NationMaster - Encyclopedia: Alprazolam

Alprazolam, also known under the trade names Xanax and Niravam, is a short-acting drug in the benzodiazepine class used to treat severe anxiety disorders and as an adjunctive treatment for anxiety associated with clinical depression. In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias. ... On the Threshold of Eternity. ...

History

Alprazolam was first synthesized by Upjohn (now a part of Pfizer). Its patent (#3,987,052)^[1] was filed on October 29, 1969, granted on October 19, 1976 and expired in September 1993. The first indication for which alprazolam was approved was panic disorder. Upjohn took this direction because of the vigorous advocacy of a young psychiatrist named David Sheehan. Sheehan's idea was to use the confusion newfangled DSM-III created in the classification of anxiety disorder by dividing it into general anxiety disorder and panic disorder. Panic disorder was incorrectly perceived to be rare and treatable only by tricyclic antidepressants and not by benzodiazepines. From his experience Sheehan knew the panic disorder to be widespread and well responding to benzodiazepines. He suggested to Upjohn that marketing alprazolam for panic disorder will both cover the wide market unavailable to other benzodiazepines and create an impression of the unique potency of alprazolam.^[2] Synthesis (from the Greek words syn = plus and thesis = position) is commonly understood to be an integration of two or more pre-existing elements which results in a new creation. ... The Upjohn Company was a pharmaceutical manufacturing firm founded in 1886 by Dr. William E. Upjohn in Kalamazoo, Michigan. ... Pfizer Incorporated (NYSE: PFE) is the worlds largest research-based pharmaceutical company[1].[1] The company is based in New York City. ... is the 302nd day of the year (303rd in leap years) in the Gregorian calendar. ... Also: 1969 (number) 1969 (movie) 1969 (Stargate SG-1) episode. ... is the 292nd day of the year (293rd in leap years) in the Gregorian calendar. ... Year 1976 Pick up sticks(MCMLXXVI) was a leap year starting on Thursday (link will display full calendar) of the Gregorian calendar. ...

Sheehan describes that the first group of patients treated by alprazolam was so impressed by its action that they new outright—this drug was going to be a hit. A few of them pulled their money and bought the Upjohn’s stock. Several months later, when alprazolam was approved by the FDA, they sold out and made a profit.^[2]

Pharmacology

Alprazolam is a triazolobenzodiazepine^[3], that is, a benzodiazepine with a triazolo-ring attached to its structure. Benzodiazepines produce a variety of effects by modulating the GABA_A subtype of the GABA receptor, the most prolific inhibitory receptor within the brain. The GABA_A receptor is made up from 5 subunits out of a possible 19, and GABA_A receptors made up of different combinations of subunits have different properties, different locations within the brain and importantly, different activities in regards to benzodiazepines. The GABAA receptor is one of the three ligand-gated ion channels responsible for mediating the effects of Gamma-AminoButyric Acid (GABA), the major inhibitory neurotransmitter in the brain. ... The GABA receptors are a group of receptors with Î³-aminobutyric acid (GABA) as their endogenous ligand. ...

In order for GABA_A receptors to be sensitive to the action of benzodiazepines they need to contain an α and a γ subunit, where the benzodiazepine binds. Once bound, the benzodiazepine locks the GABA_A receptor into a conformation where the neurotransmitter GABA has much higher affinity for the GABA_A receptor, increasing the frequency of opening of the associated Chloride ion channel and hyperpolarising the membrane. This potentiates the inhibitory effect of the available GABA leading to sedatory and anxiolytic effects. As mentioned, different benzodiazepines can have different affinities for GABA_A receptors made up of different collection of subunits. For instance, benzodiazepines with high activity at the α1 are associated with sedation whereas those with higher affinity for GABA_A receptors containing α2 and/or α3 subunits have greater anxiolytic activity.

The binding site for benzodiazepines is distinct from the binding site for barbiturates and GABA on the GABA receptor. Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ...

There is some evidence for antidepressant treatment of clinical depression in out patient settings, evidence for inpatients is lacking;^[4] other benzodiazepines are not known to have antidepressant activity. Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... On the Threshold of Eternity. ...

