Benzodiazepines alprazolam

If excessive noradrenergic transmission is a causal factor in anxiety, then it would be predicted that a lesion of central noradrenergic neurons would have an anti-anxiety effect in behavioural models of this condition. Unfortunately, the behavioural effects of such lesions are notoriously inconsistent and there are many reports of negative findings (e.g. Salmon, Tsaltas and Gray 1989). One study has even shown that a lesion of central noradrenergic neurons, induced by the selective neurotoxin, DSP-4, abolishes the anti-anxiety effects of tricyclic antidepressants and MAO inhibitors, but not those of the benzodiazepine, alprazolam, or the barbiturate, phenobarbitone (Fontana,... 

Benzodiazepines (alprazolam) COCs may inhibit oxidative metabolism Increase side effects of benzodiazepines... 

The answer is c. (tiardman, p 372. Katzung, p 375.) Compared with other benzodiazepines, alprazolam is selective for treating agoraphobia and panic disorders. 

Benzodiazepine Alprazolam Xanax Benzodiazepine receptor (GABAA) Klonopin "... 

Toyo oka T, Kumaki Y, Kanbori M, Kato M, Nakahara Y. 2003. Determination of hypnotic benzodiazepines (alprazolam, estrazolam, and midazolam) and their metabolites in rat hair and plasma by reversed-phase liquid-chromatography with electrospray ionization mass spectrometry. J Pharm Biomed Anal 30 1773. 

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. 

Early controlled studies demonstrated the effectiveness of irreversible MAOIs, particularly phenelzine and tranylcypromine, for generalized social anxiety disorder. Prior to the advent of the SSRIs, MAOis were considered the gold standard treatment for social anxiety disorder. The best studied of the MAOis, phenelzine, has proved snperior to both beta blockers and the benzodiazepine alprazolam in treating generalized social anxiety disorder. 

Benzodiazepines Alprazolam, midazolam, triazolam Ca channel plockers Diltiazem, felodipine, nimodip-ine, nifedipine, nisoldipine, verapamil... 

DeVane, C.L., Ware, M.R., and Lydiard, R.B. (1991) Pharmacokinetics, pharmacodynamics, and treatment issues of benzodiazepines alprazolam, adinazolam, and clonazepam. Psychophar-macol Bull 27 463-473. 

Benzodiazepine Alprazolam Clonazepam 0.25-6 mg/day 0.5-6 mg/day Reduces anxiety, insomnia little effect on core PTSD symptom clusters... 

Benzodiazepines are highly effective anxiolytics and sedatives. They also have muscle relaxant, amnestic, and anticonvulsant properties. Benzodiazepines effectively treat both acute and chronic generalized anxiety and panic disorder. The high-potency benzodiazepines alprazolam and clonazepam have received more attention as antipanic agents, but double-blind studies also have confirmed the efficacy of diazepam and lorazepam in the treatment of panic disorder. Although only a few benzodiazepines are specifically approved by the... 

Benzodiazepines alprazolam bromazepam clorazepate dipotassium diazepam... 

Alprazolam has caused a lower incidence of drowsiness, light-headedness and depression than diazepam. Alprazolam, like other benzodiazepines, has the potential for the development of tolerance and withdrawal symptoms, although the incidence is lower than that seen with other benzodiazepines. Alprazolam s potential for drug dependence is less in comparison to other benzodiazepines. 

FIGURE 6—17. The benzodiazepines alprazolam and triazolam are substrates for the enzyme CYP450 3A4. The nonpsychotropic drugs cisapride and astemazole are also substrates for 3A4. 

High-potency benzodiazepines (alprazolam, clonazepam) generally are more effective in panic disorder than low-potency benzodiazepines (diazepam, lorazepam, etc.). Although less research has been done on the low-potency benzodiazepines, it is generally accepted that they frequently result in sedation prior to adequately relieving panic attacks. The reader is referred to the discussion of benzodiazepines in Chapter 8 for a detailed overview of mechanism of action. A critique of the issues of benzodiazepine dependence and appropriate use is given in Chapter 13-... 

OFFICIAL NAMES Minor tranquilizers (sedative-hyp-notics/anxiolytics)/Benzodiazepines Alprazolam (Xanax) chlordiazepoxide (Librium, Novopoxide) clonazepam (Klonopin) clorazepate (Azene, Tranxene) diazepam (Valium) estazolam (ProSom) flunitrazepam (Rohypnol/illegal in the United States) flurazepam (Dalmane) halazepam (Paxipam) lorazepam (Ativan) midazolam (Versed) oxazepam (Serax) prazepam (Centrax) quazepam (Doral) temazepam (Restoril) triazolam (Halcion)... 

SSRIs and the benzodiazepine alprazolam are often used to treat panic disorder. Pharmacokinetic reactions between them could therefore be important. Alprazolam is metabolized by CYP3A4, which fluvoxamine inhibits (SEDA-22, 13). In 23 out-patients (11 men, 12 women, mean age 39 years) who took alprazolam both as monotherapy (mean dose 1.0 mg/day) and in combination with fluvoxamine (mean dose 34 mg/day), fluvoxamine increased plasma alprazolam concentrations by 58% (97). This was not associated with increased sleepiness, measured by a subjective rating scale, but objective measures of psychomotor function were not carried out and these could have been impaired by raised alprazolam concentrations. 

Alprazolam, a triazolobenzodiazepine, has been marketed as an anxiolytic with additional antidepressant properties an analogue, adinazolam, also has partial antidepressant activity (1) and is useful in panic disorder. Like other benzodiazepines, alprazolam is effective in acute and generalized anxiety its efficacy in panic disorder (2,3), premenstrual syndrome (4), and chronic pain (5) is complicated by high rates of adverse effects (6). On the other hand, low-dose alprazolam (1.4 mg/day) is useful and well tolerated in the treatment of anxiety associated with schizophrenia (SEDA-19, 34). 

In common with other benzodiazepines, alprazolam produces additional impairment of performance when it is taken together with alcohol (33). The combination can also produce behavioral disturbance and aggression (13,34). 

Pourbaix S, Desager JP, Hulhoven R, Smith RB, Harvengt C. Pharmacokinetic consequences of long term coadministration of cimetidine and triazolo-benzodiazepines, alprazolam and triazolam, in healthy subjects. Int J Clin Pharmacol Ther Toxicol 1985 23(8) 447-51. 

Benzodiazepines alprazolam, clonazepam, diazepam, midazolam, triazolam, zolpidem Calcium channel blockers diltiazem, nifedipine, nimodipine, verapamil Steroids androgens, estrogens, cortisol Others erythromycin, terfenadine, cyclosporine, dapsone, ketoconazole, lovastatin, lidocaine, alfentanil, amiodarone, astemizole, codeine, sildenafil... 

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