Buy Zoloft Blog

Dec 21

Xanax is used to treat anxiety disorders and panic attacks. Alprazolam is in a class of medications called benzodiazepines. It works by decreasing abnormal excitement in the brain. Some benzodiazepines are used to relieve anxiety. However, benzodiazepines should not be used to relieve nervousness or tension caused by the stress of everyday life.

Xanax belong to the group of medicines called central nervous system (CNS) depressants (medicines that slow down the nervous system). Xanax also is used sometimes to treat depression, fear of open spaces (agoraphobia), and premenstrual syndrome. Talk to your doctor about the possible risks of using this medication for your condition. Many of the benzodiazepines are used in the treatment of other conditions, also. Chlordiazepoxide, clorazepate, diazepam, and oxazepam are used to treat the symptoms of alcohol withdrawal. Alprazolam and clonazepam are used in the treatment of panic disorder. The benzodiazepines may also be used for other conditions as determined by your doctor.

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CONTRAINDICATIONS
XANAX Tablets are contraindicated in patients with known sensitivity to this drug or other
benzodiazepines. XANAX may be used in patients with open angle glaucoma who are
receiving appropriate therapy, but is contraindicated in patients with acute narrow angle
glaucoma.
XANAX is contraindicated with ketoconazole and itraconazole, since these medications
significantly impair the oxidative metabolism mediated by cytochrome P450 3A (CYP3A)
(see WARNINGS and PRECAUTIONS–Drug Interactions).
WARNINGS
Dependence and Withdrawal Reactions, Including Seizures
Certain adverse clinical events, some life-threatening, are a direct consequence of physical
dependence to XANAX. These include a spectrum of withdrawal symptoms; the most
important is seizure (see DRUG ABUSE AND DEPENDENCE). Even after relatively short-
term use at the doses recommended for the treatment of transient anxiety and anxiety disorder
(ie, 0.75 to 4.0 mg per day), there is some risk of dependence. Spontaneous reporting system
data suggest that the risk of dependence and its severity appear to be greater in patients treated
with doses greater than 4 mg/day and for long periods (more than 12 weeks). However, in a
controlled postmarketing discontinuation study of panic disorder patients, the duration of
treatment (3 months compared to 6 months) had no effect on the ability of patients to taper to
zero dose. In contrast, patients treated with doses of XANAX greater than 4 mg/day had more
difficulty tapering to zero dose than those treated with less than 4 mg/day.
The importance of dose and the risks of XANAX as a treatment for panic disorder: Because
the management of panic disorder often requires the use of average daily doses of XANAX
above 4 mg, the risk of dependence among panic disorder patients may be higher than that
among those treated for less severe anxiety. Experience in randomized placebo-controlled
discontinuation studies of patients with panic disorder showed a high rate of rebound and
withdrawal symptoms in patients treated with XANAX compared to placebo-treated patients.
Relapse or return of illness was defined as a return of symptoms characteristic of panic
disorder (primarily panic attacks) to levels approximately equal to those seen at baseline
before active treatment was initiated. Rebound refers to a return of symptoms of panic
disorder to a level substantially greater in frequency, or more severe in intensity than seen at
baseline. Withdrawal symptoms were identified as those which were generally not
characteristic of panic disorder and which occurred for the first time more frequently during
discontinuation than at baseline.

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In a controlled clinical trial in which 63 patients were randomized to XANAX and where
withdrawal symptoms were specifically sought, the following were identified as symptoms of
withdrawal: heightened sensory perception, impaired concentration, dysosmia, clouded
sensorium, paresthesias, muscle cramps, muscle twitch, diarrhea, blurred vision, appetite
decrease, and weight loss. Other symptoms, such as anxiety and insomnia, were frequently
seen during discontinuation, but it could not be determined if they were due to return of
illness, rebound, or withdrawal.
In two controlled trials of 6 to 8 weeks duration where the ability of patients to discontinue
medication was measured, 71%-93% of patients treated with XANAX tapered completely off
therapy compared to 89%-96% of placebo-treated patients. In a controlled postmarketing
discontinuation study of panic disorder patients, the duration of treatment (3 months compared
to 6 months) had no effect on the ability of patients to taper to zero dose.
Seizures attributable to XANAX were seen after drug discontinuance or dose reduction in 8 of
1980 patients with panic disorder or in patients participating in clinical trials where doses of
XANAX greater than 4 mg/day for over 3 months were permitted. Five of these cases clearly
occurred during abrupt dose reduction, or discontinuation from daily doses of 2 to 10 mg.
Three cases occurred in situations where there was not a clear relationship to abrupt dose
reduction or discontinuation. In one instance, seizure occurred after discontinuation from a
single dose of 1 mg after tapering at a rate of 1 mg every 3 days from 6 mg daily. In two other
instances, the relationship to taper is indeterminate; in both of these cases the patients had
been receiving doses of 3 mg daily prior to seizure. The duration of use in the above 8 cases
ranged from 4 to 22 weeks. There have been occasional voluntary reports of patients
developing seizures while apparently tapering gradually from XANAX. The risk of seizure
seems to be greatest 24-72 hours after discontinuation (see DOSAGE AND
ADMINISTRATION for recommended tapering and discontinuation schedule).

