Alprazolam

This benzodiazepine ^[1] ^[2] produce reinforcing effects indicating misuse liability in subjects with histories of drug misuse. Alprazolam’s misuse potential stems from its unique pharmacokinetic properties of rapid absorption, low lipophilicity, and short half-life Alprazolam and alprazolam-XR carry the same general risk of withdrawal as other benzodiazepines. There are also encouraging case reports and case series with the use of other antiseizure medications to help alleviate symptoms of benzodiazepine withdrawal. There are 3 case reports suggesting that valproate may be effective for the treatment of sedative-hypnotic withdrawal, but a double-blind, placebo-controlled study failed to replicate the results. When gabapentin, an antiseizure medication with high affinity for voltage-gated calcium channels was added to a structured withdrawal regimen in patients with benzodiazepines use disorder for rapid inpatient withdrawal (less than a week); patients experienced minimal discomfort and the added benefit of reduced cravings for benzodiazepines. ^[3]