Central Nervous System (CNS) depressants are medicines that include sedatives, tranquilizers, and hypnotics. These drugs can slow brain activity, making them useful for treating anxiety, panic, acute stress reactions, and sleep disorders.

Treatment for CNS depression or CNS depressant overdose depends on the substances involved. Some CNS drugs have antidotes that can reverse their effects. These include Naloxone for opioid overdoses and Flumazenil for overdoses of benzodiazepine.

Benzodiazepines. Sometimes called “benzos,” benzodiazepines are central nervous system depressants that are prescribed to treat anxiety, sleep disorders, convulsions, and other acute stress reactions. Common benzos include Valium, Xanax, and Ativan.

Ativan is effective for panic attacks, short-term and long-term treatment of insomnia and is used in combination with other medications to prevent nausea and vomiting resulting from chemotherapy. Ativan also is administered before anesthesia for sedation and used for prevention and treatment of alcohol withdrawal.

The usual dose for: anxiety – 1mg to 4mg each day; your doctor will tell you how often you need to take it. sleep problems – 1mg to 2mg before bedtime (lorazepam will start to work in around 20 to 30 minutes)

Examples of medications that could be used as alternatives to Ativan include:

• Antidepressants such as: duloxetine (Cymbalta) doxepin (Zonalon, Silenor) escitalopram (Lexapro)
• Buspirone, an anxiolytic drug.
• Benzodiazepines such as: alprazolam (Xanax) diazepam (Valium) midazolam.

The usual range is 2 to 6 mg/day given in divided doses, the largest dose being taken before bedtime, but the daily dosage may vary from 1 to 10 mg/day. For anxiety, most patients require an initial dose of 2 to 3 mg/day given b.i.d. or t.i.d.

List of the Best Non-Narcotic & Non-Addictive Treatments for Anxiety:

• SSRIs.
• SNRIs.
• Buspirone.
• Hydroxyzine.
• Gabapentin (Neurontin)
• Beta-Blockers.
• Psychotherapy.
• Cognitive Behavioral Therapy (CBT)

In such patients, alternatives to benzodiazepines may be preferable and may include antidepressants, anticonvulsants, buspirone, antihypertensive agents and the newer neuroleptic medications.

With sustained levels of anxiety, long-acting benzodiazepines such as diazepam and clorazepate are usually preferred, while episodic anxiety normally responds best to shorter-acting drugs such as oxazepam or lorazepam.

Benzodiazepines most commonly used to treat anxiety disorders are clonazepam (Rivotril)*, alprazolam (Xanax) and lorazepam (Ativan). Also used are bromazepam (Lectopam), oxazepam (Serax), chlordiazepoxide (once marketed as Librium), clorazepate (Tranxene) and diazepam (Valium).

At times, a longer-acting benzodiazepine, like Valium (diazepam), may be substituted for Xanax during detox. By keeping a small amount of a benzo in the bloodstream, drug cravings and withdrawal may be controlled for a period of time until the drug is weaned out of the system completely.

Disposing of expired Xanax If Xanax has expired, it may not be effective or safe. Do not take expired Xanax before consulting a healthcare provider. Because Xanax carries a high risk of dependency, it is important to dispose of expired or unwanted pills correctly.

Long term use is sometimes described as use not shorter than three months. Benzodiazepines are generally effective when used therapeutically in the short term, but even then the risk of dependency can be significantly high.

It can be used short-term as a way to offer people immediate relief from their symptoms or as part of a long-term management plan for GAD or panic disorder. Xanax is often prescribed for panic attacks, which can occur as part of SAD.

The Food and Drug Administration has announced a nationwide recall of a batch of alprazolam, a generic version of Xanax, because of potential contamination. The manufacturer, Mylan Pharmaceuticals, said Friday that the voluntary recall was because of the possible presence of a foreign substance.

Drugs with a shorter half-life are linked with higher potential for addiction and dependence because the effects wear off faster. That is one reason why doctors are typically hesitant to prescribe Xanax for long periods of time. After taking Xanax in pill form, peak levels are found in your blood just 1-2 hours later.

Adults—At first, 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day. Older adults—At first, 0.25 mg 2 or 3 times a day.

Alprazolam may be taken every day at regular times or on an as needed (“PRN”) basis. Typically, your healthcare provider will limit the number of doses you should take in one day. Your healthcare provider will determine the dose and method of taking the medication that is right for you based upon your response.

Using Xanax for an extended period of time comes with a risk of potentially damaging nerve tissue in the liver. When this happens, liver inflammation may occur.

Alprazolam is used to treat anxiety and panic disorders. It belongs to a class of medications called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effects of a certain natural chemical in the body (GABA).

Serious Interactions of alprazolam (Xanax) include:

• carbamazepine.
• cimetidine.
• clarithromycin.
• erythromycin base.
• erythromycin ethylsuccinate.
• erythromycin lactobionate.
• erythromycin stearate.
• idelalisib.

The 10 Worst Medications for Your Liver

• 1) Acetaminophen (Tylenol)
• 2) Amoxicillin/clavulanate (Augmentin)
• 3) Diclofenac (Voltaren, Cambia)
• 4) Amiodarone (Cordarone, Pacerone)
• 5) Allopurinol (Zyloprim)
• 6) Anti-seizure medications.
• 7) Isoniazid.
• 8) Azathioprine (Imuran)

For anxiety disorders, the dosage for adults typically starts at 0.25 mg to 0.5 mg three times per day. A doctor may incrementally increase the dosage to maximize the effect. However, the maximum dosage does not usually exceed 4 mg per day. For panic disorders, the required dose of Xanax may exceed 4 mg per day.

Federal officials are warning physicians they shouldn’t cut off patients from opioids too quickly. To fight the opioid epidemic, physicians have been advised to cut down on opioid prescriptions. But that may mean some patients were cut off “cold turkey,” causing withdrawal symptoms.

Consistent Xanax abuse can cause both weight gain and weight loss. Sometimes, people who abuse Xanax reduce their energy output and sleep more, which can cause weight gain.

Xanax, a brand name for alprazolam, is a powerful benzodiazepine that is only recommended for use for up to six weeks.

Cortisol, prolactin, and growth hormone (GH) release, MCPP and alprazolam plasma levels, anxiety level, and panic symptoms were measured over 210 minutes. MCPP was found to increase cortisol, prolactin, GH, and anxiety levels. Alprazolam decreased cortisol and GH levels but had no effect on prolactin.

Hepatotoxicity. Alprazolam, like other benzodiazepines, is rarely associated with serum ALT elevations, and clinically apparent liver injury from alprazolam is extremely rare. There have been a few case reports of acute liver injury from alprazolam and recurrence on reexposure has been reported.