Alprazolam

Alprazolam is a medication that belongs to the benzodiazepine class of drugs. It is commonly sold under the brand name Xanax and is primarily used to treat anxiety and panic disorders. Alprazolam works by affecting the levels of certain neurotransmitters in the brain, including gamma-aminobutyric acid (GABA), which helps to reduce anxiety and promote relaxation.

Alprazolam is a short-acting benzodiazepine, which means that it takes effect quickly but also has a relatively short duration of action. It is typically taken orally, in tablet or liquid form, and may be prescribed for short-term or long-term use, depending on the individual and the condition being treated.

Like any medication, alprazolam can cause side effects, some of which may be serious. Common side effects of alprazolam include drowsiness, dizziness, and cognitive impairment. It may also be habit-forming and can lead to dependence or withdrawal symptoms if used for extended periods of time or at high doses.

It is important to use alprazolam only under the guidance of a healthcare provider, who can help determine the most appropriate dosage and duration of treatment based on individual needs and medical history. Regular monitoring and screening for potential side effects may also be recommended for individuals taking alprazolam for extended periods of time.

Active Ingredient
  • Alprazolam
Brand Names
  • Xanax
  • Niravam
  • Xanor
  • Tafil
Forms & Strengths
  • Oral tablets: 0.25 mg, 0.5 mg, 1 mg, 2 mg
  • Extended-release tablets (XR): 0.5 mg, 1 mg, 2 mg, 3 mg
  • Orally disintegrating tablets: 0.25–2 mg
  • Oral solution: 1 mg/mL
Onset / Half-life
  • Onset of action: 30–60 minutes (IR), about 1–2 hours (XR) Peak plasma concentration: 1–2 hours (IR), 9–12 hours (XR) Elimination half-life: Average 11 hours (range 6–27 hours)

Warnings

  • Risk of dependence and withdrawal symptoms with long-term or high-dose use
  • CNS depression: Drowsiness, sedation, impaired coordination – avoid alcohol and operating machinery
  • Potential for misuse due to rapid onset of action
  • Avoid abrupt discontinuation to prevent withdrawal seizures
  • Caution in elderly, hepatic impairment, respiratory disorders

Monitoring

  • Regular assessment of anxiety symptoms and need for continuation
  • Monitor for sedation, cognitive impairment, psychomotor slowing
  • Screen for substance use disorder before and during treatment
  • Monitor for withdrawal symptoms upon dose reduction or discontinuation

Indications

  • Approved: Generalized anxiety disorder (GAD)
  • Approved: Panic disorder with or without agoraphobia
  • Approved: Short-term relief of severe anxiety symptoms
  • Off-label: Adjunct in depression with anxiety features
  • Off-label: Insomnia related to anxiety
  • Off-label: Premenstrual syndrome (PMS)

Guides & Questions

References

  • FDA Xanax label
  • Lexicomp Online – Alprazolam monograph
  • National Institute of Mental Health – Anxiety Disorders information
  • American Psychiatric Association Guidelines – Benzodiazepine use