Some aspects of the psychopharmacologic effectiveness of Alprazolam (Xanax, Xanor) in a general somatic practice. Often occurrence of the anxiety and depression in the whole population and prevalence of these abnormalities in patients of a somatic type - define the urgency and practical meaning of search of the drugs with analeptic and anxiolytic actions, which meet such requirements as capacity and speed of the psychopharmacologic effect, safety and life quality as well. One of the medications of the kind, combining the effects mentioned above is Alprazolam (Xanax, Xanor). The aim of the investigation is a specification of psychopharmacologic effectiveness of the medication in a general somatic practice.
The principal method of investigation is clinicopsychopathological one using structurally dynamic analysis.
Alprazolam is a benzodiazepine derivative which contains a triazol ring. This triazol ring distinguishes Alprazolam from other benzodiazepines by chemical structure as well as pharmacokinetic characteristics and pharmacological action. Further to anxiolytic and anticonvulsant activity, the medicament has an antidepressant effect as well. It allowed including Alprazolam into the group of antidepressants.
We investigated 28 patients in age from 28 to 70 years old (middle age is 39, 1). All the patients were studied by internists in the multiple-discipline territorial hospital and then were directed to the psychiatrists. Patients with gastroenterology disorders (17 persons), with diagnosis of climacteric syndrome (8 persons), vascular dystonia and neurocirculatory dystonia of hypertensive type (3 persons) have prevailed as for somatic pathology. Psychopathological evaluation has allowed defining an anxiety - depressive syndrome in all 28 patients. The duration of disorders was from 0,5 to 10 years.
The patients got Alprazolam in the form of monotherapy in dose from 0.5mg/24 hours to 4mg/24 hours. The course of the therapy varied from 1-2 to 6 months. The control checkups of the patients were carried out week by week.
Against the psycho pharmacotherapy there was a significant reduction of the affective asthenia, imitating asthenic symptom complex, vegetative characteristics became stabilize but first of all, anxiety disorders (predominantly somatic anxiety) were subjected to regression. The mental component of anxiety affect has in fact significantly graded by the end of the second week and since that time inverse dynamic of depression was noticed. On the whole an acceptability of the medicament was good and life quality of the patients was not disturbed. As for side effects (6,5% of cases) it is possible to define a pronounced sedative influence with muscle relaxation and flabbiness during first 2-3 days, drowse and 4% of the patients had a dry mouth. In none of the cases side effects led to cessation of Alprazolam therapy and more than that all of the side effects were reduced by the 5th day of the treatment. A long-term use of the medicament till 6 months in four cases (in the frames of panic disorder) defined the necessity of the main reducing of the daily dose of Alprazolam. More sharp decrease of the daily dose of the medication led to anxiety appearance, unpleasant muscular sensations (of a migratory type); there could be a sleep disturbance during a falling asleep stage.
A positive pharmacotherapeutic activity, conventionally defined as “very good” (by the type of the convalescence) was marked in 19 patients (67,8%), “good”
