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Soma Vs. Xanax- Understanding Their Differences & Similarities

Soma Vs. Xanax- Understanding Their Differences & Similarities

 

Both Soma and Xanax are effective treatment options for anxiety and muscle spasms. While the Soma pill is more effective for muscle pain despite its potent anti-anxiety properties, Xanax is a better treatment option for anxiety. 

 

 

Soma and Xanax are two distinct classes of medication, paving their mark in the pharmaceutical world. So, why are we taking the trouble of comparing them? 

Even though these medications have different clinical benefits, they share a common ground when treating anxiety and providing muscle relaxation.  

This blog explores the shared purpose of Xanax and Soma pills as muscle relaxants and anxiety medications by evaluating their unique characteristics, working mechanisms, and potential health risks. 

 

Xanax And Soma- An Overview

Carisoprodol, marked under the Soma pill in the USA, is a noncontrolled skeletal muscle relaxant [1,2]. It is a prescription drug approved for medical use by the FDA in 1959 [3]. 

Alprazolam, available under the brand Xanax, belongs to a group of medicines called benzodiazepines [4]. Its use was approved by the FDA in 2003 and has been a common therapeutic choice for anxiety ever since [5]. It is one of the most commonly prescribed psychotropic medications in the United States, with about 48 million prescriptions in 2013 [6]. 

 

Is Soma Similar To Xanax?

Soma pill and Xanax share a few similarities, as mentioned below. 

Drug Schedule In The USA-

Both Soma pills and Xanax are categorized as Scheduled IV prescription drugs in the USA by the Drug Enforcement Administration (DEA). 

Uses-

These are proven effective in improving signs of anxiety and providing muscle relaxation. 

Health Considerations-

These medications are not recommended for people with kidney, liver, and heart disorders. 

Effects-

The effects of Carisoprodol (Soma pill) are similar to tranquilizers such as Xanax, according to a ‘Monitoring the Future’ study by Mayank Gupta. 

Onset Of Action-

Both medications take 30 minutes to start acting.

Pregnancy Guidelines-

Even though Xanax and Soma pills fall into distinct pregnancy categories, administering these drugs during pregnancy and lactation is not advisable. 

Xanax is a category D pregnancy medication, indicating that a potential health risk to the fetus has been observed in human trials. Whereas the Soma pill is a category C medication demonstrating no health risks, has been studied or reported in humans, and is only limited to animal trials [21]. 

 

Potential Differences Between Xanax And Soma Pill 

Apart from the similarities, there are a few differentiating factors between the two that should be considered before choosing the right treatment option, as mentioned in the table below. 

 

Characteristics

Xanax

Soma Pill 

Generic name

Alprazolam

Carisoprodol

Brand name

Xanax

Soma pill

Manufacturer

Pfizer Pharmaceuticals

HAB Pharmaceuticals.

Legal Status

  • Australia (AU): S8 (Controlled drug)

  • Canada (CA): Schedule IV

  • Germany (DE): Anlage III (Special prescription form required) (in doses higher than 1 mg)

  • UK: Class C

  • UN: Psychotropic Schedule IV prescription drug. 

 
  • Canada (CA)- prescription drug (Schedule I, sub-schedule F1).

  • UK- Prescription only. 

 

 

Class Of Drug

Benzodiazepines.

Muscle Relaxant.

Structural Differences

alprazolam-structure

carisoprodol-structure

Soma pill or Carisoprodol has a chemical structure that is not related to benzodiazepines and is classified as a carbamate, while Xanax (alprazolam) has a benzodiazepine chemical structure with a diazepine ring.

Composition

The active compound in the formulation of Xanax is Alprazolam. The inactive compounds are corn starch, lactose, magnesium stearate, sodium benzoate, Cellulose, docusate sodium, and silicon dioxide [7]. 

Carisoprodol is the active compound in the Soma pill, and other inactive compounds such as Microcrystalline cellulose, Povidone, Croscarmellose sodium, hypromellose, Stearic acid, Magnesium stearate, and Starch.

 

The other notable distinguishing factors for people choosing the right therapeutic option between the two are listed below. 

Duration of Action: 

The action of Xanax lasts for 6 hours, whereas the effects of the Soma pill last for 4 to 6 hours. 

Dosage And Strengths: 

The Soma pill has three strengths: Soma 250mg, 350 mg, and 500 mg. 

