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alprazolam

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Alprazolam may cause memory loss in 33.1% of people.

This drug may also cause the following symptoms that are related to memory loss:

Medical Source Information
Yellow highlights indicate symptoms related to memory loss.

Nervous system side effects reported during treatment for anxiety disorders have included drowsiness (41%), lightheadedness (20.8%), depression (13.9%), headache (12.9%), confusion (9.9%), insomnia (8.9%), nervousness (4.1%), syncope (3.1%), dizziness (1.8%), and akathisia (1.6%). Nervous system side effects reported during treatment for panic disorder have included drowsiness (76.8%), fatigue and tiredness (48.6%), impaired coordination (40.1%), irritability (33.1%), memory impairment (33.1%), lightheaded/dizziness (29.8%), insomnia (29.4%), headache (29.2%), cognitive disorder (28.8%), dysarthria (23.3%), anxiety (16.6%), abnormal involuntary movement (14.8%), decreased libido (14.4%), confused state (10.4%), muscular twitching (7.9%), increased libido (7.7%), change in libido (7.1%), weakness (7.1%), muscle tone disorders (6.3%), syncope (3.8%), akathisia (3.0%), agitation (2.9%), disinhibition (2.7%), paresthesia (2.4%), talkativeness (2.2%), vasomotor disturbances (2.0%), derealization (1.9%), dream abnormalities (1.8%), fear (1.4%), feeling warm (1.3%). Seizures, hallucinations, and depersonalization have been reported in less than 1% of patients. Amnesia, psychomotor impairment, anterograde memory loss, and ataxia have also been reported. Elderly patients and/or patients with liver dysfunction may be particularly sensitive to central nervous system side effects. The smallest effective dose should be used in the elderly to avoid the development of ataxia and oversedation.

One study has reported that the frequency of ataxia in patients treated for panic disorder ranges between 17% and 24%. Another study has reported that patients treated acutely with alprazolam by intravenous administration experience a 25% to 30% decrease in whole brain cerebral blood flow. The decrease in blood flow is associated with memory impairment, a decrease in plasma epinephrine and a decrease in self-rated alertness. After a week of daily alprazolam therapy, most of the subjects developed tolerance to these effects. A 64-year-old man with a history of renal insufficiency was diagnosed with nonconvulsive status epilepticus following abrupt withdrawal of year-long alprazolam therapy at dosage 1 mg orally every night. The patient recovered with short-term oral anticonvulsant therapy and reinstitution of alprazolam followed by a more gradual taper of alprazolam therapy. The following nervous system side effects have been reported to result in discontinuation of treatment in over 5% of patients and at a greater rate than placebo: insomnia (29.5%), lightheadedness (19.3%), anxiety (19.2%), fatigue and tiredness (18.4%), abnormal involuntary movement (17.3%), headache (17.0%), irritability (10.5%), cognitive disorder (10.3%), muscular twitching (6.9%), impaired coordination (6.6%), muscle tone disorders (5.9%), and weakness (5.8%), memory impairment (5.5%), depression (5.1%), and confused state (5.0%). There have been reports of seizures in patients following rapid decrease in dose or abrupt withdrawal of treatment with alprazolam. The risk of withdrawal seizures may be higher in patients receiving doses greater than 4 mg per day.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects: unusual risk-taking behavior, decreased inhibitions, no fear of danger; depressed mood, thoughts of suicide or hurting yourself; hyperactivity, agitation, hostility, hallucinations; feeling light-headed, fainting; seizure (convulsions); urinating less than usual or not at all; muscle twitching, tremor; or jaundice (yellowing of the skin or eyes). Less serious side effects may include: drowsiness, dizziness, feeling irritable; amnesia or forgetfulness, trouble concentrating; sleep problems (insomnia); muscle weakness, lack of balance or coordination, slurred speech; blurred vision; nausea, vomiting, constipation, appetite or weight changes; dry or watery mouth, increased sweating; or loss of interest in sex. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

