AVOID Muscle Relaxants They can leave you feeling groggy and confused, increase your risk of falls, and cause constipation, dry mouth, and problems urinating. Plus, there is little evidence that they work well.
Some muscle relaxants (carisoprodol, chlorzoxazone, cyclobenzaprine, metaxalone, methocarbamol, and orphenadrine) are avoided in older adults due to risk for sedation and falls. Others (tizanidine, baclofen, dantrolene) may be helpful for neck and back pain, with the most evidence for tizanidine and baclofen.
Serious side effects associated with their use include dizziness, falls, fractures, car accidents, dependence and overdose. Muscle relaxants pose a significant risk to people over 65, and the American Geriatrics Society advises against their use in this age group.
For this reason, muscle relaxers are intended as a short-term treatment not to be prescribed for more than 2-3 weeks.
Metaxalone
Taken as 800 mg tablets 3 to 4 times a day, metaxalone (Skelaxin) has the fewest reported side effects. It's also the least likely of the muscle relaxants to make you sleepy. It may work better for chronic lower back pain that is flaring up, rather than for pain that is new.
Muscle relaxants depress the central nervous system. This can cause extreme drowsiness and a sedative effect. Activities that require mental alertness and the operation of heavy machinery should be avoided while taking muscle relaxers.
Who is Defined as Elderly? Typically, the elderly has been defined as the chronological age of 65 or older. People from 65 to 74 years old are usually considered early elderly, while those over 75 years old are referred to as late elderly.
In the elderly, should prescription medication be necessary, the first-line treatment is nonbenzodiazepines (e.g., zolpidem, eszopiclone, zaleplon, and ramelteon) as they have been found to be safer and better tolerated than tricyclic antidepressants, antihistamines, and benzodiazepines.
Important examples of drugs with a higher risk of toxic effects because of age-related reductions in first-pass metabolism include nitrates, propranolol, phenobarbital, and nifedipine.
The two main possible complications of taking muscle relaxers are the potential for overdose and dangerous interactions with alcohol.
Abuse and serious risks are possible
Because these medications depress the central nervous system, breathing can be affected, and an overdose can be fatal. Combining a muscle relaxant with alcohol or another medication that also has a sedating effect is especially dangerous.
Muscle relaxants can be addictive for some people. Taking them without a prescription, or taking more than your doctor has recommended, can increase your chances of becoming addicted. So can using them over a long period of time.
If you've ever had a back or neck muscle spasm, you know they can hurt, a lot. But taking muscle relaxants, especially every day, isn't a good idea, according to our experts at Consumer Reports Best Buy Drugs.
The Geriatric Lexi-Drugs database recommends the avoidance of muscle relaxants other than diazepam and tizanidine in patients older than age 65 years because efficacy and safety have not been established in geriatric patients.
Diazepam is used to relieve symptoms of anxiety and alcohol withdrawal. This medicine may also be used to treat certain seizure disorders and help relax muscles or relieve muscle spasm. Diazepam is a benzodiazepine.
Sleep and Aging
Older adults need about the same amount of sleep as all adults—7 to 9 hours each night. But, older people tend to go to sleep earlier and get up earlier than they did when they were younger. There are many reasons why older people may not get enough sleep at night.
Melatonin: Melatonin is considered one of the safest over-the-counter sleep aids, with few side effects. A prescription drug called ramelteon is designed to mimic the effects of melatonin. Like melatonin, it is not considered habit-forming and it does not affect balance.
One study. View Source of older adults with insomnia found that magnesium supplementation at a dose of 500 milligrams daily for eight weeks helped them fall asleep fast, stay asleep longer, reduced nighttime awakenings, and increased their levels of naturally circulating melatonin.
The United States' older adult population can thus, be divided into three life-stage subgroups: the young-old (approximately 65 to 74 years old), the middle-old (ages 75 to 84 years old), and the old-old (over age 85).
One study classified older adults into the young old (60 to 69 years), the middle old (70 to 79 years), and the very old (80 years and older).
The American Psychological Association (1) states in Section 2.17 Age, (p 69): “Elderly is not acceptable as a noun and is considered pejorative by some as an adjective. Older person is preferred.
When used safely and according to doctor's orders, they can be very beneficial. Since muscle spasms are typically healed within two to three weeks, a doctor typically will only prescribe a muscle relaxant for acute rather than chronic pain. They are usually not intended for prolonged use.
Because muscle relaxers are total body relaxants, they typically induce grogginess or sleepiness. As a result, it is not safe to drive or make important decisions while taking muscle relaxers. Muscle relaxers are often suggested for evening use due to their sedative effect. Interactions with alcohol.