Controlled trial of cyclobenzaprine for acute musculoskeletal spasm.

Cyclobenzapine (CYC) is aproved treatment of acute musculoskeletal spasm. This randomized, double-blindparalle group trial compared the efficacy and safety of the prescription doce of CYC (10 mg t.i.d) to a lower doce (5 mg t.i.d) and placebo (PBO) in 737 adults with acute back or neck pain and palpable paraspinal spasm. Compared to PBO, CYC 5 and 10 mg t.i.d for 7 days were significantly better (p<0.001) in all 3 primary patient-reported categorical scales (medication Helpful-ness, ReRelief from Starting Backache, Global Impression of Change) and a physician rating of muscle spam at primary time points (48-72 hours and 1 week).Dailypain relief ratings showed of dosing.median times to "A Lot¨or¨complete¨Relief were >2 days longer with PBO than CYC 10. The most com-mon adverse experiences were sedation and dry mouth; both were dose-related (incidence of sedation/dry mouth was 38%32& on CYC 10,32%/21& on CYC 5, and 11%/7&on PBO).Sedation was generally mild;5.2& discontinued CYC 10 with sedation versus 2.5% on CYC 5 and 0.8& on

PBO CONCLUSIONS:

CYC 5 mg and 10 mg t.i.d provided the back or neck. meaningful relief from painful muscle spasm of the back or neck. CYC 5 appeared to be less sedating than CYC 10