Alprazolam is a medication available by prescription from a number of manufacturers. It is marketed under the brand name Xanax to treat anxiety disorders, panic disorders, and anxiety caused by depression.
The treatment can also be used to reduce the severity of muscle spasms and spasticity in spinal muscular atrophy (SMA).
How alprazolam works
SMA is a rare heritable disease caused by the loss of motor neurons, or nerve cells that control the movement of muscles. This leads to muscle weakness and wasting and can cause painful muscle spasms.
Alprazolam is a benzodiazepine, a family of chemicals that binds to two benzodiazepine receptors in the central nervous system. One of these receptors, BNZ1, regulates sleep, while the other, BNZ2, controls muscle relaxation, motor coordination, anticonvulsant activity, and memory.
Both receptors are normally activated by gamma-aminobutyric acid (GABA), a signaling molecule. Benzodiazepines like alprazolam enhance the effect of GABA by increasing the affinity of the receptors for GABA. In other words, when alprazolam is bound to BNZ1 and BNZ2, GABA is more likely to also bind to the receptors.
GABA is an inhibitory neurotransmitter. It works to decrease the excitability of neurons, decreasing the nerve signal emitted. By enhancing the activity of GABA, alprazolam decreases muscle tremors and anxiety, but may also cause drowsiness.
Alprazolam in clinical trials
A small study, published in the Indian Journal of Physical Medicine and Rehabilitation, examined the effect of alprazolam in 38 patients with spasticity. Participants were treated with 0.5 mg of alprazolam once daily for 15 days, followed by 1 mg of alprazolam for an additional 15 days. Evaluations were performed at 15 and 30 days. Spasticity was assessed by the modified Ashworth scale (a measure of muscle tension) and a patient-specific functionality score (a self-report completed by each patient). Thirty-four patients completed the one-month study and showed improvement in both muscle spasms and spasticity.
Alprazolam can cause several side effects, including ataxia (difficulty moving and balancing), drowsiness, fatigue, memory impairment, changes in weight or appetite, and blurred vision.
Patients should not consume alcohol while using alprazolam as the combination can severely depress the central nervous system.
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