Xanax is FDA approved for the short-term treatment of generalized anxiety disorder (GAD) in adults. Adderall is a stimulant medication that’s prescribed for the treatment of attention deficit hyperactive disorder (ADHD). Off-label uses of Xanax include short-term treatment of temporary anxiety symptoms. Xanax is approved to treat only generalized anxiety disorder and panic disorder.
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In alprazolam overdose cases, respiration, blood pressure, and pulse rate require monitoring. Clinicians can increase the alprazolam dose to the target dose after 10 to 14 days of administering ritonavir and alprazolam concomitantly. Alprazolam dose should be reduced to 50% of the recommended dose when a patient is started on ritonavir and alprazolam concomitantly or when ritonavir is administered to a patient using alprazolam. Alprazolam is affected by drugs that inhibit or induce CYP3A4. The effects of alprazolam on milk production and lactation are unknown. The suggested method is that the daily dosage reduction is not more than 0.5 mg every three days, and some patients may require an even slower dosage reduction.
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This medication may cause withdrawal symptoms upon abrupt withdrawal or rapid tapering, which in some cases have been known to cause seizures, as well as marked delirium similar to that produced by the anticholinergic tropane alkaloids of Datura (scopolamine and atropine). Spontaneous abortions may also result from abrupt withdrawal of psychotropic medications, including benzodiazepines. In the UK, alprazolam is indicated for short-term symptomatic treatment of anxiety in adults. In one study, some long term, high-dosage users of alprazolam developed reversible depression. However, the research into antidepressant properties of alprazolam is poor and has only assessed its short-term effects against depression.
You can learn more about your condition in the MNT anxiety hub and mental health hub. The guidelines recommend other options for first-line treatment of this condition. This can make you avoid situations or places you feel may trigger a panic attack, which can lead to agoraphobia.
- When benzodiazepines and opioids are combined, the potential for benzodiazepines to significantly worsen opioid-related respiratory depression exists.
- Alprazolam is contraindicated in patients receiving strong inhibitors of CYP3A (such as azole antifungal agents), except ritonavir see CONTRAINDICATIONS (4).
- Follow patients for signs and symptoms of respiratory depression and sedation see WARNINGS AND PRECAUTIONS (5.1), DRUG INTERACTIONS (7.1).
In a controlled postmarketing dose-response study, patients treated with doses of alprazolam tablets greater than 4 mg per day for 3 months were able to taper to 50% of their total maintenance dose without apparent loss of clinical benefit. The recommended starting oral dosage of alprazolam tablets for the treatment of PD is 0.5 mg three times daily. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose. The use of benzodiazepines, including alprazolam, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death.
Alprazolam is a Schedule IV controlled substance and is a common drug of abuse. Other uses include the treatment of chemotherapy-induced nausea, together with other treatments. Alprazolam, sold under the brand name Xanax among others, is a fast-acting, potent tranquilizer of moderate duration within the triazolobenzodiazepine group of chemicals called benzodiazepines.
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Long-term use causes adaptive changes in the benzodiazepine receptors, making them less sensitive to stimulation and thus making the drugs less potent. Compared to the large number of prescriptions, relatively few individuals increase their dose on their own initiative or engage in drug-seeking behavior. Particular care should be taken in pregnant or elderly people, people with substance use disorder history, particularly alcohol dependence, and people with comorbid psychiatric disorders. Clinical studies have shown that the effectiveness is limited to four months for anxiety disorders.
In patients already receiving an opioid analgesic, prescribe a lower initial dose of alprazolam than indicated in the absence of an opioid and titrate based on clinical response. Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioids alone. Concomitant use of benzodiazepines, including alprazolam, and opioids may result in profound sedation, respiratory depression, coma, and death. Geriatric patients may be especially sensitive to the effects of benzodiazepines. After a period of extended freedom from panic attacks, a carefully supervised tapered discontinuation may be attempted, but there is evidence that this may often be difficult to accomplish without recurrence of symptoms and/or the manifestation of withdrawal phenomena see DOSAGE AND ADMINISTRATION (2.3).
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It’s possible that your doctor will adjust your dose every 3 to 4 days until you’re taking the dose that’s right for you. To learn more about dosages of Xanax XR, talk with your doctor. For more details on the dosage of Xanax, see this article. Your doctor will determine the best dosage to fit your needs. However, be sure to take the dosage your doctor prescribes for you. The following information describes dosages that are commonly used or recommended.
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- Imipramine and desipramine have been reported to increase an average of 31% and 20% respectively by the concomitant administration of alprazolam tablets.
