alprazolam / Generic mfg. - LARVOL DELTA

Clinical and etiological characteristics of catatonic disorder due to another medical condition: A retrospective study from a tertiary care center. (PubMed, Clin Neurol Neurosurg) - "Catatonic disorder due to another medical condition appears to present with diverse underlying causes and clinical manifestations. Although benzodiazepines are generally considered the first-line treatment, additional interventions were often needed. These findings underline the importance of clinical awareness and timely management, while further research is required to better understand prognostic factors and to guide treatment strategies."

Journal • Retrospective data • CNS Disorders • Immunology

Stability of 22 Sedative-Type Drugs and Metabolites in Human Urine under Variable pH, Temperature, and Freeze-Thaw Conditions. (PubMed, J Anal Toxicol) - "While compounds such as midazolam, clobazam, and zolpidem remained highly stable, others-including alprazolam, triazolam, and lorazepam-exhibited notable degradation, particularly under acidic pH and elevated temperature. Flunitrazepam and clonazepam showed distinct degradation with the formation of 7-amino metabolites at neutral pH...These findings highlight the importance of compound-specific preservation strategies. In scenarios where analyte identity or sample pH cannot be verified promptly, immediate refrigeration or freezing (ideally at -20 °C), along with minimizing freeze-thaw cycles, is strongly recommended to preserve sample integrity and ensure reliable toxicological interpretation."

Journal

Strangulation during the night: diagnosis of sleep-associated violence. (PubMed, BMC Psychiatry) - No abstract available

Journal • Obstructive Sleep Apnea • Respiratory Diseases • Sleep Apnea • Sleep Disorder

The Nausea Atlas: Identifying and Characterizing Nausea Subtypes Using Patient-Reported Information (ACG 2025) - "Ondansetron was the most effective anti-nausea medication, followed by promethazine, lorazepam, prochlorperazine, and domperidone. Marijuana was the most effective non-medication treatment, outperforming dronabinol... 745 participants (77% Female; 19% Male), reporting 1200 distinct nausea types/experiences were evaluated. The most represented age range was 31–40 years. 22% of respondents reported their nausea as severely or completely debilitating."

Clinical • Gastrointestinal Disorder • Mood Disorders • Psychiatry

Semaglutide-Induced FATAL Acute Necrotizing Pancreatitis Complicated by ARDS and Septic Shock (ACG 2025) - "Medications included lisinopril, risedronate, rosuvastatin, alprazolam, and semaglutide, started 1–2 weeks earlier, with the last dose 2 days before presentation...Hemodialysis was initiated for acute renal failure, and ventricular tachycardia was managed with amiodarone and cardioversion...After family discussions, a DNR/DNI order was established, and she succumbed to septic shock and ARDS, likely triggered by semaglutide-induced pancreatitis. This case highlights the rare but severe risk of semaglutide-associated necrotizing pancreatitis, particularly in patients with pre-existing pancreatic pathology. Clinicians should exercise caution when prescribing GLP-1 receptor agonists to such patients and monitor closely for early pancreatitis symptoms to prevent catastrophic outcomes.Figure: Acute pancreatitis with proximal pancreatic hypoenhancement, indicating necrosis, without peripancreatic fluid collections.Figure: Coronal view showing Acute pancreatitis with proximal..."

Acute Kidney Injury • Acute Respiratory Distress Syndrome • Anesthesia • Cardiovascular • Diabetes • Diabetic Nephropathy • Dyslipidemia • Endocrine Disorders • Hypertension • Metabolic Disorders • Mood Disorders • Osteoporosis • Pancreatic Cancer • Pancreatitis • Psychiatry • Pulmonary Disease • Renal Disease • Respiratory Diseases • Rheumatology • Septic Shock • Ventricular Tachycardia

