Side effects of xanax in the elderly: Alprazolam (Oral Route) Before Using

11.08.202307.07.2023 by alexxlab

Side Effects Of Xanax On The Elderly

Xanax is a short-acting benzodiazepine (benzo), also known by its generic name alprazolam. Benzodiazepines are among the most common medications prescribed for anxiety and panic disorders in older adults.

However, use of benzodiazepines is not recommended in older adults and is associated with several adverse effects. Along with an increased risk of injuries, alprazolam may be a risk factor for dementia and Alzheimer’s disease.

Effects Of Xanax On The Elderly

Alprazolam is in a class of controlled substances called benzodiazepines, which are central nervous system (CNS) depressants. Benzos slow nerve activity in the CNS by increasing the effect of the neurotransmitter gamma aminobutyric acid (GABA). This lowers anxiety and increases sedation.

Other benzodiazepines include:

valium (diazepam)
ativan (lorazepam)
klonopin (clonazepam)

Side Effects Of Xanax

According to the Food and Drug Administration (FDA), the elderly may be more sensitive to the side effects of benzodiazepines.

These side effects may include:

drowsiness
lightheadedness
depression
headache
confusion
dizziness
impaired coordination

Older adults who are prescribed alprazolam should be started on the lowest possible dose (0.25 mg) and increased slowly as needed. This can help prevent some of the more serious adverse effects.

Metabolism In The Elderly

A younger adult taking alprazolam will process the drug much quicker than an elderly person. Alprazolam will peak in a younger individual’s bloodstream within the first two hours of taking it.

Within 11 hours, the total concentration of alprazolam in their blood will reduce to half (half-life). In older adults, the half-life of alprazolam is about 16 hours. This longer half-life can lead to a toxic amount of alprazolam in their system if they take it too frequently.

Falls & Fractures

Benzodiazepines account for a large number of avoidable emergency room visits. Many older adults taking alprazolam experience falls and fractures as a result of impaired coordination and confusion.

The risk of falls and fractures is highest in the first two weeks of taking alprazolam and with each increased dose.

Risk Of Dementia & Alzheimer’s Disease

Alzheimer’s is a progressive disease that affects behavioral and cognitive functions, especially memory. Alzheimer’s may be a cause of dementia, which is the loss of cognitive abilities that is severe enough to interfere with your life.

Several studies have shown benzos to be a risk factor for dementia and Alzheimer’s in geriatric patients. However, early symptoms of dementia mimic symptoms of anxiety and insomnia, which is a possible reason for this association.

Does Xanax Cause Alzheimer’s?

Although it does not cause it, several studies have found benzodiazepines may increase the risk of Alzheimer’s. This association may be linked to the longer half-life of alprazolam in the elderly.

Taking alprazolam long-term can lead to a large accumulation of the drug in your system. This increases the likelihood of memory impairment and may lead to irreversible effects on cognition and memory.

Alternative Treatments

Benzodiazepines are most commonly used to treat anxiety because they are effective from the first dose. However, the benefits of any treatment program must outweigh the risks.

Alprazolam can be a high-risk medication for younger individuals but can be even more dangerous in older people.

Alternative treatments may include:

Antidepressants

Many individuals being treated for anxiety may be successful using an antidepressant. Antidepressants have to be taken long-term to work but they are much safer, especially in the elderly population.

Buspar

Buspar is the brand name for buspirone, a non-addictive and less potent medication that is effective for anxiety.

Caregivers of elderly individuals may choose to discuss alternative treatment options with healthcare professionals.

Learn more about Xanax Alternatives

Xanax Withdrawal & Rebound Anxiety

Alprazolam is intended for short-term treatment of anxiety and panic disorders. Long-term use can lead to physical dependence and addiction. Physical dependence means your body needs the drug to function or you may experience withdrawal symptoms.

You should seek medical attention for benzo withdrawal because it can become life-threatening.

Withdrawal symptoms include:

seizures
muscle cramps
diarrhea
blurred vision
loss of appetite
pins and needles
muscle twitch

Older adults also have a higher risk for rebound anxiety when they stop taking alprazolam. Rebound anxiety is the return of intense anxiety that is greater than before they started taking alprazolam.

Xanax Addiction Treatment

If you’re dependent on or addicted to alprazolam, it is not recommended to suddenly stop this medication. Medical detox can help you taper off alprazolam and give you access to further treatment options.

Aftercare may include long-term inpatient or outpatient programs, which are beneficial for long-term recovery from addiction.

If you or a loved one is seeking addiction treatment, please contact Ark Behavioral Health to speak with a specialist.