Pharmacokinetics

Alprazolam is readily absorbed from the gastrointestinal tract. The peak plasma concentration is achieved in 1-2 hours. Most of the drug is bound to plasma protein, mainly serum albumin. Alprazolam is hydroxylated in the liver to α-hydroxyalprazolam, which is also pharmacologically active. This and other metabolites are later excreted in urine as glucuronides. Some of the drug is also excreted in unchanged form. Blood plasma is the liquid component of blood, in which the blood cells are suspended. ... You may be looking for albumen, or egg white. ... Hydroxylation is any chemical process that introduces one or more hydroxyl groups (-OH) into a compound (or radical) thereby oxidising it. ... A metabolite is the product of metabolism. ... Glucuronide is a substance produced by attaching glucuronic acid to another substance with glycosidic bonds. ...

Indications

The main medical uses for alprazolam include: Image File history File linksMetadata Alprazolam2mgresize. ... Image File history File linksMetadata Alprazolam2mgresize. ...

The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ... Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ... Agoraphobia is an anxiety disorder which primarily consists of the fear of certain settings that may present unexpected challenges or demands. ...

Availability

Xanax is the main and most commonly known brand name for alprazolam. There is a large variety of generic brand names for Alprazolam in use throughout the world. In English-speaking countries, alprazolam is sold under the following brand names: Alprax, Alprox, Alzam, Anxirid, Apo-Alpraz, Azor, Calmax, Gerax, Helex, Kalma, Novo-Alprazol, Nu-Alpraz, Restyl, Xanax, Xanor, Zopax, Trika It is also commonly known as, "Bars," when abused and used illegally. .^[8] Image File history File links Size of this preview: 438 Ã— 599 pixelsFull resolution (558 Ã— 763 pixel, file size: 603 KB, MIME type: image/png) This is a copyrighted image that has been released by a company or organization to promote their work or product in the media, such as advertising... Image File history File links Size of this preview: 438 Ã— 599 pixelsFull resolution (558 Ã— 763 pixel, file size: 603 KB, MIME type: image/png) This is a copyrighted image that has been released by a company or organization to promote their work or product in the media, such as advertising...

Packaging

Imprints vary depending on drug manufacturer. The imprints above refer to the name-brand design in the United States and other first world countries^[9], however, every variety of alprazolam is generically available and thus individual pill design is left up to the manufacturer. Image File history File links No higher resolution available. ... The terms First World, Second World, and Third World were used to divide the nations of Earth into three broad categories. ...

The unscored enteric-coated extended-release (Xanax XR) formulation is sold in the following dosages:

Side effects

Side effects of alprazolam may occur in patients and are more likely the higher the dosage taken. If signs of an allergic reaction occur such as hives, difficulty breathing, swelling of face, lips, tongue or throat occur medical attention should be sought immediately. Medical attention should also be sought immediately if signs of jaundice appear such as yellowing of the skin or eyes. Other side effects which may occur are as follows:^[10]^[11]^[12]^[13] Urticaria or Hives is a relatively common form of allergic reaction that causes. ... Jaundice, also known as icterus (attributive adjective: icteric), is a yellowing of the skin, conjunctiva (a clear covering over the sclera, or whites of the eyes) and mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in red blooded animals). ...

Somnolence (or drowsiness, or hypersomnia) is a state of near-sleep, a strong desire for sleep, or sleeping unusually long periods. ... In everyday language depression refers to any downturn in mood, which may be relatively transitory and perhaps due to something as trivial as your team losing. ... For other uses, see Suicide (disambiguation). ... A hallucination is a false sensory perception in the absence of an external stimulus, as distinct from an illusion, which is a misperception of an external stimulus. ... Agitation may have the following special meanings Agitation, an emotional state Agitation, putting into motion (by shaking or stirring) Agitation, a term from the lexicon of Communists: political activities aimed at urging people to do something This is a disambiguation page — a navigational aid which lists other pages that... Anger is a term for the emotional aspect of aggression, as a basic aspect of the stress response in animals whereby a perceived aggravating stimulus provokes a counterresponse which is likewise aggravating and threatening of violence. ... Hyperactivity can be described as a state in which a person is abnormally easily excitable and exuberant. ... // Pre-syncope is a sensation of feeling faint. ... Lightheadedness is a common and often unpleasant sensation of dizziness and/or feeling that one may be about to faint, which may be transient, recurrent, or occasionally chronic. ... It has been suggested that Central Ischaemic Response be merged into this article or section. ... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Exhaustion redirects here. ... In medicine, arthralgia (literally: joint pain, from arthros = joint and -algia denoting pain) is the presence of painful joints in the absence of frank arthritis. ... Dysphasia is a speech disorder in which there is an impairment of speech and of comprehension of speech. ... For other uses, see Amnesia (disambiguation). ... For other uses, see Concentration (disambiguation). ... Look up clumsy, clumsiness in Wiktionary, the free dictionary. ... now. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word Î´Î¹Î¬ÏÏÎ¿Î¹Î±; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... For other uses, see Nausea (disambiguation). ... Emesis redirects here. ... Xerostomia is the medical term for a dry mouth due to a lack of saliva. ... For the band, see Saliva (band). ... Anxiety is a complex combination of the feeling of fear, apprehension and worry often accompanied by physical sensations such as palpitations, chest pain and/or shortness of breath. ... Look up agitation in Wiktionary, the free dictionary. ... For the novel by Stephen King, see Insomnia (novel); for the Norwegian movie and its American remake, see Insomnia (movie). ... Perspiration (also called sweating or sometimes transpiration) is the production and evaporation of a fluid, consisting primarily of water as well as a smaller amount of sodium chloride (the main constituent of table salt), that is excreted by the sweat glands in the skin of mammals. ... A fasciculation (or muscle twitching) is a small, local, involuntary muscle contraction (twitching) visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibres. ... For the film see Tremors (film). ... This article is about the medical condition. ...