Peripheral immune cell-specific genes in Parkinson's disease uncovered by multi-omics with therapeutic implications. (PubMed, NPJ Parkinsons Dis) - "Drug repurposing analysis identified several candidate compounds, including felodipine, amodiaquine, alprazolam, and tetrandrine, some of which are predicted to cross the blood-brain barrier. Molecular docking simulations further supported strong binding interactions between these compounds and PD-associated targets such as CTSB and ARSA. This integrative approach highlights key immune-cell-specific genes involved in PD and proposes several repurposable drugs with central nervous system potential, paving the way for more targeted therapeutic strategies."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease • CD4 • CD8 • FDFT1 • HLA-DQA1

Acupuncture for perimenopausal insomnia: a systematic review and meta-analysis. (PubMed, Front Med (Lausanne)) - "However, it did not outperform alprazolam (MD = -2.30, p = 0.27) or diazepam (MD = -6.55, p < 0.00001). However, these findings require further validation through large-scale, multicenter, double-blind RCTs using standardized protocols. https://www.crd.york.ac.uk/PROSPERO/, Identifier (CRD42018092917)."

Journal • Retrospective data • Review • CNS Disorders • Insomnia • Sleep Disorder

A DIAGNOSTIC DILEMMA IN THE ICU: SEROTONIN SYNDROME OR BENZODIAZEPINE WITHDRAWAL? (CHEST 2025) - "Toxicology was consulted, who felt her presentation possibly consistent with anticholinergic toxicity, but given her hyperreflexia, the known serotonergic component of fentanyl and baclofen plus lack of knowledge about other co-ingestions, serotonin syndrome was suspected. She met Hunter's criteria for the diagnosis and was started on as-needed IV lorazepam her symptoms...Her mental status returned to baseline, and additional history revealed ingestion of as much as 8 to 10mg daily of alprazolam over several months... Serotonin syndrome is a syndrome of agitation, hyperthermia, and hyperreflexia in the setting of serotonergic ingestion and the Hunter Criteria are sensitive and specific for the diagnosis. The features of serotonin syndrome overlap significantly with alcohol and benzodiazepine withdrawal and withdrawal syndromes should be considered when incompatible clinical features emerge or serotonin syndrome is not resolving appropriately."

Addiction (Opioid and Alcohol) • CNS Disorders • Substance Abuse

SEVERE BRADYCARDIA AND HEMODYNAMIC INSTABILITY DUE TO FLUVOXAMINE-TIZANIDINE INTERACTION: A CASE OF RECURRENT SYNCOPE (CHEST 2025) - "CASE PRESENTATION: We present the case of a a 32-year-old female with chronic psychiatric disorders on Fluvoxamine, Lamictal, and Alprazolam who was transferred to our hospital due to syncopal episodes, fatigue, dizziness, and vision changes that had been occurring periodically over the last month...She was eventually discharged in her normal state of health with levothyroxine and discontinuation of Tizanidine and Fluvoxamine... The patient's chronic psychiatric medications, particularly Fluvoxamine, in combination with tizanidine likely resulted in her recurrent syncope and hemodynamic instability. The identification of subclinical hypothyroidism as a possible contributor complicates the picture, but its role in profound bradycardia is less certain. This case underscores the importance of careful medication reconciliation with particular care given to drug interactions that may have serious cardiovascular effects."

Clinical • Cardiovascular • CNS Disorders • Endocrine Disorders • Fatigue • Heart Failure • Infectious Disease • Mental Retardation • Movement Disorders • Psychiatry • Xerostomia • CYP1A2

A Case Study: Using Virtual Reality to Treat Anxiety and Claustrophobia During Radiation Therapy Simulation—Enhancing Emotional Well-Being and Preventing Unnecessary Interventions (JADPRO 2025) - "Previous failed treatments: lack of benefit/adverse drug events — clonazepam, diazepam, alprazolam, escitalopram, fluoxetine, duloxetine...In collaboration with Anesthesia Pain Service, Radiation Oncology, and Psychiatry, a multimodal plan was implemented: Use of VR in combination with quetiapine (25mg the night prior, 50mg 1 hour prior) and lorazepam (2mg 15 mins prior) during CT simulation as a distraction modality to treat anxiety/claustrophobia...Recommended Populations: Adult and pediatric patients Recommended Settings: Dental care, burn care, surgical care, oncologic care, port access, trauma, labor pain, lumbar puncture, episiotomy repair, dressing changes, spinal cord injury, and chronic pain. Recommended VR Applications: Distraction, skill-building, mindfulness, meditation, relaxation, breath training, guided imagery, exercise, rehabilitation, exposure therapy, and patient and provider/staff education, focus shifting."

