Alprazolam: uses and side effects of this anxiolytic

Probably many of the people who read this article will know or have heard of the drug to which it refers. And it is alprazolam, one of its best known trade names being Trankimazin, is one of the most common psychotropic drugs in the treatment of anxiety, one of the mental problems that occurs in the population with greater frequency.

Throughout this article we are going to see, among other aspects, what type of substance it is, its mechanism of action and some of its main uses.

• Related article: "Types of psychotropic drugs: uses and side effects"

Alprazolam: type of substance and main characteristics

Alprazolam is a drug with psychoactive properties or psychotropic drug that is classified as anxiolytics, substances used to treat anxiety and its manifestations. Among the anxiolytics, it is part of the benzodiazepines, these being one of the most popular types of psychotropic drugs and consumed by the population (being much safer, more effective and with fewer side effects than their predecessors the barbiturates).

In the specific case of alprazolam we are facing an intermediate-acting benzodiazepine, which means that it takes a shorter time to start working in the body compared to a long-acting one but at the same time that its effects last less time than these, and vice versa in the case that we compare it with one of action short.

Its duration is approximately between 12 and 24 hours. This duration of the effect is advantageous, since it generates a lower probability of dependence and addiction to the substance and fewer doses are necessary to cause a prolonged anxiolytic effect, in addition to making the medication not take too long to take effect.

• You may be interested: "Types of anxiolytics: drugs that fight anxiety"

Mechanism of action of this benzodiazepine

Like the rest of benzodiazepines, the main mechanism of action of alprazolam is based on its interaction with gamma-aminobutyric acid or GABA, one of the main inhibitory neurotransmitters of the central nervous system.

Alprazolam acts as an agonist of this neurotransmitter at GABA A receptors, favoring its action in such a way that the realization of action potentials on the part of the neurons. In other words, they make the neuronal activation of certain areas of the brain less. This action is carried out predominantly on the limbic system (highly activated in anxiety) and the cerebral cortex.

• Related article: "GABA (neurotransmitter): what it is and what role does it play in the brain"

Disorders and problems for which it is used

Alprazolam is an effective psychotropic drug for which multiple indications have been found, especially in the field of anxiety. Some of the best known and most common are the following.

1. Anxiety disorders

The main indication for alprazolam is its use in anxiety-type disorders. Among them we frequently find panic disorder (with or without agoraphobia) and generalized anxiety disorder.

• You may be interested: "Types of Anxiety Disorders and their characteristics"

2. Adaptive disorders

Adaptive disorders, those in which some type of symptomatology appears derived and explained by the experience of a specific event or psychosocial stress, they are also often treated with alprazolam and other benzodiazepines.

3. Depression

Although it is not its priority use, alprazolam has sometimes been used in depressive disorders, especially in those with high anxiety or with mixed symptoms anxious-depressive. However, this application must be valued and applied with great caution. in patients with suicidal ideations and severe depression, as it can enhance the symptoms.

• You may be interested: "Major depression: symptoms, causes and treatment"

4. Social phobia

One of the indications for alprazolam is found in patients who suffer from social phobia, helping to reduce the level of anxiety at the prospect of exposing themselves to other people.

5. Chemotherapy

Alprazolam has also been manifested useful in the treatment of discomfort and anxiety generated by chemotherapy in patients who must undergo it because of some type of tumor.

• Related article: "Benzodiazepines (psychotropic): uses, effects and risks"

Alprazolam side effects and risks

The use of alprazolam can be very useful in the treatment of diverse symptoms, especially with regard to anxiety. However, it is a psychotropic drug that can generate different adverse effects, so its use must always be indicated and supervised by the doctor.

Among them, the most common is the presence of drowsiness and sedation, occasionally along with headache and dizziness. Concentration and attention are diminished. Nausea and vomiting, fatigue, blurred vision, hypotension, urinary incontinence, tremors, or sexual disturbances may also occur. Much less common is the presence of adverse reactions such as increases in intraocular pressure, confusion, hallucinations, irritability, agitation or aggressiveness.

Another adverse effect to take into account is that the consumption of alprazolam and other benzodiazepines can generate specific memory problems, both retrograde and anterograde. It can cause difficulties when remembering previous information, or make it difficult to learn new information. It can also be found that suicidal ideations can sometimes appear. In rare cases, paradoxical reactions also appear, that is, reactions contrary to those expected after the administration of treatment (restlessness, anxiety, agitation, etc.).

In addition to these symptoms, it must be taken into account that benzodiazepines are substances with addictive potential, running the risk of acquiring dependence on them. In the case of alprazolam, this risk exists, although it is less than that of short-acting benzodiazepines. It is also essential to note that the use of psychotropic drugs should not be stopped suddenly, since there is the possibility of withdrawal syndrome or even rebound anxiety.

Similarly, there is a risk of overdose, which can lead to cardiorespiratory failure or arrest. These overdoses can sometimes be treated with flumazenil.

Contraindications

The use of alprazolam is not recommended for all types of patients, but there are circumstances that can make this psychotropic drug contraindicated. One of them occurs in patients with narrow-angle glaucoma, as well as in those subjects who suffer alterations in the respiratory tract or suffer from respiratory failure, as it can be dangerous for them. It is also contraindicated in myasthenia.

Similarly, it should not be consumed during pregnancy and lactation. in addition neither should those patients with kidney or liver failure take this drug, or the doses must be very regulated taking into account said insufficiency.

Bibliographic references:

• Gómez, M. (2012). Psychobiology. CEDE Preparation Manual PIR. 12. CEDE: Madrid
• Salazar, M.; Peralta, C.; Pastor, J. (2011). Manual of Psychopharmacology. Madrid, Editorial Médica Panamericana.
• Stevens, J.C. & Pollack, M.H. (2005). Benzodiazepines in clinical practice: consideration of their long-term use and alternative agents. J Clin Psychiatry; 66 (Suppl 2): ​​21-7.