by Alprazolam is a short-acting benzodiazepine medication used for anxiety disorders. It was approved for medical use in the United States in 1981. Some common brand names for alprazolam include Xanax, Niravam, and Xanax XR.
Mechanism of Action
Alprazolam Tablets works by enhancing the effects of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the brain. When GABA binds to its receptor on neurons, it induces a calming effect by decreasing the excitability of neurons. Alprazolam enhances these inhibitory effects of GABA, leading to its tranquilizing and anti-anxiety properties. By decreasing neuronal excitability in the brain regions responsible for emotion and anxiety, alprazolam can help reduce symptoms associated with anxiety disorders.
Medical Uses
Alprazolam Tablets is primarily used for the treatment of anxiety disorders such as:
– Generalized anxiety disorder (GAD) – Chronic excessive worrying
– Panic disorder – Recurrent unexpected panic attacks
– Social anxiety disorder (social phobia) – Fear of social situations
– Acute stress disorder – Short term anxiety after trauma
It can provide rapid, short-term relief of anxiety symptoms. Alprazolam may also be used for other conditions as prescribed by a doctor, such as moderate-to-severe anxiety caused by depression.
Dosage and Administration
The usual recommended starting dosage of alprazolam for adults is 0.25 to 0.5 mg taken three times daily as needed. The dosage may be adjusted based on the individual’s response and tolerance. The maximum recommended daily dosage is 4 mg per day. Alprazolam is available as immediate and extended-release tablets.
Extended-release tablets (Xanax XR) are taken once daily for continuous relief throughout the day. While immediate-release tablets should be taken as single doses three times daily as needed for panic attacks, not on a scheduled basis. Alprazolam has a rapid onset of action of 30 minutes. Its peak effects are seen within 1-2 hours and have a duration of 6-12 hours.
Drug Interactions
Alprazolam may interact with several other medications if taken concurrently. Some important drug interactions include:
– CYP3A4 inhibitors like protease inhibitors, azole antifungals: These enhance alprazolam levels by inhibiting its metabolism leading to increased sedative effects.
– CYP3A4 inducers like rifampin, St. John’s wort: These reduce alprazolam levels by inducing its metabolism leading to decreased efficacy.
– CNS depressants like opioids, sedative-hypnotics, alcohol: Potentiate CNS depression when combined with alprazolam. Increased risk of sedation, respiratory depression.
– Antibiotics like erythromycin: May increase alprazolam levels through CYP3A4 inhibition.
– Antifungal drug fluconazole: Significantly increases alprazolam plasma concentration leading to increased adverse effects.
– HIV protease inhibitors like ritonavir: Greatly elevate alprazolam levels by inhibiting its metabolism and increasing toxicity risk.
Precautions and Side Effects
Alprazolam should be used with caution in certain conditions and populations such as:
– Elderly – Increased risk of side effects due to changes in pharmacokinetics. Starting dose should be lower.
– Liver or kidney disease – Increased drug levels from reduced elimination.
– Pregnancy – Potential risk to fetus if used during pregnancy. Use if benefits outweigh risks.
– Breastfeeding – Traces may pass into breastmilk. Infant monitoring suggested if used.
Common alprazolam side effects include drowsiness, dizziness, weakness, fatigue, nausea, changes in libido. Long-term use can lead to tolerance, physical or psychological dependence. Other rare but potentially serious side effects are depression, suicidal thoughts, disinhibition leading to dangerous behaviors. Withdrawal symptoms may occur if stopped abruptly after long term use.
Discontinuation and Dependency Risks
Physical dependence and withdrawal symptoms can occur with long-term use of alprazolam higher than recommended or abrupt discontinuation after regular use. Withdrawal symptoms are usually mild but include rebound anxiety, insomnia, tremors, nausea, muscle twitching, and perceptual disturbances. Tapering the dose gradually under medical supervision over weeks to months helps reduce severe withdrawal reactions. For those on long-term benzodiazepines like alprazolam, behavioral counseling is recommended along with medication to help manage anxiety after discontinuation.
Use in Specific Populations
Alprazolam passes into breastmilk in small amounts. It is usually not recommended for use in breastfeeding women unless it provides significant benefits to the mother’s condition that outweigh any potential risks to the infant. Babies exposed to benzodiazepines through breastmilk should be closely monitored for excess sedation, poor feeding, and poor weight gain.
there is limited experience with the use of alprazolam in pregnant women for seizure or panic disorders. Only use if potential benefits outweigh possible risks to the fetus. When discontinuing, physician guidance is recommended due to the risk of increased seizures if Anti-epileptic drugs are abruptly stopped.
*Note:
1. Source: Coherent Market Insights, Public Source, Desk Research
2. We have leveraged AI tools to mine information and compile it.