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Adverse Effects
The most frequently reported are drowsiness, coordination difficulties with dizziness. Release of hostility and other paradoxical effects such as irritability, excitability and hallucinations are known to occur with the use of benzodiazepines. Other side effects less frequently reported, listed by body systems, include the following:

Neurologic:
Blurred vision, headache, seizures, slurred speech, difficulty in depth perception.

Psychiatric:
Agitation, mental confusion, depression, irritability, nervousness, sleep disturbances, euphoria, lethargy, stupor.

Gastrointestinal:
Dry mouth, nausea, nonspecific gastrointestinal disturbances, vomiting.

Musculoskeletal:
Muscle spasm, muscle weakness.

Cardiovascular:
Hypotension, palpitations, tachycardia.

Dermatologic:
Pruritus, rash.

Genitourinary:
Incontinence, change in libido.

Hematologic:
Decreased hemoglobin and hematocrit, increased and decreased WBC.

Hepatic:
Elevations of alkaline phosphatase, bilirubin, AST (SGOT), ALT (SGPT).

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Miscellaneous:
Increased and decreased blood sugar levels.
Overdose
Symptoms:
Manifested as an extension of alprazolam’s pharmacologic activity. Varying degrees of CNS depressant effects such as somnolence and hypnosis can occur. Other manifestations may include muscle weakness, ataxia, dysarthria and particularly in children paradoxical excitement. In more severe cases diminished reflexes, confusion and coma may ensue. It should be remembered when treating an overdose that multiple agents may have been ingested. Fatalities with benzodiazepines rarely occur except when other drugs, alcohol or aggravating factors are involved.

Treatment:
Vomiting may be induced if the patient is fully awake. Vital signs should be monitored and general supportive measures should be employed as indicated. Gastric lavage should be instituted as soon as possible. I.V. fluids may be administered and an adequate airway should be maintained.

Experiments in animals have indicated that cardiopulmonary collapse can occur with massive i.v. doses of alprazolam. This could be reversed with positive mechanical respiration and the i.v. infusion of levarterenol.

Animal experiments with alprazolam and related compounds have suggested that hemodialysis and forced diuresis are probably of little value.
Dosage
Must be individualized and carefully titrated in order to avoid excessive sedation or mental and motor impairment. As with other anxiolytic-sedatives, short courses of treatment should be the rule for the symptomatic relief of excessive anxiety and the initial course of treatment should not last longer than 1 week without reassessment. If necessary, drug dosage can be adjusted after 1 week. Prescriptions should be limited to short courses of therapy.

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Adults:
Initially:
0.25 mg (250 mcg) given 2 or 3 times daily. If required, increases may be made in 0.25 mg (250 mcg) increments according to the severity of symptoms and patient response. It is recommended that the evening dose be increased before the daytime doses. Very severe manifestations of anxiety may require larger initial daily doses. The optimal dosage is one that permits symptomatic control of excessive anxiety without impairment of mental and motor function. Exceptionally, it may be necessary to increase dosage to a maximum of 3 mg daily, given in divided doses.

Elderly and Debilitated Patients:
The initial dosage is 0.125 mg (125 mcg) 2 or 3 times daily. If necessary, this dosage may be increased gradually depending on patient tolerance and response.
Supplied
Xanax:
0.25 mg:
Each scored white, ovoid-shaped tablet, coded “Upjohn 29,” contains: Alprazolam 0.25 mg (250 mcg). Gluten-free. Bottles of 100 and 1000.

0.5 mg:
Each scored, peach, ovoid-shaped tablet, coded “Upjohn 55,” contains: Alprazolam 0.5 mg (500 mcg). Gluten-free. Bottles of 100 and 1000.

1 mg:
Each scored, lavender, ovoid-shaped tablet, coded “Upjohn 90″ contains: Alprazolam 1 mg (1000 mcg). Gluten-free. Bottles of 100.

Xanax TS:
2 mg:
Each white, triscored tablet (3 scores), with the number “2″ on one side and Xanax on the other side contains: Alprazolam 2 mg. The tablets can be broken into 4 equal parts of 0.5 mg. Bottles of 100. Tags:Buy xanax online no prescription