Benzodiazepines as anxiolytics
Adam Doble, Ian L Martin, David Nutt in Calming the Brain: Benzodiazepines and related drugs from laboratory to clinic, 2020
The improved efficacy and safety profile of the benzodiazepines, aided by intense campaigns to restrict the use of barbiturate-type drugs, meant they rapidly became the first-choice drugs for anxiety within a few years of their being introduced. The major issues with the benzodiazepines are their sedative side-effects and the problems of cessation of their use. The principal benzodiazepines used as anxiolytics include diazepam, chlordiazepoxide, clonazepam, lorazepam, alprazolam and oxazepam. The issue of how long one should use benzodiazepines in the clinical management of anxiety disorders is the most controversial area in the field of psychopharmacology, due to the concerns over dependence and withdrawal. Benzodiazepines are also used to reduce anticipatory anxiety as an adjunct to behavioural therapy in phobic and panic disorders. A good example is dental phobia where the rationale is that in order to benefit from exposure therapy individuals have to get into the treatment situation.
Alprazolam
Louis A. Pagliaro, Ann Marie Pagliaro in Psychologists’ Psychotropic Drug Reference, 2020
This chapter describes trade name, classification, approved indications for psychological disorders, available dosage forms, storage, and compatibility, usual dosage and administration, relative contraindications, and clinically significant drug interactions of Alprazolam. The goal of alprazolam pharmacotherapy for the symptomatic management of panic disorder is a substantial reduction in panic attacks or their total elimination. Early morning anxiety and the emergence of signs and symptoms of anxiety between doses have been reported among patients receiving alprazolam pharmacotherapy at recommended maintenance dosages. Once the control of panic attacks has been achieved, discontinue alprazolam pharmacotherapy gradually. Seizures also have been associated with the discontinuation of alprazolam pharmacotherapy or upon abrupt reduction of dosage. Immediate management of the signs and symptoms of withdrawal may require reinstitution of alprazolam pharmacotherapy at a dosage sufficient to relieve the signs and symptoms of withdrawal.
Donald Klein
David Healy in The Psychopharmacologists, 2018
My first encounter with your work was when I was in Cambridge, in 1986. I became aware of it through Martin Roth’s involvement in the Upjohn trial of alprazolam in panic disorder. Even then, in the UK, most clinicians weren’t prepared to accept that panic disorder was a real entity. Your name was there as the person who created the concept. Now I am hopeful that this book will get beyond the psychiatric profession and out on the streets and panic disorder is interesting here in that it’s come from nowhere to being one of the concepts that everybody, even the person on the street, knows about now .
Acute urinary retention after alprazolam use: a case report
Published in Psychiatry and Clinical Psychopharmacology, 2018
Demet Saglam Aykut, R. A. Emel Uysal
Urinary retention is a condition in which impaired emptying of the bladder results in postvoid residual urine. Urinary retention has been well studied in observational studies and randomized controlled trials; data on the incidence of drug-induced urinary retention are scarce. In this article, a case of acute urinary retention developed after the use of alprazolam was discussed. A 67-year-old male underwent a prostatectomy operation for benign prostatic hyperplasia one month ago. Insomnia and dysphoria in the patient after the operation and alprazolam 1 mg/day was started. The patient started voiding problem after alprazolam treatment. No organic pathology was found to explain the table of existing urinary retention. The patient’s complaints resolved completely after alprazolam treatment stopped. We should be more careful about drug-induced urinary retention. When prescribing a drug to a patient, a thorough knowledge of its mode of action, adverse effects and potential drug interactions are important in preventing drug-induced urinary retention, especially in patients who have other risk factors for urinary retention.
Topiramate use in alprazolam addiction
Published in The World Journal of Biological Psychiatry, 2006
Ioannis Michopoulos, Athanasios Douzenis, Christos Christodoulou, Lefteris Lykouras
Alprazolam is successful in reducing anxiety but has a high addictive/misuse potential. Topiramate is a novel anticonvulsant which has been used as a mood stabilizer. Other anticonvulsants, such as carbamazepine and valproate, have been used in alcohol and benzodiazepine withdrawal. Topiramate has recently been used in alcohol, cocaine and opiates withdrawal. There has been also one report of topiramate use in midazolam withdrawal. In our case of a patient with reccurent major depressive disorder, subthreshold anxiety disorder and addiction to alprazolam, topiramate appears to be efficient and safe in alprazolam withdrawal.
Ingestions of Hydrocodone, Carisoprodol, and Alprazolam in Combination Reported to Texas Poison Centers
Published in Journal of Addictive Diseases, 2011
ABSTRACT The combination of hydrocodone, carisoprodol, and alprazolam is subject to abuse. Ingestions of this drug combination reported to Texas poison centers during 1998–2009 were identified (totaling 1,295 cases) and the distribution of ingestions by selected factors was determined. The number of cases increased from 0 in 1998 to 200 in 2007, and then decreased to 132 in 2009. The counties in eastern and southeastern Texas accounted for 80.9% of the cases. Of the patients, 57.3% were women and 94.6% were age 20 or older. Suspected attempted suicide accounted for 59.3% of the cases and intentional misuse or abuse for 27.3%.
Related Knowledge Centers
- Agoraphobia
- Anxiety Disorders
- Anxiolytic
- Benzodiazepines
- Panic Disorders
- Ama
- Generic Drug