Undesirable effects associated with alprazolam therapy in patients participating in controlled clinical studies and with post-marketing experience are as follows: (See Table 2.)
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In many of the spontaneous case reports of adverse behavioral effects, patients were receiving other CNS drugs concomitantly and/or were described as having underlying psychiatric conditions. Patients who have borderline personality disorder, a prior history of violent or aggressive behavior, or alcohol or substance abuse may be at risk for such events. Instances of irritability, hostility and intrusive thoughts have been reported during discontinuance of alprazolam in patients with post-traumatic stress disorder.
In addition, the following adverse events have been reported in association with the use of anxiolytic benzodiazepines including alprazolam, anorexia, fatigue, and slurred speech.
The most common adverse reactions in patients with panic-related disorders were drowsiness, and slurred speech. Less common adverse reactions were altered mood and intellectual impairment confusion.
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