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Small molecule
PubChem CID 2118

Alprazolam

Xanax
Mechanism of action
Benzodiazepine, GABA-A positive allosteric
In plain language
Boosts the effect of GABA, a natural brain chemical that puts the brakes on overactive nerve signals, turning up those brakes to quiet the racing thoughts and physical tension of anxiety and panic.
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How it works
Alprazolam (Xanax) is a 1,4-benzodiazepine. Per the FDA label, alprazolam exerts its effect for the acute treatment of generalized anxiety disorder and panic disorder through binding to the benzodiazepine site of gamma-aminobutyric acid-A (GABA-A) receptors in the brain, enhancing GABA-mediated synaptic inhibition. It is extensively metabolized, primarily by CYP3A4, to two active metabolites present at low circulating levels, with a mean plasma elimination half-life of approximately 11.2 hours in healthy adults.
Therapeutic applications
Alprazolam (Xanax) is FDA-indicated for the acute treatment of generalized anxiety disorder (GAD) in adults and for the treatment of panic disorder (PD), with or without agoraphobia, in adults. It carries a boxed warning: concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death, so such concomitant prescribing should be reserved for patients for whom alternative treatment options are inadequate. The warning also notes that alprazolam, like other benzodiazepines, carries risks of abuse, misuse, and addiction, and that abrupt discontinuation or rapid dosage reduction after continued use may precipitate acute, potentially life-threatening withdrawal reactions.
Class
Therapeutic area
CNS / Anxiety
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