Physical dependence and withdrawal

There is now a general consensus among psychiatrists that alprazolam and other benzodiazepines can cause withdrawal symptoms after long-term treatment and discontinuation should be done gradually over a period of months (or even up to a year) to avoid serious withdrawal symptoms such as agitation, panic attacks, rebound anxiety, muscle cramps and seizures.^{[citation needed]} Some patients may benefit from a substitution with diazepam or clonazepam as these drugs remain in the bloodstream longer and therefore have less potential for abuse and dependence. This article is about epileptic seizures. ... Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. ... Clonazepam (marketed by Roche under the trade-names Klonopin in the United States and Rivotril in Europe, South America, Canada, India, and Australia) is a drug which is a benzodiazepine derivative. ...

Patients taking a dosing regimen larger than 4 mg per day have an increased potential for dependence. This medication may cause withdrawal symptoms, which in some cases have been known to cause seizures. The discontinuation of this medication may also cause a reaction called rebound anxiety. Other withdrawal effects reported from discontinuing alprazolam therapy include homicidal ideation, rage reactions, hyperalertness, increased nightmares, and intrusive thoughts.^[14]

When a patient discontinues use, they may experience the symptoms they had before taking medication. Symptoms may also be accompanied by other reactions including changes in mood, anxiety, or sleep. Rebound anxiety is usually a result of abrupt discontinuation of this medication; patients who taper off are less likely to experience these symptoms.

Physical dependence is the major limiting factor against long-term use of alprazolam and other benzodiazepines. Physical dependence refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation. ...

Factors which determine the severity of the benzodiazepine withdrawal syndrome experienced during dose reduction of alprazolam include:^[15] Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ...

Alprazolam has an exceptional history insofar soon after its introduction a large number of case reports were published in the medical literature of severe withdrawal symptoms related case reports of withdrawal psychoses, seizures and intense rebound anxiety upon discontinuation of alprazolam. In the United States a survey of physicians showed that 84% of physicians reported alprazolam as being extremely problematic in terms of the severity and prolonged nature of the benzodiazepine withdrawal syndrome after discontinuation. The benzodiazepines diazepam (Valium) and oxazepam were found to produce less severe withdrawal symptoms than alprazolam (Xanax) or lorazepam (Ativan).^[15] Lorazepam is a benzodiazepine tranquilizer with short to medium duration of action. ... A medical journal is a scientific journal devoted to the field of medicine. ... Withdrawal refers to the characteristic signs and symptoms that appear when a drug that causes a physical dependency is regularly used for a long time and then suddenly discontinued or decreased in dosage. ... The word physician should not be confused with physicist, which means a scientist in the area of physics. ... Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ... Diazepam, brand names: Valium, Seduxen, in Europe Apozepam, is a 1,4-benzodiazepine derivative, which possesses anxiolytic, anticonvulsant, sedative and skeletal muscle relaxant properties. ... Oxazepam (marketed under brand names Alepam, Murelax, Oxascand, Serax, Serepax, Seresta, Sobril) is a drug which is a benzodiazepine derivative. ...

Alprazolam should never be abruptly discontinued if taken regularly for any length of time because severe withdrawal symptoms may occur. Severe psychosis has been reported in the medical literature from abrupt alprazolam withdrawal and death occurred from withdrawal-related seizures after gradual dose reduction, which suggests that alprazolam when being discontinued should be done so very slowly over a prolonged period of time to avoid severe withdrawal symptoms.^[17] Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration...

