alprazolam / Generic mfg. - LARVOL DELTA

Improved Sleep Quality and Reduction in Sleep Medication Use with Multimodal Non-Invasive Neuromodulation in Chronic Primary Insomnia: A Case Report (WSS 2025) - "Materials and Case Illustration: A 68-year-old woman with chronic sleep-onset insomnia, previously managed with polypharmacy (clonazepam, quetiapine, mirtazapine, alprazolam, fluoxetine), experienced relapse with daytime sleepiness, anxiety, and cognitive impairment. These findings highlight the potential of non-pharmacological approaches in managing refractory insomnia, particularly in elderly patients at risk for medication side effects. Further research is needed to confirm these benefits in larger and more diverse patient populations."

Case report • Clinical • Non-invasive • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Insomnia • Mood Disorders • Psychiatry • Sleep Disorder

Managing Insomnia in an Adult Female with ADHD and Sedative Abuse: A Case Report on the Combined Use of Lemborexant, Agomelatine, and Methylphenidate (WSS 2025) - "She had a longstanding diagnosis of adult ADHD and a history of alprazolam abuse. Managing insomnia in adults with ADHD and prior sedative abuse is clinically challenging. However, this case demonstrates that a thoughtfully designed regimen—combining lemborexant, agomelatine, and methylphenidate—can lead to meaningful improvement in both sleep and daytime functioning. The key lies in targeting complementary neurobiological mechanisms: orexin inhibition for arousal, melatonergic support for circadian rhythm, and dopaminergic enhancement for executive dysfunction."

Case report • Clinical • ADHD (Impulsive Aggression) • Anesthesia • Attention Deficit Hyperactivity Disorder • CNS Disorders • Insomnia • Psychiatry • Sleep Disorder

Managing Pregabalin withdrawal: A Systematic Review of Current Approaches (WFSBP 2025) - "Using alprazolam during tapering could be useful if the patient develops anxiety symptoms. Haloperidol may be a useful treatment for delirium caused on by withdrawal symptoms from pregabalin... The management of pregabaline withdrawal syndrome is a challenge due to the lack of specific guidelines. Gradual tapering appears to be the most recommended approach to minimize adverse effects. Further studies are essential to better understand the mechanisms of withdrawal and develop effective therapeutic strategies to improve patient care."

Review • CNS Disorders • Epilepsy • Mood Disorders • Neuralgia • Psychiatry

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

Counterfeit 'Xanax®' tablets: A comparative study of clinical and seizure data in Victoria, Australia. (PubMed, Addiction) - "Suspect counterfeit alprazolam products seized by police in Victoria, Australia, in 2020 and 2022 commonly contained other drugs and/or new psychoactive substances, with an apparent limited consumer awareness of the tablet composition."

Journal • CNS Disorders • Epilepsy

Application of Lactation Physiologically Based Pharmacokinetic Modeling to Predict Milk Exposure of Passively Diffused Drugs. (PubMed, J Clin Pharmacol) - "As a part of the framework, the current paper focuses on performance of lactation PBPK models to predict maternal plasma and milk concentrations for drugs that are not substrates of P-glycoprotein (P-gp) or breast cancer resistance protein (BCRP) transporters-atenolol, escitalopram, and alprazolam. The current work shows the potential of lactation PBPK models to predict drug exposure in human milk for drugs that are not P-gp or BCRP substrates. The approach will be further evaluated for drugs that are substrates for these active transporters known to be present in mammary tissues."

Journal • PK/PD data • Breast Cancer • Oncology • Solid Tumor

Psychotropic pharmaceuticals in aquatic environments: Occurrence and analytical challenges. (PubMed, Sci Total Environ) - "Antidepressants such as fluoxetine, sertraline, and venlafaxine, along with anxiolytics like diazepam, alprazolam, and oxazepam, are among the most commonly reported...Transformation products, such as O-desmethylvenlafaxine, norfluoxetine, and carbamazepine-epoxide, are also prevalent and may occur at levels exceeding those of their parent compounds, indicating persistence and potential toxicity...A scientometric overview complements the discussion, highlighting research trends and regional monitoring gaps. This review advocates for harmonized regulation, improved detection of TPs, and integrated environmental strategies."

Journal • Review • CNS Disorders

Should I test for Novel Psychoactive Substances (NPS) in Clinical Specimens? (PAINWeek 2025) - "Tianeptine is available in some states as "gas station heroin". Carfentanil is a large animal tranquilizer and is 100 times more potent than fentanyl and 10,000 times more potent than morphine. Designer benzodiazepines are taken as an alternative to traditional benzodiazepines, such as alprazolam or diazepam... In total, 8384 specimens were positive for at least 1 NPS. The majority of positive specimens (64.7%) were positive for only 1 of the 6 NPS categories, while 26.2% were positive for 2 categories, 6.6% were positive for 3 categories, 2.4% were positive for 4 categories, and 0.1% were positive for 5 categories. Of the 8,384 specimens that were positive for at least 1 NPS, 52.9% were positive for an NPS in other illicit compounds; 44.3% were positive for designer fentanyl analogs; 21.5% for designer benzodiazepines; 17.6% for synthetic cannabinoids; 6.6% for designer opioids; and 4.0% for designer stimulants."

