Alprazolam is an anxiolytic, a drug of the benzodiazepine class with an average duration of action. It has an anti-anxiety effect and is used to treat panic attacks, anxiety disorders, phobias, and depression. It is also available under other trade names; the most popular structural analogue is Xanax. The drug is addictive, and exceeding the dosage leads to a state of mild euphoria. Officially, it can only be purchased with a doctor's prescription. Alprazolam drug use is common in the US and UK among teenagers and young adults under 25 years of age.
Content:
- Alprazolam: general description of the drug: 1.1. Mechanism of action. 1.2. Indications for use. 1.3. Contraindications and features of use. 1.4. Why Alprazolam is dangerous: side effects and symptoms of overdose.
- How does addiction to Alprazolam develop?
- How to relieve addiction to Alprazolam: principles of treatment.
Alprazolam is a drug from the group of benzodiazepines, hypnotics and sedatives that inhibit the activity of the central nervous system. Benzodiazepine tranquilizers became firmly established in medical practice several decades ago, but they are still very often prescribed in psychiatry and neurology. But at the same time
Alprazolam is more likely than other medications of this pharmacological group to cause drug dependence. And often a person continues to take pills even after completing the course of treatment, obtaining them fraudulently in pharmacies or on the illegal drug market. It is not easy to cope with the uncontrolled use of the drug without the help of a narcologist, because a sudden cessation of its use is accompanied by a real withdrawal syndrome. This condition requires mandatory detoxification, psychotherapy and subsequent rehabilitation.
Side effects
Classification of the frequency of side effects: very often (≥1/10); often (≥1/100, <1/10); uncommon (≥1/1000, <1/100); rare (≥1/10,000, <1/1000); very rare (<1/10,000), including isolated reports.
Side effects of candesartan are mild and transient. The frequency of side effects does not depend on the dose of the drug and the age of the patient.
From the nervous system: often - dizziness, headache, weakness.
From the cardiovascular system: often - a pronounced decrease in blood pressure.
From the respiratory system: often - respiratory infections, pharyngitis, rhinitis, cough.
From the digestive system: very rarely - nausea, increased activity of liver transaminases, impaired liver function or hepatitis.
From the urinary system: often - impaired renal function, including renal failure in predisposed patients.
From the musculoskeletal system: very rarely - back pain, arthralgia, myalgia.
From the hematopoietic system: very rarely - leukopenia, neutropenia, thrombocytopenia and agranulocytosis.
Laboratory indicators: very rarely - hyperkalemia, hyponatremia, increased creatinine concentration in the blood, hyperuricemia, slight decrease in hemoglobin.
Allergic reactions: very rarely - angioedema, skin rash, itching, urticaria.
Other: exacerbation of gout, “flushes” of blood to the skin of the face.
general description
Alprazolam has all the properties of “classical” tranquilizers. The spectrum of its pharmacotherapeutic activity includes the following effects:
- anxiolytic;
- sedative;
- hypnotic;
- muscle relaxant;
- anticonvulsant.
Due to the high affinity for specific endogenous benzodiazepine receptors, the effect of the drug develops faster. It differs from its analogues in less severe adverse reactions: it causes daytime drowsiness, sudden mood swings, and lethargy much less frequently. That is why it is very often used in outpatient practice.
Mechanism of action
The therapeutic effect of Alprazolam is associated with its selective effect on various classes of GABA receptors (GABA or γ-aminobutyric acid is the main “inhibitory” neurotransmitter). They are localized in the cerebellum, hippocampus, spinal cord and other parts of the central nervous system. By interacting with GABA receptors, Alprazolam indirectly affects the functions of the noradrenergic, serotonergic, cholinergic and opioidergic systems. This is what explains the effectiveness of the medication for anxiety and depressive symptoms.
The drug also has lipophilic properties, so it binds well to plasma proteins and easily penetrates the blood-brain barrier. Thanks to this, the therapeutic effect appears very quickly. Up to 75–80% of the drug is excreted unchanged from the body in the urine, the rest is metabolized in the liver.
