alprazolamAdjunctive therapyBrands: XANAX, XANAX XR | Anxiety disorder and panic disorder (label). View labelExact | Dosing is typically kept at the lowest effective dose for the shortest feasible duration; dose escalation without a clear target symptom and reassessment plan is avoided.
For courses beyond a few weeks, clinicians typically taper gradually; abrupt discontinuation increases withdrawal and seizure risk. | Benzodiazepine; positive allosteric modulator of GABA-A receptors. | CYP3A4 | Single-dose mean 11.2 h; Single-dose range 6.3–26.9 h | No | | - Functional benefit and safety should be reassessed at each renewal; avoid open-ended continuation without documented goals.
- Substance use screening and prescription monitoring review are commonly used; a single prescriber and pharmacy plan can reduce misuse risk.
- Monitor sedation, falls, and driving impairment—especially in older adults and when other CNS depressants are present.
- If discontinuing after more than brief use, taper gradually and monitor for withdrawal symptoms and rebound anxiety.
| No | 2026-03-31 |
|---|
lorazepamAdjunctive therapyBrands: ATIVAN, LOREEV XR | Anxiety disorders; insomnia due to anxiety/stress (label varies by product). View labelExact | Anxiety (label ranges vary): typically 1–3 mg/day in divided doses; titration is typically cautious based on sedation and fall risk. | Benzodiazepine; positive allosteric modulator of GABA-A receptors. | Glucuronidation | Single-dose mean 12 h | No | | - Functional benefit and safety are reassessed at each renewal; open-ended continuation without documented goals is generally avoided.
- Sedation, falls, and driving impairment are monitored—especially in older adults and when other CNS depressants are present.
- For catatonia, follow-up is often frequent, with coordinated escalation pathways (medical evaluation and ECT readiness when response is incomplete).
- If discontinuing after more than brief use, gradual tapering and monitoring for withdrawal symptoms and rebound anxiety are typical.
| No | 2026-02-20 |
|---|
| Seizure disorders; panic disorder. View labelExact | Panic disorder (label): start 0.25 mg twice daily; increase every 3 days to 1 mg twice daily; maximum 4 mg/day. | Benzodiazepine; enhances GABA‑A receptor activity. | Hepatic | Steady-state mean 35 h | No | | - Sedation, cognition, gait/ataxia, and fall risk at each visit; counseling commonly covers driving and occupational safety after dose changes.
- Respiratory risk (sleep apnea, COPD) and co-prescribed CNS depressants; overdose education is important, and some settings coordinate naloxone when opioids are unavoidable.
- Misuse/diversion risk: PDMP review, documentation of indication/duration, and periodic reassessment with a time-limited plan are common.
- Withdrawal risk: written taper schedules, tracking rebound anxiety/insomnia, and slower tapers for long-term users or higher doses are typical.
| No | 2026-02-20 |
|---|
| Anxiety disorders or short-term relief of anxiety symptoms (label). View labelExact | Start 7.5 mg twice daily (or 5 mg three times daily); increase by ~5 mg/day every 2–3 days as tolerated. | Non-benzodiazepine anxiolytic; 5-HT1A partial agonist (azapirone). | CYP3A4 | Single-dose range 2–3 h | No | — | - Follow-up within 2–4 weeks is commonly used to assess adherence, side effects, and whether anxiety symptoms are trending in the right direction.
- Dizziness and activation are commonly tracked during titration; slower titration can help if patients feel “wired” or unsteady.
- Interacting medications (CYP3A4 inhibitors/inducers) and food consistency (grapefruit) are worth reviewing when response changes.
- If no meaningful benefit after an adequate trial, stopping and switching or augmenting is common rather than continuing indefinitely.
| No | 2025-12-28 |
|---|