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.
Indications for use
According to the instructions, Alprazolam is used for:
- Anxiety states and neuroses, accompanied by a feeling of danger or anxiety, deterioration of sleep, as well as somatic disorders;
- Neurotic reactive-depressive states, which are accompanied by decreased mood, insomnia, loss of interest in the environment and decreased appetite;
- Mixed anxiety and depression;
- Panic disorders with and without symptoms of phobia;
- Anxiety states and neurotic depressions that developed against the background of somatic diseases.
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.
CAN'T FIND THE ANSWER?
Consult a specialist
Or call: +7 (495) 744-85-28
Call! We work around the clock!
Contraindications
In accordance with the instructions, Alprazolam is contraindicated for use in:
- Severe depression;
- Angle-closure glaucoma;
- Shock;
- Acute poisoning with alcohol, sleeping pills and psychotropic drugs, as well as opioid analgesics;
- Chronic obstructive respiratory diseases with initial manifestations of respiratory failure;
- Myasthenia;
- Acute respiratory failure;
- Hypersensitivity to benzodiazepines or other components of Alprazolam.
The use of Alprazolam during pregnancy is contraindicated due to the toxic effects on the fetus.
The active substance of the drug is excreted in breast milk and can have a negative effect on the newborn, so breastfeeding must be interrupted while taking the drug.
Alprazolam is not prescribed to persons under 18 years of age.
During the treatment period it is contraindicated to drink alcohol.
In case of impaired renal or liver function, the drug should be used with extreme caution.
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.
Side effects
Most often, side effects occur at the beginning of treatment and manifest themselves as a feeling of fatigue, drowsiness, dizziness, ataxia, decreased ability to concentrate, unsteady gait, disorientation, and slowed mental and motor reactions.
In some cases, the use of Alprazolam may cause the following side effects:
- From the central nervous system: headache, depression, impaired motor coordination, aggressive outbursts, euphoria, anxiety and insomnia, dystonic extrapyramidal reactions, memory loss, hallucinations, confusion, psychomotor agitation, tremor, depressed mood, weakness, myasthenia gravis, dysarthria, irrational fear , muscle spasm;
- From the digestive system: loss of appetite, nausea, dry mouth or drooling, heartburn, constipation or diarrhea, vomiting, impaired liver function, jaundice;
- From the urinary system: urinary incontinence or retention, impaired renal function;
- From the cardiovascular system: decreased blood pressure and tachycardia;
- From the hematopoietic system: neutropenia, leukopenia, agranulocytosis, anemia, thrombocytopenia;
- Allergic reactions: skin rash and itching;
- From the endocrine system: libido disorders, changes in body weight and menstrual irregularities.
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,
therefore, 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.
special instructions
During treatment, it should be taken into account that long-term use of Alprazolam in high doses may develop addiction. Discontinuation of the drug must be carried out gradually. It is recommended to reduce the dose by 500 mcg when taken no more than three times a day. In some cases, slower withdrawal of the drug is required. Abrupt cessation of taking Alprazolam can lead to withdrawal syndrome, which manifests itself in the form of insomnia, increased sweating, convulsions, tremors, and skeletal muscle spasms.
In the treatment of endogenous depression, the drug can be used simultaneously with antidepressants.
Taking Alprazolam with psychotropic and anticonvulsants may enhance the negative effect of the drug on the central nervous system.
Caution should be exercised when using the drug simultaneously with histamine H2 receptor blockers, macrolide antibiotics, other tranquilizers and digoxin.
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
.
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, 24-hour medical supervision is required.
and timely pharmacological correction of possible complications. 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 addiction, it is important to strictly follow all the recommendations of your doctor
regarding the dosage regimen. Exacerbation of the condition, emotional discomfort, or any symptoms that bother the patient are mandatory indications for consulting a doctor.
Compound
Alprazolam is a white crystalline powder with excellent solubility in methanol or ethanol but is soluble in water at physiological pH. Each tablet is for oral use and contains 0.25, 0.5, 1 or 2 mg of the active ingredient alprazolam .
