Xanax (Alprazolam): use, buying, administration, side effects, and precautions
Xanax is a prescription-only anti-anxiety drug used to treat panic disorder and acute episodes of generalized anxiety disorder. Read our article to learn more about its use. Xanax: the way to find calmness or danger of dependence? Xanax is a brand name for alprazolam—a sedative drug that belongs to the class of benzodiazepines. Benzodiazepines have a calming effect; they are also called tranquilizers, or anxiolytics. Nowadays, there are Xanax generics available. They have the same active component—alprazolam—but a different name, such as:- Zolium;
- Alpram;
- Alzam;
- Alplax;
- Alark;
- Pharmapram, etc.
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Indications and off-label use
The FDA approved Xanax for the treatment of panic disorder (PD) and acute treatment of generalized anxiety disorder (GAD). Off-label (without specific FDA approval) use includes PMS, depression, and insomnia.How it works
Alprazolam binds to the GABA-A receptor and thus amplifies the activity of GABA—gamma-aminobutyric acid. GABA inhibits nerve transmission and reduces neuronal excitability, producing a calming effect. Shortly speaking, benzodiazepines act as depressants and suppress central nervous system activity.Availability, dosages, and administration
Alprazolam is a prescription-only, Schedule IV controlled substance. This means that a patient cannot obtain Xanax or its generic without a prescription from a licensed healthcare provider. The issued prescription expires in 6 months after the issue date or 5 refills, whichever occurs first. Alprazolam can be administered orally (through the mouth) or via an intravenous injection. The research states that orally-administered medication is fully available and very similar in pharmacodynamics to the IV form. Oral tablets are available in the following dosages:- 0.25 mg
- 0.5 mg
- 1 mg
- 2 mg
GAD treatment
For the acute treatment of patients who have generalized anxiety disorder, the recommended starting dosage is 0.25 mg to 0.5 mg thrice per day. The maximum total daily dosage is 4 mg (in several servings). Depending on the patient’s reaction to treatment, the dosage may be reassessed every 3-4 days and adjusted as needed. The doctor should determine the lowest possible effective dosage and regularly evaluate the need for continued therapy.PD treatment
For the treatment of panic disorder with or without agoraphobia, the recommended initial dose is 0.5 mg three times a day. If necessary, the dose may be increased every 3 to 4 days but no more than 1 mg per adjustment. The maximum effective daily dosage of Xanax registered in trials was 10 mg, and the mean dose was 5-6 mg daily. If the patient takes more than 4 mg of alprazolam per day, the dosage regimen should be periodically reevaluated. According to studies, the patients who received Xanax at dosages higher than 4 mg per day for three months were able to reduce to 50% of their entire maintenance dose without seeming to lose the therapeutic effect. For off-label use or treatment for elderly patients, patients with liver injuries, and patients who take other drugs, the dosage should be determined individually. If the drug is discontinued, it is recommended to gradually reduce the dosage by no more than 0.5 mg every 3 days. Some patients need an even more steady approach. Tapering helps to avoid withdrawal reactions.Side effects
The most common side effects of Xanax include:- Headache
- Irritability
- Dizziness
- Drowsiness
- Fatigue
- Poor balance or coordination
- Decreased mental alertness
- Trouble concentrating
- Sleep problems (insomnia)
- Memory problems
- Slurred speech
- Blurred vision
- Increased sweating
- Upset stomach
- Diarrhea
- Constipation
- Nausea
- Vomiting
- Appetite or weight changes
- Swelling of hands or feet
- Muscle weakness
- Dry mouth
- Stuffy nose
- Decrease in libido
- Worsening depression
- Hypomania
- Neonatal sedation and withdrawal syndrome (if taken during pregnancy or breastfeeding).