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Clinical use of sustained release of alprazolam (Xanax): Biopsychiatry: "Alprazolam extended release formulation (Alprazolam XR) is a new formulation with useful features in the treatment of pathological anxiety, when compared both to the original formulation of alprazolam or to other benzodiazepines, as it adds to the well known properties of alprazolam a sustained clinical effect. The available investigational clinical trials show good efficacy for this new formulation. There is the need, however, of observational studies in the clinical setting that confirm its usefulness. METHODS: We present an observational prospective naturalistic study of all the pathological anxiety cases that followed treatment with Alprazolam XR in two psychiatry outpatient centres. Sixty-eight (68) patients were included in the study. The treatment period was 21 weeks. In each of the 4 control visits, efficacy (HAMA, GCI, GCI improvement) and tolerability (adverse events) were assessed, as well as the dose, dosage pattern and need of change of the medication." http://www.biopsychiatry.com/alprazolam.html ******************************************************
Description of
Alprazolam (Xanax): Rx List: " Xanax tablets contain alprazolam which is a
triazolo analog of the 1, 4 benzodiazepine class of central nervous
system-active compounds. The chemical name of alprazolam is
8-Chloro-1-methyl-6-phenyl-4H-s-triazolo [4,3-a][1,4] benzodiazepine. Alprazolam
is a white crystalline powder, which is soluble in methanol or ethanol but which
has no appreciable solubility in water at physiological pH. Each Xanax tablet,
for oral administration, contains 0.25, 0.5, 1 or 2 mg of alprazolam. Inactive
Ingredients: Cellulose, corn starch, docusate sodium, lactose, magnesium
stearate, silicon dioxide, and sodium benzoate. In addition, the 0.5 mg tablet
contains FD&C yellow no. 6 and the 1 mg tablet contains FD&C blue no. 2.
CATEGORIES: Anxiety; Anxiety, panic disorder; Pregnancy Category D; DEA Class
CIV; FDA Approved 1981 Oct; Top 200 Drugs FDA Drug Classes:Antianxiety;
Sedatives/Hypnotics BRAND NAMES: Alcelam ; Alpaz; Alplax; Alpralid; Alpram;
Alprax; Alprazolam Intensol; Alprox; Altraxic; Alzam; Alzolam; Anpress;
Ansiopax; Apo-Alpraz; Azor; Cassadan; Constan; Frontal; Kalma; Panix; Pharnax;
Prinox; Ralozam; Relaxol; Restyl; Solanax; Tafil; Tafil D; Tensivan;
Trankimazin; Tranquinal; Tricalma; Valeans; Xanagis; Xanax; Xanax TS; Xanolam;
Xanor; Zolarem; Zoldac; Zolam; Zopax; Zopic; Zotran (Foreign Brand names outside
U.S. in italics)" ******************************************************
Warnings while taking
Alprazolam (Xanax): Mental Health: "Alprazolam is not recommended for use in
patients whose primary diagnosis is psychosis or depression. Occupational
Hazards: As with other CNS depressant drugs, patients should be cautioned
against activities requiring mental alertness, judgement and physical
coordination such as driving or operating machinery, particularly in the early
phases of treatment and until proper adjustment to side effects has been
established. Alcohol and benzodiazepines should never be mixed when driving
because of the unpredictable CNS depressant effects of this combination.