Written by Ark Behavioral Health Editorial Team

©2023 Ark National Holdings, LLC. | All Rights Reserved.

This page does not provide medical advice.

Sources

DailyMed – Xanax (Alprazolam) Tablets
Harvard Medical School – Benzodiazepine Use May Raise Risk of Alzheimer’s Disease
Mayo Clinic – Benzodiazepine Use in Older Adults: Dangers, Management, and Alternative Therapies
National Library of Medicine – Anxiety in the Elderly: Treatment Strategies
National Library of Medicine – Risk of Dementia in Long-Term Benzodiazepine Users: Evidence from a Meta-Analysis of Observational Studies

Despite risks, benzodiazepine use highest in older people

Prescription use of benzodiazepines — a widely used class of sedative and anti-anxiety medications — increases steadily with age, despite the known risks for older people, according to a comprehensive analysis of benzodiazepine prescribing in the United States. Given existing guidelines cautioning health providers about benzodiazepine use among older adults, findings from the National Institutes of Health-funded study raise questions about why so many prescriptions — many for long-term use — are being written for this age group.

The study found that among all adults 18 to 80 years old, about 1 in 20 received a benzodiazepine prescription in 2008, the period covered by the study. But this fraction rose substantially with age, from 2.6 percent among those 18 to 35, to 8.7 percent in those 65 to 80, the oldest group studied. Long-term use — a supply of the medication for more than 120 days — also increased markedly with age. Of people 65 to 80 who used benzodiazepines, 31.4 percent received prescriptions for long-term use, vs. 14.7 percent of users 18 to 35. In all age groups, women were about twice as likely as men to receive benzodiazepines. Among women 65 to 80 years old, 1 in 10 was prescribed one of these medications, with almost a third of those receiving long-term prescriptions.

“These new data reveal worrisome patterns in the prescribing of benzodiazepines for older adults, and women in particular,” said Thomas Insel, M.D., director of the National Institute of Mental Health (NIMH), which supported the study. “This analysis suggests that prescriptions for benzodiazepines in older Americans exceed what research suggests is appropriate and safe.”

Benzodiazepines — named for their chemical structure — are among the most commonly prescribed medications in developed countries. They include alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan). The most common uses of benzodiazepines are to treat anxiety and sleep problems. While effective for both conditions, the medications have risks, especially when used over long periods. Long-term use can lead to dependence and withdrawal symptoms when discontinued. In older people, research has shown that benzodiazepines can impair cognition, mobility, and driving skills, and they increase the risk of falls.

Despite the large number of prescriptions in the United States — 85 million in 2007 — relatively little was known prior to this study about the specifics of benzodiazepine prescribing in the United States relative to other countries. Mark Olfson, M.D., M.P.H., at the New York State Psychiatric Institute and Columbia University; Marissa King, Ph.D., at Yale University; and Michael Schoenbaum, Ph.D., at NIMH used data from a national prescription database (IMS LifeLink LRx Longitudinal Prescription database) and a national database on medical expenditures collected by the Agency for Healthcare Research and Quality to examine prescription patterns from 2008.

Among the findings:These medications can pose real risks, and there are often safer alternatives available,” said Dr. Schoenbaum, who was senior author. “Our findings strongly suggest that we need strategies to reduce benzodiazepine use, particularly for older women.”

Use of benzodiazepines increased steadily with age: 5.2 percent of adults 18 to 80 years old received one or more benzodiazepine prescriptions in 2008; 2.6 percent of those 18 to 35, 5.4 percent of those 36 to 50, 7.4 percent of those 51 to 64, and 8.4 percent of those 65 to 80.
Overall, about one quarter of prescriptions involve long-acting formulations of benzodiazepines.
Most prescriptions for benzodiazepines are written by non-psychiatrists. For adults 18 to 80 years old, about two thirds of prescriptions for long-term use are written by non-psychiatrists; for adults 65 to 80, the figure is 9 out of 10.

Benzodiazepines are effective in relieving anxiety and take effect more quickly than antidepressant medications often prescribed for anxiety. However, the prevalence of anxiety disorders declines with age. Practice guidelines recommend nonpharmacologic approaches and antidepressants over benzodiazepines as first-line treatment. Rates of insomnia increase with age, but practice guidelines recommend that health care providers consider behavioral interventions as first-line treatment over medication. Neither of these conditions explains the rates of prescribing benzodiazepines for older age groups.

Adding to concerns about the possible health consequences of benzodiazepine use, a recently reported study found an association between benzodiazepine use in older people and increased risk of Alzheimer’s disease. The association was stronger with increasing length of use; the risk was nearly doubled for those using benzodiazepines for more than 180 days.

The study appears online December 18 in JAMA Psychiatry.

About the National Institute of Mental Health (NIMH): The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit http://www.nimh.nih.gov.

About the National Institutes of Health (NIH):
NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health^®

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What is Xanax? Is Xanax a drug? Contact your doctor!

How Xanax works

Alprazolam, an active ingredient in the benzodiazepine group, has a depressant effect on the central nervous system. The drug reduces emotional stress, relieves anxiety, worry and fear. At the same time, the medicine has a hypnotic effect – it shortens the time to fall asleep, increases the duration of sleep, and reduces the number of nocturnal awakenings.

With an increase in the dosage of Xanax, leads to drug intoxication. With regular use, it is addictive and addictive, even if taken strictly according to the doctor’s instructions. Despite the fact that drugs are prescribed by a doctor and are sold only by prescription, more and more people are dependent on them. The distribution and over-the-counter sale of this drug is punishable by law, however, this stops few people.

Alprazolam and its analogues may be prescribed if the person is concerned about:

alarm conditions;
sleep disorders;
neuroses;
panic attacks;
anxiety-depressive states, neurotic depressions.

Xanax can also be prescribed in the complex treatment of somatic diseases, drug addiction and alcoholism.

The tranquilizer begins to act very quickly – the person’s mood immediately improves, he feels physical and mental relaxation.

Antidepressant is available in tablets, the dosage is prescribed by the doctor. In case of non-compliance with the rules of admission and regular use of the remedy for depression, a person develops dependence.

Drug addicts experience mild euphoria, peace, self-confidence, physical comfort, calmness after taking Xanax. In some cases, the feeling of fear disappears, which can manifest itself in driving without rules, the absence of fear of heights.

How side effects manifest themselves

When used properly, Xanax effectively relieves anxiety and panic attacks. But the drug is not suitable for everyone and can cause side effects. Also, a side effect can be observed if the dosage is violated.

The drug slows down the reaction, causes drowsiness. But, when the dosage is exceeded, the tranquilizer causes euphoria . A severe overdose can cause fear, aggression, suicidal thoughts.

The drug in large doses affects not only the psyche, it can also cause intestinal disorders, deterioration of the liver, menstrual cycle disorders in women, rashes, itching.

The drug is prescribed only if there are no contraindications.

How Xanax Addiction Develops

Xanax addiction is not limited to those who use it as a drug. Addiction is also formed in those who drink pills strictly according to the instructions. Prolonged use of a tranquilizer causes withdrawal symptoms. By reducing the dose of pills or stopping them, a person feels a number of extremely unpleasant symptoms. Without a tranquilizer, the addict cannot fully exist – he feels depressed, irritable, tense. Physical manifestations in the form of insomnia, dizziness, sweating, and a general deterioration in well-being are added to psychological discomfort.

If Xanax is prescribed by a physician and the patient adheres to the dosage, addiction develops slowly. Gradually, the drug loses its therapeutic effect, so either a large dosage or a replacement of the drug is required. The specialist controls these moments and selects a safe treatment regimen.

If a tranquilizer is used to achieve drug intoxication, addiction is formed in 2-3 months.

To achieve a euphoric effect, the drug is taken:

overdose, several tablets at a time;
combined with alcohol and other drugs.

Stages of drug addiction

The process of addiction formation is usually divided into stages.

Stage I: mental dependence. Xanax is great for anxiety disorders, neuroses, and depression. But in order to cure the cause of the disease, an integrated approach is needed. If you treat only the manifestations, the cause will not go anywhere. The patient cannot refuse the medicine because he is afraid of the return of unpleasant symptoms. With medicine, a person feels better, but without it, psychological problems return – anxiety is restored, panic attacks are repeated.
Stage II: physical dependence. Long-term use of alprazolam is addictive, the usual number of tablets no longer works. In this case, you need to adjust the treatment with your doctor, but some patients increase the dose on their own. This is where the key mistake lies. The substance begins to accumulate in the body and is included in metabolic processes.
stage III: withdrawal syndrome. If you abruptly stop taking the medicine, the patient’s condition will worsen. Drug withdrawal is added to the psychological discomfort. Withdrawal becomes so unbearable that it is easier for a person to take a new dose than to endure this state.

Signs of drug dependence

The very first sign of drug addiction is an acute need for sensations of euphoria, a surge of strength, vivacity, which are caused by a tranquilizer in an increased dosage.

