A Review of Alprazolam Use, Misuse, and Withdrawal
- PMID: 28777203
- PMCID: PMC5846112
- DOI: 10.1097/ADM.0000000000000350
A Review of Alprazolam Use, Misuse, and Withdrawal
Abstract
: 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.
Conflict of interest statement
The authors report no conflicts of interest.
Similar articles
-
Alprazolam withdrawal in patients with panic disorder and generalized anxiety disorder: vulnerability and effect of carbamazepine.Am J Psychiatry. 1994 Dec;151(12):1760-6. doi: 10.1176/ajp.151.12.1760. Am J Psychiatry. 1994. PMID: 7977882 Clinical Trial.
-
A comparison of the safety and efficacy of alprazolam versus other agents in the treatment of anxiety, panic, and depression: a review of the literature.J Clin Psychiatry. 1993 Oct;54 Suppl:25-45; discussion 46-8. J Clin Psychiatry. 1993. PMID: 8262888 Review.
-
Anxiety sensitivity.Am J Psychiatry. 1996 Aug;153(8):1109-10. doi: 10.1176/ajp.153.8.aj15381109. Am J Psychiatry. 1996. PMID: 8678187 No abstract available.
-
Abuse liability of alprazolam relative to other commonly used benzodiazepines: a review.Neurosci Biobehav Rev. 1993 Fall;17(3):277-85. doi: 10.1016/s0149-7634(05)80011-9. Neurosci Biobehav Rev. 1993. PMID: 7903805 Review.
-
[Gabapentin treatment in a female patient with panic disorder and adverse effects under carbamazepine during benzodiazepine withdrawal].Psychiatr Prax. 2007 Mar;34(2):93-4. doi: 10.1055/s-2005-915276. Epub 2006 Nov 23. Psychiatr Prax. 2007. PMID: 17124639 German.
Cited by
-
Quantification of 108 illicit drugs and metabolites in bile matrix by LC-MS/MS for the toxicological testing of sudden death cases.Arch Toxicol. 2024 Jan;98(1):135-149. doi: 10.1007/s00204-023-03631-z. Epub 2023 Dec 5. Arch Toxicol. 2024. PMID: 38051366 Free PMC article.
-
Bioequivalence Study of Two Tablet Formulations of Clonazepam 2 mg: A Randomized, Open-Label, Crossover Study in Healthy Mexican Volunteers Under Fasting Conditions.Neurol Ther. 2024 Feb;13(1):141-152. doi: 10.1007/s40120-023-00567-5. Epub 2023 Dec 2. Neurol Ther. 2024. PMID: 38041794 Free PMC article.
-
A brain-tumor neural circuit controls breast cancer progression in mice.J Clin Invest. 2023 Dec 15;133(24):e167725. doi: 10.1172/JCI167725. J Clin Invest. 2023. PMID: 37847562 Free PMC article.
-
Mitochondrial dysfunction following repeated administration of alprazolam causes attenuation of hippocampus-dependent memory consolidation in mice.Aging (Albany NY). 2023 Oct 5;15(19):10428-10452. doi: 10.18632/aging.205087. Epub 2023 Oct 5. Aging (Albany NY). 2023. PMID: 37801512 Free PMC article.
-
Drug prescriptions preceding opioid-related deaths-a register study in forensic autopsy patients.PLoS One. 2023 May 31;18(5):e0285583. doi: 10.1371/journal.pone.0285583. eCollection 2023. PLoS One. 2023. PMID: 37256903 Free PMC article.
References
-
- ACOG. American College of Obstetricians and Gynecologists Practice Bulletin No. 87 November 2007: Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol. 2007;110:1179. - PubMed
-
- Adler LE, Bell J, Kirch D, et al. Psychosis associated with clonidine withdrawal. Am J Psychiatry. 1982;139:110–112. - PubMed
-
- Albeck JH. Withdrawal and detoxification from benzodiazepine dependence: a potential role for clonazepam. J Clin Psychiatry. 1987;48(Suppl):43–48. - PubMed
-
- Altshuler L, Cohen L. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. Year Book Psychiatry Appl Mental Health. 1997;1997:491. - PubMed
-
- Apelt S, Schmauss C, Emrich H. Preference for alprazolam as opposed to diazepam in benzodiazepine-dependent psychiatric inpatients. Pharmacopsychiatry. 1990;23:70–75. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