Auxiliary ingredients:
- lactose monohydrate;
- corn starch;
- sodium benzoate;
- microcrystalline cellulose;
- colloidal silicon dioxide;
- povidone;
- sodium docusate;
- magnesium stearate.
Alprazolam price, where to buy
A very common question is where to buy Alprazolam in Moscow and whether it is even sold in pharmacies in our country. Below is a list of Moscow pharmacies where this drug can be purchased:
- Pharmacy 36.6;
- AVE Pharmacy;
- Anti-Speed Pharmacy;
- Pharmacy, LLC Agba-market;
- Pharmacy VitaPharm;
- Pharmacy Doctor Stoletov;
- Kremlevskaya Pharmacy;
- Pharmacy First Aid;
- Rigla Pharmacy;
- Pharmacy Samson-Pharma;
- Capital Pharmacies;
- Pharmakon Pharmacy;
- Central Pharmacy No. 1, Ministry of Internal Affairs of the Russian Federation;
- Central Pharmacy, State Unitary Enterprise;
- Pharmacy Evalar.
The price of Alprazolam varies from 155 rubles and above, depending on the number of tablets in the package.
So what is alprazolam?
Wikipedia says that alprazolam or Xanax is an anti-anxiety drug, a medium-acting benzodiazepine derivative that is used to treat panic disorders, anxiety neuroses such as anxiety disorder or social phobia.
And it must be said that it copes with these goals excellently: those who take this medicine as prescribed by a doctor for, for example, relieving severe anxiety or panic attacks are satisfied. But is this substance safe when used systematically and uncontrolled for euphoria?
It is worth noting that all benzadiazepine tranquilizers have one of the most severe withdrawal symptoms, sometimes even surpassing opioids such as heroin. This means that if you use the same Xanax for a long time and constantly, you can get a very strong withdrawal or withdrawal syndrome.
Having an effect on the psyche for a long time as a sedative, relaxing agent, upon withdrawal a number of extremely unpleasant symptoms appear, but the main thing is that a person can no longer fully function without this substance as before. Here's what users of benzodiazepines like Xanax write about it on foreign forums:
“I feel very anxious even after 5 weeks of lowering the dosage and drinking a lot. I still feel it even weeks later. Even when I took Dilaudid and Tramadol every day for 5 weeks, long enough to feel stoned all the time, my withdrawal symptoms were much milder and smoother.
After 4-5 months of using benzodiazepines, I became so ill that I began to hallucinate and feel crazy, like it was a never-ending “bad trip.” Brain zaps from benzodiazepines are even worse than from antidepressants, and a couple of times they even turned into full-blown seizures.
It was as if I heard a loud “BAM” sound, then saw a flash of light, and my body began to convulse. That's how it was! It was like a flashbang went off in my head. Scary as hell!
Pharmacodynamics and pharmacokinetics
At the organic level, the drug acts by binding to specific receptors in specific areas of the brain. The reaction and response of the central nervous system largely depend on the correctness of the selected dose, therefore such therapy is carried out only with the permission of a doctor and under his supervision.
After oral administration, the drug is quickly absorbed by the mucous membrane of the digestive organs. Its peak plasma concentration is observed after 1-2 hours. About 80% of the active substance is bound to the patient’s serum protein. Its metabolism occurs in the liver, after which the breakdown products are excreted by the kidneys. The medicine does not accumulate in the tissues of the body, so even with long-term use, the likelihood of an overdose is minimal.
Analogues of "Alprazolam"
Pharmacological companies around the world offer numerous synonyms for the drug. They all contain the same active substance, which determines their similar properties, descriptions, and characteristics. This list includes Alzolam, Zolomax, Neurol, Helex, Alprox and a number of other drugs.
Analogs of the product contain other active ingredients, but give similar results when used. This is a broad group of medications, among which doctors distinguish Nozepam, Relanium, Sibazon, and Phenazepam. Only the attending physician can select a replacement for a prescription medication.