Contraindications

Use of alprazolam should be avoided, or carefully monitored by medical professionals, in individuals with the following conditions:^[18]^[19]

Myasthenia gravis (sometimes abbreviated MG; from the Greek myastheneia, lit. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... Sleep apnea, sleep apnoea or sleep apnÅ“a is a sleep disorder characterized by pauses in breathing during sleep. ... Myasthenia gravis (sometimes abbreviated MG; from the Greek myastheneia, lit. ... The heart and lungs (from an older edition of Grays Anatomy) The lung is an organ belonging to the respiratory system and interfacing to the circulatory system of air-breathing vertebrates. ... Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration... Allergy is an abnormal reaction to a substance foreign to the body that is acquired, predictable and rapid. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... Borderline Personality Disorder (DSM-IV Personality Disorders 301. ... Rather than surrender to US soldiers, the Mayor (BÃ¼rgermeister) of Leipzig, Germany, committed suicide along with his wife and daughter on April 20, 1945. ... Correlation does not imply causation is a phrase used in the sciences and statistics to emphasize that correlation between two variables does not imply there is a cause-and-effect relationship between the two. ...

Overdose

Overdoses caused by alprazolam alone are seldom fatal: The acute oral LD50 in rodents is high: ranging from 331 to 2,171 mg/kg^[21]--for every kilogram a person weighs, the lowest possible amount that would be expected to cause death would be 331 milligrams (e.g., someone weighing only 10 kilograms [22 pounds] would not be expected to die taking less than 3,310 (331 x 10) milligrams, and the amounts prescribed to patients are far below 3,310 milligrams). Even still, overdose alone can lead to complications or coma, and especially overdose in combination with other depressants (e.g., alcohol) can easily be fatal and in any case, overdoses of any variety require immediate medical attention. Overdose symptoms of alprazolam overlap with other depressants and include: An LD50 test being administered In toxicology, the LD50 or colloquially semilethal dose of a particular substance is a measure of how much constitutes a lethal dose. ... See also sedative. ... See also sedative. ...

Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... In medicine, hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo means below) to perform needed gas exchange. ... For other uses, see Coma (disambiguation). ...

Pregnancy

Women who are pregnant or are planning on becoming pregnant should avoid starting alprazolam.^[22] If you are currently planning to become pregnant, discuss this and all medicines with your obstetrician or other doctor. This article needs cleanup. ...

Teratogenicity classification

Marked Pregnancy Category D by the U.S. FDA. The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ...

Effects on the fetus

It should be considered that the child born of a mother who is receiving benzodiazepines may be at risk of developing withdrawal symptoms from the drug during the postnatal period. Also, neonatal flaccidity and respiratory problems have been reported in children born of mothers who have been receiving benzodiazepines.^[23] Withdrawal refers to the characteristic signs and symptoms that appear when a drug that causes a physical dependency is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...

Labor and delivery

Nursing mothers (neonates)

Benzodiazepines, including alprazolam are known to be excreted in human milk.^[24] Chronic administration of diazepam to nursing mothers has been reported to cause their infants to become lethargic and to lose weight. As a general rule, nursing should not be undertaken by mothers who use alprazolam. Benzodiazepines are known to be passed into breast milk. This can cause infants to become lethargic and lose weight.^[25]

Geriatric use

Elderly individuals should be cautious in the use of alprazolam due to the possibility of increased susceptibility to side effects, especially loss of coordination and drowsiness.^[26]

Food and drug interactions

Eating grapefruits or drinking grapefruit juice while using alprazolam increases blood concentrations by inhibiting the intestinal metabolism.^[27]

In fact, any drug that inhibits CYP3A4, for which alprazolam is a substrate, will increase serum concentrations of alprazolam significantly if administered prior or concurrently. Tagamet (cimetidine) is a widely used H2 blocker antacid that inhibits numerous cytochrome P450 enzymes. Cytochrome P450 3A4 (abbreviated CYP3A4) (EC 1. ... Cimetidine is a histamine H2-receptor antagonist that inhibits the production of acid in the stomach. ...

Oral contraceptive pills, reduce the clearance of alprazolam which may lead to increased plasma levels of alprazolam and accumulation.^[28]

Special precautions

Like all central nervous system depressants, including alcohol, alprazolam in doses of 0.5 mg and above can cause significant deterioration in vigilance, combined with increased feelings of sleepiness.^[29] People driving or conducting activities which require vigilance should exercise caution in using alprazolam or any other depressant. A diagram showing the CNS: 1. ... See also sedative. ... This article does not cite any references or sources. ... Vigilance is the act of watching for something to happen, of watching for danger. ...

