How alprazolam works
Alprazolam belongs to the group of drugs known as benzodiazepines – a very frequently prescribed group of drugs with proven sedative and anxiety-relieving (anxiolytic) activity. The active ingredient enhances the effect of an inhibitory nerve messenger (GABA) in the brain. This makes the nerve cells less excitable – a calming and anxiety-relieving effect is achieved.
In contrast to other benzodiazepines, alprazolam in therapeutic doses has a primarily antianxiety and sedative effect, rather than anticonvulsant and muscle relaxant effects.
Absorption, breakdown and excretion
The active substance is taken as a tablet and is almost completely absorbed into the bloodstream in the intestine. In the liver, the substance is converted into its actual active form (α-hydroxyalprazolam).
When is alprazolam used?
The benzodiazepine alprazolam is used for the symptomatic treatment of acute and chronic states of tension, agitation and anxiety.
Another area of application is panic disorders with or without phobic avoidance behavior (agoraphobia).
How alprazolam is used
Because the active ingredient can become addictive quite quickly, it should only be used temporarily. Prolonged use also entails the risk of tolerance development: the body responds less and less to the active ingredient. The alprazolam dosage would then have to be successively increased to produce the usual effect, which carries the risk of severe side effects (including dependence).
What are the side effects of alprazolam?
Commonly, alprazolam causes side effects such as:
- drowsiness and sleepiness during the day
- Risk of falls (due to dizziness and gait disturbances, especially in the elderly)
Rare alprazolam side effects include:
- Respiratory impairment (respiratory depression)
- Liver dysfunction
Another alprazolam effect is activation of the reward center in the brain. For this reason, there is a high potential for addiction.
What should be considered when taking alprazolam?
Do not use alprazolam with:
- pathological muscle weakness (myasthenia gravis)
- disturbances of movement coordination (ataxia)
- severe respiratory insufficiency (such as severe lung disease)
- acute or untreated narrow-angle glaucoma (a form of glaucoma)
Alprazolam should be used with great caution in cases of severe liver and kidney disease, respiratory disease, and nocturnal breathing pauses (sleep apnea syndrome).
Interaction
Alprazolam may impair the ability to react in road traffic.
Some drugs may increase or decrease the effect of alprazolam when used concomitantly. Examples include the antibiotic erythromycin, the antidepressants fluoxetine, fluvoxamine, and St. John’s wort, and the anticonvulsants (antiepileptics) carbamazepine and phenytoin.
Age restriction
Pregnancy and lactation
The use of alprazolam during pregnancy should be avoided, especially in the first trimester. After the first trimester, the drug can be taken for a short time in case of emergency.
As an alternative for acute antianxiety treatment in pregnant women, the better-studied promethazine is an option.
During breastfeeding, alprazolam may be used briefly and in moderate doses if necessary. Regular use should be avoided. The child should be well observed in during the period of use.
How to obtain medication with alprazolam
Since when is alprazolam known?
Alprazolam was approved in America as early as 1981. In Germany, it has been on the market since 1984.
Alprazolam is one of the most commonly prescribed, but also abused, benzodiazepines.
