alprazolam / Generic mfg. - LARVOL DELTA

Impact of Beers Criteria Medications in Elderly Patients with Head and Neck Cancer (COSM 2025) - "The three most common medications were Lorazepam, Alprazolam, and Zolpidem. Over half of patients aged 65 and over with head and neck cancer were prescribed one or more Beers Criteria Medications to Avoid and 5.4% were prescribed three or more in the year following their cancer diagnosis. Increased prescription of Beers Criteria medications was associated with inferior overall survival and increased emergency department utilization. Further research regarding how to minimize the use of these medications in elderly patients with head and neck cancer is warranted."

Clinical • Gastrointestinal Disorder • Head and Neck Cancer • Oncology • Pain • Solid Tumor

Intrauterine Exposure to Psychotropic Medications as a Risk Factor for Neonatal Opioid Withdrawal Syndrome (PAS 2025) - "Those with exposure to psychotropic medication were more likely to also have exposure to other substances (i.e., alcohol, nicotine, marijuana, and methamphetamine) (84% vs. 69%; p< 0.05; Table 1). Of the 1,305 infants included in the ESC-NOW study, 297 (22.8%) had antenatal co-exposure to psychotropic medications. The mean length of stay was 1.6 days longer for infants with psychotropic exposure compared to those without exposure (12.1 vs. 10.5 days, respectively; p < 0.001) (Table 2)."

Clinical • Addiction (Opioid and Alcohol) • Substance Abuse

Global Innovations in Overdose Prevention: Which Strategies Used Internationally Could the United States Adopt to Curb Youth Deaths? (PAS 2025) - "Three in four deaths among youth involve fentanyl, a highly potent opioid illicitly manufactured to look like prescription opioids (e.g., oxycodone) and benzodiazepines (e.g., alprazolam)...Presentations will cover: (1) novel approaches to testing drug safety, including community-based testing centers; (2) the evidence behind medically supervised safe consumption sites, with an emphasis on how such services can serve as a point of contact for youth addiction treatment; and (3) unique approaches to medication treatment for opioid addiction, including primary care-based treatment with methadone, use of slow-release morphine to address cravings and withdrawal, and prescriptions for hydromorphone to reduce individuals’ reliance on the illicit drug market...Summarize the evidence base for medically supervised safe consumption sites and their role in overdose prevention and linkage to addiction treatment, particularly for youth. Delineate novel pharmacotherapies to treat..."

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

Identification of the Potential Pharmacotherapeutic Risk in Hospitalized Geriatric Patients. (PubMed, Cureus) - "Our results underscore the urgent need for medication reviews by hospital pharmacists and the active promotion of drug deprescription among clinicians."

Journal • Geriatric Disorders

Opioid Drug Interaction Study (clinicaltrials.gov) - P1/2 | N=25 | Recruiting | Sponsor: Shanna Babalonis, PhD | Trial completion date: Jun 2028 ➔ Jun 2029 | Trial primary completion date: Jan 2028 ➔ Jan 2029

Trial completion date • Trial primary completion date

An Extension Test of Whether to Use Oral Anti-anxiety Drugs (XANAX) When Patients Choose Second Eye Cataract Surgery After Unblinding, and Analyze Their Anxiety, Satisfaction and Pain Satisfaction (clinicaltrials.gov) - P4 | N=250 | Recruiting | Sponsor: National Taiwan University Hospital | Not yet recruiting ➔ Recruiting

Enrollment open • Anesthesia • Cataract • Ophthalmology • Pain • Psychiatry

Distribution of Alprazolam Into the Milk of Lactating Mares and Subsequent Absorption by Nursing Foals. (PubMed, J Vet Pharmacol Ther) - "This study shows that milk:serum ratios of alprazolam in mares are variable. Foal serum concentrations and RFD suggest that alprazolam is safe for use in mares with nursing foals."

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In vitro-in vivo scaling of cytochrome P450-mediated metabolic clearance using a relative activity factor approach. (PubMed, Drug Metab Dispos) - "We selected multiple probe substrates for CYP1A2 (caffeine, tizanidine, phenacetin), CYP2C9 ((S)-acenocoumarol, glimepiride, lornoxicam, tolbutamide, (S)-warfarin), CYP2C19 ((S)-lansoprazole, omeprazole, pantoprazole), CYP2D6 (desipramine, metoprolol, nebivolol, tolterodine), and CYP3A4 (alprazolam, felodipine, midazolam, nisoldipine, sildenafil, triazolam) to calculate the representative RAF value for each P450 isoform based on the in vivo-to-in vitro clearance ratio of the multiple probe substrates...The fm values of the responsible P450 isoform(s) could be well predicted for mexiletine, tamsulosin, risperidone, celecoxib, and glibenclamide...By applying relative activity factor values obtained from multiple probe substrates, this study was able to quantitatively predict the in vivo clearances mediated by CYP1A2, CYP2C9, CYP2C19, CYP2D6, and CYP3A4. This simple, practical method will help optimize metabolic clearances via the major cytochrome P450..."

