Bibliographic record
Abstract
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®). 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's 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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".