From the FDA Drug Label
In three of these studies there was a significantly greater improvement with cyclobenzaprine than with diazepam, while in the other studies the improvement following both treatments was comparable The efficacy of cyclobenzaprine hydrochloride tablets 5 mg was demonstrated in two seven-day, double-blind, controlled clinical trials enrolling 1405 patients.
The current treatment guidelines for tension headaches may include cyclobenzaprine, as it has been shown to be effective in clinical trials for the treatment of musculoskeletal disorders, which may be related to tension headaches.
- Key points:
- Cyclobenzaprine has been demonstrated to be effective in clinical trials for the treatment of musculoskeletal disorders.
- The efficacy of cyclobenzaprine hydrochloride tablets 5 mg was demonstrated in two seven-day, double-blind, controlled clinical trials.
- Cyclobenzaprine may be used as part of the treatment for tension headaches, but the FDA label does not directly address this condition 1.
From the Research
Current treatment guidelines for tension headaches recommend a stepwise approach starting with non-pharmacological interventions like stress management, regular exercise, adequate sleep, and proper hydration. For acute episodes, over-the-counter analgesics are first-line treatments, including acetaminophen (500-1000mg every 4-6 hours, not exceeding 4000mg daily) or NSAIDs such as ibuprofen (400-600mg every 6-8 hours, maximum 3200mg daily) or naproxen sodium (550mg initially, then 275mg every 6-8 hours as needed) 2. These medications work by reducing pain signals and inflammation. Some key points to consider when treating tension headaches include:
- The use of acetaminophen 1000 mg provided a small benefit in terms of being pain free at two hours for people with frequent episodic TTH who have an acute headache of moderate or severe intensity 2.
- NSAIDs and acetaminophen are both effective for short-term pain relief in patients with TTH, with no specific type of NSAID being clearly more effective than others, but ibuprofen showing fewer side effects 3.
- For frequent or severe tension headaches, preventive treatments may be necessary, including amitriptyline (starting at 10mg nightly, gradually increasing to 25-50mg if needed) or other tricyclic antidepressants, which help by modulating pain pathways in the brain.
- Muscle relaxants like cyclobenzaprine (5-10mg three times daily) may be prescribed for headaches associated with muscle tension.
- Combination analgesics containing caffeine should be used sparingly due to the risk of medication overuse headaches.
- Physical therapy, massage, heat/cold therapy, and biofeedback can complement medication.
- Patients should maintain a headache diary to identify triggers and monitor treatment effectiveness, and should seek medical attention if headaches worsen, change in character, or are accompanied by concerning symptoms like fever or neurological changes.