Journal • Preclinical • CYP1A2 • CYP2C19 • CYP2C9 • CYP3A4

Long-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trial. (PubMed, Sci Rep) - "This phase I/II randomized controlled trial assessed the safety and efficacy of long-term treatment with Remygen® (Diamyd Medical), a controlled-release oral GABA formulation, as a potential beta-cell regenerative therapy in adults with long-standing T1D. Thirty-five male subjects with T1D (≥ 5 years) were randomized into three arms receiving the study drug(s) once daily for 6 months: GABA 200 mg (Arm 1), GABA 600 mg (Arm 2) and GABA 600 mg + alprazolam 0.5 mg for 3 months followed by GABA 600 mg alone for 3 months (Arm 3)...Hypoglycemic hormonal counter-regulation was unaltered. To conclude, we found no clinical evidence of a beta-cell regenerative effect of GABA, but side effects were commonly observed."

Clinical • Journal • Diabetes • Inflammation • Metabolic Disorders • Type 1 Diabetes Mellitus

Sleep Quality of Patients on a General Department During the First Days of Hospitalization. (PubMed, Nat Sci Sleep) - "Moderate correlations were identified between hospitalization data and RCSQ scores, with the strongest positive correlation for alprazolam use (Ra = 0.604)...There were no significant changes in subjective sleep quality ratings during the first three days of hospitalization. The FIRST questionnaire is not a suitable screening tool for identifying individuals with situational sleep disturbance in hospital."

Journal • CNS Disorders • Insomnia • Pain • Sleep Disorder

Psychotropic Drug Use in Korean Patients With Osteoarthritis. (PubMed, J Korean Med Sci) - "A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults."

Journal • CNS Disorders • Epilepsy • Immunology • Osteoarthritis • Pain • Psychiatry • Rheumatology

Impact of Beers Criteria Medications in Elderly Patients with Head and Neck Cancer (AHNS-COSM 2025) - "The three most common medications were Lorazepam, Alprazolam, and Zolpidem. Over half of patients aged 65 and over with head and neck cancer were prescribed one or more Beers Criteria Medications to Avoid and 5.4% were prescribed three or more in the year following their cancer diagnosis. Increased prescription of Beers Criteria medications was associated with inferior overall survival and increased emergency department utilization. Further research regarding how to minimize the use of these medications in elderly patients with head and neck cancer is warranted."

Clinical • Gastrointestinal Disorder • Head and Neck Cancer • Oncology • Pain • Solid Tumor

Opioid Drug Interaction Study (clinicaltrials.gov) - P1/2 | N=25 | Recruiting | Sponsor: Shanna Babalonis, PhD | Not yet recruiting ➔ Recruiting

Enrollment open

In Situ Mass Spectrometry Imaging to Elucidate the Effects of an Adenosine A2A Receptor Agonist and Alprazolam on Sleep Regulation. (PubMed, ACS Pharmacol Transl Sci) - "CGS21680 (CGS), a selective agonist of the adenosine A2A receptor, exhibits neuroinhibitory properties. The coadministration of Alp and CGS resulted in the regulation of GABA, glutamate, and glutamine during the sleep latency and sleep maintenance periods, respectively. In conclusion, the potentiating effect of CGS on the sleep-inducing properties of Alp is attributed to its ability to modulate the distribution of Alp in the brain by enhancing BBB permeability and its influence on Alp-induced neurotransmitter release."

Journal • CNS Disorders • ADORA2A

Expecting medication misuse: a proactive approach to drug discovery to prevent fatal overdose. (PubMed, Future Med Chem) - "Misuse of central nervous system (CNS) depressants (alprazolam, fentanyl, etc.) is a major cause of fatal overdose, with a high prevalence of deaths involving polydrug interactions from the victim's own prescriptions. We then suggest a drug discovery pathway focused on physiological parameters. It is our opinion that this approach would dramatically decrease the lethality of overdose and improve outcomes of treatments for pain, anxiety, and withdrawal from alcohol, benzodiazepines, and opioids."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Mood Disorders • Pain • Psychiatry • Substance Abuse

Tusi but not 2C: A Miami-Dade medical examiner case series highlighting the variable drug composition in colored powder paraphernalia. (PubMed, J Forensic Sci) - "Other substances identified in the powders include stimulants (cocaine, methylenedioxyamphetamine [MDA], and methamphetamine), opioids (oxycodone), benzodiazepines (alprazolam), synthetic cathinones (eutylone), and over-the-counter medications (diphenhydramine and loratadine). Five of the powders contained cocaine; however, none contained fentanyl or 4-bromo-2,5-dimethoxyphenethylamine (2C-B)...The peripheral blood concentrations of ketamine and its metabolite, norketamine, ranged from 0.38-8.8 and 0.16-3.0 mg/L, respectively, and the concentration of MDMA and its metabolite, MDA, ranged from 0.10-3.0 and <0.01-0.27 mg/L, respectively. The medical examiner cases reported are the first to illustrate, through analytical testing, the variable drug composition of "tusi" powders and the impact its use may have in medicolegal death investigation."

