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Anxiety, as well as fear, is a normal reaction in everyday life to a dangerous or tense situation. However, it is considered inadequate if anxiety manifests itself regularly and with great intensity - this indicates mental illness or physical illness.
Panic attack - inexplicable, painful for the patient, attack of severe anxiety, accompanied by unreasonable fear, in combination with various vegetative (somatic) symptoms. The most effective drug to treat anxiety and panic attacks is xanax.
Xanax (alpazolam) is a drug, an anxiolytic (anti-anxiety agent), a benzodiazepine derivative of medium duration, which is used to treat panic disorders, anxiety neuroses, such as anxiety disorder or social phobia.
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Alprazolam has anxiolytic, central muscle relaxant, anticonvulsant, sedative-hypnotic and anti-panic effect. It has a depressant effect on the central nervous system, which is realized mainly in the thalamus, hypothalamus and limbic system. Enhances the inhibitory effect of gamma-aminobutyric acid, which is one of the main mediators of pre- and postsynaptic inhibition of the transmission of nerve impulses in the central nervous system.
The mechanism of action of alprazolam is determined by stimulation of the benzodiazepine receptors of the supramolecular gamma-aminobutyric acid-benzodiazepine-chlorionophore prescription complex, leading to activation of the gamma-aminobutyric acid receptor, causing a decrease in the excitability of the subcortical brain structures, inhibition of polysynaptic spinal reflexes Anxiolytic effect is manifested in the reduction of emotional stress, easing the symptoms of anxiety, fear.
Pronounced anxiolytic activity is combined with moderate hypnotic effects; shortens the period of sleep, increases the duration of sleep, reduces the number of night awakenings. The mechanism of hypnotic action is the inhibition of the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that violate the mechanism of sleep. Virtually no effect on the cardiovascular and respiratory system.
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Treatment of neurotic and neurosis-like disorders with manifestation of anxiety, incl. associated with depression. Panic disorders.
Hypersensitivity to alprazolam or other benzodiazepines. Coma, shock, angle-closure glaucoma, myasthenia gravis, acute poisoning by alcohol, narcotic drugs, sleeping pills and psychotropic drugs; severe course of chronic obstructive pulmonary diseases, severe depression (suicide attempts), sleep apnea syndrome, marked impaired renal and liver function, pregnancy (especially I trimester), breastfeeding period.
With care, cerebral and spinal ataxia, drug dependence in history, susceptibility to psychotropic drugs, hyperkinesis, organic brain diseases, psychosis (paradoxical reactions are possible), hypoproteinemia, old age.
Drowsiness, fatigue, dizziness, unsteadiness of gait, slowing down of mental and motor reactions, decreased concentration, nausea, constipation, dysmenorrhea, decreased libido, pruritus, paradoxical reactions (aggression, agitation, irritability, anxiety, hallucinations), addiction, drug dependence, withdrawal syndrome.
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It should be borne in mind that anxiety or stress associated with everyday stress usually do not require treatment with anxiolytics. In the event of a paradoxical reaction, it is necessary to stop taking the drug. During treatment, the use of alcoholic beverages is unacceptable. Use with caution while working drivers of vehicles and people whose profession is associated with increased concentration of attention.
Alprazolam enhances the action of other psychotropic drugs, anticonvulsants and antihistamines, ethanol and drugs that have a depressant effect on the central nervous system. Inhibitors of microsomal oxidation - increase the risk of toxic effects. Inductors of liver microsomal enzymes - reduce the effectiveness of alprazolam. Antihypertensive drugs may increase the severity of blood pressure reduction. With simultaneous appointment with clozapine may increase respiratory depression. Reduces the effectiveness of levodopa in patients with parkinsonism. Increased toxicity of zidovudine is potentially possible.
Alprazolam at a dose of 4 mg / day increases plasma concentrations of imipramine and desipramine (by 31% and 20%, respectively), while taking it simultaneously. The metabolic clearance of alprazolam is reduced while taking the usual therapeutic doses of cimetidine and macrolide antibiotics. Care should be taken to consider reducing the dose of alprazolam when it is taken with cimetidine, macrolides, nefazodone, fluvoxamine, fluoxetine, propoxyphene, sertraline, daltiazem, digoxin and oral contraceptives.
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Inside, 2-3 times a day, regardless of the meal. The dose of the drug is selected individually and is corrected in the course of treatment, depending on the effect and individual tolerance. The use of minimal effective doses is recommended. In case of anxiety, the initial dose is 0.25-0.5 mg three times a day. If necessary, this dose can be increased to 4 mg / day (divided into several doses).
In old age, the initial dose is 0.25 mg 2-3 times a day. For depression-related anxiety, the initial dose is 0.5 mg three times a day. If necessary, the dose is increased to 4.5 mg / day. An initial dose may be given at bedtime to minimize daytime sleepiness. The duration of treatment is 4-12 weeks. Discontinuation of the drug should be done with great caution. The dose should be reduced gradually and slowly, no more than 0.5-1 mg at bedtime or 0.5 mg three times a day. For most patients, a sufficient dose is 4-6 mg / day for 4-12 weeks. In some cases, if necessary, the dose can be increased up to 10 mg / day (but not more than 1 mg every 3-4 days), and the duration of treatment up to eight months. In the treatment of elderly and debilitated patients, smaller doses should be used: the initial dose is 0.25 mg 2-3 times a day, if necessary, and well tolerated, it is gradually increased to 0.5-0.75 mg / day.
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