In United Kindom (or United States), Alprazolam is a prescription drug that you can only buy in a pharmacy with a prescription. But thousands of people search the internet every day for Xanax and prescription free or buy without prescription.
In fact, you can easily buy Alprazolam online without having to show a prescription. There are several websites that offer this drug. This is not an outright black market, although the delivery to German consumers is legally questionable.
The operators of these portals appear equally questionable. As a rule, there is no imprint, which every German website must have. It states who is legally responsible - including the exact address. Some websites provide a German telephone number - for customers who want to order large quantities. The price for over-the-counter Xanax is steep: for 30 pills you pay more than 200 Euros.
I think: If you want to buy Xanax without prescription, you are either an addict or you are looking for a party drug. In both cases you have a problem that you will never solve with Alprazolam. For withdrawal, its best to talk to a doctor you trust. You can find self-confidence and a positive attitude towards life yourself. It is quicker and easier with psychotherapy.
My experiences with Xanax
At the age of 48 I slipped into a deep depression in the time before menopause - without really noticing it. I could no longer sleep properly and a cloak of gray had descended over my world. Joie de vivre was yesterday. All the people around me seemed to be doing better.
Then I started having intermittent bleeding. My gynecologist examined me and found that I was suffering from depression. He prescribed me 20 mg of Prozac (fluoxetine) daily and 0.5 mg of Xanax to help me fall asleep. Prozac made me feel better within a short time.
Xanax worked just as quickly in getting me to sleep, usually within 15 minutes of taking it - and I didnt wake up constantly during the night. At the time, I had no idea of the addictive potential of this drug. I was living in India, where alprazolam was sold over the counter as Restyl at the time.
After a few weeks, I stopped taking Prozac because I wanted to experience my true self again without a chemical filter. But I continued to take Xanax, for a total of a full year. I easily halved the dosage to 0.25 mg. In the meantime I was interested in what I was actually taking every evening. So I found out that Restyl was actually Xanax. I also informed myself about the danger of addiction.
After about a year, I decided to replace Xanax with strong chamomile tea. This worked without any problems. I had no withdrawal symptoms at all. Therefore, I believe that dosage plays a significant role in addiction.
To be honest: I felt quite groggy after 0.25 mg and cant imagine how people can take 3 mg or more daily.
On the Internet you can find numerous reports about Xanax. They range from severe withdrawal symptoms to similar experiences.
Alprazolam is primarily used to treat anxiety and panic disorders. However, taking the active ingredient only treats the symptoms, not the cause of the symptoms. Since alprazolam can have considerable side effects, it should only be used when absolutely necessary. Learn more about the effects, side effects and dosage of alprazolam here.
In some cases, alprazolam is also used as a complementary agent in the treatment of depression. Here, however, the active ingredient is controversial: Although it has proven effective in some cases for a short treatment period, there is a risk of increasing depressive symptoms if it is taken for a longer period of time. Therefore, alprazolam should never be used as the sole treatment for depression.
Furthermore, side effects such as menstrual irregularities, liver dysfunction, loss of appetite, coordination disorders, nausea, constipation, hyperprolactinemia, blurred vision, skin reactions, as well as a change in libido may also be triggered by the intake.
In children or the elderly, aggression, nightmares, hallucinations, irritability, and restlessness may also occur. If such symptoms occur, the attending physician should be consulted and treatment with alprazolam should be discontinued. For a complete list of all side effects of alprazolam, please take a look at the package insert of your medication.
Risk of dependence
If dependence is present, abrupt discontinuation of the active substance can lead to side effects such as anxiety, restlessness, irritability, and headaches and muscle pain. In extreme cases, more serious disorders such as loss of reality and personality or hypersensitivity reactions to light, noise or physical contact may also occur.
In addition to the aforementioned symptoms, the so-called rebound phenomenon may also occur after discontinuation of this benzodiazepine. In this case, the symptoms that led to treatment with alprazolam briefly intensify. During this time, side effects such as anxiety, restlessness, and mood swings are possible. To avoid the rebound phenomenon, the active substance should not be discontinued abruptly, but slowly and gradually.
Do not take for longer than 12 weeks
The duration of intake as well as the exact dosage of alprazolam depend on the disease and its severity as well as the individual reaction to the active substance. In general, the dose should always be kept as low as possible, as should the duration of use, in order to minimize the risk of dependence.
It is generally recommended that the active substance, including the phase-out period, should not be used for longer than twelve weeks at a time. During this time, the treating physician should always check whether treatment is still necessary. When discontinuing, the dose must be slowly reduced step by step to prevent the occurrence of side effects.
