ALPROBEST 0.5MG TAB

• Enhances GABA-A receptor activity, producing anxiolysis usually within an hour of a dose.
• The higher strength suits patients whose symptoms are inadequately controlled at 0.25 mg, or those in whom panic disorder requires a larger dose.
• Effective in panic disorder, reducing both the frequency and severity of attacks while a longer-term treatment takes effect.
• Provides short-term cover during the initiation of an SSRI or of psychological therapy.
• Relieves the physical symptoms of anxiety — tension, restlessness, palpitations — as well as the psychological ones.

Not everyone gets these. Most are mild and settle as the course finishes.

• Alprazolam carries a real risk of tolerance, dependence and withdrawal. Prescribe for the shortest period possible — generally two to four weeks including tapering — and review at every visit.
• Never stop abruptly after regular use. Withdrawal can cause rebound anxiety, insomnia, tremor and seizures; taper under supervision.
• Contraindicated in myasthenia gravis, severe respiratory insufficiency, sleep apnoea syndrome, severe hepatic impairment and narrow-angle glaucoma.
• Combining with opioids causes profound sedation and respiratory depression and can be fatal. Avoid; if unavoidable, use the lowest doses with close monitoring.
• Avoid alcohol entirely during treatment.
• Causes drowsiness and impairs reaction time. The patient must not drive or operate machinery until the effect is known.
• Contraindicated in pregnancy and breastfeeding.
• Start at a lower strength in the elderly, in hepatic impairment and in the benzodiazepine-naive, and use with caution in any history of substance misuse.