"Alprazolam": instructions for use - method and dosage
For the main indications for taking the drug, doctors rarely use its basic dosage, preferring an individual selection of the treatment regimen. Depending on the diagnosis, age, and severity of the problem, the indicator can vary widely. To obtain a lasting therapeutic effect, start with the minimum permissible volume of the active substance. It is gradually increased, bringing it to the level at which the desired response of the body is achieved - the alarming symptoms disappear.
Universal rules for taking the drug:
- the product is taken orally, swallowed whole, without chewing, with 100 ml of water, regardless of food;
- when taking a psychotropic drug for the first time and in old age, the starting and therapeutic doses are 50-70% of the base ones;
- if during therapy the patient experiences a decrease in coordination or severe drowsiness, the volume of the active substance is reduced;
- The daily volume of medication is divided into 2-3 doses. The largest dose is taken in the evening to reduce the risk of daytime sleepiness and provide the patient with a good night's sleep;
- initial daily dosages of the drug are 0.25-0.5 mg. They are increased gradually, usually by 0.25 mg every 3 days, over several weeks. First, the increase affects the evening dose, then moves to the daytime dose;
- the maximum daily volume of the active component should not exceed 10 mg.
How long to take Alprazolam depends on the patient’s condition, indications, goals of therapy, and the severity of positive dynamics. Usually doctors try to make do with short courses of a few days. Such approaches allow you to get rid of acute fear, for example, against the background of nervous shock. In such cases, therapy begins with basic volumes of the drug, which are not increased.
Long courses are necessary to combat chronic conditions that are accompanied by fear and anxiety. They last on average from 8 weeks to six months or longer.
Rules for drug withdrawal
The patient is gradually withdrawn from prolonged drug therapy. If you do this abruptly, withdrawal syndrome will develop. It will manifest itself in the form of a rapid return of symptoms for which the medicine was used, an intensification of the clinical picture. On average, it takes 2-6 weeks to quit the drug, this period depends on the volume of the therapeutic dose.
To prevent complications, the therapeutic dosage begins to be reduced by 0.25-0.5 mg every 3 days. First, the morning and day doses are sequentially adjusted, then the evening doses. If during the withdrawal process the patient returns to relieved symptoms, the dosage is again slightly increased and maintained for 1-2 weeks. Then they return to the release schedule again, but if possible make it even smoother.
Deaths from Xanax overdose
It is difficult to get a fatal overdose from alprazolam alone, but the thing is that it is often mixed with other, more potent substances: for example, opiates or alcohol. And such a “combo” can be very dangerous. This is often done in the West, and it is possible that the same fashion will come to Russia.
The most sensational case in recent times: the death of rapper Gustav Ara, better known as Lil Peep. At the peak of his popularity, at 22, he became heavily involved in drugs. Once, after mixing the powerful synthetic opioid fentanyl with Xanax, his breathing stopped because alprazolam significantly enhances the depressant effects of other drugs on the respiratory system, such as opiates or alcohol.
It is reported that Lil Peep had previously used drugs and was addicted to cocaine and alprazolam; He regularly mentioned the topic of drugs in his texts and messages on social networks. In one Instagram post, Gustav declared himself a "productive drug addict" and called for abstinence from drugs.
Do you want to know about the cost of services?
8 call our specialist
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.
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
Reviews about "Alprazolam"
There are practically no negative reviews about the drug. The only negative aspect of therapy is the risk of developing addiction or withdrawal syndrome, but this can be avoided by strictly following the doctor’s recommendations. Some consumers also note the relatively high cost of the drug, but this point is offset by its effectiveness.
Positive reviews about the product are associated with its pronounced therapeutic effect and the rapid appearance of signs of positive dynamics. According to patients and doctors, the medicine copes better than many others with the symptoms of panic attacks and anxiety. An additional advantage is the possibility of using the product one time or in short courses.