The 350 mg of Carisoprodol is more suited for beginners and people with mild body pain. In comparison, people order Soma 500 mg for moderate to severe acute pain. 

Xanax is marketed in four strengths- 0.25mg, 0.5 mg, 1 mg, and 2 mg.

 

Soma Vs. Xanax- A Comparison Of Their Medical Benefits

Soma and Xanax are prescribed for different medical conditions; however, they are both considered effective for treating symptoms of anxiety and muscle spasms. So, let us first look at the individual benefits of these medications. 

Uses And Benefits Of The Soma Pill - 

The Soma pill treats period cramps, back pain, headache, and fibromyalgia. This muscle relaxer's analgesic effect helps treat short-term musculoskeletal acute pain [8]. 

Medical Uses Of Xanax -  

Xanax or Alprazolam is a prescription for treating panic and generalized anxiety disorders [6]. It is also an effective treatment option for chemotherapy-induced nausea [4]. 

Soma Vs Xanax For Muscle Spasms-

The use of Xanax for muscle spasms is an off-label benefit of the medication and is not approved by the FDA  to treat pain [9]. However, the potential use of Xanax for relaxing muscles is scientifically proven by many clinical studies. 

A 1984 study reviewing the pharmacodynamic properties and efficacy of Alprazolam by G W Dawson et al. suggests that this drug, along with anticonvulsant and antianxiety properties, also has muscle-relaxing activities. It also states that Xanax is a much more potent muscle relaxant than diazepam [10]. 

Another study by Tobin T. George and Jayson Tripp explains the mechanism of action of benzodiazepines that is associated with their muscle-relaxing effects works by activating the alpha-2 and alpha-3 subunits of the GABA (Gamma-aminobutyric acid) receptor [11]. 

In addition to clinical studies supporting the beneficial effects of Alprazolam as a muscle relaxer, some studies contradict these findings. 

One such study was published in 2012 by Bethan L Richards et al. in the Cochrane Library. The study demonstrated that the use of benzodiazepines was not effective in improving pain over 24 hours or 1 week [12]. 

On the other hand, the Soma pill or Carisoprodol is a prescription medication for managing muscle cramps and spasms. Some of the notable studies suggesting the analgesic effect of Carisoprodol or Soma pill are mentioned below. 

- Clinical Study 1

A study by  Peter E. Toth (MD, Ph.D.) et al. published on ScienceDirect in 2004 put forward the effective management of lower back pain due to muscle spams by muscle relaxants such as Carisoprodol [13]. 

- Clinical Study 2

Patients with acute muscle pain or spasms experienced significant and rapid relief from pain from Carisoprodol, according to a study by Lee Ralph published on the website Tandfonline. 

- Clinical Study 3

A study by Richard W. Payne (MD) evaluating the use of Meprobamate (primary metabolite of Carisoprodol or Soma pill) suggest it significantly improves sleeping pattern in individuals along with relieving pain [15]. 

Soma And Xanax For Treating Anxiety 

The use of Soma pill or Carisoprodol for treating anxiety is an off-label benefit of the muscle relaxer and is not approved by the FDA. However, clinical studies indicate its beneficial effects in improving the signs of anxiety. 

Meprobamate, a primary metabolite of Carisoprodol or Soma pill, also contributes to its anti-anxiety properties. The Council on Pharmacy and Chemistry of the American Medical Association suggests the effectiveness of Meprobamate as a tranquilizing agent that can be beneficial for treating stress and anxiety [16]. This is further confirmed and supported by numerous other studies, some of which are listed below. 

- Scientific Study 1

A controlled trial conducted in 1958 by John M. Hinton suggests that treating patients with anxiety showed significant improvement with Meprobamate. The study reports great alleviation in anxiety, phobic symptoms, and tension [17]. 

Assessment Of Change In Symptoms Of Two Groups At The End Of Trial

The ability and extent to which Meprobamate and Placebo were able to improve the signs of anxiety, tension, depression, anorexia, and compulsions or phobias in the test subjects are represented in the table below. 

 

Symptoms

Group

Much Better

Better

Unchanged

Anxiety

Meprobamate

2

13

2

Placebo

1

7

11

Tension

Meprobamate

6

7

5

Placebo

2

8

8

Depression

Meprobamate

1

6

6

Placebo

-

9

6

Anorexia

Meprobamate

1

4

3

Placebo

-

4

4

Compulsions or phobias 

Meprobamate

1

5

6

Placebo

-

1

6

 

The FDA approves Alprazolam or Xanax for treating anxiety disorders. Its potency as an anti-anxiety drug is corroborated by countless scientific research. 