Indications for use
As practice and clinical research data show, Alprazolam is most effective for pathologies accompanied by anxiety, fear and restlessness. This:
- panic, obsessive-compulsive, acute stress, generalized anxiety disorder;
- some forms of depression;
- phobias;
- alcohol or drug withdrawal (with caution due to the risk of complications);
- severe premenstrual syndrome;
- somatic diseases accompanied by anxiety syndrome.
Contraindications and application features
Based on the characteristics of metabolism, Alprazolam is prescribed with caution in chronic pathologies of the liver and kidneys. In such cases, individual dose selection is required. A gradual accumulation of the drug and a high risk of intoxication cannot be ruled out. Therefore, for such diseases, the medication is prescribed only according to strict indications and the impossibility of choosing a safer analogue.
During the course of treatment with Alprazolam, medications that reduce the activity of liver enzymes are contraindicated. These are the following:
- antiviral;
- antifungal;
- some antibacterials (in particular, erythromycin and ciprofloxacin);
- antidepressants;
- antiulcer (omeprazole), etc.
Due to the risk of overdose, narcotic analgesics, other sedative and hypnotic medications, and alcohol are strictly prohibited. Alprazolam is contraindicated in:
- respiratory failure, obstructive chronic pulmonary diseases;
- individual intolerance and allergic reaction;
- pregnancy due to the risk of severe congenital malformations of the fetus, you should also stop breastfeeding;
- in childhood and adolescence (up to 18 years);
- severe depression with suicide attempts (benzodiazepines increase the symptoms of the disorder).
Why Alprazolam is dangerous: side effects and overdose symptoms
The most common adverse reactions are of a neurological nature. This feeling of fatigue, dizziness, drowsiness, exercise intolerance, general malaise. They are most pronounced at the initial stage of the course of treatment, and then gradually disappear in most patients. Also possible:
- lack of appetite;
- stool disorders, heartburn, flatulence;
- weight gain;
- in women - irregular menstrual cycle.
Overdose is accompanied by severe symptoms:
- slurred speech;
- impaired coordination of movements;
- slowing down the reaction rate;
- respiratory depression.
However, exceeding the daily dose is especially dangerous if you are dependent on Alprazolam, when the person no longer follows the doctor’s recommendations. When combined with alcohol or drugs, an overdose can be fatal.
Physiological effects
Alprazolam has anxiolytic, central muscle relaxant, anticonvulsant, sedative-hypnotic and antipanic effects. The anti-anxiety effect is manifested by the elimination of emotional tension, anxiety, anxiety and fear. A less pronounced sedative-hypnotic effect weakens symptoms of neurotic origin. The period of falling asleep is shortened, the duration of sleep increases, and the number of night awakenings is reduced. This is achieved by reducing the susceptibility of emotional, motor and vegetative (from internal organs) stimuli.
How does addiction to Alprazolam develop?
The standard daily dose of a tranquilizer is 0.75–4.5 mg, which is divided into three doses (it is recommended to take the tablets at the same time). The risk of developing psychological and physical dependence on Alprazolam is especially high if the course of treatment lasts longer than 4–6 weeks.
One of the prerequisites for the safe use of benzodiazepines is their gradual, slow withdrawal with a gradual reduction in the daily dosage. Quitting Alprazolam often takes longer than the therapy itself. Abrupt withdrawal of medication causes:
- recurrence of initial symptoms: feelings of anxiety, fear and other emotional and mental disorders reappear;
- “recoil syndrome”, which is accompanied by insomnia and panic attacks.
But the most difficult to tolerate is withdrawal syndrome, which manifests itself:
- irritability, depression, apathy;
- nausea, vomiting;
- malaise, weakness and weakness;
- increased sensitivity to bright light, loud sounds, strong odors;
- decreased concentration;
- convulsive seizures;
- hallucinosis;
- crazy ideas;
- depersonalization;
- pain syndrome;
- tremor of hands, tongue;
- tinnitus;
- slow speech and general lethargy.
