alprazolam / Generic mfg. - LARVOL DELTA

Development of Triazole based Anticonvulsants through Various Catalytic Approaches. (PubMed, Mini Rev Med Chem) - "Triazolam and Alprazolam are both drugs containing a triazole ring, and these are well-established drugs that are used in the treatment of epilepsy...1,2,4-triazoles are a key scaffold in a large number of triazole derivatives that produce diverse pharmacological effects. This review focuses on the pharmacological significance and the synthesis of triazole derivatives in medicinal chemistry."

Journal • CNS Disorders • Epilepsy • Oncology

Isolation and identification of the designer benzodiazepine cyclopropylflualprazolam in pressed candies marketed for sleep improvement. (PubMed, J Pharm Biomed Anal) - "Since alprazolam is a psychotropic controlled substance, this finding has garnered significant attention from regulatory authorities. It is recommended that cyclopropylflualprazolam be included in the screening list of prohibited substances in functional foods."

Journal

Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2017-2023. (PubMed, Natl Vital Stat Rep) - "Among drug overdose deaths with mention of at least one specific drug, the most frequently mentioned drugs during 2017-2023 included: fentanyl, heroin, oxycodone, morphine, methadone, hydrocodone, alprazolam, diphenhydramine, cocaine, methamphetamine, amphetamine, gabapentin, and xylazine. In 2023, the most frequently mentioned drugs in unintentional drug overdose deaths were fentanyl, methamphetamine, and cocaine, while the most frequently mentioned drugs for suicide-related drug overdoses were diphenhydramine, oxycodone, and bupropion. This report identifies patterns in the specific drugs most frequently involved in drug overdose deaths from 2017 through 2023."

Journal

Benzodiazepine prescribing patterns among Medicare providers, 2017 to 2023. (PubMed, Front Med (Lausanne)) - "The top three most prescribed BZD medications were alprazolam, lorazepam, and clonazepam, totaling around 88% of all the BZD prescriptions being written to Part D beneficiaries. Despite repeated warnings about the harms of their use in this population, BZDs are being increasingly prescribed to Medicare Part D recipients. Some states and prescriber classes prescribe BZDs significantly over 30 days per beneficiary to older adults."

Journal • Medicare • Reimbursement • US reimbursement • Psychiatry

Benzodiazepines Prescribed to Hospitalized Patients with Major Depressive Disorder: A 3-year Retrospective Observational Study. (PubMed, Neuropsychiatr Dis Treat) - "For non-selective benzodiazepines at baseline, the most commonly prescribed were lorazepam (39.6%, n=110), oxazepam (23.7%, n=66), and clonazepam (16.2%, n=45)...However, the use of clonazepam, estazolam, and alprazolam remained comparable (P > 0.05)...While its use varied significantly over time (P 0.05)...It is advisable to limit benzodiazepine prescriptions for MDD patients to within 12 months. Discontinuing benzodiazepines becomes more challenging after prolonged use beyond this period."

Journal • Observational data • Retrospective data • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

CNS Drugs Targeting the Neuropsychiatric and Cognitive Symptoms of Alzheimer's Disease (AAN 2026) - "Objective: This project investigates the effects of two CNS drugs, benzodiazepines (BZDs) and psilocybin, on neuropsychiatric and cognitive symptoms in Alzheimer's disease (AD).Background: Benzodiazepines impair memory via GABA-A modulation, while psilocybin enhances synaptic plasticity; both may influence neuropsychiatric and cognitive symptoms in Alzheimer's disease, yet clinical mechanisms remain unclear.Design/ We conducted a structured review (2010–2025) of studies on BZD use and cognition in community-dwelling adults, extracting data on study design, dementia incidence, cognitive outcomes, and confounder control.In parallel, we examined alprazolam's effects on memory circuits in male and female mice using contextual fear conditioning and postmortem analysis of hippocampal activity (ArcCreERT2 x EYFP tagging, c-Fos staining).To assess psilocybin as a BZD alternative, APP^NLGF^ mice received a single dose one week before behavioral or electrophysiology..."

