Indications
Therapeutic Class
Pharmacology
Alprazolam binds with high affinity to the GABA benzodiazepine receptor complex. Considerable evidence suggests that the central pharmacologic or therapeutic actions of alprazolam are mediated via interaction with this receptor complex.
Alprazolam, a benzodiazepine, bind nonspecifically to benzodiazepine receptors BNZ1, which mediates sleep, and BNZ2, which affects muscle relaxation, anticonvulsant activity, motor coordination, and memory. As benzodiazepine receptors are thought to be coupled to gamma-aminobutyric acid-A (GABAA) receptors, this enhances the effects of GABA by increasing GABA affinity for the GABA receptor. Binding of the inhibitory neurotransmitter GABA to the site opens the chloride channel, resulting in a hyperpolarized cell membrane that prevents further excitation of the cell.
Dosage & Administration
Must be individualized and carefully titrated in order to avoid excessive sedation or mental and motor impairment.
For Adults:Â Initially 0.25 mg given 2 or 3 times daily. If required, increases may be made in 0.25 mg increments according to the severity of symptoms and patient response.
It is recommended that the evening dose should be increased before the daytime doses. Very severe manifestations of anxiety may require larger initial daily doses. The optimal dosage is one that permits symptomatic control of excessive anxiety without impairment of mental and motor function. Exceptionally, it may be necessary to increase dosage to a maximum of 3 mg daily, given in divided doses.
For Elderly and Debilitated Patients:Â The initial dosage is 0.125 mg 2 or 3 times daily. If necessary, this dosage may be increased gradually depending on patient tolerance and response.
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