alprazolam (Xanax)

Alprazolam (Xanax XR, Niravam), is an anti-anxiety medication in the benzodiazepine drug family, the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others. Alprazolam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders. The FDA approved alprazolam in October 1981.

Xanax is used for the treatment of anxiety disorders and panic attacks. Anxiety disorders are characterized by:

• Unrealistic worry and apprehension
• Symptoms of restlessness
• Aches
• Trembling
• Shortness of breath
• Smothering sensation
• Palpitations
• Sweating
• Cold clammy hands
• Lightheadedness
• Flushing
• Exaggerated startle responses
• Problems concentrating
• Insomnia

Xanax also is used for treating anxiety associated with panic attacks. Panic attacks occur either unexpectedly or in certain situations (for example, driving), and can require higher dosages of Xanax.

The most common side effects of Xanax taken at lower doses are:

• Drowsiness
• Fatigue

Other side effects include:

• Memory problems
• Speech problems
• Constipation
• Changes in weight
• Addiction (dependency)
• Headache
• Constipation
• Dry mouth

Withdrawal Addiction is more likely to occur at high doses given over prolonged periods. Abrupt discontinuation of alprazolam after prolonged use can lead to symptoms of withdrawal such as:

• Insomnia
• Headaches
• Nausea
• Vomiting
• Lightheadedness
• Sweating
• Anxiety
• 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.

• The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.
• The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily.
• The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.
• Alprazolam may be taken with or without food.

• Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam.
• Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.
• Carbamazepine and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver.

• Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.
• Alprazolam is excreted in breast milk and it can affect nursing infants. Therefore, women who are should not take alprazolam while breastfeeding.

Alprazolam is available as:

• Tablets: 0.25, 0.5, 1 and 2 mg.
• Tablets ER (extended release): 0.5, 1, 2 and 3 mg.
• Tablets (Orally disintegrating): 0.25, 0.5, 1 and 2 mg. Solution: 1 mg/ml

Keep alprazolam should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

Alprazolam is available in generic form, and you need a prescription from your doctor or other health-care professional to obtain this drug.

Brand names for alprazolam are Xanax, Xanax XR, and Niravam.