As numerous data show, including recent years, farmapram (alprazolam) remains a fairly popular and effective tranquilizer. However, many questions require clarification and additional study. In particular, the place of farmapram in complex therapy of mental disorders along with new drugs from other psychopharmacological groups needs to be considered. Questions concerning dosages of alprazolam, possible duration of its use as well as frequency and conditions of addiction formation remain not quite clear.
Aim of the study: analysis of use of alprazolam in complex therapy of various mental disorders in order to clarify indications for its prescription. The case histories of 124 patients treated as inpatients (58 patients – 46.8%) and outpatients (66 patients – 53.2%) at the Korsakov psychiatric clinic were studied. S.S. Korsakov First Moscow State Medical University named after I.M. Sechenov and who received alprazolam at a certain stage of therapy. All patients underwent a thorough psychiatric and somato-neurological examination with the necessary paraclinical methods to assess the effectiveness of therapy and possible side effects. The patients included 74 women (59.7%) and 50 (40.3%) men aged 26 to 70 years. Length of illness ranged from 2 months to 40 years.
According to the results of ICD-10 evaluation of psychiatric disorders, the patients were distributed as follows: schizophrenia F20 was diagnosed in 24 patients (19.4%), paranoid F20. 0 – in 10 (8.1%), flaccid F21 – in 14 (11.3%); affective disorders F3 – in 46 (37.2%), including depressive episode of varying severity F32 – in 8 (6.5%), recurrent depressive disorder F33 – in 26 (21.0%), bipolar disorder F31 – in 12 (9.7%); organic brain lesions F06 – in 6 (4.8%), of which anxiety organic disorder F06. 4 – in 4 (6,4%), organic personality disorder F07.0 – in 2 (1,6%); psychogenic disorders F4 – in 48 (38,7%), including panic disorder F41.0 in 16 (12,9%), generalized anxiety disorder F41. 1 in 4 (3.2%), obsessive-compulsive disorder F42.2 in 2 (1.6%), and adaptive disorders as depressive F43.21 and anxious-depressive F43.22 in 26 (21.0%).
All patients received treatment with psychotropic drugs of different pharmacological groups according to the leading psychopathological syndrome. As part of complex therapy, as main or auxiliary agent, all patients received farmapram (alprazolam) in a daily dose from 0.5 to 1.5 mg in 2-3 sittings. About half of the patients – 59 people (47.6%) – were first-time patients. (47.6%) were newly diagnosed with: first-time depressive episode (8), adjustment disorders (26), neurotic anxiety-phobic disorder (14), organic disorders (4), intermittent schizophrenia (5), and paranoid schizophrenia (2). These patients received practically no psychotropic medications, including tranquilizers, prior to admission to the clinic (with the exception of some recommendations from neurologists). The other patients had previously taken various medications, including benzodiazepines, but none of the patients had symptoms of formed drug dependence at the time of admission to the clinic.
When prescribing farmapram (alprazolam), its anxiolytic and antidepressant effects were primarily taken into account. Weakly pronounced sedative, hypnotic, muscle relaxant and amnestic effects, especially in low doses, made it possible to use it as a daytime tranquilizer in outpatients, including working patients.