Use Of Alprazolam Research Articles

A meta-analysis of treatments for panic disorder with agoraphobia: Imipramine, alprazolam, and in vivo exposure

The most common pharmacological treatments for panic disorder with agoraphobia (PDA) include the use of imipramine and alprazolam while the most common behavior therapy is the use of graded in vivo exposure. Several studies have found these treatments to be superior to placebo in the treatment of PDA, but it has not been clear if there are differences among these three treatments. It has also not been clear for what aspects of PDA each treatment is the most effective. The purpose of this study was to conduct a meta- analysis of the results of relevant treatment outcome studies on a number of dependent variables (e.g., panic attack severity, dysphoria, avoidance behavior). Few studies satisfied the minimum criteria for inclusion and the final data pool consisted of 34 treatments studies. Imipramine was found to be generally ineffective for most variables. Alprazolam was significantly effective for panic and anxiety variables in PDA, while exposure was significantly effective for phobia variables. Exposure had the most consistently strong effect sizes.

The use of Alprazolam for decreasing problem wandering in geriatric patients

The effects of wandering behavior have been well identified as a problem in providing care for the cognitively impaired. Wandering behavior takes its toll not only on the patient, but also upon the caregiver who is trying to manage and redirect this behavior. This wandering behavior may precipitate admission to a long term care facility where several residents with wandering behaviors present treatment, management, and staff concerns. The costs to the patient have been in the use of traditionalpharmacological options that have potential side effects and iatrogenicity. The costs to the caregiver are stress, frustration, and time constraints in providing care for others. Though the literature discusses wandering, there are varied definitions. This study attempts to define more precisely which wandering behaviors are perceived as problematic, disruptive and intrusive. Secondly, the study investigates the use of Alprazolam as a less toxic, potentially more effective option for decreasing problem wandering.

Clonazepam

Clonazepam 0.5 mg was evaluated in a sleep laboratory study of 6 insomniac patients. The 16-night protocol consisted of 4 placebo-baseline nights, 7 nights of drug administration and 5 placebo-withdrawal nights. Clonazepam produced a significant decrease in total wake time initially (nights 5-7), as well as with continued administration (nights 9-11). With later but not immediate withdrawal, significant rebound insomnia occurred, on the 3rd withdrawal night, both wake time after sleep onset and total wake time increased markedly, with the latter significantly increased. These findings are discussed in light of clonazepam's increasing use for panic disorder; specifically, due to its maintained efficacy, it has the advantage of avoiding interdose rebound anxiety which is frequently reported with use of alprazolam.

Prevention of claustrophobia induced by MR imaging: use of alprazolam.

Patients who have claustrophobia and other anxiety-related disorders may be unable to remain inside an MR imager long enough for an imaging study to be completed. Some centers have studies cancelled for as many as 30% of patients because of this problem. My colleagues and I have used oral Xanax (alprazolam) prophylactically to treat claustrophobia in 100 adults who were scheduled for MR imaging. We were able to complete the MR studies in all 100 patients. The treatment is as follows: Approximately 30 to 60 mm before the MR study, the patient is given 0.5 mg of alprazolam orally. After checking in at the admissions desk, the patient is given an additional 0.5 mg of alprazolam sublingually. The pill is bitter, but patients are encouraged to keep it under the tongue as long as possible before they swallow it. Noneof our 100 patients became unconscious or insensible when this regimen was used, and none required any other medication. All were warned not to drive themselves home.

Problems in the Treatment of Premenstrual Syndrome

Three categories of treatments for premenstrual syndrome (PMS) have been proposed: those designed to correct the cause of the disorder; those designed for symptom relief; and those aimed at eliminating the menstrual cycle. Many of these recommendations are based on poor research with loose definitions of the disorder and uncontrolled open trials. This paper reviews the literature on treatment methods with emphasis on recent random, placebo controlled, double-blind studies. The most effective current management of PMS is a conservative one including accurate diagnosis, stress control, sensible levels of diet and exercise and perhaps the use of alprazolam in the premenstrual period. Other approaches such as the use of mefenamic acid and evening oil of primrose remain unproven. Progesterone has been proven uneffective. Further research is required into the value of antidepressant medication.

