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Alprazolam, available under the trade name Xanax, is a potent, short-acting benzodiazepine anxiolytic—a minor tranquilizer. It is commonly used for the treatment of anxiety disorders, especially of panic disorder, but also in the treatment of generalized anxiety disorder (GAD) or social anxiety disorder.
In 2010 it was the 12th most prescribed medicine in the United States. Alprazolam, like other benzodiazepines, binds to specific sites on the GABAA receptor. It possesses anxiolytic, sedative, hypnotic, skeletal muscle relaxant, anticonvulsant, amnestic, and antidepressant properties. Alprazolam is available for oral administration as compressed tablets (CT), orally disintegrating tablet (ODT) and extended-release tablets (XR).
Greatest alleviation of generalized anxiety disorder (GAD) may take up to a week. It has been suggested that there is tolerance to the anxiolytic and antipanic effects of the drug, but not all authorities agree; tolerance will, however, develop to the sedative and hypnotic effects within a couple of days. Withdrawal symptoms or rebound symptoms may occur after ceasing treatment abruptly following a few weeks or longer of steady dosing, and may necessitate a gradual dose reduction. Other risks include increased rates of suicide, possibly due to disinhibition.
Alprazolam was first released by Upjohn (now a part of Pfizer) in 1981. The first approved use was of panic disorder, and within two years of its original marketing, Xanax became a blockbuster drug in the US. As of 2010, alprazolam is the most prescribed and the most misused benzodiazepine in the US. The potential for misuse among those taking it for medical reasons is controversial, with some expert reviews stating that the risk is low and similar to that of other benzodiazepine drugs. Others state that there is a substantial risk of misuse and dependence in both patients and non-medical users and that the high affinity binding, high potency, short elimination half-life, and rapid onset of action may increase the misuse potential of alprazolam. Compared to the large number of prescriptions, relatively few individuals increase their dose on their own initiative or engage in drug-seeking behavior. Alprazolam is classified as a Schedule IV controlled substance by the U.S. Drug Enforcement Administration (DEA).
Xanax has gained attention by the media as young people have been buying it on the Internet illegally. Most people who have bought it have been in their 20s or 30s.