alprazolam / Generic mfg. - LARVOL DELTA

THE TWILIGHT ZONE: A CASE REPORT OF DELAYED EMERGENCE AFTER GENERAL ANESTHESIA FOR A ROUTINE CYSTOSCOPY (ASRA-SPRING 2025) - "Her home medications prior to the procedure included diphenhydramine 25 mg, Imbruvica 140 mg, Flexeril 5 mg, Prazosin 2 mg, alprazolam 1 mg, zolpidem 10 mg, ropinirole 1 mg, Seroquel 100 mg...Induction was performed with propofol, fentanyl, rocuronium and maintenance with sevoflurane...She was reversed appropriately with sugammadex with qualitative TOF showing 4 twitches without fade prior to extubation...Our suspicion is that this patient may have suffered delayed emergence secondary to residual effects of volatile anesthetics or potentially secondary to a psychiatric disorder related to a catatonic response. Figure 1 displays a broad range of differential diagnoses to keep in mind when encountering a patient with DE."

Case report • Clinical • Anesthesia • Cardiovascular • Chronic Lymphocytic Leukemia • Chronic Obstructive Pulmonary Disease • CNS Disorders • Depression • Dyslipidemia • Gastroesophageal Reflux Disease • Hematological Malignancies • Hypertension • Immunology • Leukemia • Mental Retardation • Metabolic Disorders • Oncology • Pain • Psychiatry • Respiratory Diseases • Rheumatology • Type 2 Diabetes Mellitus

Poisonings With Opioids and Benzodiazepines in Denmark: A Retrospective Study From the Danish Poison Information Centre. (PubMed, Basic Clin Pharmacol Toxicol) - "In our 9-year study period, we observed large increases in poisonings with alprazolam and oxycodone. In the remaining drugs examined, we observed no change or even a reduction of the poisonings when adjusted for the general increase in enquiries to the DPIC."

Journal • Observational data • Retrospective data • Addiction (Opioid and Alcohol) • CNS Disorders • Insomnia • Mood Disorders • Pain • Psychiatry • Sleep Disorder

Neuro-ophthalmic findings of Visual Snow Syndrome in Korea. (PubMed, Jpn J Ophthalmol) - "Korean patients with VSS exhibited clinical features, neuroimaging findings, and treatment responses similar to those reported in Western populations. Ophthalmic procedures, such as refractive surgery and bright-light examinations, may act as potential triggers in susceptible individuals. Although functional imaging, including 18F-FDG PET, may be useful for evaluating VSS, further studies with healthy controls and quantitative analyses are needed to validate its diagnostic value. Given the modest treatment efficacy, a multidisciplinary approach combining pharmacological intervention, filter glasses, and psychological support is essential to optimize outcomes."

Journal • CNS Disorders • Depression • Ophthalmology • Psychiatry

A Case of Creutzfeldt-Jakob Disease, a Rare Differential for Memory Loss and Neurological Deficit (ATS 2025) - "Here, we present a patient diagnosed with sporadic CJD.Clinical Case Summary:A 61-year-old male presented to the ED for memory loss following three weeks of behavioral changes, a diagnosis of major depressive disorder, and a three-day trial of escitalopram and alprazolam. Though CJD is uniformly fatal, broad differential for neurologic deficits, early diagnosis, and referral to palliative care can improve patient quality of life with early supportive treatment. When there is suspicion for CJD, broad workup of rapidly progressive dementia should always be performed to rule out reversible causes and expedite end-of-life care."

Clinical • Absence Seizure Disorder • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • Depression • Epilepsy • Immunology • Major Depressive Disorder • Mood Disorders • Movement Disorders • Palliative care • Parkinson's Disease • Psychiatry

Burning Up - How Heat Stroke Can Spark GBS (ATS 2025) - "Case Presentation: A 50-year-old female with diabetes mellitus and bipolar disorder (managed with citalopram, high-dose quetiapine, alprazolam, and oxcarbazepine) presented with acute confusion and lethargy...A central line was placed, and sedation was maintained with midazolam... Guillain-Barré Syndrome secondary to heat stroke presents a unique diagnostic challenge. This case highlights the critical role of early diagnosis and intervention, as timely initiation of IVIG may improve prognosis. Further research into the pathophysiological link between heat stroke and GBS could better inform clinical management and enhance awareness of this rare association."

Anesthesia • Bipolar Disorder • Cardiovascular • CNS Disorders • Diabetes • Epilepsy • Infectious Disease • Metabolic Disorders • Mood Disorders • Myositis • Pain • Psychiatry • Respiratory Diseases

Benzodiazepine and Opioid Withdrawal Induced Neuroleptic Malignant Like Syndrome: A Clinical Case Report With Management Complexities. (PubMed, Neuropsychopharmacol Rep) - "This patient was a 54-year-old man in a northern Iranian city with dependency on 20-30 mg of alprazolam and 120-150 mg of acetaminophen-codeine daily for over a year and a half. The clinical difficulty of identifying and treating Neuroleptic Malignant Like Syndrome (NMLS), which is brought on by benzodiazepine and opioid withdrawal, is illustrated by this case."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders

Effects of Acamprosate on Alprazolam-Induced Conditioned Place Preference in Male Rats: The Role of GABA and NMDA Receptor Subunits. (PubMed, Eur J Pharmacol) - "Besides, the gene expression of NR1, NR2A, and NR2B subunits of NMDA receptors were significantly enhanced by acamprosate (P<0.001). These findings suggest that acamprosate is able to reduce the duration of extinction and reinstatement of alprazolam-induced CPP in male rats."

Journal • Preclinical • Addiction (Opioid and Alcohol)

Utilizing Physiologically Based Pharmacokinetic Models to Support Rational Medication in Chinese Elderly Population. (PubMed, Drug Des Devel Ther) - "For Chinese elderly, PBPK models for four drugs (ticagrelor, rivaroxaban, alprazolam, midazolam) showed strong agreement with observed data. In conclusion, PBPK models for 50 commonly prescribed drugs within the Chinese elderly population were developed, tackling general data gaps associated with these specific medications. Medication plans were developed specifically tailored for the elderly population, presenting an alternative methodology and perspective for the implementation of individualized and rational medication practices."

Journal • PK/PD data • Psychiatry

Carbon Materials in Voltammetry: An Overview of Versatile Platforms for Antidepressant Drug Detection. (PubMed, Micromachines (Basel)) - "Moreover, the combination of voltammetric approaches with the unique characteristics of carbon and its derivatives has led to the development of powerful electrochemical sensing tools for detecting antidepressant drugs, which are highly desirable in healthcare, environmental monitoring, and the pharmaceutical industry. In this review, carbon-based materials, such as glassy carbon and boron-doped diamond, and a wide spectrum of carbon nanoparticles, including graphene, graphene oxides, reduced graphene oxides, single-walled carbon nanotubes, and multi-walled carbon nanotubes were described in terms of the sensing performance of agomelatine, alprazolam, amitriptyline, aripiprazole, carbamazepine, citalopram, clomipramine, clozapine, clonazepam, desipramine, desvenlafaxine, doxepin, duloxetine, flunitrazepam, fluoxetine, fluvoxamine, imipramine, nifedipine, olanzapine, opipramol, paroxetine, quetiapine, serotonin, sertraline, sulpiride, thioridazine, trazodone, venlafaxine,..."

Journal • Review • CNS Disorders • Depression • Mood Disorders • Personality Disorder • Psychiatry

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."

Journal

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)