Modafinil Alprazolam

Substance-Induced Anxiety Disorder. Numerous medicines and drugs of abuse can produce panic attacks. Panic attacks can be triggered by central nervous system stimulants such as cocaine, methamphetamine, caffeine, over-the-counter herbal stimulants such as ephedra, or any of the medications commonly used to treat narcolepsy and ADHD, including psychostimulants and modafinil. Thyroid supplementation with thyroxine (Synthroid) or triiodothyronine (Cytomel) can rarely produce panic attacks. Abrupt withdrawal from central nervous system depressants such as alcohol, barbiturates, and benzodiazepines can cause panic attacks as well. This can be especially problematic with short-acting benzodiazepines such as alprazolam (Xanax), which is an effective treatment for panic disorder but which has been associated with between dose withdrawal symptoms. 

Schedule IV (examples alprazolam, phenobarbital, meprobamate, modafinil) ... 

Modafinil reduces triazolam levels. It may therefore also affect the metabolism of other similarly metabolised benzodiazepines such as alprazolam and midazolam. Conversely, modafinil might increase diazepam levels. 

Modafinil is known to induce the cytochrome P450 isoenzyme CYP3A4, by which triazolam is metabolised, and it is therefore likely to reduce triazolam levels by this mechanism. It seems possible that other benzodiazepines metabolised by CYP3A4 (alprazolam, midazolam) may be similarly affected. It would therefore seem prudent to monitor for a reduction in the sedative effects and a reduced duration of action of these benzodiazepines in patients taking modafinil increase the dose if necessary. ... 

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See also in sourсe #XX -- [ ]

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