Alprazolam is a drug that belongs to the benzodiazepine family and is used for the treatment of anxiety states, especially in panic attacks, agoraphobia, panic attacks and intense stress.
It is sold under a generic name or under different trade names depending on the country, all with identical effects, only practically changing the excipient or the design of the pill/tablet.
It has a hypnotic effect (promoting sleep in the short term) and works by decreasing the excitement of the brain.
Alprazolam has sedative, hypnotic, and anticonvulsant properties,
but the most notable effect is anxiolytic. However,
due to its addictive potential and the development of tolerance after a relatively short period of a few weeks,
its administration is recommended only in short-term treatments.
What is anxiety?
Occasional anxiety is a normal part of life. However, those suffering from anxiety disorder have intense,
excessive and persistent fears very frequently in everyday situations.
Frequently, in anxiety disorders, there are repeated episodes of sudden feelings of intense anxiety
and fear or terror that peak in a matter of minutes (panic attacks).
Feelings of panic and anxiety are sometimes very difficult to control as they are disproportionate to reality
and can last a long time, leading to interference with daily activities.
Agoraphobia belongs to the spectrum of anxiety disorders and consists of the fear of places and situations
capable of generating panic or the feeling of being trapped, ashamed or defenceless.
Panic disorder consists of several episodes of unexpected feelings of very intense anxiety or
fear that can reach very high levels in a matter of minutes (panic attacks).
The person may experience sensations of catastrophe, dyspnea, chest pain,
or heart palpitations. Once these attacks happen,
the patient will cause the person to worry and watch for them to happen one more time and will try to avoid
the situations in which they have happened previously.
Main uses of Xanax
The fundamental indication for Xanax is in anxiety-type disorders.
Among these disorders, we can highlight panic disorder with or without agoraphobia and generalized anxiety disorder.
Adaptive disorders are those in which some type of derived and explicable symptoms appear
from the experience of a specific event or psychosocial stress, are also often treated with alprazolam
and other benzodiazepines.
This is not a formal indication. However,
Xanax has been used in depressive disorders that are associated with anxiety disorders.
However, this application should be evaluated and applied with great caution in patients with
suicidal ideations and severe depression, as it can potentially enhance symptoms.
One of the indications for alprazolam is found in patients with social phobia,
helping to reduce the level of anxiety at the prospect of being exposed to other people.
Alprazolam has also been shown to be useful in treating the discomfort and
anxiety generated by chemotherapy in patients who must undergo it due to some type of tumour.
Background and history
Let’s go back to the 1960s for a moment. Psychiatric treatments were the new norm and the new fashion of the day.
Everyone was talking about it, and many were undergoing such treatments. It was the mainstream thing to do at that point.
Researchers decided to develop ways to help people who were suffering from insomnia,
mostly due to anxiety as the main cause.
That’s when Dr Leo Sternbach created benzodiazepine (which was Librium) in 1956. His goal was simple for the public to understand: to create a safer,
theoretically less addictive alternative to traditional tranquilisers of the time such as barbiturates.
Dr Sternbach is credited with creating Klonopin, Valium and other drugs of a similar nature.
The first patent for alprazolam was approved and granted during the ’70s.
It was developed by J.B. Hester at the former Upjohn Company laboratories (which later became part of Pfizer Inc).
Alprazolam, the generic name for the later Xanax,
was first made with the idea of aiding sleep as well as acting as a muscle relaxer.
By the 1970s, the most famous prescription drug in the United States was Valium,
and Alprazolam was following the heels of it. Although Valium was very popular,
it was not patented for the treatment of anxiety and panic.
That’s when the creators of the early Xanax found an opportunity to market it.
It was launched by Upjohn company in 1981;
perfect timing as the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III),
published by the American Psychiatric Association in 1980 had included anxiety disorders in the clinical category.
The FDA approved the drug in 1981. The patent came just before the Valium patent was about to expire.
Dr David Sheehan was one of the first researchers to demonstrate this drug’s effectiveness in treating panic disorders,
anxiety and so on. In fact, its effects are known to be rapid as well as not lose effectiveness over time.
After its first two years on the market, Xanax had become the new antidote of the day in the United States.
Characteristics of Xanax
Alprazolam is a drug with psychoactive or psychotropic properties that is classified within anxiolytics, substances used to treat anxiety and its manifestations. Among the anxiolytics, it is part of the benzodiazepines, these are one of the most popular types of psychoactive drugs and consumed by the population (being much safer, more effective and with fewer side effects than their predecessors, barbiturates).
In the same way as the rest of the benzodiazepines, the mechanism of action of Xanax consists of its interaction with GABA,
one of the most important neurotransmitters for the inhibition of the central nervous system.
Xanax acts by stimulating positively on GABA A receptors, thus favouring the inhibition of action potentials in neurons.
In other words, it reduces the activity of neurons in certain parts of the brain.
This activity is completed dominatingly on the limbic system (profoundly activated in anxiety) and the cerebral cortex.
In the specific case of alprazolam, we are dealing with an intermediate-acting benzodiazepine, which implies that it takes a shorter time to start to take effect in the body compared to a long-acting one,
but at the same time that its effects last for less time than these.
and vice versa in the case that we compare it with a short-acting one.
Its effect lasts between 12 and 24 hours approximately.
This represents a great advantage since the probabilities of dependence and addiction to the drug are reduced.
So small doses are necessary to achieve a longer effect, without the need for it to take too long to take effect.