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Carisoprodol
General information
Carisoprodol is a precursor of meprobamate, an oral anxiolytic with similarities to benzodiazepines. The spasmolytic effect of carisoprodol is thought to be due to interruption of neuronal communication within the reticular formation and spinal cord. Major adverse effects are sedation and drowsiness.
Because of an increased risk of abuse and addiction [ , ] carisoprodol was withdrawn from many countries in 2008. However, in a nationwide longitudinal prescription study of 53 116 individuals in Norway, previous users of carisoprodol switched, to a limited extent, to other prescribed drugs with abuse potential after withdrawal [ ].
Organs and systems
Nervous system
In 104 cases carisoprodol and its metabolite meprobamate were detected in the blood of car drivers who were either involved in accidents or arrested for impaired driving [ ]. In many of these cases, either alcohol or other nervous system depressants were also found. In 21 cases carisoprodol/meprobamate were the only drugs detected. Symptoms and reported driving behavior were similar in all cases. Impairment of driving ability appeared to be possible at any concentration of these two drugs. However, the most severe driving impairment and most overt symptoms of intoxication were noted when the combined concentration of carisoprodol and meprobamate exceeded 10 mg/l.
The potential effect of carisoprodol abuse on the ability to drive has been addressed in a retrospective analysis [ ]. Among 140 000 blood samples from drivers stopped by the police, carisoprodol and its metabolite meprobamate were the only substances found in 62 cases. Drivers with psychomotor impairment had higher plasma carisoprodol concentrations than those not impaired. There was no conclusive relation between driving impairment and plasma meprobamate concentration, which led the authors to suggest that carisoprodol itself in supratherapeutic concentration had an effect on the ability to drive, independent from the effect of its metabolite.
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