- Your doctor may need to change the dosages of your medications and will monitor you carefully.
- See the end of this Medication Guide for a complete list of ingredients in alprazolam tablets.
- They can prescribe the drug, or you can purchase it over the counter at a pharmacy, To learn more, talk with your doctor or pharmacist.
It is not necessary to reduce alprazolam tablets dose in patients who have been taking ritonavir for more than 10 to 14 days. Increase the alprazolam tablets dosage to the target dose after 10 to 14 days of dosing ritonavir and alprazolam tablets together. In patients with hepatic impairment, the recommended starting oral dosage of alprazolam tablets is 0.25 mg, given 2 or 3 times daily. In geriatric patients, the recommended starting oral dosage of alprazolam tablets is 0.25 mg, given 2 or 3 times daily. The necessary duration of treatment for PD in patients responding to alprazolam tablets are unknown.
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For patients receiving doses greater than 4 mg per day, periodic reassessment and consideration of dosage reduction is advised. Acute treatment of generalized anxiety disorder (GAD) in adults. Abrupt discontinuation or rapid dosage reduction of alprazolam after continued use may precipitate acute withdrawal reactions, which can be life-threatening. The continued use of benzodiazepines, including alprazolam, may lead to clinically significant physical dependence. Follow patients for signs and symptoms of respiratory depression and sedation see WARNINGS Alprazolam injection AND PRECAUTIONS (5.1), DRUG INTERACTIONS (7.1).
However, people with panic disorder have been treated on an open basis for up to eight months without apparent loss of benefit. Alprazolam is effective in the relief of moderate to severe anxiety and panic attacks. Alprazolam is used in the management of anxiety disorders and nausea due to chemotherapy. Alprazolam tablets may cause an increase in activity and talking (hypomania and mania) in people who have depression. Tell your healthcare provider if you have abused or been dependent on alcohol, prescription medicines or street drugs. Your healthcare provider can tell you more about the differences between physical dependence and drug addiction.
Chemical Composition of Xanax
There is a risk of abuse, misuse, and addiction with benzodiazepines, including alprazolam tablets, which can lead to overdose and serious side effects including coma and death. Inform patients that the use of alprazolam, even at recommended dosages, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose and death, especially when used in combination with other medications (e.g., opioid analgesics), alcohol, and/or illicit substances. Early morning anxiety and emergence of anxiety symptoms between doses of alprazolam have been reported in patients with panic disorder taking prescribed maintenance doses. Controlled trials of alprazolam tablets in the treatment of panic disorder included dosages in the range of 1 mg to 10 mg daily. Alprazolam and other benzodiazepines may also cause the development of physical dependence, tolerance, and benzodiazepine withdrawal symptoms during rapid dose reduction or cessation of therapy after long-term treatment.
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If signs and symptoms of respiratory depression, hypoventilation, or apnea occur, discontinue alprazolam. There have been reports of death in patients with severe pulmonary disease shortly after the initiation of treatment with alprazolam. Episodes of hypomania and mania have been reported in association with the use of alprazolam in patients with depression see ADVERSE REACTIONS (6.2). Because of its CNS depressant effects, patients receiving alprazolam should be cautioned against engaging in hazardous occupations or activities requiring complete mental alertness such as operating machinery or driving a motor vehicle. In either case, it is presumed that the prescribed dose is not sufficient to maintain plasma levels above those needed to prevent relapse, rebound, or withdrawal symptoms over the entire course of the interdosing interval.
Therefore, it is recommended to taper to discontinue alprazolam gradually To reduce the risk of alprazolam withdrawals and reactions, which can be fatal. The continued use of alprazolam, like all benzodiazepines, may lead to clinically significant physical dependence. There is no need to reduce the alprazolam dose in patients taking ritonavir for 10 to 14 days.
Xanax tablets are scored and can be split if your doctor or pharmacist advises this. And you can take the medication with or without food. If you have difficulty opening medication bottles, ask your pharmacist if they can put Xanax in an easy-open container. If your symptoms feel life threatening, call 911 or your local emergency number immediately. Your doctor may increase your dosage again and then reduce it more slowly.
Many people who misuse Xanax do so by snorting it rather than just taking it orally. When taken together, Xanax can amplify the effects of alcohol because of its solubility. Xanax is a popular drug because, well, it works, and it has a rather interesting chemical structure that makes this so. Their synthesis led to Upjohn Laboratories (now a part of Pfizer), which released alprazolam in 1981. When used as prescribed, it can be effective at reducing the severity of symptoms and can help a person live a more functional, enjoyable life.
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