Analysis Antidepressants in the United States - Term Paper Example

Title Instructor Date Introduction This essay discusses a drug in the group of antidepressants. The drug under study is Alprazoram, also known as Xanax in the United States. It is known by other terms in other countries. The essay consists of a brief description of the drug, its uses, its biochemical action upon ingestion, the safety of its intake, and the side effects that surface upon its ingestion. There are also discussions about the history of the drug which explains the reason behind its popularity and countrywide high rates of subscription. Xanax is a Benzodiazepines (BZD) and is the most popular of Benzodiazepines. There is a recommendation of the areas that need further research in relation to the drug and the areas that require clarification in relation to the drug. Although no conclusive results are available in relation to the occurrence of dementia in the future as a result of the prolonged use of Xanax, there are various studies that attribute dementia to Xanax in the long run. Despite being highly addictive when misused and abused, their impact is rapid and they remain the most preferred anti-anxiety drugs in the US and some other parts of the world. Overview of Anti-anxiety medications with focus on Alprazoram (Xanax) Benzodiazepines (BZDs) are among the most popular group of anti-anxiety drugs with Xanax being the most popular and most prescribed anti-anxiety drug. Although Selective Serotonin Reuptake Inhibitors (SSRIs) are usually the first choice of most psychotherapists, they take a month or more to reach the maximum efficacy and are delicate when combined with other drugs. The other group is that of the Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) which are quite similar to SSRIs but have the unique effect of increasing the frequency of the signalling of neurons. Anti-anxiety drugs could be prescribed in isolation or alongside other medications depending on the condition and its severity. Psychotherapy is recommended for the adoption of long term anxiety coping skills. Various approaches are recommended for the alleviation of anxiety based on the severity of the condition and the need for an urgent response for the sake of resuming to their normal functionality. They include Psychotherapy, Physical therapy, and the administration of drugs. The history of Xanax gives a clear idea of its effectiveness and safety over previously used anti-anxiety medications before its approval in 1981. Anti-anxiety medications have gained popularity over the years because of their fast action as compared to psychotherapy. They are especially important in cases where anxiety disorders are a common phenomenon. That is different from psychotherapy which requires frequent consultation with a therapist and an undefined expected period of treatment. Anti-anxiety medications work through the reduction of the abnormal electric activity that the patient experiences in the brain. My preference for the analysis of Xanax, a Benzodiazepine, is its fast action and easy availability in America despite its high likelihood of dependence. One of the greatest limitations of anti-anxiety medication is the high likelihood of the development of tolerance towards the drugs. Tolerance necessitates an increment of the dosage for the drugs to take effects. Unfortunately, the increment of the dosage results in the increased risk and severity of the repercussions of the long-term side effects of the drug. Xanax has various information points of interest, including the side effects, the likelihood and rate of addiction, and the rate of abuse. Some people believe that it is not possible to get addicted to prescription drugs even upon taking an overdose. There are also myths around the severity of the impact of the addiction to the prescribed anti-anxiety medication, the comparison to illicit drugs, and the automatic loss of memory upon the intake of the drugs. There are also instances of the development of dependence of the drugs which increases the likelihood of the abuse of the drugs. The use of Xanax is discouraged for people that have a history of addiction. There are also instances where the prescribed anti-anxiety medications exacerbate the problem and undermine the efficacy of the ongoing psychotherapy. Alprazoram (Xanax) is commonly used to treat general anxiety disorder and panic attacks. It is also used to treat various types of anxiety disorders (such as social anxiety) and panic attacks. Various treatments are used in conjunction with Xanax. Based on the most common use of Xanax which is anxiety, psychotherapy and physical therapy are common accompanying treatment for Xanax. The combination of benzodiazepines with antidepressants has outcomes that are often better