Clinical • CNS Disorders

A Cross-Sectional Study on the Drug Use of Insomnia in a Chinese Medicine Hospital in Shenzhen. (PubMed, Psychiatry Clin Psychopharmacol) - "The 10 most commonly used drugs ranged from more to less were estazolam (29.99%), Zaoren anshen capsule (15.50%), oryzanol (14.82%), diazepam (14.51%), flupentixol and melitracen (14.30%), alprazolam (8.12%), zolpidem tartrate (5.29%), vitamin B6 (4.76%), sertraline (4.03%), and clonazepam (2.97%). The use of oryzanol and vitamin B6 was abused in Chinese medicine hospitals, and the use of Chinese medicine should be evaluated more rigorously. Nonbenzodiazepines should be promoted and more widely understood in the Chinese medicine hospital in Longgang, Shenzhen."

Journal • Observational data • CNS Disorders • Depression • Insomnia • Mental Retardation • Mood Disorders • Pain • Psychiatry • Sleep Disorder

Cognitive Behavioral Couple Therapy for Perinatal Distress (clinicaltrials.gov) - P=N/A | N=96 | Completed | Sponsor: Sameera Shafiq | Not yet recruiting ➔ Completed

Trial completion • CNS Disorders • Depression • Mood Disorders • Perinatal Disorders • Psychiatry

Rapid diagnosis of alprazolam poisoning by Fourier transform infrared spectroscopy on saliva samples. (PubMed, Sci Rep) - "FTIR spectroscopy is an effective method for diagnosing alprazolam toxicity in saliva samples, offering a quick, efficient, and non-invasive alternative to traditional techniques. This study opens the door for further research on FTIR in toxicological screening, with the potential to transform clinical practices in drug overdose management."

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Pharmacological manipulation of neurotransmitter activity induces disparate effects on cerebral blood flow and resting-state fluctuations. (PubMed, Imaging Neurosci (Camb)) - "We assessed changes in resting measures of BOLD and ASL MRI in response to two neurotransmitter modulators: citalopram, a selective serotonin reuptake inhibitor, and alprazolam, a positive allosteric modulator of GABA type A receptor. BOLD and ASL are each sensitive to drugs targeting neurotransmitter systems, but appear to reflect different aspects of neural metabolism and the balance between excitatory and inhibitory activity. Accordingly, their combination may best capture the effects of neurotransmitter modulations, and thus be advantageous for pharmacological MRI studies."

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Efficacy of Alprazolam in the Management of Chronic Non- Bacterial Prostatitis in Elderly Male Patients (UAA 2025) - No abstract available

Clinical • Infectious Disease

Effect of zaleplon on Cognitive Function of Insomnia Patients: a randomized, controlled multi-centre study (ChiCTR) - P=N/A | N=250 | Not yet recruiting | Sponsor: Shanxi Bethune Hospital (Shanxi Academy of Medical Sciences); Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences

New trial • CNS Disorders • Insomnia • Sleep Disorder

Using a rich-lean transition procedure to evaluate putative antianxiety medications. (PubMed, J Pharmacol Exp Ther) - "Acute administration of benzodiazepines (midazolam, alprazolam) and an imidazotriazine (TPA-023B) selectively reduced pausing in rich-lean transitions, a behavioral effect consistent with clinically effective antianxiety drugs in other preclinical anxiolysis procedures. Morphine and (+)amphetamine selectively increased rich-lean pausing, an effect consistent with an anxiogenic response in other anxiolysis procedures...SIGNIFICANCE STATEMENT: Transitions from favorable to unfavorable (ie, rich-lean) schedules of reinforcement reliably disrupts operant behavior, and these disruptions can be ameliorated via benzodiazepine administration. Our results indicate that the rich-lean transition procedure has utility in the assessment of putative antianxiety medications."

Journal • Mood Disorders • Psychiatry

Prevalence estimation of essential tremor in Hungary between 2010 and 2020 based on the National Health Insurance Fund Database. (PubMed, Sci Rep) - "Most of the rest used alprazolam followed by propranolol for the longest period of time; the alprazolam and propranolol combination was the most preferred. Our strict methods probably underestimate the essential tremor prevalence in Hungary, which, however, does not differ considerably from international results. Given the limitations of medication therapy, expanding and improving neurosurgical interventions may help improve the quality of life of patients with essential tremor."

Journal • Reimbursement • US reimbursement • CNS Disorders • Essential Tremor • Movement Disorders • Parkinson's Disease

Poisoning suicide due to paroxetine overdose toxicity aided by benzodiazepine and antipsychotic drugs. (PubMed, Int J Legal Med) - "It was classified as X61 in International Classification of Diseases (10th revision). This is the first fatal case reporting the simultaneous presence of antipsychotics (quetiapine and clozapine) and benzodiazepines (alprazolam) with toxic paroxetine levels."