References

Comparison of the spectrum of cognitive effects of alprazolam and adinazolam after single doses in healthy subjects. Fleishaker JC, Garzone PD, Chambers JH, Sirocco K, Weingartner H Psychopharmacology (Berl) 1995;120:169-76.
Memory functions, alprazolam and exposure therapy: a controlled longitudinal study of agoraphobia with panic disorder. Curran HV, Bond A, Osullivan G, Bruce M, Marks I, Lelliot P, Shine P, Lader M Psychol Med 1994;24:969-76.
Efficacy and safety of alprazolam, imipramine and placebo in treating panic disorder. A Scandinavian multicenter study. Andersch S, Rosenberg NK, Kullingsjo H, et al. Acta Psychiatr Scand Suppl 1991;365:18-27.
Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. II. Patient acceptance, side effects, and safety. Noyes R, Jr DuPont RL, Jr Pecknold JC, Rifkin A, Rubin RT, Swinson RP, Ballenger JC, Burrows GD Arch Gen Psychiatry 1988;45:423-8.
Safety and side-effects of alprazolam - controlled study in agoraphobia with panic disorder. Osullivan GH, Noshirvani H, Basoglu M, Marks IM, Swinson R, Kuch K, Kirby M Br J Psychiatry 1994;165:79-86.
Comparative single-dose kinetics and dynamics of lorazepam, alprazolam, prazepam, and placebo. Greenblatt DJ, Harmatz JS, Dorsey C, Shader RI Clin Pharmacol Ther 1988;44:326-34.
Alprazolam plasma concentrations and treatment response in panic disorder and agoraphobia. Lesser IM, Lydiard RB, Antal E, Rubins RT, Ballenger JC, DuPont R Am J Psychiatry 1992;149:1556-62.
Product Information. Niravam (alprazolam). Anonymous Schwarz Pharma, Mequon, WI.
Comparison of acute alprazolam (0.25, 0.50 and 1.0 mg) effects versus those of lorazepam 2 mg and placebo on memory in healthy volunteers using laboratory and telephone tests. Vermeeren A, Jackson JL, Muntjewerff ND, Quint PJ, Harrison EM, Ohanlon JF Psychopharmacology (Berl) 1995;118:1-9.
Effects of acute and chronic alprazolam treatment on cerebral blood flow, memory, sedation, and plasma catecholamines. Roy-Byrne P, Fleishaker J, Arnett C, Dubach M, Stewart J, Radant A, Veith R, Graham M Neuropsychopharmacology 1993;8:161-9.
Pharmacologic effects and abuse liability of bretazenil, diazepam, and alprazolam in humans. Busto U, Kaplan HL, Zawertailo L, Sellers EM Clin Pharmacol Ther 1994;55:451-63.
Product Information. Xanax XR (alprazolam). Anonymous Pfizer U.S. Pharmaceuticals Group, New York, NY.
Product Information. Xanax (alprazolam). Anonymous Pharmacia and Upjohn, Kalamazoo, MI. PROD;
The relative efficacy of high-dose buspirone and alprazolam in the treatment of panic disorder: a double-blind placebo-controlled study. Sheehan DV, Raj AB, Harnett-Sheehan K, Soto S, Knapp E Acta Psychiatr Scand 1993;88:1-11.
Prescription-event monitoring of 10,895 patients treated with alprazolam. Edwards JG, Inman WH, Pearce GL, Rawson NS Br J Psychiatry 1991;158:387-92.
Nonconvulsive status epilepticus resulting from benzodiazepine withdrawal. Olnes MJ, Golding A, Kaplan PW Ann Intern Med 2003;139:956-8.
Anxiolytics and memory: a comparison of lorazepam and alprazolam. Kumar R, Mac DS, Gabrielli WF, Jr Goodwin DW J Clin Psychiatry 1987;48:158-60.
Pharmacokinetics of alprazolam in geriatric patients with neurotic depression. Dehlin O, Kullingsjo H, Liden A, Agrell B, Moser G, Olsen I Pharmacol Toxicol 1991;68:121-4.

Multum version: 154.0 (Jun 16, 2010)

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