Alprazolam Lawsuit / Xanax Lawsuit
Alprazolam is sold under the brand names Xanax®, Xanor®, Alprax®, and Niravam®. Alprazolam is a short-acting benzodiazepine used primarily to treat moderate to severe anxiety disorders and panic attacks. The drug has anxiolytic, sedative, hypnotic, anticonvulsant, and muscle relaxant properties.1 It is often used as an adjunctive medication for anxiety associated with moderate depression. Xanax XR is an extended-release form of alprazolam. 
Alprazolam is habit-forming, may cause physical dependence, and withdrawal upon abrupt cessation. Alprazolam is a schedule IV controlled substance under the Controlled Substances Act.2
Discontinuation of alprazolam should be carefully managed by a physician.Some common symptoms of alprazolam discontinuation include tachycardia, dysphoria, dry mouth, loss of appetite, insomnia, anxiety, dizziness, tremors, nausea, cramps, vomiting, diarrhea, panic attacks, mood swings, heart palpitations, memory loss. Less common and more severe reactions can occur, including hallucinations, seizures, and death. Grand mal seizures have occurred after abrupt cessation even after only short-term use.  Severe psychosis has also been reported from abrupt alprazolam discontinuation, and one death occurred from withdrawal-related seizures after gradual dose reduction.3-11
Alprazolam is contraindicated for patients with certain conditions including myasthenia gravis, acute narrow-angle glaucoma, severe liver deficiencies (e.g., cirrhosis), severe sleep apnea, pre-existing respiratory depression, marked neuromuscular respiratory weakness including unstable myasthenia gravis, acute pulmonary insufficiency, chronic psychosis, hypersensitivity or allergy to alprazolam or other drugs in the benzodiazepine class, and borderline personality disorder (may induce suicidality and dyscontrol.  Alprazolam can be dangerous for women who are pregnant or are planning to become pregnant.11-16
Food and drug interactions
Several drugs have been found to interfere with the metabolism of alprazolam and dangerously increase levels of alprazolam including alcohol, erythromycin, fluoxetine, fluvoxamine, itraconazole, ketoconazole, nefazodone, propoxyphene, and ritonavir17-18
In a study conducted by SAMHSA, benzodiazepines were deemed to be the most frequently-used recreational drug in the US with 35% of drug-related visits to the Emergency Department involving benzodiazepines. According to that report, alprazolam is the most common benzodiazepine for recreational use followed by clonazepam, lorazepam, and diazepam.3
Overdoses of alprazolam can be fatal.  Most alprazolam deaths are associated with the concomitant use of other cns depressants, such as opiates, including methadone and OxyContin. Alprazolam is significantly more toxic in overdose than other benzodiazepines with higher rates of fatalities. A study in New Zealand found that alprazolam is almost 8 times more likely to result in death in overdose than other sedative hypnotics as a group, with higher rates of ICU admissions and mechanical ventilation. Combined use with tricyclic antidepressants, alcohol, or opiates increases the likelihood for severe toxicity and possible fatality.18-19
In one study, about 50% of the cases of death involving alprazolam were attributed to combined drug toxicity of alprazolam and another drug, most often cocaine and methadone. Only 1% of these deaths was attributed to alprazolam alone. 20-26
Contact Us
If you have questions about why your family member died or whether he or she died from a benzodiazepine overdose, and would like a free legal consultation, please contact a Xanax lawyer or submit a case review form to a benzodiazepine overdose attorney at http://overdoselaw.com/page/contacts
A Xanax overdose lawyer can review the relevant records, and help you understand why your family member died.
  1. ^ Mandrioli R, Mercolini L, Raggi MA (October 2008). "Benzodiazepine metabolism: an analytical perspective". Curr. Drug Metab. 9 (8): 827–44. doi:10.2174/138920008786049258. PMID 18855614. http://www.benthamdirect.org/pages/content.php?CDM/2008/00000009/00000008/0009F.SGM
  2. ^ "DEA, Drug Scheduling". DEA. http://www.usdoj.gov/dea/pubs/scheduling.html. Retrieved 2008-10-31. 