when compared to monotherapy. The combination of the drugs, however, is that which is done in an authentic clinical setting. The reason the two medications work so well together is the fact that anxiety disorders often occur alongside depressive disorders. It is also possible for the subscription of Xanax and an SSRI because of the rapid effect of Xanax and the safety of SSRIs. This is especially the case where the medication is likely to last over a long period and there is the fear of addiction to Xanax. In such instances, the two are used together at the beginning after which Xanax is discontinued upon the onset of the impact of the SSRIs[Boa08]. There are also additional anecdotes that are said to work in treating anxiety disorders such as the intake of Back flower extracts. According to a my best friend, Katherine, Bach flower calms her down during panic attacks and reduce her overall anxiety levels, the hormonal balance that is achieved is as a result of the presence of some of the life force of the plants in the extracts which helps balance the hormones out. According to her, the combination of the anecdote with breathing exercises, training, and biblio-therapy helps cause long-lasting calmness. She often goes for yoga and maintains a healthy lifestyle of consistent exercise and healthy eating to ensure good health and reduce anxiety. As part of her anecdote, Rahab engages in reading self-help books which motivate and increase her anxiety and panic attack coping knowledge. Upon hearing her testimony, I did a brief research and found a book on anecdotes and just like she said, Reavley, Allen and Jorm (2010) support the same anecdotes for the treatment of anxiety. The Biochemical Action Alprazoram (Xanax) As a tranquilizer, Alprazoram (Xanax) has a molecular weight of 308.769 g/mol has an immediate calming effect on the body and mind. It works through its binding action with the γ aminobutyric acid-A (GABAA) receptors which reduce the brain activity alleviating anxiety and Anxiety and panic disorders. Anxiety and panic disorders are linked to the hyperthalamo-pituitary-adrenal (HPA) disturbances. Alprazoram interacts with the neurobiochemical activities of the brain. Cortisol and the hormone that release corticotrophin are directly linked to fear and anxiety. People with General Anxiety Disorders (GAD) and panic disorders exhibit increased levels of the basal rate of cortisol. The health practice requires the treatment of anxiety disorders with psychotherapy where the administration of drugs comes if the related symptoms cause significant functional impairment. Its action is through slowing down he activity of the brain which is usually working too fast thus the panic or anxiety. They suppress anxiety-related symptoms and prevent adverse outcomes form the condition. Such include panic attacks and severe anxiety disorders that affect the normal functionality of the person[Car151]. Alprazoram is a high-potency triazolobenzodiazepine that works through the 5-HT1A serotonerorgic receptors. The result is a decrease in the noradrenergic volatility which causes a resultant preventive impact in the brain. The impact is effected through the noradrenergic system. The administration of Alprazoram in low doses results in the varied impact on the γ aminobutyric acid -A (GABAA) receptors. There is an upregulation among patients suffering from chronic stress with the minimization of the impact of the medication on the cognitive functions of the patient[Car151]. Benzodiazepines are GABAergic substances that have sedative and axiolyitic and sedative effects. The administration of Alprazoram yields a reduction in the cortisol levels of the patient. Inconsistencies are possible depending on the group of the patient, gender, and the dosage of the medication[Boe11]. Studies show that when taken by normal people whose cortisol levels are at normal levels, there is an increase in their levels of dehydroepiandrosterone, a decrease in the concentrations of MHPG, and a decrease in the noradrenergic volatility. The impact of the intake of Alprazoram is on the GABAergic neurons, the catecholaminergic transmitters, and the serotoninergic transmitters. The result is the reduction of the cortisol in the body. Other possible reactions include a decrease in the noradrenergic volatility which is detected by the differences in the concentration of nonadredaline. Some medicines and complex meals should not be mixed with Xanax because of the possibility of adversity upon mixing them. The reactions of mixing medicines vary across various types of medications because of their chemical composition. The reason why Xanax and other BZDs are said to cause amnesia as a side effect is the presence of BZ1 in the GABAA receptors[Cha13]. There are instances of