Alprazolam (trade name Xanax, among others) is a potent short-acting drug of the benzodiazepine class. It is primarily used to treat moderate to severe anxiety disorders (e.g., social anxiety disorder) and panic attacks, and is used as an adjunctive treatment for anxiety associated with moderate depression. It is available in an instant release and an extended-release (Xanax XR) preparation, both of which are available under several generic names. Alprazolam possesses anxiolytic, sedative, hypnotic, anticonvulsant, and muscle relaxant properties.[3]
Alprazolam has a fast onset of symptom relief (within the first week). It is the most commonly misused benzodiazepine; however, the majority of prescribed users do not develop a substance use disorder.[4][5] Tolerance to the therapeutic effects of alprazolam is controversial with one view being that alprazolam is ineffective with long term use[6] and the other view being that tolerance to the therapeutic effects does not occur.[7] A physical dependence commonly occurs as a result of alprazolam treatment, typified by a withdrawal and rebound symptoms necessitating a gradual reduction in dosage to minimize withdrawal effects when discontinuing.[4] 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 and insomnia to a major syndrome that may include anxiety, abdominal pain, muscle cramps, vomiting, depression, sweating, tremors and in rare cases suicidal ideation or suicide itself.[8]
Alprazolam has a fast onset of symptom relief (within the first week). It is the most commonly misused benzodiazepine; however, the majority of prescribed users do not develop a substance use disorder.[4][5] Tolerance to the therapeutic effects of alprazolam is controversial with one view being that alprazolam is ineffective with long term use[6] and the other view being that tolerance to the therapeutic effects does not occur.[7] A physical dependence commonly occurs as a result of alprazolam treatment, typified by a withdrawal and rebound symptoms necessitating a gradual reduction in dosage to minimize withdrawal effects when discontinuing.[4] 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 and insomnia to a major syndrome that may include anxiety, abdominal pain, muscle cramps, vomiting, depression, sweating, tremors and in rare cases suicidal ideation or suicide itself.[8]
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