  3. ^ a b United States Government. http://dawninfo.samhsa.gov/files/ed2006/DAWN2k6ED.htm. Retrieved 9 February 2009.  ; U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (2006). "Drug Abuse Warning Network, 2006: National Estimates of Drug-Related Emergency Department Visits". Substance Abuse and Mental Health Services Administration
  4. ^ Risse SC; Whitters A, Burke J, Chen S, Scurfield RM, Raskind MA. (1990). "Severe withdrawal symptoms after discontinuation of alprazolam in eight patients with combat-induced posttraumatic stress disorder". The Journal of clinical psychiatry. 51 (5): 206–9. PMID 2335496
  5. ^ Breier, A; Charney, Ds; Nelson, Jc (Dec 1984). "Seizures induced by abrupt discontinuation of alprazolam.". The American journal of psychiatry 141 (12): 1606–7. PMID 6150649
  6. ^ Noyes R, Perry PJ, Crowe RR, et al. (January 1986). "Seizures following the withdrawal of alprazolam". J. Nerv. Ment. Dis. 174 (1): 50–2. doi:10.1097/00005053-198601000-00009. PMID 2867122
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  9. ^ Schatzberg, Alan; DeBattista, Charles (2003). Manual of Clinical Psychopharmacology. Washington, DC: American Psychiatric Pub.. pp. 328–331. ISBN 1-58562-209-5
  10. ^ Higgitt, A; Fonagy, P; Lader, M (1988). "The natural history of tolerance to the benzodiazepines.". Psychological medicine. Monograph supplement 13: 1–55. PMID 2908516
  11. ^ Professor Heather Ashton (August 2002). "The Ashton Manual - Benzodiazepines: How They Work and How to Withdraw". http://www.benzo.org.uk/manual/
  12. ^ Hori A. (February 1998). "Pharmacotherapy for personality disorders". Psychiatry and clinical neurosciences. 52 (1): 13–9. doi:10.1111/j.1440-1819.1998.tb00967.x. PMID 9682928
  13. ^ Gardner DL, Cowdry RW (January 1985). "Alprazolam-induced dyscontrol in borderline personality disorder". Am J Psychiatry 142 (1): 98–100. PMID 2857071
  14. ^ "Alprazolam". British National Formulary. 2007. http://www.bnf.org/bnf/bnf/53/3173.htm. Retrieved 3 August 2007. 
  15. ^ mentalhealth.com (2007). "Alprazolam". http://www.mentalhealth.com/drug/p30-x01.html. Retrieved 3 August 2007. 
  16. ^ "Xanax (Alprazolam) Drug Information: Uses, Side Effects, Drug Interactions and Warnings at RxList". USA: RxList.com. July 2008. pp. 4. http://www.rxlist.com/xanax-drug.htm#wcp
  17. ^ García-Algar O; López-Vílchez MA, Martín I, Mur A, Pellegrini M, Pacifici R, Rossi S, Pichini S. (2007). "Confirmation of gestational exposure to alprazolam by analysis of biological matrices in a newborn with neonatal sepsis". Clinical toxicology (Philadelphia, Pa.). 45 (3): 295–8. PMID 17453885
  18. ^ DataBank, Inc (July 2008). "Xanax (Alprazolam) Drug Information: Uses, Side Effects, Drug Interactions and Warnings at RxList". RxList. pp. 8. http://www.rxlist.com/cgi/generic/alpraz_wcp.htm. Retrieved 7 December 2008. 
  19. ^ a b "ALPRAZOLAM - ORAL (Xanax) side effects, medical uses, and drug interactions". MedicineNet. July 2005. http://www.medicinenet.com/alprazolam-oral/article.htm. Retrieved 7 December 2008. 
  20. ^ MARCIA LANE (29 September 2006). "Xanax, alcohol mix kills 2". USA: St. Augustine Record. http://staugustine.com/stories/092906/news_4113407.shtml. Retrieved 10 December 2008. 
  21. ^ Wright State University and the University of Akron (January 2008). "OSAM - O- GRAM Highlights of Statewide Drug Use Trends" (PDF). USA: Ohio Government. http://www.odadas.state.oh.us/WebManager/UltimateEditorInclude/UserFiles/WebDocuments/Planning/Jan05ExecSummry.pdf. Retrieved 10 December 2008. 
  22. ^ Detective Eladio M. Paez (15 June 2008). "STATEMENT ON RAVES AND CLUB DRUGS TO THE SUBCOMMITTEE ON CRIME, CONGRESS OF THE UNITED STATES, HOUSE OF REPRESENTATIVES". USA: GOV House Judiciary. http://judiciary.house.gov/Legacy/paez0615.htm. Retrieved 10 December 2008. 
  23. ^ "SURVEILLANCE OF DRUG ABUSE TRENDS IN THE STATE OF OHIO - A Report Prepared for the Ohio Department of Alcohol and Drug Addiction Services". USA: The Ohio Substance Abuse Monitoring Network. 31 July 2001. http://www.odadas.ohio.gov/GD/DocumentManagement/DocumentDownload.aspx?DocumentID=225. Retrieved 10 December 2008. 
  24. ^ Isbister GK, O'Regan L, Sibbritt D, Whyte IM (July 2004). "Alprazolam is relatively more toxic than other benzodiazepines in overdose". Br J Clin Pharmacol 58 (1): 88–95. doi:10.1111/j.1365-2125.2004.02089.x. PMID 15206998
  25. ^ Wolf BC, Lavezzi WA, Sullivan LM, Middleberg RA, Flannagan LM (2005). "Alprazolam-related deaths in Palm Beach County". Am J Forensic Med Pathol 26 (1): 24–7. doi:10.1097/01.paf.0000153994.95642.c1. PMID 15725773
  26. ^ Rogers, Wo; Hall, Ma; Brissie, Rm; Robinson, Ca (Jan 1997). "Detection of alprazolam in three cases of methadone/benzodiazepine overdose.". Journal of forensic sciences 42 (1): 155–6. PMID 8988593
  27. ^ Merck Manual. http://www.unboundmedicine.com/merckmanual/ub/view/Davis-Drug-Guide/51030/8/alprazolam. Retrieved 10 March 2009.  ; Davis-Drug-Guide (5 February 2009). "alprazolam". Unbound Medicine