Pregnancy: Safety in pregnancy has not been established, therefore its use is
not recommended. Studies have suggested an increased risk of congenital
malformations associated with the use of the benzodiazepines, such as
chlordiazepoxide, diazepam, and also meprobamate, during the first trimester of
pregnancy. Since alprazolam is a benzodiazepine derivative, its administration
is rarely justified in women of childbearing potential. If the drug is
prescribed to a woman of child bearing potential she should be warned to consult
her physician regarding the discontinuation of the drug if she intends to become
or suspects that she is pregnant. Lactation: Studies in rats have indicated that
alprazolam and its metabolites are secreted into the milk. Therefore, nursing
should not be undertaken while a patient is receiving the drug. Safety and
efficacy of alprazolam in patients under the age of 18 years has not been
established." ******************************************************
Alprazolam (Xanax)
Symptoms or Effects: Psyweb: "Common: Clumsiness / Sleepiness. Rare:
Abdominal cramps, blurred vision, dry mouth, racing heartbeat / palpitations,
shaking / slurred speech, urination problems, convulsions, hallucinations,
memory loss, trouble breathing, staggering / trembling, headache, confusion,
sore breast / milk secretion, or irregular menstruation. See physician always:
Abdominal cramps, blurred vision, dry mouth, racing heartbeat / palpitations,
shaking / slurred speech, urination problems, convulsions, hallucinations,
memory loss, trouble breathing, staggering / trembling, headache, confusion,
sore breast / milk secretion, or irregular menstruation. See physician if
severe: Clumsiness / Sleepiness. See physician NOW: Convulsions, hallucinations,
memory loss, trouble breathing, or staggering /trembling." ******************************************************
Guidelines for
Discontinuing Xanax (alprazolam): Lexington Online: "There is a
neurotransmitter in your brain called GABA. It stands for gamma amino butyric
acid. GABA is your natural God-given tranquilizer. It is present at 80% of the
nerve connections in your brain. When you are too nervous your brain cells
release GABA which causes negatively charged chlorine atoms to stream into your
nerve cells. That's good because it makes it harder for other stimulating
neurotransmitters to trigger the firing of that nerve. If your brain were a car,
anxiety might be like the car speeding down a hill toward a sharp curve. As it
comes to a curve it must slow down. The car brakes are applied so that the car
can negotiate the curve and not burst through the guard rail. The GABA molecules
of your brain are like the brakes in your car. If you don't have enough GABA,
your brain is going to be like the car speeding toward a curve with worn out
brakes! Xanax acts by making what little GABA you do have work more strongly.
This is sort of like applying stronger pressure on worn out brakes so that your
car will negotiate a curve safely.When you take Xanax for a couple of weeks it
usually works great for panic disorder but then it does not seem to work as well
as time goes on. This is to be expected. Why? This could be for two reasons. One
possibility is that your brain cuts back on the release of GABA. It is sort of
like your brain says, "Gosh, things are a lot calmer in here. I don't think I
need to make as much GABA as I used to." Well, you likely didn't have enough
GABA to begin with. And now your brain makes even less than it did before you
started taking Xanax. Naturally, the Xanax wouldn't work as well once GABA is
reduced." ******************************************************
Treatment with Alprazolam
(Xanax): The Body: "In general, the minimum effective dose of the drug
should be used. For treatment of symptoms of anxiety, 0.25 to 0.5 mg taken three
to four times a day is the usual starting dosage. The dose may be increased, if
necessary, at intervals of three to four days. The maximum daily dose is 4 mg.
When discontinuing the drug, it is recommended that the daily dose be decreased
by no more than 0.5 mg every three days to avoid withdrawal symptoms. Some
people may require an even slower dose reduction. Treatment of panic is usually
started at 0.5 mg taken three times a day, but may require more than 4 mg per
day. In clinical studies, participants have used dosages up to 10 mg per day,
but the appropriate dose must be determined for each individual by starting at a
low dose and slowly increasing until the desired effect is observed (as long as
the drug is tolerated without serious side effects). After a period free of
attacks, a carefully controlled dosage reduction and weaning may be
attempted." ******************************************************
Side effects of
Alprazolam (Xanax): Web MD: "Side effects that you should report to your
prescriber or health care professional as soon as possible: confusion,
forgetfulness, depression, difficulty pasing urine, difficulty sleeping,
difficulty speaking, lightheadedness or fainting spells, mood changes,
excitability or aggressive behavior, muscle cramps, staggering or jerky
movements, tremors, weakness or tiredness, Side effects that usually do not
require medical attention (report to your prescriber or health care professional
if they continue or are bothersome): constipation or diarrhea, drowsiness,
dizziness, dry mouth, decrease or increase in amount of saliva, increase or
decrease in appetite, menstrual changes, sexual dysfunction, weight
changes" ******************************************************
Alprazolam
(xanax) drug interactions: Health Center: "Remember, always follow your
physician's recommendations on how to take your medication. Even if you are
taking one of the following substances, continue taking your medication as
prescribed and consult your physician. Also, if you are taking any herbal
remedies, vitamins, and/or over-the-counter medications, be sure to tell your
physician. The following section offers some, but not necessarily all, of the
possible drug interactions. Do not take this medication with ethanol, Buspar
(buspirone), TCA antidepressants, narcotics, or other CNS depressants. This
combination can increase CNS depression. Be sure not to take other sedative,
benzodiazepines, or sleeping pills with this drug. The combinations could be
fatal. Do not smoke or drink alcohol when taking Xanax. Alcohol can lower blood
pressure and decrease your breathing rate to the point of unconsciousness.
