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Alprazolam is one of the most widely prescribed benzodiazepines for the treatment of generalized anxiety disorder and panic disorder. Its clinical use has been a point of contention as most addiction specialists consider it to be highly addictive, given its unique psychodynamic properties which limit its clinical usefulness, whereas many primary care physicians continue to prescribe it for longer periods than recommended. Clinical research data has not fully shed light on its “abuse liability,” yet it is one of the most frequently prescribed benzodiazepines. “Abuse liability” is the degree to which a psychoactive drug has properties that facilitate people misusing it, or becoming addicted to it, and is commonly used in the literature. We have replaced it in our manuscript with “misuse liability” as it reflects a more updated terminology consistent with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In this paper, we have reviewed alprazolam’s indications for use, its effect on pregnant women, misuse liability, withdrawal syndrome, pharmacodynamic properties, and suggest better clinical prescription practice of alprazolam by presenting an indepth theory of its clinical effects with use and withdrawal. Buy Kalma Alprazolam 2mg online in New Zealand and Australia

Alprazolam is not only the most commonly prescribed benzodiazepine, but it is the most commonly prescribed psychotropic medication in the United States, accounting for more than 48 million prescriptions dispensed in 2013 (Grohol, 2016). This persists despite the fact that many prescribers consider alprazolam to have high misuse liability and it is shown to result in a more severe withdrawal syndrome than other benzodiazepines, even when tapered according to manufacturer guidelines (Browne and Hauge, 1986; Kantor, 1986). Based on national emergency department (ED) visit data, alprazolam is the second most common prescription medication and the most common benzodiazepine to be involved in ED visits related to drug misuse (SAMHSA, 2013). Buy Alprazolam 2mg online Canada-Alprazolam 2mg for sale Canada

Benzodiazepines are implicated in approximately one-third of intentional overdoses or suicide attempts (Henderson et al., 1993). A database review of poisoning admissions to a regional toxicology service revealed that when alprazolam was involved, the median length of stay (LOS) was 19 hours, which was 1.27 (95% confidence interval [CI] 1.04, 1.54) times longer compared with other benzodiazepines, and patients were 2.06 (95% CI 1.27, 3.33) times more likely to be admitted to the intensive care unit (ICU) compared with other benzodiazepines after multivariate analysis adjusting for age, dose, sex, time to ingestion, and co-ingested drugs (Isbister et al., 2004). In a longitudinal cohort study between July 1, 2011, and June 30, 2012, more than half of the patients who visited hospital and “community practice-based research network” received benzodiazepine prescriptions at least once from their primary care physician (PCP). Those clinicians were found to prescribe benzodiazepines disproportionately to patients with at least some known risk factors for benzodiazepine-related adverse events including increased age, pulmonary diseases, and other substance use disorders (Kroll et al., 2016). Buy Kalma Alprazolam 2mg online in New Zealand and Australia

INDICATIONS FOR USE AND EFFICACY

Alprazolam is a high-potency triazolobenzodiazepine that is US Food and Drug Administration (FDA)-approved for the treatment of anxiety and panic disorders. Alprazolam is biotransformed by hepatic microsomal oxidation, yielding 4 and α-hydroxyalprazolam as its principal metabolites, and is metabolized by cytochrome P450 (CYP) 3A4 (Greenblatt and Wright, 1993). Buy Kalma Alprazolam 2mg online in New Zealand and Australia

The US FDA’s approval for alprazolam came after 2 large, randomized, clinical trials that demonstrated short-term efficacy and clinically acceptable tolerability versus placebo (Ballenger et al., 1988; Klerman, 1988). A plasma concentration range between 20 and 40 ng/mL has been suggested for targeting symptoms of panic disorder, with higher concentrations being associated with more significant central nervous system depressant effects. The side effects of alprazolam tablets are likely to be an extension of its pharmacological activity, and most commonly include drowsiness, dizziness, fatigue, dysarthria, headache, memory impairment, and depression. Buy Kalma Alprazolam 2mg online in New Zealand and Australia