Case study • Clinical • Anesthesia • Breast Cancer • Depression • Epilepsy • Fatigue • General Anxiety Disorder • Immunology • Infectious Disease • Migraine • Mood Disorders • Ocular Infections • Ophthalmology • Otorhinolaryngology • Pediatrics • Psychiatry • Solid Tumor • Vertigo

Drug use pattern of suspected drug-influenced drivers in Hungary (2019-2023). (PubMed, Forensic Sci Int) - "To evaluate clinical tests, the prevalence of positive and negative clinical findings was compared for amphetamine/methamphetamine, THC, MDMA, alprazolam, and clonazepam above and below their fixed concentration limits. Given that sNPS was detected in 24.1 % of drivers, the medical investigation system requires a major revision. The aim of this study was to investigate the illicit and licit drug consumption of suspected impaired drivers in Hungary and to present the disadvantages of the system currently used for diagnosing and proving impairment."

Journal • CNS Disorders • Epilepsy

Psychotropic and neurodegenerative drugs modulate platelet activity via the PAF pathway. (PubMed, Neurochem Int) - "Results revealed that most of the compounds assessed inhibited more effectively the PAF-induced aggregation of platelets compared to their effect on the ADP-pathway, with perphenazine showing the greatest anti-PAF potency. Several drug combinations, notably those including alprazolam and diclofenac, demonstrated significant synergistic effects. These findings suggest that commonly prescribed psychotropic drugs and medications for neurodegenerative disorders can influence platelet activity, mostly through the PAF-pathway, and that their interactions with NSAIDs may amplify their efficacy. Nevertheless, some drugs and their combinations induced lysis of platelets at much higher concentrations than their IC50 values, which stems safety concerns for their use."

Journal • Alzheimer's Disease • CNS Disorders • Depression • Mood Disorders • Movement Disorders • Parkinson's Disease • Psychiatry • Schizophrenia

Episodic Generalized Dystonia with Opisthotonus Posturing in Early Stages of Anoxic Brain Injury with Mild Degrees of Caudate Involvement (MDS Congress 2025) - " We present a 27-year-old woman with heroin and alprazolam use disorder who suffered a non-shockable cardiac arrest (10-minute downtime)...Despite sedation, antiepileptics, gabapentin, and opioids, she developed spontaneous clonic movements and dystonic posturing with opisthotonus by day 6, showing limited response to treatment...Hydromorphone and diazepam provided partial relief, while benztropine and amantadine were ineffective... This case suggests that posterior limb involvement, along with mild caudate and hippocampal changes, may contribute to generalized dystonic posturing after anoxic injury. The episodic nature of opisthotonus was unique and did not follow expected responses to sedatives or antiepileptics. This case highlights the complexity of post-anoxic movement disorders and the need for further research into their mechanisms and management."

CNS Disorders • Dystonia • Movement Disorders • Vascular Neurology

A case of neuroleptic malignant syndrome following antipsychotic use in unrecognised catatonia: recognising Catatonia prior to antipsychotic exposure (ECNP 2025) - "He was treated at the emergency service with daily intramuscular haloperidol 5 mg and biperiden 5 mg for six consecutive days...Although lorazepam is the first-line agent for catatonia, it was unavailable; thus, alprazolam 0.5 mg three times daily was initiated. Adjunctive treatments included bromocriptine (4x1/2) and amantadine sulphate (100 mg once daily), which was later increased to twice daily...Quetiapine 100 mg/day was introduced, and alprazolam was increased to 1 mg four times daily...Given the persistence of psychotic symptoms and the elevated risk of recurrence with other antipsychotics, clozapine was selected as the safest option in this context [4]...In catatonic patients, benzodiazepines and/or ECT should be prioritised, and antipsychotics must be used with extreme caution only after clinical improvement has been achieved [2,4]. The literature highlights the diagnostic overlap between catatonia and NMS and emphasises that failure to identify catatonia may..."