adversities in the cognitive functionality upon the use of Alprazoram as a result of the lack of close monitoring and the lack of self-control and adherence to the drug administration instructions among the patients. Suh cases mostly consist of taking excess dosages of the drug based on the assumption that it being a subscription drug automatically renders it safe despite misuse. The long-term use of Xanax is also risky for the user because of the extended effects on the cognitive function of the brain of the patient. Although no conclusive results are available in relation to the occurrence of dementia in the future as a result of the prolonged use of Xanax, there are various studies that attribute dementia to Xanax in the long run. The same applies to the increase of the dosage of Xanax on patients as a result of the gradual increase of resistance towards the drug. Increased dosages might also be as a result of abuse among patients that feel the normal dosage is not enough and take extra pills without the subscription approval. This is a common type of abuse among patients to whom the drug is prescribed. It is for such reasons that Xanax is often subscribed alongside SSRIs and SNRIs-to reduce the impact of the adverse side effects of the consumption of the drug. Its sudden discontinuation after prolonged use results in unpleasant withdrawal symptoms. The build-up of tolerance towards the medication also requires the administration of higher doses of the drug. The common side effects of taking Xanax include dizziness, nausea, headaches, drowsiness, confusion, nightmares, and fatigue. The negative impact of the use of Alprazoram on the cognition of the patient is mediated through the agonist action upon the γ aminobutyric acid -A receptors in the brain. The γ aminobutyric acid –A is an influential inhibitory neurotransmitter[Bil121]. Alprazoram (Xanax): A historical overview Alprazoram (Xanax), the most subscribed drug in the US, was developed by Upjohn Laboratories in the 1960s. Leo Sternbach discovered Librium, the first psychoactive drug, in 1955 which happened by accident. There was need for such after the Second World War where immediate relievers were essential. Soldiers came home with severe cases of Post-Traumatic disorders and other psychiatric problems such as depression and anxiety. These came with panic disorders and insomnia which called for immediate medication to relieve the condition besides the long=term psychotherapy. Upon their discovery, the anti-anxiety drugs were prescribed in isolation or alongside other medications depending on the condition and its severity. Psychotherapy is recommended for the adoption of long term anxiety coping skills. Xanax has since become a popular lexicon in the US upon the discovery of its effect on panic attacks. Its official introduction to the world was in 1960. Alprazoram was initially used to treat panic disorder. It became very popular and is currently classified as a schedule IV under the USDEA[Mic134]. The person to whom its invention is primarily credited is Dr.David Sheehan because of his push for further research on Xanax and its impact on panic and anxiety upon joining Upjohn Laboratories. The research on the drug was supported by other scientists including Dr.Leo Sternbach. The readiness to embark on the research came as a result of the negative side effects of the anti-anxiety drugs that were in use at the time. The addictive properties of Alprazoram, although not always the case, are the reason why it is not recommended for people with a history of addiction[Ame14]. Since its invention, there was awareness about its addictive potential, its side effects, and potential harm upon prolonged intake. However, it was preferred over the ones that existed at the time since their effects were worse where some of them had toxic effects on the consumers. There had been other antidepressants in use before Xanax which despite alleviating anxiety, depression, and related disorders, caused more harm to the human body and the central nervous system than they did well. Alprazoram is a popular prescription drug among psychiatrists and is approved as ‘Tafil’ in Latin America. The sudden discontinuation of the use of Xanax after a long time of use results in unpleasant withdrawal symptoms. The build-up of tolerance towards the medication also requires the administration of higher doses of the drug. The common side effects of taking Xanax include dizziness, nausea, headaches, drowsiness, confusion, nightmares, and fatigue[Placeholder4]. Recent discoveries have shown that women are more prone than men to become dependent on Xanax. It has also been discovered that although Xanax was way better than the anti-anxiety and panic disorder drugs it replaced in the past, its effects are also quite harmful, especially in the long run. This comes in the form of the addiction kind of withdrawal symptoms that face long-term users.