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Alprazolam is a short acting benzodiazepine used for its anxiolytic effects to treat anxiety disorders. It is sold under several brand names such as Xanax, Xanor, Alplax, Tranquinal, Trankimazin, and Tafil.
Alprazolam has a calming effect, with potential side effects of drowsiness, clumsiness, fatigue, and headache. The drug can also have more severe side effects, such as blurred vision, slurred speech, and changes in normal behavior. The drug is habituating, and users develop a tolerance. Physical and psychological dependence after several months of alprazolam treatment is common. As a result, long-term alprazolam treatment cannot be abruptly terminated, but must instead be slowly reduced in dosage over a course of weeks (as is the case with many drugs operating on neurotransmitters). Abrupt cessation may cause rebound anxiety, insomnia, and seizures, among other symptoms.
For more long-term relief of anxiety, selective serotonin reuptake inhibitor medicines such as paroxetine, sertraline, or fluoxetine are often prescribed.
In the United States, the sale of alprazolam is regulated by the Food and Drug Administration, and requires a doctor's prescription. Internationally, alprazolam is a Schedule IV drug under the Convention on Psychotropic Substances[1].
Mechanism of action
Alprazolam is a triazolobenzodiazepine, that is, a benzodiazepine with a triazolo-ring attached to its structure. Alprazolam binds to the GABA receptor GABAA, causing a conformational change and thus increasing inhibitory effects of GABA. Unlike other benzodiazepines, alprazolam also has some antidepressant activity.
Pharmacokinetics
Alprazolam is readily absorbed from the gastrointestinal tract. The peak plasma concentration is achieved in 1-2 hours. Most of the drug is bound to plasma protein, mainly albumin. Alprazolam is hydroxylated in the liver to α-hydroxyalprazolam, which is also active. This and other metabolites are later excreted in urine as glucuronides. Some of alprazolam is also excreted in unchanged form.
Recreational use
As with all benzodiazepines, alprazolam offers relaxing sedative effects which many find suitable to recreational environments. The drug is almost always administered by ingestion, as alprazolam is a non-polar molecule and thus ineffective when "snorted" (insufflation). Oral ingestion results in decreased inhibition, decreased social anxiety, and a general feeling of well-being. It is often combined with other drugs such as alcohol, cannabis, and cocaine.
Alprazolam or similar benzodiazepines are also used on the come-down of certain drugs, such as the longer-lasting hallucinogens like LSD, and stimulants such as cocaine and methamphetamines, as it can allow an otherwise intoxicated person to relax at the end of the drug's effects and possibly fall asleep, which they would not be able to do otherwise. It is also occasionally taken, sometimes self-administered, during a dysphoric experience on hallucinogens such as LSD or psilocybin, because it will often tone down the experience, allowing the user to cope with a dysphoric hallucinogenic experience better.
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