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Alprazolam: effects on sleep and withdrawal phenomena
A Kales1, E O Bixler, A Vela-Bueno
1Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey.
Journal of Clinical Pharmacology
|July 1, 1987
Summary
Alprazolam initially improved sleep in chronic insomniacs but tolerance developed rapidly. Withdrawal led to rebound insomnia, limiting its clinical utility for sleep disorders.
Area of Science:
- Pharmacology
- Sleep Medicine
- Clinical Psychology
Background:
- Chronic insomnia is a prevalent sleep disorder.
- Benzodiazepines, like alprazolam, are commonly prescribed for insomnia.
- Understanding the efficacy and side effects of alprazolam is crucial for patient care.
Purpose of the Study:
- To evaluate the efficacy and safety of alprazolam in chronic insomniacs.
- To assess the development of tolerance to alprazolam during short-term use.
- To investigate the occurrence of rebound insomnia after alprazolam withdrawal.
Main Methods:
- A 16-night sleep laboratory protocol was employed.
- Four nights of placebo baseline were followed by seven nights of alprazolam (1 mg bedtime).
- Five nights of placebo withdrawal were included to assess rebound effects.
Main Results:
- Alprazolam was effective in inducing and maintaining sleep initially.
- Significant tolerance developed within one week, reducing efficacy by approximately 40%.
- Rebound insomnia occurred upon withdrawal, with sleep difficulty exceeding baseline levels.
Conclusions:
- Alprazolam's clinical utility for insomnia is limited by rapid tolerance development.
- Potential disinhibitory side effects were noted during alprazolam use.
- Rebound insomnia following withdrawal further restricts its therapeutic application.