[Fox14]. This was more of a theory in the 80’s but has been proven by the exhibition of withdrawal symptoms among patients that are under prescription. It is also upon further research that it was discovered that addiction to Xanax is not only a threat to people with the likelihood of addiction with regard to their genetics or people with a history of addiction. Rather, even therapeutic Xanax prescribed for medical use where the patient observes the prescribed dosage. This is especially more likely to be experienced after the long term use of the drugs. Although various research results show different results on occasion, the relationship between dementia and the long-term use of Xanax was discovered some time in  2013 or thereabout[cch13]. Myths/Truths Xanax The popularity of Xanax also leads to controversy about the nature and safety of the use of the drug. That is mainly because of the increased likelihood of the drug to cause dependence and unpleasant side effects such as drowsiness, fatigue, and headaches among others. There are, however, myths that claim that Xanax is utterly safe because it is prescribed by the doctor. The same myth is further interpreted to mean that it is okay to increase the dosage since it is a subscription drug. The truth is that although the subscription is safe, an increase is dangerous and the drug could also react when mixed with certain foods and other medications[Mer12]. There is the other myth that states that “prescription drugs are safer that illicit drugs,” and that “the addiction to prescription drugs is different from the addiction to illicit drugs.” When used by patients that do not suffer the symptoms of anxiety and panic disorders, the intake of Xanax is equally dangerous as the use of other illicit drugs. Addiction to anti-anxiety medications such as Xanax may require rehabilitation, just like the case with illicit drugs. It is common for young people thot get involved in the abuse and misuse of Xanax which includes self-administration and the consumption of the drug for relaxation purposes or the overdose of the drug among the genuinely ill patients. Based on the assumption that prescription drugs are completely safe for the people to who it is subscribed, overdoses are likely to be witnessed and it is also as difficult to get out of the addiction to Xanax as it is with illicit drugs[Cov161]. Recommendations for further research The impact of the long term use of BDZs on the cognition of the patients. There are various sources of research on the topic but the findings conflict and there is no single conclusion on the matter. While some studies show the likelihood of the improvement of the memory of the patients with the likelihood of the development of dementia in the future, others find a possibility of the enhancement of the coping mechanisms of dementia patients in the future[Bil121]. Some of the results are not even conclusive. The elucidation of the connection between the long term use of BZDs and the increased likelihood of the development of dementia is yet to be done. In addition to that, the differences recorded among different genders upon the use of BDZs are not factored in the research on the impact of BDZs on memory. Conclusion In conclusion, anxiety disorders are a common phenomenon with varying degrees of the condition among different people. Depending on the severity of the condition of the patient and its impact on their functionality, various approaches are recommended for the alleviation of the condition. They include Psychotherapy, Physical therapy, and the administration of drugs. The history of Xanax gives a clear idea of its effectiveness and safety over previously used anti-anxiety medications before its approval in 1981. The administration of Xanax could be done in isolation or in conjunction with other treatment approaches. Psychotherapy, however, is often recommended for the treatment of the underlying issues causing the anxiety. Xanax is not without side effects, dementia being one of the most speculated major side effects of its use in the long run. The speculations are based on proof of its negative impact on the cognitive function of the brain of the patient. Annotated Bibliography Website resources American Chemical Society. Molecule of the Week-Alprazolam. 5 11 2014. Web. 9 6 2014. https://www.acs.org/content/acs/en/molecule-of-the-week/archive/a/alprazolam.html This resource explains the molecular structure of Alprazolam (Xanax), its impact on anxiety and panic disoorders, and the components that make up the drug. Covenant Hills. Adderall and Xanax Addiction: Common Myths, Truths. 