Journal • Addiction (Opioid and Alcohol)

An Extension Test of Whether to Use Oral Anti-anxiety Drugs (XANAX) When Patients Choose Second Eye Cataract Surgery After Unblinding, and Analyze Their Anxiety, Satisfaction and Pain Satisfaction (clinicaltrials.gov) - P4 | N=250 | Not yet recruiting | Sponsor: National Taiwan University Hospital

New P4 trial • Anesthesia • Cataract • Ophthalmology • Pain • Psychiatry

Delayed Post-hypoxic Leukoencephalopathy: An Elusive Diagnosis (AAN 2025) - "Objective:To report two cases of Delayed Post-Hypoxic Leukoencephalopathy (DPHL) associated with Mounjaro injections for weight loss, and Xanax intentional overdose, respectively.Background:DPHL is a rare and underrecognized condition of white matter injury provoked by cerebral hypoxia. DPHL is characterized by a biphasic presentation where there is a deceiving initial neurological improvement after a cerebral hypoxic event, only for further deterioration to occur shortly after. Obtaining a thorough and detailed history, along with recognizing the classic clinical presentation and imaging patterns should alert clinicians to such diagnosis, and can help avoid unnecessary expensive investigations and futile treatments."

CNS Disorders • Depression • Immunology • Oncology • Psychiatry

Comparison of the effects of two amino acids, Gamma-aminobutyric acid (GABA) and L-theanine, on sedation, anxiety, and cognition in preoperative surgical patients - A randomized controlled study. (PubMed, J Anaesthesiol Clin Pharmacol) - "Psychomotor and cognitive functions improved with L-theanine and GABA (P = 0.0001) and decreased with alprazolam (P = 0.0001). GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills."

Journal • Anesthesia • Psychiatry

Evaluating the Anxiolytic Efficacy of Oral Alprazolam in Modulating Vital Parameters During Minor Oral Surgical Procedures: A Quasi-experimental Study. (PubMed, Cureus) - "Premedication with 0.25 mg oral alprazolam effectively alleviated anxiety and stabilized vital parameters during minor oral surgeries, thereby enhancing patient comfort and procedural efficacy. These findings emphasize the importance of incorporating anxiolytic strategies into dental practice to optimize patient care and surgical outcomes. Future studies should explore different doses and broader populations to refine the anxiolytic interventions."

Journal • Anesthesia • Psychiatry

Identifying bromazolam, etizolam, and flualprazolam in blood using gas chromatography-mass spectrometry. (PubMed, J Forensic Sci) - "A method originally validated to identify and quantitate alprazolam was modified to quantitate flualprazolam, etizolam, and bromazolam, as well as identify adinazolam and 4'-chloro-deschloroalprazolam. The most prevalent drugs found with bromazolam in the blood were fentanyl, methamphetamine and/or amphetamine, and cocaine. The optimized GC-MS method provides a way to identify and quantitate designer benzodiazepines in postmortem blood and to also qualitatively monitor two newer designer benzodiazepines: 4'-chloro-deschloroalprazolam and adinazolam."

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Brain lipidomic profiles of sleep enhancement through co-administration of alprazolam and CGS21680. (PubMed, FEBS Lett) - "Other lipid classes exhibited reductions, with fatty acids decreasing in 10 regions, carnitines in seven regions, ceramides in nine regions, and diacylglycerols in 10 regions. The research provides valuable insights into sleep-related regulation pathways by delineating the regulation of various lipid biomarkers in multiple brain regions."

Journal • Anesthesia

Anxiety and Surgery Satisfaction for Cataract Patient With Different State Anxiety (clinicaltrials.gov) - P=N/A | N=30 | Recruiting | Sponsor: National Taiwan University Hospital

New trial • Anesthesia • Cataract • Ophthalmology • Pain • Psychiatry

Evaluating the Usefulness of Online Tools for Detecting Inappropriate Prescriptions in the Geriatric Population at a Tertiary Care Teaching Hospital in Central India: A Retrospective Study. (PubMed, Cureus) - "Of which, furosemide, alprazolam and digoxin were identified exclusively by this online software with appropriate substantiating evidence. This study provides insight into how to remain cautious while prescribing drugs to elderly patients and stimulates physicians to utilize the available tools in routine practice. By adequate compilation of many such Indian studies on the elderly population, it will be possible to develop guidelines for prescribing in the elderly Indian population."

Journal • Retrospective data

Impact of Chinese criteria on potentially inappropriate medication use in China. (PubMed, J Glob Health) - "We used interrupted time series analysis on the prescription data of older outpatients from 59 hospitals in six major geographic regions of China to compare changes in the overall prevalence of PIM use, the prevalence of PIM use stratified by different numbers of PIMs, and the prevalence of top five PIMs (i.e. clopidogrel, estazolam, zolpidem, sliding-scale insulin, and alprazolam) from 2015 (before) to 2021 (after) the release of criteria in 2018. Conversely, there was a significant increase in the prevalence of zolpidem, after the criteria were released (β = 0.030; 95% CI = 0.002, 0.057; P = 0.036). We found that the release of criteria for effectively identifying and managing PIM use has had a positive effect on its prevalence among older outpatients in China."

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