Recreational use

Alprazolam, like all benzodiazepines, has the potential for abuse. Although it is not manufactured illegally, and its misuse and abuse is dwarfed by benzodiazepines like flunitrazepam and temazepam, it is still often diverted to the black market, particularily in the United States where alprazolam is the most widely prescribed benzodiazepine. The state of relaxation, anxiolysis, and disinhibition induced by benzodiazepines is the main reason for their illicit use. Image File history File linksMetadata No higher resolution available. ... Image File history File linksMetadata No higher resolution available. ... Flunitrazepam (IPA: ; is marketed by Roche under the trade name Rohypnol. ... Temazepam (marketed under brand names RestorilÂ®, NormisonÂ®, PlanumÂ®, TenoxÂ® and TemazeÂ®) is a benzodiazepine derivative with powerful hypnotic properties. ... To meet Wikipedias quality standards, this article or section may require cleanup. ...

Most alprazolam abusers "are generally but not entirely limited to patients involved in a polydrug use pattern"^[30] In fact, according to an April 2004 report by the U.S. SAMHSA, "over three-quarters (78%) of benzodiazepine-related (emergency room) visits involved 2 or more drugs."^[31]. Poly drug use refers to the use two or more psychoactive drugs in combination to achieve a particular effect. ... Substance Abuse and Mental Health Services Administration (SAMHSA) is the US Federal agency charged with improving the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses. ... The emergency room is the American English term for a room, or group of rooms, within a hospital that is designed for the treatment of urgent and medical emergencies. ...

Injection of alprazolam is considered especially dangerous by medical professionals^[32] because, when crushed in water it will not fully dissolve (40µg/ml of H₂O at pH 7, and 12 mg/mL at pH 1.2 per 1mg of alprazolam,^[33]) potentially causing severe damage to arteries if not filtered properly. While it is somewhat soluble in alcohol, the combination of the two, particularly when injected, has the potential to cause a serious, and potentially fatal overdose. Alprazolam may also be insufflated; clinical testing indicates potent activity through insufflation.^[34] Section of an artery An artery or arterial is also a class of highway. ... This article does not cite any references or sources. ... This article or section does not cite its references or sources. ... Insufflation (Latin insufflatio blowing on or into) is the practice of inhaling substances into a body cavity. ...

Alprazolam is sometimes used with other recreational drugs to relieve the panic or distress of dysphoric reactions to psychedelics such as LSD and also to promote sleep in the "come-down" period following use of recreational drugs with stimulant or insomniac properties (such as LSD, cocaine, amphetamines, DXM, and MDMA along with the related amphetamines). It is also often used in conjunction with marijuana or heroin to potentiate the relaxing effect. Look up dysphoria in Wiktionary, the free dictionary. ... For psychedelics, see psychedelic drug. ... Lysergic acid diethylamide, commonly called LSD, LSD-25, or acid. ... Lysergic acid diethylamide, commonly called LSD, LSD-25, or acid. ... Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. ... Amphetamine or Amfetamine(Alpha-Methyl-PHenEThylAMINE), also known as beta-phenyl-isopropylamine and benzedrine, is a prescription stimulant commonly used to treat Attention-deficit hyperactivity disorder (ADHD) in adults and children. ... This article needs cleanup. ... ecstasy and religious ecstasy MDMA, most commonly known today by the street name ecstasy, is a synthetic entactogen of the phenethylamine family whose primary effect is to stimulate the brain to rapidly secrete large amounts of serotonin, causing a general sense of openness, empathy, energy, euphoria, and well-being. ... Cannabis, also known as marijuana[1] or ganja,[2] is a psychoactive product of the plant Cannabis sativa L. subsp. ... For other uses, see Heroin (disambiguation). ...

Patients at a high risk for abuse and dependence

At a particularly high risk for misuse, abuse, and dependence are polydrug abusers (someone who already uses at least one substance in a recreational context). However, the following can also indicate potential problems in the future:

Patients from the aforementioned group should be monitored very closely during therapy for signs of abuse and development of dependence. Discontinue therapy if any of these signs are noted. Long-term therapy in these patients is not recommended, unless the net benefit to the patient outweighs the net risk.