Without taking a narcotic substance, the following are observed:

irritability, tension, dissatisfaction, capriciousness;
hypertension;
tachycardia;
tremor;
pale skin.

As time goes on, the symptoms get worse and the withdrawal becomes very severe.

Causes of drug dependence

Addiction is formed as a result of the interaction of biological, psychological and social factors. Heredity, brain injury, example of drinking parents, environment, lack of attention in childhood can play a role in the formation of drug addiction. The reasons can be both obvious and non-obvious. Quite often, quite healthy people from prosperous families become drug addicts, the reason for this may be unresolved psychological problems, general dissatisfaction with life. Creative people can also be addicted in search of inspiration.

The main problem of addiction treatment is that the person denies addiction to the drug. Most drug addicts believe that they can stop using at any time. It is extremely difficult to persuade such a person to be treated.

What is abstinence and how does it manifest itself

Withdrawal syndrome or abstinence is a manifestation of ailments when the dosage of the drug is reduced or when it is canceled. Withdrawal symptoms depend on what exactly the addict uses, on the general state of health, associated addictions, and alcoholism. At the peak of withdrawal, auditory and visual hallucinations, panic attacks, thoughts of suicide can occur. With prolonged use, abstinence can last up to 2-3 weeks, and then for several more months the patient may experience apathy, sleep disturbances, and fatigue.

Manifestations of withdrawal symptoms:

palpitations;
abdominal pain, indigestion;
nausea, vomiting;
increased sweating;
jumps in blood pressure;
pain all over the body;
feeling of anxiety, fear;
insomnia at night, drowsiness during the day;
aggression;
intolerance to bright light, loud sounds.

At stages 1-2, withdrawal is not so pronounced, the addict is still able to cope with it. The longer the experience of use, the more painful the breakdowns are. The addict sees the only salvation in a new dose of the substance.

Consequences of taking

With prolonged use, the effect of the pills decreases, so the addict increases the dose. To increase the effect, the tranquilizer is mixed with alcohol and other drugs. Because of such experiments, overdoses often occur.

Signs overdose :

confusion;
pale skin;
slow heart rate;
chills;
sweating;
tremor;
vomiting;
violation of coordination.

This is a serious medical emergency.

Long-term uncontrolled drug use leads to:

conduct disorders;
depression, suicidal ideation;
neurotic disorders;
disorders of the liver, kidneys, cardiovascular system;
deterioration of the brain, difficulty in speech, memory impairment;
the use of alcohol and other drugs to enhance the effect.

Over time, a person loses his job, old friends, family relationships collapse. The addict may start drinking, stealing. Former values lose all meaning, there is a degradation of the individual.

Xanax addiction prevention

If a doctor has prescribed Xanax for the treatment of serious psychological conditions, it is necessary to strictly observe the dosage and not forget about preventive measures.

Only a specialized specialist can prescribe a medicine after an examination. It is necessary to exclude contraindications.
It is important to follow the recommendations during treatment. If you have a feeling that the tranquilizer has stopped working or is causing unpleasant symptoms, be sure to tell your doctor. The specialist will either revise the dosage or prescribe a different medication. It is forbidden to increase the dose on your own to achieve the desired effect.
Do not drink alcohol during treatment with Xanax. In addition, alprazolam is incompatible with a number of other drugs when used simultaneously.
Xanax cannot be stopped abruptly. Withdrawal syndrome during withdrawal occurs even in those who took the drug clearly according to the doctor’s instructions. It may take several months to phase out the tranquilizer.

What to do if a person uses Xanax?

If you have a persistent desire to take Xanax, you should immediately contact the doctor who prescribed the tranquilizer. If Xanax was originally used as a narcotic drug, then one cannot do without the help of a narcologist.

Xanax addiction treatment is carried out in stages in the inpatient drug treatment clinic.

First, detoxification is carried out – complete cleansing of the body from alprazolam. Toxins are removed from the body using droppers containing saline, sedatives, vitamins and other components. Detoxification also helps with withdrawal symptoms.

The doctor then prescribes therapy based on the history of use and the general health of the patient. Recovery of the body involves medical procedures, physiotherapy, diet and sleep.

Rehabilitation is of great importance. When the body is cleansed and restored, it is important to consolidate the result. During the course of rehabilitation, the patient visits a psychotherapist, group and individual sessions, restores communication skills, social connections. Be sure to work with the relatives of the patient. Experts recommend going through a rehabilitation course in the treatment of any stage of drug addiction.

