Can Xanax be a sleep aid

Off label - alprazolam as a sleep aid

The benzodiazepine alprazolam has an anxiolytic, calming and muscle relaxing effect. The active ingredient crosses the blood-brain barrier and binds to the GABA receptor in the brain. Alprazolam thereby strengthens the inhibitory effect of the neurotransmitter GABA in the central nervous system (CNS).

Alprazolam is used for the symptomatic short-term treatment of acute and chronic states of tension, excitement and anxiety. Alprazolam should not be used as the sole measure for anxiety disorders, especially not if depression is associated with it. Otherwise, depressive symptoms may be exacerbated and the risk of suicide may be increased as a result.

The customer has been taking a tablet before bed for three weeks. Prescription as a sleeping aid for sleep disorders is common, but alprazolam is not approved for it. It is therefore an off-label use.

For treatment with benzodiazepines, the principle applies to keep the dose as low and the duration of use as short as possible. The usual daily dose is 0.5-4 mg alprazolam, divided into several individual doses. A dose reduction is necessary in elderly patients. Often in this group of patients a dosage of 0.25 to 0.5 mg alprazolam before going to bed is sufficient. The tablets are divisible. The dose should be taken with sufficient fluids. A tolerance development is possible.

Treatment with alprazolam must in any case be tapered due to possible rebound effects that can occur two to four days after the abrupt discontinuation. Withdrawal should be done gradually (maximum 0.5 mg every three days) to avoid withdrawal symptoms after an application period of more than a week.

In order to minimize the risk of psychological and physical dependence, the maximum duration of use, including the withdrawal phase, should be limited to eight to twelve weeks.

Older customers who are taking a benzodiazepine for the first time should be advised of the increased risk of falling while taking alprazolam (due to dizziness, drowsiness and unsteady movement and gait).

In older patients in particular, psychiatric as well as “paradoxical” reactions such as restlessness, irritability, aggressiveness, hallucinations, psychoses and other behavioral disorders can occur, which make it necessary to discontinue therapy.

Other possible side effects include sedation (desirable in this case), ataxia, headache, depression, weight changes and, rarely, respiratory depression in patients with chronic respiratory disease.

The ability to react may be impaired during the treatment.

The customer is to be informed of the danger of psychological and physical dependence with withdrawal and rebound phenomena. She is sensitive to the fact that the preparation can only be of help for a short time in fearful situations that are triggered by the grief.