Alprazolam

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The active ingredient alprazolam is used to treat anxiety and panic disorders. Above all, it has an anti-anxiety and calming effect. Alprazolam is used in tablet form. Due to its high potential for addiction, it should only be taken for a short time. Here you can read everything you need to know about the use, effects and side effects of alprazolam.

This is how alprazolam works

Alprazolam belongs to the group of so-called benzodiazepines - a very frequently prescribed group of drugs with proven calming and anxiolytic effectiveness. The active ingredient strengthens the effect of an inhibitory neurotransmitter (GABA) in the brain. As a result, the nerve cells are less excitable - a calming and anxiety-relieving effect occurs.

The effect of alprazolam is used, for example, to treat generalized anxiety disorder. This is a long-lasting fear that does not relate to specific situations or objects. Rather, the patients are constantly worried, suffer from physical restlessness, tension headaches and tremors. The benzodiazepine can alleviate the anxiety here and provide the necessary relaxation.

In contrast to other benzodiazepines, alprazolam, in therapeutic doses, is primarily anti-anxiety and calming, less antispasmodic and muscle-relaxing.

Uptake, breakdown and excretion

The active ingredient is taken as a tablet and almost completely absorbed into the bloodstream in the intestine. In the liver, the substance is converted into its actual active form (α-hydroxyalprazolam).

α-Hydroxyalprazolam quickly reaches the central nervous system, where it takes effect. This lasts between 12 and 15 hours.

When is alprazolam used?

The benzodiazepine alprazolam is used for the symptomatic treatment of acute and chronic states of tension, excitement and anxiety.

Another area of application is panic disorders with or without phobic avoidance behavior (agoraphobia).

This is how alprazolam is used

The active ingredient is taken several times a day in the form of tablets, in a dosage determined individually by the doctor. In Switzerland, there are also sublingual tablets (tablets that dissolve under the tongue) on the market.

Because the active ingredient can quickly become addictive, it can only be used temporarily. If taken for a long time, there is also the risk of developing tolerance: the body responds less and less to the active ingredient. The alprazolam dosage would then have to be increased successively in order to produce the usual effect, which carries the risk of serious side effects (including dependence).

The active ingredient must not be stopped abruptly to end the therapy, but the dose must be reduced slowly and gradually over several weeks. Otherwise, withdrawal symptoms and an increased recurrence of the original symptoms (rebound effect) can occur.

What side effects does alprazolam have?

Often alprazolam causes side effects such as:

Fatigue and sleepiness during the day
Risk of falling (due to dizziness and gait disorders, especially in the elderly)

Rare alprazolam side effects include:

Impaired breathing (respiratory depression)
Liver dysfunction

Another alprazolam effect is the activation of the reward center in the brain. Because of this, there is a high potential for addiction.

What should be considered when taking alprazolam?

Contraindications

Alprazolam must not be used in:

pathological muscle weakness (myasthenia gravis)
Movement coordination disorders (ataxia)
severe respiratory failure (such as severe lung disease)
acute or untreated angle-closure glaucoma (a type of glaucoma)

Alprazolam should only be used with great caution in the case of severe liver and kidney diseases, respiratory diseases and nocturnal pauses in breathing (sleep apnea syndrome).

interaction

The depressant (sedative) effect increases if other depressant drugs or alcohol are taken at the same time.

Alprazolam can impair your ability to react to traffic.

Some drugs can increase or decrease the effect of alprazolam when used at the same time. Examples are the antibiotic erythromycin, the antidepressants fluoxetine, fluvoxamine and St. John's wort, and the anticonvulsants (antiepileptics) carbamazepine and phenytoin.

Age restriction

The safety and effectiveness of alprazolam in children and adolescents under the age of 18 has been poorly studied. The active ingredient should therefore not be used in this age group.

pregnancy and breast feeding period

Alprazolam should be avoided during pregnancy, especially in the first trimester of pregnancy. After the first trimester, the active ingredient can be taken briefly in an emergency.

If taken regularly in the last trimester or in high doses during childbirth, serious side effects can occur in the child. Examples are breathing problems, adjustment disorders and the so-called floppy infant syndrome. Among other things, the newborn suffers from weak muscles and drinking, indifference, accelerated breathing and a racing heart (tachycardia). Withdrawal symptoms are also possible.

As an alternative to acute anxiety-relieving treatment for pregnant women, the better-researched promethazine can be used.

If necessary, alprazolam can be used briefly and in moderate doses during breastfeeding. Regular consumption should be avoided. The child should be carefully observed during the application period.

How to get medicines with alprazolam

Due to its addictive potential, alprazolam falls under the Narcotics Act and is therefore only available in Germany, Austria and Switzerland upon presentation of a special prescription in pharmacies. The patient must also be carefully informed about the risks of taking such as addiction development and withdrawal syndromes.