Alprazolam (Xanax, Niravam)
Alprazolam is in the class of drugs known as benzodiazepines. These are
psychotropic drugs with potent hypnotic and sedative action; used predominantly
as anti anxiety and sleep-inducing drugs. Their exact mechanism of action
is unknown. Clinically, all benzodiazepines cause a dose-related central
nervous system depressant activity varying from mild impairment of task
performance to hypnosis.
Alprazolam is indicated for the management of anxiety disorder and panic disorder. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic (anti-anxiety medication), so you should not take it without a doctor's recommendation.
Side Effects
Side effects to alprazolam tablets, if they occur, are generally observed
at the beginning of therapy and usually disappear upon continued medication
as your body adjusts. The most frequent side effects are drowsiness and
light-headedness.
Precautions
Alprazolam should not be taken with any other anti anxiety, anti depressives,
anti convulsive meds, antihistamines, alcohol or any substance that depresses
the central nervous system.
Alprazolam should not be used if you have any liver, kidney or breathing
problems. Any liver or kidney impairment prevents the drug from being properly
excreted from the body. Medication used in breathing treatments interacts
with Alprazolam and has caused death in some cases.
Oral contraceptives have been known to diminish the effectiveness of alprazolam.
Pregnancy and Nursing Mothers
Alprazolam can have a Teratogenic effect. This means it can cause abnormalities
in the fetus. The infant can also suffer withdrawal symptoms soon after
birth. Also respiratory problems have been reported in children born of
mothers who have been receiving benzodiazepines. Benzodiazepines are known
to be excreted in mother's milk. It should be assumed that alprazolam is
as well. Chronic administration of diazepam to nursing mothers has been
reported to cause their infants to become lethargic and to lose weight.
For these reasons, pregnant women and nursing mothers should not take alprazolam.
Pediatric Use
Alprazolam should not be used in children under 18.
Drug Abuse and Dependence
Alprazolam is a controlled substance and has the potential for dependence
and abuse. Withdrawal symptoms similar in character to those noted with
sedative/hypnotics and alcohol have occurred following discontinuance of
benzodiazepines, including alprazolam. The symptoms can range from mild
dysphoria (depression) and insomnia to a major syndrome that may include
abdominal and muscle cramps, vomiting, sweating, tremors, and convulsions.
Psychological dependence is a risk with all benzodiazepines, including alprazolam. The risk of psychological dependence may also be increased at doses greater than 4 mg/day and with longer term use, and this risk is further increased in patients with a history of alcohol or drug abuse. Some patients have experienced considerable difficulty in tapering and discontinuing from alprazolam, especially those receiving higher doses for extended periods. Addiction-prone individuals should be under careful surveillance when receiving alprazolam. As with all anxiolytics, repeat prescriptions should be limited to those who are under medical supervision.
Recommended Dosage
Treatment usually starts with a dose of 0.5 mg three times daily. Depending on the response, the dose may be increased at intervals of 3 to 4 days in increments of no more than 1 mg per day. The times of administration should be distributed as evenly as possible throughout the waking hours, that is, on a 3 or 4 times per day schedule.
There is no set period of how long a patient needs to be on alprazolam since everyone responds differently. After a period of extended freedom from anxiety attacks, a carefully supervised tapered discontinuation may be attempted, but there is evidence that this may often be difficult to accomplish without recurrence of symptoms and/or the manifestation of withdrawal phenomena. In any case, reduction of dose must be undertaken under close supervision and must be gradual.
Overdose
Manifestations of alprazolam overdosage include somnolence (sleepiness during
the day), confusion, impaired coordination, diminished reflexes and coma.
Death has been reported in association with overdoses of alprazolam by itself,
as it has with other benzodiazepines. In addition, deaths have been reported
in patients who have overdosed with a combination of a single benzodiazepine,
including alprazolam, and alcohol.
Even though this drug is widely available over the Internet and in many
cases used for recreational purposes, you must remember that it a controlled
substance with potentially harmful effects if not monitored closely. Medical
supervision is necessary when taking this drug.