Clinical • CNS Disorders • Psychiatry • Schizophrenia • CRP

Navigating the interaction: benzodiazepine use during virtual reality exposure therapy and its impact on fear extinction learning in anxiety disorders (ECNP 2025) - "One notable randomized trial in acrophobia utilizing traditional VR exposure found that while alprazolam reduced intra-sessional distress compared to D-cycloserine and placebo, it led to weaker long-term retention of extinction learning... The available evidencestrongly suggests that concomitant benzodiazepine use can interfere with the consolidation of extinction learning, a core mechanism of VRET. This poses a significant concern, as the short-term anxiolytic benefit of benzodiazepines during VRET may interfere with attenuated long-term therapeutic efficacy. The identified methodological limitations, for example the lack of VRET-specific trials, the inconsistent medication reporting, highlight the need for further research."

CNS Disorders • Mood Disorders • Post-traumatic Stress Disorder • Psychiatry

Anti-N-Methyl-D-Aspartate receptor encephalitis presenting with catatonia: A case report (ECNP 2025) - "IVIG therapy is ongoing, and symptomatic management with alprazolam and biperiden is being concurrently administered...This may not only fail to improve symptoms but also worsen the clinical picture, as illustrated in our patient who developed neuroleptic malignant syndrome after haloperidol. While benzodiazepines remain the first-line symptomatic treatment for catatonia, treating the underlying pathology is essential in cases secondary to medical conditions [5]. Our patient exhibited minimal response to a lorazepam challenge test but showed a significant clinical improvement following IVIG therapy, underscoring the need for immunomodulatory treatment in anti-NMDAR encephalitis."

Case report • Clinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • Epilepsy • Frontotemporal Lobar Degeneration • Mental Retardation • Mood Disorders • Movement Disorders • Psychiatry • Psychomotor Agitation

From discontinuation to dysfunction: a rat model of benzodiazepine withdrawal syndrome induced by alprazolam (ECNP 2025) - "Abstract will be available on 3 October."

Preclinical • CNS Disorders

From discontinuation to dysfunction: a rat model of benzodiazepine withdrawal syndrome induced by alprazolam (ECNP 2025) - "The behavioural findings presented are consistent with the symptoms commonly seen in human BDZ withdrawal syndrome, such as increased anxiety and impaired social behaviour, thereby supporting the model's face validity in addition to its intrinsic construct validity. The model provides a robust tool for further investigation of the neuroadaptive mechanisms underlying BDZ withdrawal. Our future work will focus on identifying the precise molecular neuroadaptations and synaptic remodelling that underlie withdrawal symptoms."

Preclinical • Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Epilepsy • Mood Disorders • Psychiatry

Benzodiazepine prescriptions in Croatia: An analysis of national database trends (ECNP 2025) - "In the USA, diazepam and alprazolam have been reported as the most commonly prescribed benzodiazepines [1], while in the EU the most frequently prescribed were lorazepam and oxazepam [2], namely to the older population. This study highlights a consistent increase in benzodiazepine prescriptions in Croatia over the past decade, with a notable peak during the COVID-19 pandemic, reflecting global trends of heightened anxiolytic use. The predominance of prescriptions among older adults, particularly women, underscores ongoing concerns regarding the vulnerability of high-risk populations despite existing guidelines advising caution. Although the overall post-pandemic period showed a slight decline in prescriptions, the persistence of long-term use in a significant subset of patients raises important public health considerations regarding dependency and appropriate prescribing practices."

CNS Disorders • Mood Disorders • Psychiatry

Therapeutic potential of cannabidiol in modulating alterations induced by acute spontaneous alprazolam withdrawal in adult mice: a sex-oriented approach (ECNP 2025) - "CBD showed therapeutic potential to ameliorate the behavioral alterations induced by spontaneous APZ withdrawal, exerting an anxiolytic effect and normalizing hyperactivity and somatic signs changes in both male and female mice. Importantly, these effects were accompanied by several modulatory actions on the expression of GABAergic and endocannabinoid targets. Overall, the results of this work suggest that CBD deserves attention as a new pharmacological tool for the treatment of APZ withdrawal syndrome."