Tobacco and marijuana smoking can add to the sedative effects of Xanax. Xanax
may increase the effects of Lanoxin (digoxin). Xanax may decrease the effects of
Sinemet (levodopa). Sporanox (itraconazole), Nizoral (ketoconazole), Tagamet
(cimetidine), Antabuse (disulfiram), Prozac (fluoxetine), Luvox (fluvoxamine),
Rifamate (isoniazid), macrolide antibiotics (i.e. erythromycin), Prilosec
(omeprazole), oral contraceptives, Norvir (ritonavir), and Depakene (valproic
acid) may increase the effects of Xanax. Tegretol (carbamazepine), Rimactane
(rifampin), and Theo-Dur (theophylline) may decrease the effects of Xanax.
" ******************************************************
Precautions while using
Alprazolam (Xanax): Recreational Drugs Information: "Women who are pregnant,
plan to become pregnant, think that they may be pregnant, or are breast-feeding
should inform their doctors before taking alprazolam. If you become pregnant
while taking this drug, contact your doctor immediately. Before you take
alprazolam, tell your doctor and pharmacist what prescription and non
prescription drugs you are taking, especially cimetidine, digoxin, disulfiram
(Antabuse), levodopa, Ketoconazole (Nizoral), itraconazole (Sporanox), seizure
medication, sleeping pills, prescription pain medication, medication for
depression, barbiturates, tranquilizers, sedatives, antihistamines, and
medication for allergies and colds. Do not smoke while taking alprazolam.
Smoking can decrease its effectiveness. If you have liver or kidney disease,
tell your doctor before taking alprazolam. Do not allow anyone else to take your
medication." ******************************************************
Drug
interactions for Alprazolam (Xanax): Focus on Depression: "PRESCRIBED FOR:
Alprazolam is used for the treatment of anxiety disorders and panic attacks.
Anxiety disorders are characterized by unrealistic worry and apprehension,
causing symptoms of restlessness, aches, trembling, shortness of breath,
smothering sensation, palpitations, sweating, cold clammy hands,
lightheadedness, flushing, exaggerated startle responses, problems
concentrating, and insomnia. Panic attacks occur either unexpectedly or in
certain situations (i.e. driving), and can require higher dosages of alprazolam.
DOSING: Alprazolam may be taken with or without food. Alprazolam is metabolized
by the liver and excreted mainly by the kidney. Dosages of alprazolam may need
to be lowered in patients with abnormal kidney function. DRUG INTERACTIONS:
Alprazolam should not be taken with keoconazole or itraconazole. Alcohol should
be avoided by patients taking benzodiazepines. Alprazolam can lead to addiction
(dependency), especially at high dosages over prolonged periods of time. Because
of alprazolam's addicting potential, dosages should never be increased by the
patient. In patients addicted to alprazolam, abrupt discontinuation of the
medicine can lead to symptoms of withdrawal (insomnia, headaches, nausea,
vomiting, light headedness, sweating , anxiety, and fatigue). Seizures can occur
in more severe cases of withdrawal. Consequently, patients on alprazolam for
extended periods of time should slowly taper the medication under a doctor's
supervision rather than abruptly stopping the medication."
Alprazolam: ******************************************************
Alprazolam: ******************************************************
Alprazolam, Drug Monograph: For the management of anxiety disorders or the short-term symptomatic relief of symptoms of excessive anxiety. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic. ******************************************************
Alprazolam - RxList Monographs: ******************************************************
Project Inform's HIV Drug Book: Benzodiazepines ****************************************************** ******************************************************
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On Health: Benzodiazepines
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