Alprazolam, commonly referred to by its brand name Xanax, is the one of the most common benzodiazepine used. Benzodiazepines like alprazolam are anxiolytics (antianxiety drugs) used in the treatment of a number of diseases including panic disorder, generalized anxiety disorder and social anxiety disorders. Occasionally the drug is used for nausea and vomiting symptoms associated with chemotherapy. (PubMed Health “Alprazolam” May 2017).
Alprazolam Mechanism of Action
Alprazolam, like all benzodiazepines, binds nonspecifically to benzodiazepine receptors at the BDZ site. This bind tightens the connection of GABA with the receptor and results in increasing hyperpolarization of neurons. This mechanism is the base for the drug’s antianxiety effects.
Alprazolam Side Effects
Alprazolam has a significant effect on a major neurotransmitter which results into psychiatric and nervous system side effects. According to the FDA label on Xanax, the most common adverse effects include (occur in more than 1% of patients):
- Derealization or alteration of perception
- Dream abnormalities
- Drowsiness (77% of patients)
- Impaired coordination (40% of patients)
- Memory impairment
- Cognitive disorder
- Balance disorders
- Nasal congestion
- Upper respiratory tract infections
- Fatigue/tiredness (49%)
- Edema (swelling)
- Decreased libido (14%) and increased libido
- Micturition difficulties (inability to urinate etc)
- Menstrual disorders (in females)
- Sexual dysfunction
- Tachycardia (increased heart rate)
- Chest pain
- Increased appetite (33%)/ decreased appetite (28%)
- Weight gain (27%)/ loss (23%)
The Xanax label from the FDA reports Alprazolam has rare side effects, which are anger, self-harm and irregular menstruation. These occur in less than 1% of patients
Risk of Suicide
Research has shown that the use of benzodiazepines can influence suicide risk. A literature review evaluated studies that involved the relationship between benzodiazepines and concluded there was a significant relationship between increased suicide risk and benzodiazepines (The Primary Companion for CNS Disorders “Prescribed Benzodiazepines and Suicide Risk” March 2017). The results were consistent in different populations and methods used. The review also found that possible suicidal warnings may include “increases in impulsivity or aggression, rebound or withdrawal symptoms, and toxicity in overdose.”
Alprazolam and Pharmacogenetic Testing
Some patients do not develop any side effects when taking Alprazolam and some do. This interpatient variability may be due to differences in patients’ genetics. Polymorphisms in the genes that code for enzymes and receptors that interact with Alprazolam have been shown to account for a significant proportion of this inter patient variability.
Alprazolam is metabolized by the cytochrome P450 superfamily of enzymes, namely isoenzymes CYP3A4 and CYP2C9. Polymorphisms in these enzymes have been shown to alter the blood plasma concentrations of the drugs they metabolize. Alleles may alter the probability of individual developing side effects when taking Alprazolam.
Understand Your Genetic Risks for Side Effects with the Rxight Test
Identifying these polymorphisms can aid in clinical decision-making. Knowing a patient has a given polymorphism can result in a clinician altering the starting dose of a medication like Alprazolam, potentially reducing their probability of developing side effects.
MD Labs provides a genetic testing service, Rxight®. Accurate, reliable, and easy to understand, Rxight® sequences 18 genes to establish how a patient is likely to respond to hundreds of clinically relevant medications (including Alprazolam).
As a key component of precision medicine, Rxight® allows your healthcare provider and pharmacist to see if Alprazolam is right for you and create the best possible treatment for you. With a simple cheek swab done at your pharmacy, Rxight® will provide you with a DNA Blueprint that minimizes drug’s side effects and proper course for present and future treatments.