Legal status

In the United States, alprazolam is a prescription drug and is assigned to Schedule IV of the Controlled Substances Act by the Drug Enforcement Administration. Under the UK drug misuse classification system benzodiazepines are class C drugs.^[35] Internationally, alprazolam is included under the United Nations Convention on Psychotropic Substances as Schedule IV.^[36] The Controlled Substances Act (CSA) was enacted into law by the Congress of the United States as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. ... The Controlled Substances Act (CSA) was enacted into law by the Congress of the United States as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. ... The DEAs enforcement activities may take agents anywhere from distant countries to suburban U.S. homes. ... Convention on Psychotropic Substances Opened for signature February 21, 1971 in Vienna Entered into force August 16, 1976 Conditions for entry into force 40 ratifications Parties 175 The Convention on Psychotropic Substances is a United Nations treaty designed to control psychoactive drugs such as amphetamines, barbiturates, and psychedelics. ...

References

^ Patent 3,987,052
^ ^a ^b Healy, David (2000). The psychopharmacologists III: interviews. London: Arnold, 479-504. ISBN 0-340-761105.
^ J Med. Chem. Vol. 14, p. 1078-1081 (1971) DOI: 10.1021/jm00293a015
^ [1]
^ FDA (23rd). FDA APPROVED LABELING FOR XANAX XR (pdf) 4. Federal Drug Administration. Retrieved on 2nd Aug 2007. “The longer-term efficacy of XANAX XR has not been systematically evaluated. Thus, the physician who elects to use this drug for periods longer than 8 weeks should periodically reassess the usefulness of the drug for the individual patient.”
^ NetDoctor (1). Xanax. netdoctor.co.uk. Retrieved on 2nd Aug 2007.
^ The British National Formulary (2007). Alprazolam. BNF. Retrieved on 2nd Aug 2007.
^ [2]
^ [3]
^ Complete Alprazolam information from Drugs.com. drugs.com. Retrieved on 2nd Aug 2007.
^ ALPRAZOLAM - ORAL (Xanax) side effects, medical uses, and drug interactions.. medicinenet.com. Retrieved on 2nd Aug 2007.
^ Alprazolam – Complete medical information regarding this treatment of anxiety disorders on MedicineNet.com. medicinenet.com. Retrieved on 2nd Aug 2007.
^ alprazolam Side Effects, Interactions and Information - Drugs.com. drugs.com. Retrieved on 2nd Aug 2007.
^ Risse SC; Whitters A, Burke J, Chen S, Scurfield RM, Raskind MA. (1990). "Severe withdrawal symptoms after discontinuation of alprazolam in eight patients with combat-induced posttraumatic stress disorder.". The Journal of clinical psychiatry. 51 (5): 206-9. PMID 2335496.
^ ^a ^b Wolf B; Griffiths RR. (1991). "Physical dependence on benzodiazepines: differences within the class.". Drug and alcohol dependence. 29 (2): 153-6. PMID 1686752.
^ The Ashton Manual - Benzodiazepines: How They Work and How to Withdraw by professor Heather Ashton
^ Haque W; Watson DJ, Bryant SG. (Jan 1990). "Death following suspected alprazolam withdrawal seizures: a case report.". Texas medicine. 86 (1): 44-7. PMID 2300914.
^ Alprazolam. British National Formulary (2007). Retrieved on 3rd Aug 2007.
^ mentalhealth.com (2007). Alprazolam. Retrieved on 3rd Aug 2007.
^ Hori A. (Feb 1998). "Pharmacotherapy for personality disorders.". Psychiatry and clinical neurosciences. 52 (1): 13-9. PMID 9682928.
^ http://www.rxlist.com/cgi/generic/alpraz_od.htm
^ [4]
^ García-Algar O; López-Vílchez MA, Martín I, Mur A, Pellegrini M, Pacifici R, Rossi S, Pichini S. (2007). "Confirmation of gestational exposure to alprazolam by analysis of biological matrices in a newborn with neonatal sepsis.". Clinical toxicology (Philadelphia, Pa.). 45 (3): 295-8. PMID 17453885.
^ Oo CY; Kuhn RJ, Desai N, Wright CE, McNamara PJ. (Sep 1995). "Pharmacokinetics in lactating women: prediction of alprazolam transfer into milk.". British journal of clinical pharmacology. 40 (3): 231-6. PMID 8527284.
^ [5][6]
^ http://www.medicinenet.com/alprazolam-oral/article.htm]
^ http://www.fhma.com/grapefruit.htm
^ Back DJ; Orme ML. (Jun 1990). "Pharmacokinetic drug interactions with oral contraceptives.". Clin Pharmacokinet. 18 (6): 472-84. PMID 2191822.
^ Kozená L; Frantik E, Horváth M. (May 1995). "Vigilance impairment after a single dose of benzodiazepines.". Psychopharmacology (Berl). 119 (1): 39-45. PMID 7675948.
^ Landry, J. Understanding Drugs of Abuse: The Processes of Addiction, 1994.
^ http://www.oas.samhsa.gov/DAWN/benzodiazepines.pdf
^ Eric C; Wang, Felix S, Chew. (2006). "MR Findings of Alprazolam Injection into the Femoral Artery with Microembolization and Rhabdomyolysis" (pdf). Radiology Case Reports 1 (3).
^ [7]
^ http://www.panthrax.host.sk/snort_benzos.html
^ [8]
^ List of psychotropic substances under international control