Alzheimer's Disease • CNS Disorders • Dementia • Mood Disorders • Psychiatry • CA3 • FOS

A Novel Therapeutic Use of Amantadine for Palilalia and Bruxism Following Anoxic Brain Injury (AAN 2026) - " A 63-year-old woman was found unresponsive at home with respiratory depression and severe hypoxemia near a prescription bottle of alprazolam used for anxiety. This case supports a possible role for amantadine in post-anoxic encephalopathy presenting with palilalia and bruxism. Amantadine may enhance dopaminergic signaling and attenuate glutamatergic activity, potentially stabilizing basal ganglia–thalamocortical and frontal–subcortical circuits implicated in speech initiation and oromotor control. Reports of improvement in palilalia or bruxism after anoxia are rare; post-anoxic bruxism has been treated with botulinum toxin in case reports, and palilalia after anoxic injury is described but uncommon."

CNS Disorders • Dental Disorders • Depression • Epilepsy • Infectious Disease • Vascular Neurology

HYPNOGYN: Preoperative Hypnosis Versus Premedication in Gynecological Surgery (clinicaltrials.gov) - P4 | N=128 | Not yet recruiting | Sponsor: Central Hospital, Nancy, France

New P4 trial • CNS Disorders • Gynecology • Psychiatry

HYPNOGYN: Preoperative Hypnosis Versus Premedication in Gynecological Surgery (clinicaltrials.gov) - P4 | N=128 | Not yet recruiting | Sponsor: Central Hospital, Nancy, France | Initiation date: Dec 2017 ➔ May 2018

Trial initiation date • Gynecology • Psychiatry

HYPNOGYN: Preoperative Hypnosis Versus Premedication in Gynecological Surgery (clinicaltrials.gov) - P4 | N=128 | Recruiting | Sponsor: Central Hospital, Nancy, France | Not yet recruiting ➔ Recruiting

Enrollment open • CNS Disorders • Gynecology • Psychiatry

Efficacy and safety of etifoxine versus alprazolam in generalized anxiety disorders with somatic symptoms: A randomized, double-blind, comparative study. (PubMed, J Anxiety Disord) - "Treatment-emergent AEs were mild and observed in 10% and 7.7% of patients in the Etifoxine and Alprazolam groups, respectively. Etifoxine was non-inferior to Alprazolam in reducing anxiety symptoms in GAD, was well-tolerated, and can be a promising alternative for anxiety management without drug dependence risk."

Clinical • Journal • CNS Disorders • General Anxiety Disorder • Mood Disorders • Psychiatry

Two cases of estazolam poisoning presenting to an emergency department in Western Australia. (PubMed, Clin Toxicol (Phila)) - "Toxicological analysis detected estazolam and alprazolam...Two patients poisoned with estazolam experienced prolonged sedation. Toxicological analysis within a clinically relevant timeframe informed management."

Journal • Anesthesia • CNS Disorders • Critical care

Bromazolam Tablet Quantification and Analysis of Post-Mortem Cases From the National Programme on Substance Use Mortality (NPSUM). (PubMed, Drug Test Anal) - "Over half of the tablet submissions (55%) mimicked the appearance of licensed pharmaceuticals alprazolam or diazepam, raising significant concerns around mis-selling of street bromazolam tablets and the risks of unintentional high-dose exposure to an NPS compound. Notably, bromazolam was co-detected with an average of seven other substances per case, most commonly other central nervous system (CNS) depressants. These findings underscore the public health risks posed by bromazolam as an NPS benzodiazepine and highlight the urgent need for monitoring, harm reduction and forensic toxicology guidance."

Journal

Melatonin and Alprazolam as Anxiolytic Agents in Minor Oral Surgical Procedures - A Comparative Study. (PubMed, Ann Maxillofac Surg) - "The modified Aldrete scores were similar (P = 1.00), and no negative effects were noted. Although both treatments are successful in lowering perioperative anxiety, melatonin's superior anxiolytic effects and a positive sedation-recovery profile make it a potential substitute for benzodiazepines in minor oral surgical operations."

