Alprazolam long-term effects

Kilic C, Curran HV, Noshirvani H, Marks IM, Basoglu M. Long-term effects of alprazolam on memory a 3.5 year follow-up of agoraphobia/panic patients Psychol Med 1999 29(1) 225-31. 

Long-term effects of alprazolam in children/adolescents are unknown... 

Walker BM, Ettenberg A The effects of alprazolam on conditioned place preferences produced by intravenous heroin. Pharmacol Biochem Behav 75 75 80, 2003 Weens EM, Griffiths RR Zolpidem self-injection with concurrent physical dependence under conditions of long-term continuous availability in baboons. Behav Pharmacol 9 285—297, 1998... 

Benzodiazepines. The best studied of the benzodiazepines for social anxiety disorder, clonazepam has been demonstrated in controlled trials to be effective during both acute treatment (at an average dose of 2.4mg/day) and long-term maintenance therapy lasting up to 2 years. A controlled study of another high potency benzodiazepine, alprazolam, also proved effective, though it was outperformed by the MAOI antidepressant phenelzine and exhibited response rates lower than those reported with clonazepam. 

Benzodiazepines. Longer-acting clonazepam and shorter-acting alprazolam have also been used in the treatment of social anxiety disorder, and controlled trials have shown them to be quite effective. In our experience, alprazolam is best suited for discrete periods of intermittent anxiety, though both clonazepam and the new long-acting alprazolam (Xanax XR) are likely effective for long-term treatment. 

The speciflc clinical use of the numerous available benzodiazepines depends on their individual pharmacokinetic and pharmacodynamic properties. Drugs with a high affinity for the GABAa receptor (alprazolam, clonazepam, lorazepam) have high anxiolytic efficacy drugs with a short duration of action (temazepam) are used as hypnotics to minimise daytime sedative effects. Diazepam has a long half-life and duration of action and may be favoured for long-term use or when there is a history of withdrawal problems oxazepam has a slow onset of action and may be less susceptible to abuse. 

A second issue relating to long-term medication is the effect of withdrawing medication at the end of a period of treatment. Benzodiazepines are associated with discontinuation symptoms, and their repeated use may foster the development of true physiological dependence. In a study of discontinuation of treatment for panic disorder [Rickels et al. 1993) with either alprazolam [n = 27), imipramine [n = 11) or placebo [n = 10), a withdrawal syndrome was observed in almost all patients treated with alprazolam but in few pa-... 

Charney DS, Heninger GR. Noradrenergic function and the mechanism of action of antianxiety treatment. I. The effect of long-term alprazolam treatment. Arch Gen Psychiatry 1985 42 458-467. 

The use of benzodiazepines with carbamazepine is common, although some evidence suggests that the effects of the benzodiazepines are sometimes reduced. Levels of alprazolam were reduced by almost 50% and levels of midazolam were markedly reduced and its effects almost abolished by carbamazepine. Single-dose studies have shown that the sedative effects of zopiclone and carbamazepine are additive, however it has been predicted that when taken long-term carbamazepine will reduce the effects of zopiclone. 

St John s wort decreases the plasma levels of quazepam, although this did not reduce its effects in one study. Alprazolam appears not to interact, although this needs confirmation. The bioavailability of midazolam was reduced by long-term but not single doses of St John s wort... 

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