Preclinical • CNS Disorders • Mood Disorders • Psychiatry

A case of treatment-resistant depression unresponsive to multiple antidepressants, antipsychotics, mood stabilizers, and electroconvulsive therapy is presented (ECNP 2025) - "He was started on fluoxetine 40 mg/day at an external center in early 2023...Due to lack of clinical improvement, olanzapine 2.5 mg/day and venlafaxine 75 mg/day were initiated, with the latter increased to 150 mg/day. His suicidal ideation and restlessness worsened, leading to further emergency admissions and multiple medication adjustments.The patient was subsequently treated with a series of psychotropic medications, including escitalopram (up to 20 mg/day), clonazepam, lorazepam, amisulpride, and clomipramine, in various combinations...He was hospitalized multiple times and underwent six sessions of ECT, without significant improvement.Later, his regimen was modified to include quetiapine (100 mg/day IR and up to 200 mg/day XR), trifluoperazine, and alprazolam...Mood stabilizers, including valproic acid 750 mg/day and lamotrigine up to 100 mg/day, were introduced, along with aripiprazole and continued quetiapine...In this patient, persistent suicidality, poor..."

Clinical • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Movement Disorders • Psychiatry • Suicidal Ideation

Benzodiazepine use in hospitalised youth: Who gets prescribed and why? (ECNP 2025) - "Women were more frequently prescribed alprazolam, while lorazepam and clonazepam were more common among male patients (χ²(5) = 19.95, p = .001)...Clonazepam was used primarily for affective disorders and anxiety-related conditions, while diazepam and lorazepam were more frequently prescribed for behavioural and developmental disorders... Findings indicate that benzodiazepines are selectively prescribed in youth psychiatric care, with clear variation by demographic and clinical factors. These patterns may reflect clinical judgment shaped by symptom presentation, diagnostic profile, and perceived risk. Given concerns about safety, dependency, and limited evidence in pediatric populations, further research is needed to clarify the rationale behind prescribing decisions, treatment duration, and long-term outcomes, particularly in institutional care context."

Clinical • Behavior Disorders • CNS Disorders • Mood Disorders • Psychiatry

Docking and molecular dynamics studies of benzodiazepines and receptor A2A antagonists to hypothesize the paradoxical reaction to benzodiazepines (ECNP 2025) - "The ligands (adenosine, caffeine, pentoxifylline, alprazolam, clonazepam and diazepam) were downloaded from the ZINC15 database [4] and optimized in YASARATM by addition of hydrogen atoms and partial charge assignment. This antagonistic behavior on A2AR could help to explain, at least partially, the paradoxical reactions clinically observed with the use of benzodiazepines. In this sense, cross-interaction with A2AR emerges as a new pathophysiological mechanism to consider and opens a promising line for future research on the dual profile of these drugs."

CNS Disorders

The dynamic duo of venlafaxine & alprazolam: a therapeutic partnership in anxiety disorders (ECNP 2025) - "Industry session financially supported by Viatris Abstract not received."

CNS Disorders • Mood Disorders • Psychiatry

Unseen and misunderstood: the role of masking and diagnostic overshadowing in late autism diagnosis – two case reports (ECNP 2025) - "He is currently under follow-up with atomoxetine and has been referred to a social skills training program for young adults with ASD...We added lithium to his exisiting treatment regimen which included venlafaxine, valproic acid, risperidone, alprazolam as needed...Whenever possible, adults suspected of having ASD should be evaluated by clinicians with expertise in adult autism, and psychiatrists should recognize how masking and diagnostic overshadowing can complicate identification. Although ASD is not curable, obtaining a diagnosis can lead to meaningful improvements in well-being and psychological health, even for adults with subtle or mild symptoms.[2]"

Case report • Clinical • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Depression • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • Social Anxiety Disorder