 

Study

Publication

Findings

Alprazolam in the treatment of generalized anxiety and panic disorders: A double-blind placebo-controlled study.

Journal of Psychopharmacology, springer [18]. 

A double-blind controlled study showed Alprazolam dosages between 0.25 and 3 mg/day effectively treat panic disorder. 

Preoperative Alprazolam Reduces Anxiety in Ambulatory Surgery Patients: A Comparison with Oral Midazolam [19]. 

Journal of Anesthesia and Analgesia.

International Anesthesia Research Society. 

The study concludes that 0.5 mg of alprazolam can be used as a premedication to reduce anxiety before ambulatory surgery. 

A comparison of the safety and efficacy of alprazolam versus other agents in the treatment of anxiety, panic, and depression: A review of the literature [20].

American Psychological Association. 

A case study involving 84 medications conducted on 8,876 patients indicated Alprazolam is an effective treatment for panic disorder, anxiety issues, and depression. The study further concludes that no reports of withdrawal reactions, suicidality, psychosis, or seizures were reported from this treatment. 

 

 

So, it would be safe to say that a comparative analysis of Meprobamate vs Xanax for treating anxiety symptoms suggests that even though Meprobamate or Soma pill showcase effective anti-anxiety properties, its medical use is not recommended and approved by the FDA, thus making Xanax a better treatment option. 

 

Administration Guidelines 

The following administration guidelines should be followed before taking both Carisoprodol and Alprazolam pills-

  • Avoid alcoholic beverages.

  • Both these medications should be taken orally three to four times a day. 

  • Do not administer other medications and supplements while taking them.

  • Avoid crushing and splitting the tablets.

  • They can be taken before or following a light meal.

  •  Long-term use of these medications is not advisable. Alprazolam should not be taken over 6 weeks, and Carisoprodol should not be over 3 weeks. 

 

Side Effects Of Xanax And Soma Pill 

The common side effects of the Soma pill include Headache, Blurred vision, Nervousness, Agitation, Irritability, Vomiting, Hiccups, and Upset stomach. It may also cause a few rare but serious side effects, including fever, twitching, diarrhea, and loss of coordination. 

The common notable side effects of Xanax include loss of interest or pleasure, tiredness, slurred speech, lightheadedness, lack of appetite, discouragement, Being forgetful, unsteadiness, trouble speaking and sleeping, and unsteady walking. 

A few rare side effects that may require medical attention are feeling jittery, chest pain, ringing or buzzing noise in the ears, loss of control of the legs, voice changes, and suicidal thoughts. 

 

Xanax Vs. Soma- Dependency and Abuse Potency

The soothing effect of both Carisoprodol and Alprazolam helps reduce anxiety by relaxing and calming the brain activity but results in a higher risk for abuse. 

Xanax is a mild tranquilizer that results in sedation by slowing down the activities of the central nervous system (CNS) and the brain. It works down by slowing the brain functioning and thus is considered the most addictive benzodiazepine today. 

Carisoprodol is a Central Nervous System depressant and thus also known to cause sedative effects.  It may be habit-forming, especially when combined with other medications and supplements. 

It is important to note the following key points- 

  • The Soma pill and Xanax produce a euphoric and sedative effect that addicts often seek.

  • The Soma pill can intensify the effects of other drugs, such as Xanax when taken together. 

Xanax is also one of the most widely abused tranquilizers, whereas Soma pill abuse has significantly decreased from 1.4 (2008) to 0.2 (2019), according to a 2020 study by Mayank Gupta. 

Is Soma A Benzo? 

Even though Carisoprodol is marketed as a muscle relaxant, its primary metabolite, Meprobamate, is considered a benzodiazepine class of tranquilizing medications [8]. 

Xanax also belongs to the benzodiazepine drug class. 

 

Drug Interactions

Both Soma pills and Xanax can interact with other medications and supplements, thus lowering the efficacy of the treatment and increasing the risk of side effects. 

Carisoprodol or Soma pills can interact with 362 medications, whereas Xanax can interact with 542 drugs. Some of the common medications that should not be taken with Soma pill and Xanax are mentioned in the table below. 