External links

Categories: All articles with unsourced statements | Articles with unsourced statements since August 2007 | Anxiolytics | Benzodiazepines | Hypnotics | Triazoles Brotizolam (marketed under brand name Lendormin) is a drug which is thienobenzodiazepine (a benzodiazepine derivative). ... Clotiazepam (marketed under brand name Trecalmo) is a drug which is a benzodiazepine derivative. ... Etizolam (marketed under brand name Sedekopan) is a drug which is a benzodiazepine derivative. ... Arfendazam is a drug which is a benzodiazepine derivative. ... Clobazam is triazolobenzodiazepine, also known as a 1,5-benzodiazepine, meaning that its diazepine ring has its nitrogen atoms at the 1 and 5 positions instead of the usual 1 and 4. ... Lofendazam is a drug which is a benzodiazepine derivative. ... Triflubazam is a drug which is a 1,5-benzodiazepine derivative, related to clobazam. ... Girisopam (GYKI-51189) is a drug which is a 2,3-benzodiazepine derivative, related to tofisopam. ... GYKI-52895 is a drug which is a 2,3-benzodiazepine derivative. ... Nerisopam (GYKI-52322) is a drug which is a 2,3-benzodiazepine derivative, related to tofisopam. ... Tofisopam (marketed under brand name Emandaxin) is a drug which is a benzodiazepine derivative. ... Avizafone is the international non-proprietary name (INN) for a water soluble prodrug of diazepam. ... Rilmazafone (Rhythmy, 450191-S) is a water-soluble benzodiazepine prodrug developed in Japan. ... Bentazepam (also known as Thiadipone) is a drug which is a benzodiazepine derivative. ... Ketazolam (marketed under brand names Anseren, Anxon, Contamex, Loftran, Marcen, Sedotime, Solatran, Unakalm) is a drug which is a benzodiazepine derivative. ... Tifluadom is a benzodiazepine derivative with an unusual activity profile. ... Zolazepam is a benzodiazepine derivative used as an anaesthetic for a wide range of animals in veterinary medicine. ... In pharmacology, a psycholeptic is a medication which produces a calming effect upon the patient. ... An anxiolytic is a drug prescribed for the treatment of symptoms of anxiety. ... A section of the Anatomical Therapeutic Chemical Classification System. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... Adinazolam is a benzodiazepine derivative. ... Bretazenil was originally developed as an anti-anxiety drug, but never commercialised. ... Bromazepam (marketed under brand names Calmepam, Compendium, Creosedin, Durazanil, Lectopam, Lexaurin, Lexilium, Lexomil, Lexotan, Lexotanil, Normoc, Somalium)[1] is a drug which is a benzodiazepine derivative. ... Camazepam (marketed under the brand name Albego) is a drug which is a benzodiazepine derivative. ... Chlordiazepoxide (pronounced [ËˆklÉ”ËrËŒdaÉªÉ™zepËˆoksaÉªd], marketed under the trade name LibriumÂ®) is a sedative/hypnotic drug which is a benzodiazepine derivative. ... Clobazam is triazolobenzodiazepine, also known as a 1,5-benzodiazepine, meaning that its diazepine ring has its nitrogen atoms at the 1 and 5 positions instead of the usual 1 and 4. ... Clorazepate (marketed under the brand names TranxeneÂ® and TranxiliumÂ®) is a drug which is a benzodiazepine derivative. ... Clonazepam (marketed by Roche under the trade-names Klonopin in the United States and Rivotril in Europe, South America, Canada, India, and Australia) is a drug which is a benzodiazepine derivative. ... Clotiazepam (marketed under brand name Trecalmo) is a drug which is a benzodiazepine derivative. ... Cloxazolam (marketed under brand name Sepazon) is a drug which is a benzodiazepine derivative. ... Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. ... Ethyl loflazepate (marketed under brand name MeilaxÂ®) is a drug which is a benzodiazepine derivative. ... Etizolam (marketed under brand name Sedekopan) is a drug which is a benzodiazepine derivative. ... Fludiazepam (marketed under the brand name Erispan) is a drug which is a benzodiazepine derivative. ... Halazepam is a benzodiazepine derivative. ... Imidazenil is an anxiolytic drug which is derived from the benzodiazepine family, and is most closely related to other imidazobenzodiazepines such as midazolam, flumazenil and bretazenil. ... Ketazolam (marketed under brand names Anseren, Anxon, Contamex, Loftran, Marcen, Sedotime, Solatran, Unakalm) is a drug which is a benzodiazepine derivative. ... Lorazepam is a benzodiazepine tranquilizer with short to medium duration of action. ... Medazepam is a drug of the Benzodiazepine family. ... Nordazepam (CalmdayÂ®, StilnyÂ®, MadarÂ®), formerly known as nordiazepam, is a 1,4-benzodiazepine derivative. ... Oxazepam (marketed under brand names Alepam, Murelax, Oxascand, Serax, Serepax, Seresta, Sobril) is a drug which is a benzodiazepine derivative. ... Pinazepam (marketed under the brand name DomarÂ®) is a drug which is a benzodiazepine derivative. ... Parazepam belong to the group of medicines called central nervous system depressants (medicines that slow down the nervous system). ... Tofisopam (marketed under brand name Emandaxin) is a drug which is a benzodiazepine derivative. ... The nonbenzodiazepines are comparatively new drugs whose actions are very similar to those of the benzodiazepines, but are structurally unrelated to the benzodiazepines and are believed to have fewer side effects. ... Alpidem is a prescription drug used for the treatment of moderate to severe anxiety. ... Ocinaplon is an anxiolytic drug in the pyrazolopyrimidine family of drugs. ... This article or section is not written in the formal tone expected of an encyclopedia article. ... Panadiplon (U-78875) is an anxiolytic drug with a novel chemical structure that is not closely related to other drugs of this type. ... Pipequaline (PK-8165) is an anxiolytic drug with a novel chemical structure that is not closely related to other drugs of this type. ... Diphenylmethane is a compound consisting of two phenyl groups joined to a single carbon. ... Hydroxyzine is a piperazine derivative that is used as an antihistamine (especially for itches), anti-emetic (nausea reducing), and anxiolytic (anxiety reducing) drug. ... Captodiame (INN, also known as captodiamine) is an anxiolytic. ... Carbamates are a group of organic compounds sharing a common functional group with the general structure -NH(CO)O-. More precisely the carbamate group is considered an amide group with an alkoxy or hydroxy functional group next to the carbonyl group. ... Emylcamate (marketed as StriatranÂ® by Merck) is an anxiolytic and muscle relaxant. ... Carisoprodol is a centrally-acting skeletal muscle relaxant whose active metabolite is meprobamate. ... Mebutamate is an anxiolytic. ... Meprobamate (marketed under the brand names MiltownÂ® by Wallace Laboratories and EquanilÂ® by Wyeth) is a carbamate derivative which is used as an anxiolytic drug. ... Phenprobamate is a centrally acting skeletal muscle relaxant. ... Tybamate is an anxiolytic. ... Î²-Carboline (9H-pyrid-[3,4-b]-indole) is an organic amine that is the prototype of a class of compounds known as Î²-Carbolines. ... Abecarnil (ZK-112119) is an anxiolytic drug from the Î²-Carboline family. ... Gedocarnil is an anxiolytic. ... Benzoctamine is an anxiolytic. ... Azaspirodecanediones are a class of drugs with anxiolytic effects used in the treatment of anxiety. ... A serotonin receptor agonist is a compound that activates serotonin receptors, mimicking the effect of the neurotransmitter serotonin. ... Buspirone (brand-names Ansial, Ansiced, Anxiron, Axoren, Bespar, BuSpar, Buspimen, Buspinol, Buspisal, Narol, Spitomin, Sorbon) is an anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. ... Gepirone (BMY 13805, MJ 13805, ORG 13011, ArizaÂ®, Variza) is a pyridinyl piperazine partial 5-HT1A agonist that has anxiolytic effects. ... The introduction to this article provides insufficient context for those unfamiliar with the subject matter. ... Mephenoxalone is an anxiolytic. ... Etifoxine (or etafenoxine) is an anxiolytic. ...

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