Dosage of Alprazolam
Tablets containing alprazolam are usually available in doses of 0.25, 0.5, or 1 milligram. The exact dosage should always be determined by the treating physician. Initially, 0.25 to 0.5 grams of alprazolam three times daily is often prescribed. If needed, the dose can be increased up to 3 milligrams per day. Generally, you should take the tablets unchewed with plenty of liquid.
After taking benzodiazepines, memory lapses may occur for the period immediately after use. Therefore, care should be taken to ensure that the patient sleeps for a sufficient period of time after taking the drug.
If you have taken an excessive amount of alprazolam, you should immediately consult a doctor or the emergency room at the nearest hospital. Typical symptoms of overdose include drowsiness, dizziness, confusion, and lethargy. In the event of a significant overdose, you may also experience a drop in blood pressure, muscle flaccidity, and impaired respiratory function. In the worst case, central nervous depression can be so severe that the affected person falls into a coma or even dies.
Alprazolam must not be used if there is hypersensitivity to the active substance or to any other benzodiazepine. In addition, alprazolam must not be taken in certain medical conditions. These include the following:
- Severe hepatic insufficiency
- Obstructive pulmonary disease
- Acute narrow-angle glaucoma
- Sleep apnea syndrome
- Myasthenia gravis
Similarly, the drug must not be used in individuals who are manic depressives or suffer from endogenous depression or depression with psychotic features. Alprazolam is also contraindicated in those with a history of dependence on alcohol, drugs, or medications. The same applies if there is acute intoxication with alcohol, sedatives, sleeping pills or painkillers.
If you suffer from certain pre-existing conditions, you should consult with your treating physician before taking it. This is appropriate, among others, if you suffer from kidney dysfunction or have problems with breathing. In such a case, the dose will probably have to be slightly lower.
Pregnancy and breastfeeding
Alprazolam should not be used during pregnancy. Women who intend to become pregnant should also not take the active substance. If the active substance must still be used, a negative effect on the unborn child must be expected. Possible consequences may include weakness in drinking, respiratory insufficiency, hypothermia and low blood pressure. Since alprazolam passes into breast milk, it should also not be used during breastfeeding.
Xanax (Alprazolam) Interactions
While taking alprazolam, it may interact with a number of other medications. For example, concomitant use of antidepressants, antiepileptics, antihistamines, anxiolytics, analgesics, narcotics, or neuroleptics may increase the depressant effect on the central nervous system.
In addition, interactions may also occur with the following agents:
- Antifungal agents such as ketoconazole or itraconazole.
- Hormone-containing contraceptives such as the birth control pill
- medicines used to treat HIV
- medicines that lower blood pressure
- Muscle relaxants
- Under no circumstances should you take the active substance together with alcohol, otherwise the effect of the benzodiazepine may be altered.
The word double-edged hits the nail on the head with the active ingredient alprazolam. The benzodiazepine sold under the trade name Xanax relieves anxiety and relaxes wonderfully.
But floating on cloud nine has its price: the little pills become addictive very quickly and it is often difficult to get off them.
Active ingredient alprazolam: the new Valium
The US pharmaceutical company Upjohn introduced alprazolam from the group of benzodiazepines to the public as Xanax in 1981 (1). After ten years of development, the FDA (Food and Drug Administration) had approved the anxiety-relieving benzodiazepine with the chemical formula C17H13ClN4 as a psychotropic drug for panic disorders (F41.0). It also reliably treats anxiety and related depression (2).
Better than Mothers little Helper
At the time, Valium, with its active ingredient diazepam, was the most popular anxiety reliever - the Rolling Stones immortalized the pills in a hit song as Mothers little Helper. Valium, also a benzodiazepine, replaced barbiturates as sedatives beginning in 1963.
Today, barbiturates are rarely prescribed because they cause severe side effects. In the beginning, benzodiazepines were thought to have few undesirable side effects. Since the 1960s, therefore, they have enjoyed a triumphal march around the globe. Today, they are still among the most commonly used drugs worldwide (3).
Strokes for the psyche
Soon after its market launch, it became apparent that Xanax also performed well as a sleep aid and general sedative. It largely supplanted Valium as a relaxing drug. One reason was that it caused less drowsiness (4).
In the U.S., Xanax is now considered the most popular benzodiazepine. Apparently, it administers strokes to the psyche better than other sedatives (5). It has been prescribed well over 25 million times a year for several years (6).