 

Soma Pill Drug Interactions

Xanax Drug Interaction

Acetylcarbromal

Amprenavir

Armodafinil

Buprenorphine

Buprenorphine

Chlorpheniramine

Carteolol

Esmolol

Esmolol

Fosamprenavir

Felodipine

Halazepam

Ganaxolone

Itraconazole

Hydroxyzine

Lonafarnib

Kava

Meperidine

Nicardipine

Posaconazole

 

Can You Mix Xanax And Soma?

Mixing soma and Xanax is not advisable as it increases the risk of experiencing side effects. 

In early 2000, Alprazolam (Xanax) and Carisoprodol with Hydrocodone were taken for recreation purposes. This cocktail of medication is called the “Holy Trinity” or the “Houston Cocktail.” The Concomitant use of these compounds enhances the euphoric effect of these medications and results in respiratory depression [22]. 

Some potential health risks of Xanax and soma interaction include drowsiness, difficulty concentrating, dizziness, and confusion. Such interaction in elderly people may further impair judgment, motor coordination, and thinking ability. 

Management- 

If, under any condition, both these medications are co-administered, in such cases, it is essential to monitor the patient for respiratory and CNS depression regularly, as taking a Soma pill with Xanax is addictive and is also potentially dangerous. 

 

 

Advisory Note From The Author

Carisoprodol and Alprazolam should only be taken together after consulting a physician. This drug combination, even if prescribed to you by your physician, should not be suggested or given to a friend or a family member without consultation.

 

 

Which Among Alprazolam And Carisoprodol Is More Affordable? 

Based on the price list on the website Drugs, the cost of 0.25 mg of Xanax is about $556 for a supply of 100 tablets ($5.56 per pill) [23]. 

On the contrary, the Soma 350 mg price is $298 for 400 tablets ($0.74 per pill) at online pharmacies such as Healthnaturo. However, it is essential to note that the cost of these medications may vary based on the pill package and the pharmacy. 

 

Xanax Vs. Soma- Withdrawals Symptoms And Risks 

Carisoprodol is a Schedule IV controlled substance (any medication with a limited potential for dependency and abuse). 

A report by Roy R. Reeves et al. in the Journal of Osteopathic Medicine suggests limiting the use of Carisoprodol to short-term musculoskeletal pain due to its abuse potency [24]. 

This abuse potency may result in withdrawal symptoms upon sudden discontinuation of the muscle relaxer. Some common symptoms of Soma withdrawal are insomnia, body aches, and perspiration. 

A case study by Karen Ni from the University of California reports the development of delirium (confusion, inability to think, and disorientation) after the abrupt discontinuation of Carisoprodol. The withdrawal symptoms of the Soma pill are also attributed to its metabolite, Meprobamate [25]. 

Alprazolam is a Schedule 8 prescription medication with strict legislative controls and a high potency for addiction and abuse. The clinical use of Alprazolam has been a factor of concern as most physicians consider it to be highly addictive. This gives Xanax unique psychodynamic properties that limit its usefulness [6]. 

It is estimated that about 40% of people experience severe Xanax withdrawal while 60% of users experience mild symptoms, according to an article by Healthline. Some of the withdrawal symptoms of Xanax include muscle spasms, insomnia, panic attacks, sweating, restlessness, hallucination, seizures, palpitations, seizures, hand tremors, confusion, and anxiety. 

Withdrawal Timeline For Soma And Xanax- 

 

Timeline

Soma

Xanax

Onset of Withdrawal 

Symptoms may occur after 12-48 hours from the last dosage. 

It usually begins within 24 hours after the last dose. 

How long do the symptoms last? 

The symptoms of Soma withdrawal cease within 12 to 48 hours. 

An acute withdrawal may last between 5 to 28 days, whereas, in severe cases, it may last for about a year. 

 

Precaution And Warnings For Soma And Xanax

  • As both these medications are known to cause a sedative effect, driving and using heavy machinery should not be used after administration. 

  • Ensure you are not allergic to any of the compounds present in the formulation of these medicines. 

  • People with porphyria should not use Soma pills without consulting a physician. 

  • Soma pill is not recommended for people below the age of 17 years, and patients below 18 years should not take Xanax. 

 

Our Final Thoughts On The Soma Vs. Xanax Debate

Xanax and the Soma pill are both FDA-approved medications with similar medical benefits. However, the Soma pill is a preferred medication for body pain, whereas Xanax is commonly prescribed for anxiety. 

Factors To Consider While Choosing Between Xanax And Soma Pill 

If you still haven't made up your mind on which is the correct treatment option for you, we are here to help you. The table below is a summary of all the key factors that should be taken into consideration while choosing between Alprazolam and Carisoprodol. 

