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Alprazolam (By mouth)

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Alprazolam is used to relieve symptoms of anxiety, including anxiety caused by depression. It is also used to treat panic disorder in some patients. Alprazolam is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system. This medicine is available only with your doctor's prescription… Read more
Brand names include
Gabazolamine-0.5, Niravam, Xanax, Xanax XR
Drug classes About this
Antianxiety

What works? Research summarized

Evidence reviews

Alprazolam for depression

Additional options to help those with depression control their mood, besides psychotherapy and antidepressants, can be important, especially when there is also anxiety involved. One of the drug options is alprazolam, a benzodiazepine. We evaluated the effect of alprazolam for depression. The best evidence currently available suggests that alprazolam may be moderately more effective than a placebo, and as effective as conventional antidepressants, in the treatment of major depression. We cannot conclude whether this is due to its specific antidepressant effect or to a non‐specific effect on sleep and anxiety. There were relatively few short‐term side effects. However, the multiple shortcomings of the currently available evidence, including probable sponsorship bias, publication bias, the age of the studies and the heterogeneity of the results, limit confidence in these findings.

Use of alprazolam for treatment of essential tremor

Essential tremor (ET) is the most common movement disorder. Although benign in term of its effect on life expectancy, it is typically progressive and is potentially disabling. Treatment is based primarily on pharmacological agents (propranolol and primidone as first‐line therapy) that could be ineffective in 25% to 55% of patients. Alprazolam has been suggested as potentially useful in ET. The authors of this review tried to assess its efficacy and safety in people with ET. One randomized study, which compared alprazolam and placebo in 24 people with head and/or limb ET, was included. Alprazolam produced a reduction in tremor severity associated with a high frequency of adverse events. However, the small number of studies and evidence of many methodological limitations in the one included study prevent firm conclusions on the benefit‐risk profile of this treatment. Further research is needed to confirm efficacy and to assess long‐term safety of alprazolam for treatment of patients with ET.

Effectiveness of alprazolam in the treatment of panic disorder: a systematic review

Bibliographic details: Feijo de Mello M.  Effectiveness of alprazolam in the treatment of panic disorder: a systematic review. Revista Brasileira de Medicina 2006; 63(11): 606-610

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Summaries for consumers

Alprazolam for depression

Additional options to help those with depression control their mood, besides psychotherapy and antidepressants, can be important, especially when there is also anxiety involved. One of the drug options is alprazolam, a benzodiazepine. We evaluated the effect of alprazolam for depression. The best evidence currently available suggests that alprazolam may be moderately more effective than a placebo, and as effective as conventional antidepressants, in the treatment of major depression. We cannot conclude whether this is due to its specific antidepressant effect or to a non‐specific effect on sleep and anxiety. There were relatively few short‐term side effects. However, the multiple shortcomings of the currently available evidence, including probable sponsorship bias, publication bias, the age of the studies and the heterogeneity of the results, limit confidence in these findings.

Use of alprazolam for treatment of essential tremor

Essential tremor (ET) is the most common movement disorder. Although benign in term of its effect on life expectancy, it is typically progressive and is potentially disabling. Treatment is based primarily on pharmacological agents (propranolol and primidone as first‐line therapy) that could be ineffective in 25% to 55% of patients. Alprazolam has been suggested as potentially useful in ET. The authors of this review tried to assess its efficacy and safety in people with ET. One randomized study, which compared alprazolam and placebo in 24 people with head and/or limb ET, was included. Alprazolam produced a reduction in tremor severity associated with a high frequency of adverse events. However, the small number of studies and evidence of many methodological limitations in the one included study prevent firm conclusions on the benefit‐risk profile of this treatment. Further research is needed to confirm efficacy and to assess long‐term safety of alprazolam for treatment of patients with ET.

At this time, benzodiazepines cannot be recommended for the treatment of non‐alcohol related delirium

A systematic review of benzodiazepine treatment of non‐alcohol related delirium discovered very few trials (one randomized, controlled study of mechanically ventilated patients, and thus poorly reflective of delirious patients as a whole; and two partially controlled studies), the results of which indicate that at this time there is no evidence to support the use of benzodiazepines in the treatment of non‐alcohol withdrawal related delirium among hospitalised patients.

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