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Carisoprodol, better known by its trade name Soma, is a pharmaceutical muscle relaxant indicated for painful muscle spasms. It is a centrally-acting muscle relaxant; this means that it exerts its muscle-relaxing effects on the central nervous system, not on the muscle itself. It is often prescribed for muscle strains, particularly of the low back and is used as an adjunct with an analgesic.

Carisoprodol is efficacious in the treatment of low back pain and other types of muscular strains for a few reasons. The first relates to its tendency to act as a euphoric as well as a mild sedative. In addition to relieving the actual muscle spasm, these two side effects can be useful if the pain is causing anxiety or difficulty sleeping. The other feature that makes carisoprodol efficacious in pain relief is that it potentiates, or increases the effectiveness of opioid pain relievers (morphine derivatives). It is often prescribed concomitantly with opioid pain relievers such as codeine or hydrocodone for maximal pain relief. One formulation combines carisoprodol with aspirin and codeine.

The controversy that surrounds carisoprodol is related to its abuse potential. It is a schedule IV drug under the Controlled Substances Act, which means that it has been determined to have a low abuse potential when compared with higher level drugs such as hydrocodone. Despite this, it still does have a reputation for abuse and dependency and has been taken off the market in Sweden due to this. Its abuse potential may be due to the fact that it is a euphoric, which means that it produces a marked feeling of wellbeing and happiness. Over time one may develop a tolerance to its therapeutic effects and need to take a larger amount to render those same effects. Its abuse potential may also be related to it ability to intensify the effects of opioid pain relievers, which themselves can be addictive.

The ideal usage of Carisoprodol would be as a temporary medication, combined with an analgesic as needed, for the relief of painful muscle spasms. Because it does have some sedating effects, it would be ideal in a setting where one did not have to drive or operate machinery. To avoid dependency it is always best to not take more than the prescribed amount. It is also advisable to avoid prolonged use of this drug, especially when taken with opioid pain relievers.

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