The action of the anxiolytic Xanax® is aimed at inhibiting the state of excitation of the neurons which may be the basis of the pathological state; in fact they act by stimulating the γ-aminobutyric acid system, called GABA, which is the main inhibitory neurotransmitter in mammals, giving the drug anxiolytic, hypnotic and sedative properties.
Xanax is metabolized in the liver and eliminated by urinary excretion in the majority, in a minor part by the fecal route
The dosage of Xanax® must be modulated according to the severity of the symptoms; you start with a low dosage and then increase it if the therapy does not have the desired effects. Dosage variations must be gradual and controlled; particular attention should be paid to elderly or debilitated patients in whom the risk of overdose is greater, to avoid complications related to residual sedation.
The Benzodiazepines are drugs that can cause physical and psychological dependence, which is why it is important:
- Carefully and periodically assess the need for therapy
- Discontinue therapy gradually to avoid abrupt terminations that can lead to withdrawal symptoms, such as headache, muscle aches, tension, confusion, irritability, extreme anxiety
The initial dose can vary from 0.25 to 0.50 mg 3 times/day, a dosage that can be increased up to a maximum of 4 mg per day, for a period between 8 and 12 weeks, to be reshaped according to the clinical condition of the patient.
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When Xanax is contraindicated
Xanax - alprazolam is contraindicated in patients with known hypersensitivity to benzodiazepines, myasthenia gravis, respiratory failure, severe syndrome, sleep apnea, liver failure severe.
Xanax can produce depressive effects on the central nervous system (CNS) when administered concomitantly with opioids, alcohol or other drugs that act on the CNS such as neuroleptics, hypnotics, antidepressants, antiepileptics.
The resulting effects can lead to severe respiratory depression, coma, and even death.
Side effects of Xanax
Physical/psychic dependence, retrograde amnesia, depression, psychiatric and paradoxical reactions (restlessness, agitation, irritability, nightmares, hallucinations, psychosis, behavioral changes).
Overdose: Increased drug activity including somnolence, dysarthria, poor motor coordination, coma, and respiratory depression. In the event of an overdose, it is important to support respiratory and cardiovascular functions.
It may be necessary to empty the stomach within the first hour after intake by stimulating vomiting in conscious and cooperating patients, while with mechanical gastric lavage and protection of the airways in unconscious and uncooperative patients.
Also commercially available is the antidote Flumazenil , which can be administered in acute intoxication to antagonize the binding of benzodiazepines to the GABA receptor.