Alprazolam: just another benzodiazepine?

AbstractThe literature on alprazolam is reviewed. It is concluded that it is an effective anxiolytic but that it is not an antidepressant. When used in sufficiently high dosage it can block panic attacks, but it is not the only antipanic agent available. It may be used as an alternative to other benzodiazepines in the acute detoxification of alcoholics. It should be avoided where there is strong individual likelihood of abuse. Chronic usage (more than a few weeks) demands a very slow tapering of dosage. Carbamazepine may ameliorate withdrawal symptoms. The use of alprazolam in other conditions remains unproven.

Dr. Ciraulo and Associates Reply

Back to table of contents Previous article Next article ArticleNo AccessDr. Ciraulo and Associates ReplyDOMENIC A. CIRAULO, Brian F. SANDS, and RICHARD I. SHADERDOMENIC A. CIRAULOSearch for more papers by this author, Brian F. SANDSSearch for more papers by this author, and RICHARD I. SHADERSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.146.5.683-bAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Dr. Ciraulo and Associates Reply." American Journal of Psychiatry, 146(5), pp. 683-b–684 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byAlcoholism: Clinical & Experimental Research, Vol. 29, No. 8Clinical aspects of chronic use of alprazolam and lorazepam1 April 2006 | American Journal of Psychiatry, Vol. 152, No. 8The Treatment of Anxiety: Realistic Expectations and Risks Posed by Controlled Substances1 January 2021 | Journal of Law, Medicine & Ethics, Vol. 22, No. 3The American Journal on Addictions, Vol. 1, No. 4 Volume 146Issue 5 May 1989Pages 683-b-684 Metrics PDF download History Published online 1 April 2006 Published in print 1 May 1989

Alprazolam in the Treatment of Anticipatory and Acute Situational Anxiety in Children with Cancer

A population of childhood cancer patients who undergo scheduled, periodic, stressful events such as bone marrow aspirations and spinal taps was chosen as a model for the investigation of the use of alprazolam in the treatment of anticipatory and acute situational anxiety in children. An open-label dose-ranging study was completed on 13 children. Because this was an early trial of a drug not approved for use in children, doses were low. Nonetheless, safe efficacious use of alprazolam was demonstrated and indicates that antianxiety agents may have a useful purpose for brief intervention situations in children.

Prevalence of mental illness in a community nursing home.

A research psychiatrist using a standardized interview found that 94% of a random sample of residents at a large, intermediate-care nursing home had mental disorders according to DSM-III criteria. Primary degenerative dementia and multi-infarct dementia were the most common diagnoses. In addition, the majority of demented patients also had noncognitive symptoms such as delusions and hallucinations, and these residents were significantly more likely to have an associated behavioral disorder than were residents without delusions or hallucinations. Replications of these results would point out the need for major revisions in the funding and delivery of psychiatric care for nursing home residents.

Alprazolam (Xanax, the Upjohn Company).

Alprazolam is a triazolobenzodiazepine, a derivative of the benzodiazepines. Comparison studies of alprazolam and diazepam or chlordiazepoxide in patients suffering from clinical anxiety secondary to anxiety neurosis or chronic alcohol withdrawal suggest an equal efficacy of those agents. Studies examining the use of alprazolam for the treatment of "primary depression" suggest that it is as effective as imipramine in the treatment of exogenous (reactive) depression. Although alprazolam may be effective in patients with exogenous depression, no extrapolation can be made to the treatment of endogenous depression. Mechanisms of action have not been fully elucidated, but probably are similar to those of other benzodiazepines. Peak blood levels are reached in 0.7-1.6 hours and the elimination half-life after steady state is approximately 19 hours. Daily dosages established from clinical studies ranged from 1 to 6 mg. Clinically, alprazolam appears to be ten times more potent than diazepam. Drowsiness, headaches, lightheadedness, dry mouth, and depression appear to be the most common side effects of the drug. It is concluded that alprazolam offers no striking therapeutic advantage over currently marketed benzodiazepines.