Journal • CNS Disorders • Psychiatry

Urinary metabolic ratio of pain management and substance abuse treatment drugs: Drug-drug interactions. (PubMed, J Opioid Manag) - "The 18 drugs include dextromethorphan, oxycodone, hydrocodone, tramadol, morphine, buprenorphine, fentanyl, clonazepam, alprazolam, quetiapine, carisoprodol, tapentadol, ketamine, methadone, impramine, and amitriptyline. The 14 interfering drugs include fluoxetine, paroxetine, bupropion, citalopram, sertraline, venlafaxine, duloxetine, risperidone, trazodone, aripiprazole, cyclobenzaprine, amphetamine, and tetrahydrocannabinol...Using the MR reference intervals of the 18 drug pairs established in an earlier study, and the current DDI system, we can alert providers of unusual metabolism caused by DDIs. This will help providers do better prescribing or review more closely all medications and supplements patients are taking, thus avoiding underdosing or potential medication adverse reactions."

Journal • Pain • Substance Abuse • CYP2C19 • CYP3A4

Urinary metabolic ratio of pain management and substance abuse treatment drugs: Reference intervals. (PubMed, J Opioid Manag) - "These drugs were dextromethorphan, morphine, oxycodone, hydrocodone, quetiapine, tapentadol, tramadol, buprenorphine, clonazepam, fentanyl, imipramine, ketamine, carisoprodol, alprazolam, methadone, and amitriptyline. Ratio values outside of this reference range could be considered to be caused by genetic metabolizing variants, drug-drug interactions, age, or deception. Alerting providers of the variance in metabolism from the expected norm might reduce overdosing or underdosing patients."

Journal • Pain • Substance Abuse

Benzodiazepine Co-Exposure Among Patients Presenting to the Emergency Department With a Confirmed Opioid Overdose. (PubMed, Acad Emerg Med) - "Nearly a third of patients with confirmed opioid overdose presenting to the ED also had concomitant benzodiazepine exposures. Those with novel benzodiazepines had significantly higher odds of intubation, suggesting greater severity of overdose."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Psychiatry

Effect of a single dose of lorazepam on resting state functional connectivity in healthy adults. (PubMed, Brain Imaging Behav) - "Lorazepam is a fast-acting benzodiazepine that is widely used to manage anxiety symptoms through modulation of GABAergic activity. Reduced connectivity within higher-order cognitive networks partly supports what has been reported for other benzodiazepines such as midazolam and alprazolam. However, differences across benzodiazepines - possibly due to pharmacokinetics, dosage and receptor selectivity - underscore the need for further research."

Journal • Mood Disorders • Psychiatry

Prevalence and factors with potentially inappropriate prescribing among older outpatients with depression: a multicentre study across China. (PubMed, J Glob Health) - "The top five PIM were alprazolam, clonazepam, olanzapine, lorazepam, estazolam. Logistic regression demonstrated that tertiary-level hospital (odds ratio (OR) = 1.215; 95% confidence interval (CI) = 1.100, 1.342, P < 0.001), department of psychiatry (OR = 1.958; 95% CI = 1.855, 2.067, P < 0.001), age ≥80 (OR = 1.069; 95% CI = 1.016, 1.124, P = 0.01), more diseases (OR = 1.209; 95% CI = 1.092, 1.339, P < 0.001), polypharmacy (OR = 1.672; 95% CI = 1.541, 1.814, P < 0.001) exhibited positive links to PIP among older outpatients suffering from depression. This investigation revealed that the occurrence of PIP in older outpatients with depression is high in China."

Journal • CNS Disorders • Depression • Mood Disorders • Psychiatry

Is Abrupt Withdrawal of Benzodiazepines a Risk Factor for Neuroleptic Malignant Syndrome? A Case Report With Single-Dose Haloperidol. (PubMed, Clin Case Rep) - "His medical history included long-term use of clonazepam, alprazolam, and methadone maintenance therapy (MMT)...The treatments with bromocriptine and lorazepam further led to gradual improvement, and the patient was discharged after 11 days following the resolution of NMS symptoms...The shared mechanisms between the pathophysiology of NMS and benzodiazepine withdrawal suggest that the abrupt cessation of GABAergic agents may lower dopaminergic activity, contributing to the onset of NMS. Clinicians must be accordingly cautious in distinguishing benzodiazepine withdrawal from other causes of delirium and then option for appropriate treatment approaches to mitigate risks."

Journal • CNS Disorders

Trends in publicly and privately prescribed anxiolytics in Croatia: do we need a new regulatory framework. (PubMed, Int J Pharm Pract) - "Despite being either not recommended by clinical guidelines or of doubtful efficacy in many cases, prescribing of anxiolytics is common. There is a noticeable increase in anxiolytic drug use in Croatia during the investigated period, while the total financial expenditure has decreased due to price pressure on medications imposed by the national insurer. The high rate of private prescription of anxiolytics is observed. An enhanced national regulatory framework for prescribing anxiolytics in Croatia is needed."

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