It is these symptoms that force the patient to return to the pills, and often he takes the medicine in a higher dose than was prescribed by the doctor. At the same time, there is a fear of stopping treatment, because this is accompanied by a pronounced deterioration in well-being.
Alprazolam in Russia
Oddly enough, in Russia you can now easily get this drug. Of course, you can’t buy it just like that: by going to the pharmacy and begging the pharmacist to give you a pack. This drug belongs to the list of medicines subject to quantitative accounting. This means that the prescription for it (with all the stamps and signatures) is given and remains in the pharmacy. But, nevertheless, for a decent amount on the black market you can find several tablets of Xanax, so coveted by some fans of modern hip-hop culture. This means that it is quite possible to use it systematically. We wrote above what this entails.
How to break your addiction to Alprazolam
A strict indication for drug detoxification is symptoms of overdose. Cleansing therapy is carried out only in a hospital, it consists of the following stages:
- gastric lavage;
- use of high doses of adsorbents;
- use of medications from the group of benzodiazepine receptor antagonists;
- correction of concomitant somatic disorders.
If there is no effect from the procedures performed, hemodialysis and plasmapheresis are indicated.
However, the vast majority of patients started taking the medication for therapeutic reasons, and detoxification will inevitably lead to relapse. That is why the drug is continued, but in order to relieve dependence on Alprazolam, its dose is gradually reduced over several weeks.
In this condition, round-the-clock medical monitoring and timely pharmacological correction of possible complications are necessary. Therefore, until the end of treatment, the addict must remain in an inpatient drug treatment clinic.
A course of psychotherapy is mandatory. Experts suggest that consultations with a psychologist will help cope with the underlying disease, for the treatment of which Alprazolam was, in fact, prescribed. Sometimes, if psychotherapy is not enough, antidepressants and “mild” sedatives are additionally selected.
Undoubtedly, many diseases cannot be treated without benzodiazepines, but in order to avoid the development of dependence, it is important to strictly follow all the recommendations of the attending physician regarding the dosage regimen. Exacerbation of the condition, emotional discomfort, or any symptoms that bother the patient are mandatory indications for consulting a doctor.
What now?
Nowadays, the picture has become a little better: potent narcotic medications have become very difficult to purchase without a prescription, but there are still a lot of them on the black market, and they are very expensive.
More recently, at the peak of popularity in the States was the so-called “Purple drank” - a drink based on cough syrup with a strong narcotic effect from the main active ingredient codeine.
This type of drug has not taken root in Russia, because now it is very difficult to get pure codeine, much less mix it and make syrups. Although you can find this on the black market for a huge price. Today, the benzodiazepine tranquilizer alprazolam, better known under the trade name “Xanax,” is at the peak of popularity.
Many Western rappers do not disdain Xanax, often using it and even composing their tracks about it. From overseas, fashion has come to us: in Russia, too, there are hip-hop artists praising this substance. And, as you know, the main audience of modern Russian rappers are young guys who love to experiment with different things.
- You can't convince me to get treatment
? - We will help you with motivation for treatment. As a rule, it is difficult for loved ones to persuade or force an addict to undergo treatment. World experts have developed EFFECTIVE motivation schemes, using which you can lead an addict to the decision to seek help. 8
Literature:
- Fursov B.B., Papsuev O.O. Use of alprazolam in clinical practice. - Special clinical psychiatry, 2012. - vol. 22, no. 1.
- Mosolov S.N. Alprazolam is the first benzodiazepine with a thymotranquilizing effect. - Doctor, 1999. - No. 8
- Kalinin V.V. New data on the use of alprazolam in psychiatry (literature review). - Psychiatry and psychopharmacotherapy, 2000. - T.2, No. 4.
- Sychev D.A., Zhuchkov A.V., Tereshchenko O.V. Gradual withdrawal (deprescribing) of benzodiazepine tranquilizers. — Neurology, neuropsychiatry, psychosomatics, 2021. — 11(1).
The text was checked by expert doctors: Head of the socio-psychological service of the Alkoklinik MC, psychologist Yu.P. Baranova, L.A. Serova, a psychiatrist-narcologist.
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