Journal • Anesthesia • Pain • Psychiatry

Retrieval Augmented Generation (RAG) for Evaluating Regulatory Compliance of Drug Information and Clinical Trial Protocols. (PubMed, CPT Pharmacometrics Syst Pharmacol) - "The drug information for adalimumab, insulin glargine, atorvastatin calcium, sertraline, and alprazolam was evaluated for compliance with Food and Drug Administration (FDA) clinical pharmacology guidance for indications, use in specific populations, and warnings and precautions. The reasons for the withdrawal of rofecoxib, valdecoxib, and troglitazone were elicited. The clinical trial protocol evaluation system was used to assess a Phase-2a clinical trial protocol of Rifafour in tuberculosis with the FDA E9 and E9 (R1) guidance documents...The findings aligned with manual protocol reviews. RAG-based AI methods can improve the usefulness of LLMs in document-restricted settings and are a promising approach for evaluating the compliance of clinical pharmacology documents."

Compliance • Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Deconvoluting Gut Versus Liver Cytochrome P450 3A4 Function: Drug Probes, Biomarkers, and Tissue Biopsy. (PubMed, J Clin Pharmacol) - "As reviewed in the current narrative, approaches have included the profiling of tissue biopsy samples, use of novel plasma-based liquid biopsies, studies with individuals undergoing liver transplant, intravenous (IV) probe pharmacokinetics (PK) to measure hepatic CYP3A4 activity (e.g., midazolam and erythromycin breath test, ERBT), oral probe PK to differentially capture gut and liver CYP3A4 activity (e.g., midazolam and alprazolam), biomarkers (e.g., 6β-hydroxy cortisol/cortisol [6βHC/C] and 1β-hydroxy deoxycholic acid/deoxycholic acid [1βHDCA/DCA] urine ratio, and 4β-hydroxy cholesterol/cholesterol [4βHC/C] plasma ratio), modeling (e.g., static and physiologically based PK), and dosing of agents to inhibit intestinal CYP3A4 (e.g., grapefruit juice [GFJ]). Data for biomarkers are mixed, however, indicating that 4βHC/C plasma ratio is largely reflective of liver CYP3A4 in the basal state, unlike 6βHC/C and possibly 1βHDCA/DCA urine ratio. Literature reports also showcase..."

Biomarker • Journal • Review • Transplantation • CYP3A4 • CYP3A5

BENZODIAZEPINE TREATMENT IN CHILDREN AND ADOLESCENTS WITH ANXIETY: PRESCRIBING PATTERNS OF PRIMARY CARE PEDIATRICIANS (WRMC 2026) - "Summary of Among 7742 patients with anxiety, 184 (2.4%) were prescribed BDZ in the study period, most often lorazepam and alprazolam. In the examined primary care network, many pediatricians prescribed BDZ for children and adolescents with anxiety, mostly as a onetime treatment of anticipated extreme distress. Most patients prescribed BDZ had not received first-line medication (i.e., SSRIs). These findings can inform medical education efforts and development of guidelines defining the limited role of BDZ in the treatment of childhood anxiety - enhancing evidence-based treatment decisions in primary care."

Clinical • CNS Disorders • Epilepsy • Mood Disorders • Pediatrics • Psychiatry

FENTANYL'S YOUNGEST VICTIMS: HOSPITAL ENCOUNTER OUTCOMES RELATED TO FENTANYL USE IN PATIENTS 18 AND UNDER (WRMC 2026) - "The rise in pediatric substance use underscores the urgent need for healthcare providers to better recognize, refer, and treat these cases. Emergency department presentations involving fentanyl-laced pills, including counterfeit Percocet and Xanax, are a significant part of this emerging crisis. Increasing public access to naloxone is a crucial step in preventing these opioid overdoses from becoming fatal."

Clinical • Addiction (Opioid and Alcohol) • Cardiovascular • CNS Disorders • Mood Disorders • Respiratory Diseases

Efficacy and safety of pharmacological treatments in borderline personality disorder: A systematic review and network meta-analysis. (PubMed, Mol Psychiatry) - "Topiramate (200-250 mg/day, 8-10 weeks), lamotrigine (50-200 mg/day, 8 weeks), and aripiprazole (15 mg/day, 8 weeks) most effectively reduced hostility, aggressiveness, and anger, and improved anger control. Carbamazepine (200-1200 mg/ day, 6 weeks) and asenapine (5-10 mg/day, 12 weeks) improved impulsivity and emotional dysregulation, respectively...Conversely, alprazolam, methylphenidate, haloperidol, and valproate had only low-certainty evidence in unselected BPD samples and should not be prioritised. Prescription should be limited to specific, individualised indications, such as panic, comorbid ADHD, or transient psychotic features, following cautious clinical appraisal."

