed in the U.S. and South America for pain. It is no longer used throughout the European Union since 2008 due to its potential for misuse, dependence, and addiction.