What is Xanax used for
What is Xanax used for?
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Xanax is converted through the liver by hepatic microsomal oxidation, yielding hydroxyalprazolam, and is metabolized by cytochrome P450 (CYP) 3A4.
The FDA’s approval for Xanax depended on two large, randomized, clinical trials that analyzed the efficacy and tolerability of Xanax versus placebo (no_effect drug).
For targeting symptoms of panic disorder, the plasma concentration of Xanax should range between 20 and 40 ng/mL, as higher concentrations are associated with more central nervous system CNS depressant effects.
The most common side effects of Xanax include depression, dizziness, fatigue, drowsiness, headache, memory impairment, and dysarthria.
In a review of Xanax efficacy as monotherapy for the treatment of depression, anxiety, and panic disorder, 84 studies of Xanax have been reviewed versus other drugs and/or placebo and it was found that Xanax was superior to placebo and as effective or superior to all comparator benzodiazepines, including lorazepam, diazepam, and bromazepam and all comparator antidepressants, including dothiepin, imipramine, amitriptyline, and buspirone for the treatment of anxiety disorder.
The review found that the onset of the action of Xanax was significantly more rapid compared with amitriptyline, propranolol, and imipramine.
However, a meta-analysis of randomized controlled trials comparing Xanax with other benzodiazepines as antipanic agents found no significant difference in clinical efficacy if compared with other agents.
About the overdose, the studies found that Xanax is relatively more toxic than other benzodiazepines.
The antidepressant Xanax has not been systematically evaluated so its use as an antidepressant is still off-label. In a review of 25 studies included 2643 participants, Xanax was found to be superior to placebo, and as effective as all comparator antidepressants including doxepin, imipramine, amitriptyline, desipramine, clomipramine, and dothiepin for the treatment of neurotic and moderate depression, whereas the other antidepressants were perhaps superior to Xanax for the treatment of severe depression.
“neurotic depression” was defined as depressive symptoms associated with major personality disorders. According to the review, data collected from several studies concluded that the onset of antidepressant effect was significantly more rapid for Xanax compared with the other antidepressants, and Xanax was just as well-tolerated as all comparator medications.
A Cochrane review of Xanax’s efficacy as antidepressant monotherapy evaluated 21 more recent randomized controlled trials and found that Xanax was superior to placebo and as effective as the tricyclic antidepressants, including dothiepin, desipramine, amitriptyline, doxepin, and imipramine. However, this review included heterogeneous, or poor-quality studies and only pointed to the short-term effects, thus the conclusion was not significantly confirmed.
The clinical trials involved Xanax didn’t include any comparison between the newer antidepressant drugs called selective serotonin reuptake inhibitors SSRIs However, while the available data show that Xanax monotherapy is as effective as other benzodiazepines for the treatment of anxiety and panic disorders, this must be weight with its propensity for dependence, tolerance, and rebound anxiety.
What is Xanax used for? And how much do you need from it?
1- Anxiety: (monotherapy or adjunctive therapy): start with 0.25g three times daily, increase the dose according to efficacy and tolerability by less than or equal to 1mg by day at intervals ≥3 days to reach a usual dose of 2 to 6 mg/day in 3 to 4 divided doses. The dose may reach 8 mg/day for an optimal response the maximum dose is 10 mg/day. Increase the dose slowly with doses >4 mg/day to minimize the chance of adverse effects, periodically reassess and consider dosage reduction.
Xanax should only be used for a short term until the main therapy becomes effective. The duration should not exceed 12 weeks. Long-term, low-dose therapy (eg, 2 mg/day) can be an option for patients not controlled on other treatments or with patients who cannot tolerate other treatments well. Benzodiazepines may worsen symptoms in patients suffering from posttraumatic stress disorder PSD.
2- Procedural anxiety: Xanax can be used as a premedication before general anesthesia, a dose of 0.5 mg can be used 30 to 90 minutes before the procedure and may be repeated after 30 to 60 minutes.
3-Vertigo as an alternative agent in acute episodes and only reserved for those lasting several hours to days.
Discontinuation of Xanax:
Gradually withdraw the high doses of benzodiazepines to minimize the rebound symptoms of withdrawal.
The optimal tapering plan will vary from person to person but you can taper the total daily dose by 10% to 25% every 1 to 2 weeks based on response and tolerability.
The tapering period may last for more than 6 months.
For patients on high doses, you can taper rapidly in the beginning and slow the reduction rate over time.
This was a brief about what Xanax is used for And it’s clinical uses it.