Journal • Retrospective data • Review • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Borderline Personality Disorder • CNS Disorders • Mood Disorders • Personality Disorder • Psychiatry

Effect of acupuncture Baihui acupoint-Yintang acupoint-Neiguan acupoint combined with conventional Western medicine treatment on cerebral blood flow in insomnia patients: a 3D-ASL functional magnetic resonance imaging study. (PubMed, Front Neurol) - "Based on the alprazolam treatment in the control group, the study group received acupuncture treatment...After 28 days of treatment, the PSQI score and HAMA score of the study group were significantly lower than those of the control group (p < 0.05). Acupuncture Baihui acupoint-Yintang acupoint-Neiguan acupoint combined with conventional Western medicine treatment can effectively improve the sleep quality and anxiety symptoms of insomnia patients, and fMRI visualizes the effect of acupuncture, provides guidance for acupuncture treatment."

Journal • CNS Disorders • Insomnia • Mood Disorders • Psychiatry • Sleep Disorder

Non-targeted screening of alprazolam and flualprazolam metabolites in in vitro metabolism of different species by high-resolution mass spectrometry. (PubMed, J Hazard Mater) - "Notably, newly identified benzene-ring hydroxylated metabolites were more abundant in rats and livestock, and toxicity predictions indicated that these metabolites, including M1, M5, and M7, may pose higher ecotoxicological or developmental risks than the parent drugs, with greater predicted toxicity than the α-hydroxylated metabolites currently used as residue markers. These findings provide detailed insights into interspecies metabolic patterns, emphasize the need to consider species-specific metabolites in residue monitoring, and inform the toxicological assessment of benzodiazepines in food and environmental contexts."

Journal • Preclinical

Effect of Dexmedetomidine Nasal Spray on Sleep Quality in Patients Undergoing Orthopedic Surgery: An Interventional Study (ChiCTR) - P=N/A | N=164 | Recruiting | Sponsor: The Seventh Affiliated Hospital, Sun Yat-sen University; The Seventh Affiliated Hospital, Sun Yat-sen University

New trial • Orthopedics

Domestic Abuse of Codeine: A Case Study of Non-Medical Use Leading to Fatal Outcome. (PubMed, Toxics) - "Post-mortem LC-MS/MS analysis revealed the presence of codeine (0.66 µg/mL), morphine (0.02 µg/mL), hydroxyzine (2.52 µg/mL), alprazolam (0.15 µg/mL), paracetamol (30.64 µg/mL), and additional substances in blood samples. Concentrations of codeine and hydroxyzine exceeded therapeutic ranges and were consistent with values reported in fatal intoxications, confirming a poly-drug poisoning. This case highlights the danger associated with non-medical codeine use, particularly when combined with central nervous system (CNS) depressants, and underscores the need for stricter regulation of OTC codeine-containing products as well as improved public awareness of the risks associated with domestic extraction methods."

Journal • Pain

Orthostatic tremor and its subtypes: a single centre cohort of 74 patients. (PubMed, J Neurol) - "We provide further insight into the clinical phenotypes of the OT subgroups and encourage future studies to validate these findings with larger sample sizes and establish reliable tools to measure OT severity to better assess disease progression and treatment response."

Journal • Retrospective data • Movement Disorders

Risk of miscarriage after benzodiazepine use during pregnancy: updated systematic review and meta-analysis. (PubMed, BMC Pregnancy Childbirth) - "This updated meta-analysis indicates that early pregnancy exposure to benzodiazepines is associated with an increased risk of miscarriage. The consistency across analyses and evidence of dose-response strengthen confidence in this association. Clinicians should carefully weigh risks and benefits, consider non-pharmacological alternatives, and ensure close monitoring when prescribing benzodiazepines to women of childbearing potential."

Journal • Retrospective data • Review • CNS Disorders • Epilepsy • Mood Disorders • Psychiatry