Name Alprazolam
Classes Central Nervous System Agent
Psychotherapeutic Agent
Anxiolytic
Benzodiazepine
Sedative and Hypnotic
Diseases Anxiety
Depression
Mental Disorder
Panic Attack

Alprazolam

Alprazolam is a fast acting with a medium duration of action tranquilizer of the triazolobenzodiazepine class. Alprazolam is a GABA-A receptor agonist. GABA receptors when stimulated produces inhibitory effects on other neuronal signals. 

Alprazolam is indicated in the following conditions-

  • Anxiety
  • Panic attacks/ disorder

Anxiety

  • Adults: 250 micrograms (0.25 mg) to 500 micrograms (0.5 mg) three times daily, increasing if required to a total of 3 mg daily.
  • The elderly or in the presence of debilitating disease: 250 micrograms (0.25 mg) two to three times daily to be gradually increased if needed and tolerated.

Panic Disorder

  • The successful treatment of many panic disorder patients has required the use of Alprazolam at doses greater than 4 mg daily. The mean dosage is 7mg daily.

Common side effects are-

  • Constipation
  • Dry mouth
  • Anorexia
  • Confusion
  • Disorientation
  • Agitation
  • Hallucination
  • Lethargy
  • Dizziness
  • Ataxia
  • Blurred vision
  • Concurrent use of benzodiazepines and opioids, including Alprazolam, can cause extreme drowsiness, respiratory depression, coma, and death. Because of these dangers, simultaneous prescribing of these medications should only be used in patients who have exhausted all other therapeutic alternatives.
  • Physical reliance on Alprazolam causes a variety of severe clinical outcomes, some of which are life-threatening. There is a wide range of withdrawal symptoms, the most serious of which is seizure.
  • Because panic disorder treatment frequently necessitates daily dosages of Alprazolam more than 4 mg, the risk of dependence among panic disorder patients may be higher than among those treated for less acute anxiety.
  • For severely depressed patients or those in whom there is reason to expect concealed suicidal ideation or plans, the usual precautions regarding drug administration and prescription size apply, as they do for other psychotropic medications. Panic disorder has been linked to both primary and secondary severe depressive illnesses, as well as an increased risk of suicide in patients who are untreated.
  • In individuals with depression, episodes of hypomania and mania have been described in connection with the administration of Alprazolam.
  • The uricosuric impact of alprazolam is minimal. Despite the fact that other drugs with a modest uricosuric activity have been linked to acute renal failure, there have been no cases of acute renal failure linked to Alprazolam treatment.

Contraindication

  • Alprazolam Tablets are contraindicated in patients with known sensitivity to this drug or other benzodiazepines, such as-
  • Alprazolam is contraindicated with ketoconazole and itraconazole, since these medications significantly impair the oxidative metabolism mediated by cytochrome P450 3A.