44 Alprazolam
immunodeficiency syndrome]) can drastically boost the potency of alprazo-
lam. In contrast, alprazolam’s effects are reduced by the epilepsy drugs phe-
nytoin and carbamazepine, by the tuberculosis medicine rifampin, and by the
asthma medication theophylline. A case of glaucoma resulting in blindness is
attributed to a multidrug regimen of antidepressants and antianxiety medi-
cines including alprazolam. Some tests find that the substance worsens reac-
tion time and memory. Taking alprazolam with diazepam can cause persons
to forget what happened while they were under the drugs’ influence. In one
experiment alprazolam by itself seemed to interfere with memory even weeks
after taking it, but deeper analysis of the results caused investigators to ques-
tion any long-lasting effect. Persons functioning adequately while drinking
alcohol decline in performance when a dose of alprazolam is added, and the
combination may increase hostile attitudes and actions. Findings in a mice
experiment showed alprazolam boosting pain relief provided bymorphine,
but a human experiment found no such increase (although alprazolam re-
duced the typical nausea effect of morphine—a benefit that has also been
demonstrated in cancer chemotherapy patients). Alprazolam has cross-
tolerance withchlordiazepoxide.
Cancer. A two-year rat experiment found no evidence that alprazolam
causes cancer. Measurements of persons receiving alprazolam for panic dis-
order indicated the substance does not reduce levels of tumor necrosis factor-
alpha, a protein that helps the body fight off cancer.
Pregnancy.Alprazolam experimentation with mice yielded no birth defects.
Examination of pregnancies in which women used the drug during the first
trimester found no more birth defects than would be expected if the drug
were not taken at all, but researchers cautioned that the sample sizes (411 in
one study and about 200 in another) were too small to reach firm conclusions
about the drug’s effect on fetal development. A study of 88 infants born to
women who used alprazolam during pregnancy found 10 born with “major”
deformities. Mice having prenatal exposure to the drug show reduced social
interaction, and males are more aggressive than normal. Such mice also exhibit
subtle trouble with hind legs.
Clinicians have observed alprazolam to increase the hormone that prepares
female breasts for milk production. When combined with the pain reliever
tramadol and the antidepressant citalopram, alprazolam has been known to
cause excessive milk flow. Alprazolam passes into milk, and nursing is not
recommended for mothers taking the drug. In one case an infant even exhib-
ited drug withdrawal symptoms when a nursing mother who was receiving
alprazolam ceased nursing.
Additional scientific information may be found in:Edwards, J.G. “Prescription-Event Monitoring of 10,895 Patients Treated with Alpra-
zolam.”British Journal of Psychiatry158 (1991): 387–92.
Jonas, J.M., and M.S. Cohon. “A Comparison of the Safety and Efficacy of Alprazolam
versus Other Agents in the Treatment of Anxiety, Panic, and Depression: A
Review of the Literature.”Journal of Clinical Psychiatry54 (1993, Suppl.): 25–45.
Nishith, P., et al. “Brief Hypnosis Substitutes for Alprazolam Use in College Students: