{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:47:10Z","timestamp":1791380830717,"version":"4.3.3"},"reference-count":9,"publisher":"MedWorks Media","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychopharmacol Bull"],"abstract":"<jats:p>Due to the stringent regulatory environment for therapeutics, common side-effects of drugs in the general population are largely well-documented. This is however less the case with certain patient subgroups who may exhibit significant adverse responses to therapeutics that are otherwise well-tolerated. We report a case of psychosis induced by exposure to a commonly prescribed drug to treat muscle spasms and associated pain cyclobenzaprine (Flexeril\u00ae). Cyclobenzaprine is structurally very similar to tricyclic anti-depressants, such as amyltriptine. While it is well known that agitation caused by cyclobenzaprine is not an uncommon occurrence in the elderly, there have also been sporadic reports of significant psychosis in association with the use of cyclobenzaprine in younger patients. We report a case of reversible mania in a susceptible 44-year-old patient with a lengthy history of mild borderline personality and bipolar disorder. Shortly after being treated with cyclobenzaprine for pain due to a minor injury, this patient exhibited significant signs of mania although these signs were readily reversible upon termination of the treatment with cyclobenzaprine. The patient\u2019s severe adverse reaction to this normally innocuous drug adds weight to the notion that there is reason for caution with its prescription for potentially susceptible patient subgroups.<\/jats:p>","DOI":"10.64719\/pb.4575","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:39:16Z","timestamp":1761046756000},"page":"15-19","source":"Crossref","is-referenced-by-count":1,"title":["Induction of Psychosis by Cyclobenzaprine"],"prefix":"10.64719","volume":"48","author":[{"given":"Johan Y.","family":"Cohen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Am\u00e9lie","family":"Guilbault","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54175","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"ref1","unstructured":"Beeber AR, Manring JM., Jr Psychosis following cyclobenzaprine use. J Clin Psychiatry. 1983;44:151\u2013152."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Bulbena-Cabre A, Dunn RG, Swift G. Cyclobenzaprine-Induced Hallucinosis. Primary Care Companion CNS Disord. 2015;17(3) doi: 10.4088\/PCC.14l01773.","DOI":"10.4088\/PCC.14l01773"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Harsch HH. Mania in two patients following cyclobenzaprine. Psychosomatics. 1984;25:791\u2013793.","DOI":"10.1016\/S0033-3182(84)72967-7"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Lewis JL, Winokur G. The induction of mania: A natural history with controls. Arch Gen Psychiatry. 1982;39:303\u2013306.","DOI":"10.1001\/archpsyc.1982.04290030041007"},{"key":"ref5","unstructured":"O\u2019Neil BA, Knudsen GA, Bhaskara SM. First episode psychosis following cyclobenzaprine use. Can J Psychiatry. 2000;45:783\u2013764."},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Prien RF, Klett J, Coffey EM., Jr Lithium carbonate and imipramine in prevention of affective episodes: A comparison in recurrent effective illness. Arch Gen Psychiatry. 1973;29:420\u2013425.","DOI":"10.1001\/archpsyc.1973.04200030104017"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Quitkin FM, Kane J, Rifkin A. Prophylactic lithium carbonate with and without imipramine for bipolar patients. Arch Gen Psychiatry. 1981;38:902\u2013907.","DOI":"10.1001\/archpsyc.1981.01780330060006"},{"key":"ref8","unstructured":"Share NN. West Point PA: Postgradudate Medicine Publications; 1978. Pharmacological properties of cyclobenzaprine. In: Merck Sharp & Dohme, ed. Clinical Evaluation of Flexeril (cyclobenzaprine HCl\/MSD) pp. 14\u201318."},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Shprecher D, Sloan CT, Sederholm B. Neuropsychiatric side effects of cyclobenzaprine. BMJ Case Reports. 2013 doi: 10.1136\/bcr-2013-008997.","DOI":"10.1136\/bcr-2013-008997"}],"container-title":["Psychopharmacology Bulletin"],"original-title":[],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:34:32Z","timestamp":1791315272000},"score":1,"resource":{"primary":{"URL":"https:\/\/medworksmedia.com\/pb-article\/induction-of-psychosis-by-cyclobenzaprine\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":9,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,8,12]]}},"URL":"https:\/\/doi.org\/10.64719\/pb.4575","relation":{},"ISSN":["2472-2448"],"issn-type":[{"value":"2472-2448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]}}}