Alprazolam or Trankimazin, Facts and Curiosities

Alprazolam is an anxiolytic, hypnotic muscle relaxant, and anticonvulsant. It also has specific activity in panic attacks.

Alprazolam or Trankimazin is used for anxiety, one of the most frequent mental problems in society. Let’s get to know it in depth.

Main characteristics and indications

Alprazolam is an immediate-acting benzodiazepine, which means that it takes less time than others to take effect in the body, although its effects are maintained for less time as well. Because of this, it creates less probability of dependence and addiction.

It has psychoactive properties (chemical substances of natural or synthetic origin that affect the functions of the central nervous system, that is, the brain and spinal cord) and is classified as anxiolytic, being used to treat anxiety and its manifestations, such as panic or depression, fear of open spaces and also PMS.

Mechanism of action

It exerts its effect by interacting with gamma-aminobutyric acid (GABA), one of the main inhibitory neurotransmitters of the central nervous system. Therefore, it works by decreasing abnormal arousal in the brain.

It’s an anxiolytic, hypnotic muscle relaxant and anticonvulsant. It also has specific activity in panic attacks.

Contraindications of alprazolam or trankimazin

Alprazolam can’t be used in:

• Cases of hypersensitivity to it or to benzodiazepines.
• Myasthenia gravis: an autoimmune neuromuscular disease in which muscle weakness stands out.
• Severe respiratory failure.
• Sleep apnea syndrome: a disorder in which breathing is interrupted or very shallow.
• Narrow-angle glaucoma.
• Severe liver failure, due to the associated risk of presenting encephalopathy.
• Acute intoxication by alcohol or other active agents on the central nervous system.

In nursing mothers, the use of alprazolam is contraindicated, despite the fact that the levels excreted in breast milk are low.

Warnings and cautions

It can produce tolerance, physical and mental dependence, rebound insomnia and anxiety, as well as inducing memory loss or producing psychiatric and paradoxical reactions, especially in children and the elderly.

It isn’t recommended as a first-line treatment for psychotic illness, nor is it recommended to use it only for anxiety associated with depression, due to the risk of suicide.

Caution should be exercised in patients with panic disorders treated with high doses of alprazolam, if they have severe depression, or suicidal thoughts. It can’t be given to children under 18 years of age.

In the elderly and in patients with kidney failure, lower doses should be used due to the associated risk of respiratory depression. It can also increase plasma concentrations of digoxin in the elderly.

Alprazolam or trankimazin interactions

You can experience

• A sedative effect enhanced by alcohol
• A depressant effect on the central nervous system enhanced by antipsychotics or neuroleptics, hypnotics, anxiolytics, sedatives, liver enzyme inhibitors, narcotic analgesics.

When combining it with other medications, some points should be taken into account:

• It can’t be co-administered with azole antifungals.
• The dose must be reduced when taking nefazodone, fluvoxamine, and cimetidine.
• Caution is necessary when administering alprazolam with fluoxetine, dextropropoxyphene, oral contraceptives, diltiazem, or macrolides.
• The dose must be adjusted or treatment with ritonavir must be discontinued.

If used in late pregnancy, or in high doses during birth, hypothermia, hypotonia, moderate respiratory depression and withdrawal syndrome may appear in the newborn baby.

Effects on the ability to drive

Depending on the dose and the individual sensitivity, alprazolam may decrease attention, alter the ability to react, alter muscle function, and cause drowsiness, partial or complete loss of memory or sedation, especially at the beginning of treatment or after an increase. of the dose.

It isn’t advisable to drive vehicles or operate machinery that require special attention or concentration until it’s verified that the ability to carry out these activities isn’t affected.

Adverse reactions of alprazolam

Alprazolam can produce some adverse reactions, such as:

• Depression
• Sedation
• Drowsiness
• Headache
• Dizziness
• Ataxia
• Memory impairment
• Dysarthria
• Constipation
• Dry mouth
• Fatigue
• Irritability

Overdose

If the patient is conscious it will be necessary to perform a gastric lavage, within one hour after overdosing. If the patient is unconscious, a gastric lavage must also be performed, but keeping the airway clear. If gastric emptying doesn’t achieve anything, it will be necessary to administer activated charcoal to reduce absorption.

Flumazenil, which is an antagonist of benzodiazepine receptors, can be used as an antagonist or antidote.

The symptoms of overdose are usually:

• Drowsiness
• Dysarthria: Difficulty in articulating sounds and words, caused by the paralysis or ataxia of the nerve centers that govern the organs responsible for generating and amplifying the sound produced when speaking.
• Coordination disorders.
• Confusion
• Lethargy: Prolonged drowsiness caused by certain diseases.
• Hypotonia: Decreased muscle tension or tone, or organ tone.
• Hypotension, respiratory depression, coma (rarely) and death (very rarely).