The drug is also popular in Germany. However, it came only 13th in the hit list of best-selling tranquilizers (7). German physicians often prescribe it as a sleep aid, a so-called off-label use. Originally, the German trade name was Tafil. Today you can also get Xanax retard and Xanor as well as various generics, for example from Ratiopharm, which you can recognize by the word alprazolam.
The effect of Xanax
Alprazolam - like all benzodiazepines - acts on the three different receptors for the calming neurotransmitter GABA (8). This explains the anxiety-relieving, relaxing effect in panic disorder. Indications also include other anxiety disorders such as generalized anxiety disorder or agoraphobia.
GABA is considered the main neurotransmitter that counteracts excitatory neurotransmitters (9). However, serotonin reuptake inhibitors appear to be more effective at combating panic attacks than Xanax (10).
Interestingly, Xanax also increases the concentration of the neurotransmitter dopamine in the striatum, an important switching point in the brain (11). In this, alprazolam resembles illicit drugs with high addictive potential such as cocaine, amphetamines and opiates (12) (13).
According to experts, one of the reasons for the popularity of Xanax is its rapid onset of action. You often feel the effect after a few minutes, at the latest after half an hour. It takes a maximum of 1.7 hours to reach the highest plasma concentration in the blood (14).
Duration of action and dosage
Xanax is also characterized by a long duration of action. The half-life is between 12 and 15 hours. This value indicates the period of time in which half of the active substance is broken down. This means that the metabolism needs more than a day to completely eliminate alprazolam. In terms of duration of action, Xanax outperforms other benzodiazepines such as lorazepam and bromazepam (16).
As little and as short as possible
When dosing and prescribing, responsible physicians follow the principle: as little and as short as possible. Overall health, severity of illness, and age and weight influence the required dose.
For anxiety disorders, the average daily dosage is between 0.5 and 4 mg. For severe panic attacks, the dose can reach 10 mg (8).
Experts also advise approaching the optimal dosage. Initially, half a tablet should be taken three times a day. This corresponds to 0.25 or 0.5 mg. Then the dosage can be gradually increased at intervals of three to four days. Xanax retard tablets work longer in the body. Therefore, you need to take this type of tablets only once or twice a day.
You can buy tablets with 0.5 mg, 1 mg, 2 mg and 3 mg alprazolam.
Low dose for falling asleep
The dosage for sleeping can be much lower. Many people or patients fall asleep without problems after taking 0.25 mg or 0.5 mg. However, numerous individuals develop tolerance relatively quickly and must increase the dosage (17).
Side effects of Xanax
Drowsiness and dizziness are common side effects at the beginning of treatment. At higher doses, impaired concentration and coordination are also common. Other side effects include mood swings, nervousness, headache, blurred vision, and memory impairment.
If you are hypersensitive to alprazolam you should avoid it. Also, people with the following problems should not take Xanax:
- Severe liver dysfunction
- Sleep apnea syndrome
- myasthenia gravix (autoimmune disease)
- severe respiratory failure
- Xanax, driving, and alcohol
Even one tablet of Xanax impairs your ability to react. Therefore, you should never get behind the wheel or operate dangerous machinery after using or taking it. Alcohol increases the effect of alprazolam in an unpredictable way. Therefore it is better to avoid the combination.
As with other medications, paradoxical reactions are possible with Xanax. Then the opposite of what you actually expect occurs. Anxiety, restlessness, and sleep disturbances worsen in case of such a paradoxical reaction instead of getting better.
Interactions with other drugs
The liver needs enzymes of the cytochrome P450 family (exactly CYP3A4) to break down alprazolam (20). The body processes numerous drugs with the same enzymes. Therefore, many different drug interactions can occur. If you are on a medication, be sure to ask your doctor about side effects.
Interactions with the following medications are known:
- oral contraceptives (the pill)
- protease inhibitors
- Caution with grapefruit
Grapefruit is a prohibited fruit with many medications, including Xanax. The reason: they contain furanocoumarins. These substances destroy the enzymes that metabolism needs to process Xanax and many other drugs (21). Thus, alprazolam can accumulate in the body and reach dangerous concentrations.
Xanax in pregnancy
High doses of alprazolam can harm unborn babies (27). The drug enters the baby through the placenta and can cause severe malformations. If you regularly take Xanax and plan to become pregnant, be sure to stop taking the drug beforehand.
However, withdrawal symptoms can pose an even greater danger to pregnant women and their children than continuing to take Xanax. This is especially true in cases of severe mental disorders.
Nursing mothers should avoid Xanax if possible. The baby becomes accustomed to the benzodiazepine with breast milk (28). Weaning symptoms may therefore occur after weaning.