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Alprazolam, best known as Xanax®, is a prescription medication that first became available in the 1980s, and has since that time been used principally to treat anxiety. It has both benefits and disadvantages. Its benefits include occasional relief from anxiety symptoms, but its disadvantages include its highly addictive nature and possibly serious adverse effects if abruptly discontinued. It is also a drug that is prone to abuse and illegal usage.
Xanax® belongs to a class of medicines called benzodiazepines and is a close relative of Valium®, Ativan®, and Klonipin®. It tends to have a shorter half-life than most of these medicines, and in initial use, may promote calm more quickly with less feeling of sedation, and with quicker clearance of any drug effects. With extensive use, more of the drug may be needed to promote the same effect, and greater amounts used raise risk of physical dependency. People who use more than 4 milligrams a day of alprazolam are considered most at risk for developing addiction.
In itself, dependency is not necessarily problematic. It means patients will need to check in with doctors to be certain safe dose levels adequately treat the underlying condition. To extend the time before tolerance is built to the medication, doctors might recommend a strategy of switching from one benzodiazepine to another every few days. Ultimately, long-term use can render the medication ineffective.
The trouble with dependency largely arises if a person is taking the medication without doctor prescription or if the medication is abruptly stopped. Cold-turkey cessation of drugs like alprazolam can lead to very severe symptoms of withdrawal that can include return of anxiety in extreme amounts, super fast heart rhythm, and even seizures. Discontinuation, if addiction is suspected, must be tapered and done under physician guidance.
Many people will take alprazolam for short-term nervous conditions, and should take the medicine as prescribed, never increasing dose without first talking to a doctor. Most uses of Xanax® encounter common side effects like drowsiness, irritability, dizziness, stomach upset, changes in gait or balance, and dry mouth. Sometimes allergic reaction to alprazolam (hives, difficulty breathing, swollen mouth and face) occurs and needs emergency treatment. People should contact a doctor immediately if they encounter other rare side effects like suicidality, hallucinations, loss of consciousness, or seizures.
Use of alprazolam isn’t appropriate to all people. Certain medical conditions or other medicines may contraindicate it. Generally, unless a patient is instructed by a doctor to do so, mixing benzodiazepines with each other or with many pain medications and other sedating medicines is not advised. Alprazolam is often combined with other psychiatric medications, but this needs to be done with care. Xanax® may also interact with certain antacids and antifungal medicines. Patients should give doctors a full list of medications, including any over the counter drugs or herbal preparations.
Alprazolam is also inappropriate during pregnancy and nursing. It’s not advised in people who have respiratory conditions that impair breathing. Generally this medication may also not be given if people have kidney disease or if they have a history of problems with addiction to narcotics or alcohol.
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