A Review of Alprazolam Use, Misuse, and Withdrawal

J Addict Med. 2018 Jan/Feb;12(1):4-10. doi: 10.1097/ADM.0000000000000350.


: Alprazolam is one of the most widely prescribed benzodiazepines for the treatment of generalized anxiety disorder and panic disorder. Its clinical use has been a point of contention as most addiction specialists consider it to be highly addictive, given its unique psychodynamic properties which limit its clinical usefulness, whereas many primary care physicians continue to prescribe it for longer periods than recommended. Clinical research data has not fully shed light on its "abuse liability," yet it is one of the most frequently prescribed benzodiazepines. "Abuse liability" is the degree to which a psychoactive drug has properties that facilitate people misusing it, or becoming addicted to it, and is commonly used in the literature. We have replaced it in our manuscript with "misuse liability" as it reflects a more updated terminology consistent with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In this paper, we have reviewed alprazolam's indications for use, its effect on pregnant women, misuse liability, withdrawal syndrome, pharmacodynamic properties, and suggest better clinical prescription practice of alprazolam by presenting an indepth theory of its clinical effects with use and withdrawal.

Publication types

  • Review

MeSH terms

  • Alprazolam / adverse effects*
  • Alprazolam / therapeutic use
  • Anxiety Disorders / drug therapy
  • Benzodiazepines / adverse effects*
  • Benzodiazepines / therapeutic use
  • Female
  • Humans
  • Panic Disorder / drug therapy
  • Pregnancy
  • Prescription Drug Misuse*
  • Substance Withdrawal Syndrome / therapy*


  • Benzodiazepines
  • Alprazolam