6 9 2016. Web. 6 9 2017. https://covenanthillstreatment.com/adderall-and-xanax-addiction-common-myths-truths/ This site discusses the various myths and several truths that surround anti-anxiety medication. Most of them are centered on the side effects, the addiction rate, and the rate of abuse. Some people believe that it is not possible to get addicted to prescription drugs even upon taking an overdose. There are also myths around the severity of the impact of the addiction to the prescribed anti-anxiety medication, the comparison to illicit drugs, and the automatic loss of memory upon the intake of the drugs. Stoddart, Tim. Xanax Addiction – Right or Wrong for Your Anxiety? 24 5 2013. Web. 6 9 2017. https://sobernation.com/xanax-addiction-right-or-wrong-for-your-anxiety/ This resourc focuses on theh high likelihood of dependability on xanax among long-term users, the llikelihood of adddiction among people that misuse the drug, take an overdose, and those that take the drug despite their drug addiction history. Me, Merely. Anxiety Treatment: 5 Myths About Taking Medication. 14 6 2012. Web. 6 9 2017. . The popularity of Xanax also leads to controversy about the nature and safety of the use of the drug. That is mainly because of the increased likelihood of the drug to cause dependence and unpleasant side effects such as drowsiness, fatigue, and headaches among others. Journal Articles Boeuf-Cazou O, Bongue B, Ansiau D. "Impact of long-term benzodiazepine use on cognitive functioning in young adults: the VISAT cohort." Eur J Clin Pharmacol (2011): 1045–1052. Web This article ddiscusses the effects of the long-term use of Xanax among young ppatients. The main focus is the imact of the medication on cognitive functioning, given that the GABAA present in the drugs has a side effect of amnesia among users. Gage, Sophie Billioti de, et al. "Benzodiazepine use and risk of dementia: prospective population based study." 2012 (2012): 345-6231. Web. http://www.bmj.com/content/345/bmj.e6231 Although conclusve research is not available, this article is research work attempting to prove the relationship between the long term use of Xanax, its amnesia effect, and the likelihood of its causing deementia at a later age. Dunlop, Boadie W. and Paula G. Davis. "Combination Treatment With Benzodiazepines and SSRIs for Comorbid Anxiety and Depression: A Review." The Primary Care Companion for the Journal of Clinical Psychiatry. ; 10(3): (2008): 222–228. Web. . This source discusses the various treatments used in conjunction with Xanax. It explains the frequency of the combination of Xanax subscriptions with SSRIs because of the rapid effect of Xanax and the safety of most SSRIs as compared to Xanax. This is especially the case where the medication is likely to last over a long period and there is the fear of addiction to Xanax. Books Gerald, Michael C. The Drug Book: From Arsenic to Xanax, 250 Milestones in the History of Drug. New York: Sterling, 2013. Web. . This resource gives a history of anti-anxiety medications since the fifties, the advancement of the treatment appraches, the reason for the need for different drugs for the treatment of anxiety, and the discovery and study of Xanax. It explains why Xanax remains to be the most popular anti-anxiety drugs whose popularity is measured by the number of drugs distributed from subscriptions around the country. Ulbricht, Catherine. Natural Standard Medical Conditions Reference E-Book: An Integrative Approach. New York: Elsevier, 2009. Web. This book explains the various conditions that require the prescription of Xanax. Despite their use for anxiety, they are used in conjunction with anti-depressants for the treatment of depressive disorders and related symptoms. They are also a quick option for the alleviation of panic attacks. Reavley, Nicola, et al. A Guide to What Works for Anxiety Disorders. Melbourne: beyondblue: the national depression initiative, 2010. Web. http://learn.beyondblue-elearning.org.au/workplace/resources/pdf/topic5/GuideToWhatWorksForAnxiety.pdf This book focuses on various anecdotesfor the treatment of anxiety that people use and claim to benefit from. Besides breathing exercises, biblio-therapy, and the consumption of Back flower extracts, the rationale and explanations behind how they work is further explained. Most agree with the anecdotes used by Katherine, my best friend, when treating her anxiety disorders. References Boa08: , (Dunlop and Davis), Car151: , (Soria, Remedi and Núñez), Car151: , (Soria, Remedi and Núñez 3), Boe11: , (Boeuf-Cazou O), Cha13: , (Griffin, Kaye and Bueno), Bil121: , (Gage, Bégaud and Bazin), Mic134: , (Gerald), Ame14: , (American Chemical Society), Placeholder4: , (Ulbricht), Fox14: , (FoxNews), cch13: , (cchrflorida), Mer12: , (Me), Cov161: , (Covenant Hills; Me), Read More