 

Characteristics

Carisoprodol

Alprazolam 

Onset of action

30 minutes.

30 minutes.

Duration of action

4 to 6 hours.

6 hours.

Affordability

More affordable ($0.74 per pill).

Less affordable. 

Abuse Potency

Comparatively low. 

Highly addictive. 

Safer Pregnancy option

There are no reports of side effects in humans, and it is comparatively safer. 

Reports of health issues in infants when used by pregnant women. 

Drug Interaction

Lower drug interactions. 

Alprazolam has a higher risk of drug interaction. 

 

Our findings suggest taking Soma pills for body pain, whereas Xanax if you struggle with anxiety. 


FAQ's

No, both Xanax (Alprazolam) and Carisoprodol are different classes of medication. Soma pill is a prescription muscle relaxant, whereas Xanax is prescribed for treating anxiety disorder.

Apart from using Xanax for anxiety, other treatment options are diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan), and temazepam (Restoril). Carisoprodol (Soma) is also an effective treatment option that works within 30 minutes of intake but however, is not approved by the FDA.

Since Xanax and Soma pills belong to different drug classes, thus it can be difficult to say which is a stronger medication. However, the Soma pill is a stronger muscle relaxant or analgesic than Xanax and provides better pain relief in 30 minutes.

Yes, Carisoprodol or Soma pill is considered a benzodiazepine due to its primary metabolite Meprobamate.

Muscle relaxers such as Soma pill, Diazepam, and Oxazepam can help manage signs of anxiety.

Soma pill has an effective anti-anxiety property and works by calming the activity of the brain. It works within 30 minutes; however, it is not approved by the FDA for anxiety disorders. Thus, people should take Soma for anxiety after consulting a doctor.

Yes, muscle relaxers work on the Central Nervous System of the body, causing a sedative effect. It thus helps in relaxing the brain of the user.


References-

  1. Carisoprodol (Soma): a new and cautious perspective on an old agent, europepmc. 

  2. Carisoprodol: Update on Abuse Potential and Legal Status, researchgate. 

  3. Soma (Carisoprodol) tablets for oral use - Accessdata.fda.gov. 

  4. Alprazolam, wikipedia. 

  5. Drug Approval Package: Xanax X-R (Alprazolam) NDA #021434. 

  6. A Review of Alprazolam Use, Misuse, and Withdrawal, NCBI. 

  7. XANAX® alprazolam tablets, USP - Accessdata.fda.gov

  8. Carisoprodol, NCBI. 

  9. Xanax & Muscle Tension, stepstorecovery. 

  10. Alprazolam- A Review of its Pharmacodynamic Properties and Efficacy in the Treatment of Anxiety and Depression, springer.com. 

  11. Alprazolam, NCBI. 

  12. Muscle relaxants for pain management in rheumatoid arthritis, cochranelibrary. 

  13. Commonly used muscle relaxant therapies for acute low back pain: a review of carisoprodol, cyclobenzaprine hydrochloride, and metaxalone, ScienceDirect. 

  14. Double-blind, placebo-controlled trial of carisoprodol 250-mg tablets in the treatment of acute lower-back spasm, Tandfonline. 

  15. Diazepam, Meprobamate, and Placebo in Musculoskeletal Disorders, jamanetwork. 

  16. A critical review of the efficacy of meprobamate (Miltown, Equanil) in the treatment of anxiety, ScienceDirect. 

  17. A controlled trial of meprobamate in anxious out-patients, NCBI. 

  18. Alprazolam in the treatment of generalized anxiety and panic disorders: A double-blind placebo-controlled study, springer.

  19. Preoperative Alprazolam Reduces Anxiety in Ambulatory Surgery Patients: A Comparison with Oral Midazolam, journals.lww.com.  

  20. A comparison of the safety and efficacy of alprazolam versus other agents in the treatment of anxiety, panic, and depression: A review of the literature, psycnet.apa.org. 

  21. Pregnancy Medications, NCBI. 

  22. Houston Cocktail: Driving under influence of hydrocodone, alprazolam, and carisoprodol, ScienceDirect. 

  23. Xanax Prices, Coupons, Copay & Patient Assistance, Drugs.com. 

  24. Carisoprodol: A drug of continuing abuse, degruyter. 

  25. Carisoprodol withdrawal induced delirium: A case study, NCBI.