Many people ask if it is possible to cure addiction on their own. In rare cases, a person manages to overcome drug addiction on his own. This requires motivation, willpower, the right environment, the ability to cope with withdrawal symptoms without taking drugs. But, unfortunately, most often, independent attempts end up in the search for a new dose, so you can’t ignore the problem in any case. To help yourself or your loved ones, do not hesitate, seek help from specialists.

Alprazolam (Zolomax)

Alprazolam is a sedative used to treat anxiety/stress/depression, panic attacks and sleep disorders.

Analogues (generics, synonyms)

Zolomax;
Xanax;
Alzolam.

Available by prescription, listed in the register of strict reporting.
Active ingredient: Alprazolam

Prescription form 148-1/u-88
Latin prescription:
Rp.: Alprazolami 0.00025
D.t.d.: No. 50 in tab.
S: Take by mouth. 1-3 tablets of
for anxiety/panic attacks.
Do not exceed 5 tablets per day.

Rp.: Alprazolami 0.001
D.t.d.: No. 50 in tab.
S: Take by mouth. 1-2 tablets of
for anxiety/panic attacks.
Do not exceed 3 tablets per day.

Form
The product is produced in tablets with a dosage of 0.25 mg and 1 mg, 50 pieces per pack.

1 tablet of Alprazolam 0.25 contains:
Alprazolam 0.25 mg;
Additional ingredients including milk sugar.

1 tablet of Alprazolam 1.0 contains:
Alprazolam 1 mg;
Additional ingredients including milk sugar.

Mechanism of action
It is thought to exert its action by binding to stereospecific receptors located in the SCN. It has anxiolytic, hypnotic, muscle relaxant and anticonvulsant properties, and also has specific activity in stress crises.

Therapeutic indications
Neuroses, anxieties and fears of various origins, reactive psychoses, panic attacks.

Directions for use
Orally, swallowed whole, with or without food, with plenty of liquid. The dosage is adjusted by the doctor depending on the disease. The maximum daily dose is 10 mg.

Contraindications
Hypersensitivity to alprazolam, benzodiazepines, myasthenia gravis, insuf. Severe respiratory illness, sleep apnea syndrome, severe I. H., angle-closure glaucoma. Acute poisoning by alcohol or other substances acting on the central nervous system.

Warnings and precautions
History of alcohol or drug addiction. It can cause tolerance, physical and mental dependence, bouts of insomnia and anxiety; cause anterograde amnesia; cause psychic and paradoxical reactions, especially in children and the elderly. It is not recommended as a primary first-line psychotic treatment, nor is it used alone for depression-related anxiety due to the risk of suicide. . Do not use in children (<18 years). Use lower doses in the elderly and patients with chronic respiratory failure due to the associated risk of respiratory depression.

Liver failure

Contraindicated due to associated risk of encephalopathy. Caution with moderate-acting intravenous infusion, reduce dose.

Renal failure
Precaution. Adjust doses to avoid severe sedation.

Interactions

Increases sedation: alcohol.
The depressive effect on the central nervous system is enhanced by: antipsychotic (neuroleptic), hypnotics, anxiolytic sedatives, antidepressants, antiepileptic, anesthetic and sedative antihistamines, liver enzyme inhibitors (cytochrome P450 3A4), narcotic analgesics (increase the sedative effect during euphoria may enhance mental addiction).
Do not administer with: antifungal azoles. Reduce dose with: nefazodone, fluvoxamine, and cimetidine.

Precautions: fluoxetine, dextropropoxyphene, oral contraceptives, diltiazem, macrolides. Adjust dosage or stop taking the drug. C: ritonavir.
Increases plasma concentrations of digoxin, especially in the elderly.

Pregnancy
There are no reliable data on teratogenicity and effects on behavior and postpartum development after treatment with benzodiazepines. Initial studies with other drugs from the benzodiazepine group showed that the effect of these drugs on the uterus may be associated with malformations. Subsequent studies of this group of drugs have not shown clear evidence of their association with any type of defect.
There are insufficient data on the use of alprazolam in pregnant women.
Alprazolam is not recommended during pregnancy unless the expected benefits to the mother outweigh the potential risks to the fetus.
If, for medical reasons, alprazolam is prescribed late in pregnancy or at high doses during labor, the neonate may experience effects such as hypothermia, hypotension, and mild respiratory depression.
Babies born to mothers who took benzodiazepines chronically during the last period of pregnancy may develop physical dependence that can cause postpartum withdrawal symptoms.

Breastfeeding
Although levels of benzodiazepines excreted in breast milk (including alprazolam) are low, their use is contraindicated in breastfeeding mothers.