Psych Drug Truth

Common Xanax Side Effects

Xanax is an addictive drug and should not be reduced quickly.

Xanax

Anxiety - Insomnia - Agitation

For proper Xanax withdrawal

 
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Xanax withdrawal. Xanax withdrawal side effects, withdrawal warnings, withdrawal precautions, withdrawal adverse effects, overdose, withdrawal symptoms and Xanax natural alternatives. Before you begin the spiral down with these drugs, try giving your body what it really wants. 

Xanax

Xanax Withdrawal

Are you experiencing Xanax withdrawal?

The Road Back Program has been assisting people with Xanax withdrawal since 1999, and have helped over 50,000 people become drug free.

If you are suffering from Xanax withdrawal or Xanax side effects, you should try one key supplement used in their Xanax withdrawal method.

The supplement is called Neuro Endure Mini and is available at Amazon.com Click here to go directly to the supplement on Amazon.

The program suggests you take 1 tablet 3 times a day 5 hours apart. If most of the anxiety and insomnia goes away with taking the 3 tablets a day but not all of the symptoms, they suggest you increase the frequency you take the Neuro Endure Mini. You can take a total of 12 tablets each day and up to 4 tablets at a time.

The tablets dissolve in 15-minutes after swallowing.

Xanax Pharmacology

On this Web Site find information about Alprazolam (Xanax) Xanax. Xanax side effects, warnings, precautions, adverse effects, overdose, withdrawal symptoms and Xanax natural alternatives. Before you begin the spiral down with these drugs, try giving your body what it really wants. Xanax alprazolam, xanax, xanax alprazolam stress, xanax alprazolam anxiety, stress, anxiety, stress xanax alprazolam, anxiety xanax alprazolam, XANAX ALPRAZOLAM, xanax alprazolam side effects, side effects xanax alprazolam, xanax alprazolam dangers, side effects xanax alprazolam, side effects xanax alprazolam, xanax alprazolam, stress and anxiety, stress medication, stress relief, relief from stress, stress, xanax alprazolam and children, xanax alprazolam withdrawal, how to get off xanax alprazolam, xanax alprazolam therapy, ssri, ssri's, xanax alprazolam and depression, side effects of xanax alprazolam, difference between xanax alprazolam and xanax alprazolam, xanax alprazolam and depression, xanax alprazolam and obsessive compulsive disorder, american psychiatric association, mental disorder, mental disorders and dangers of xanax alprazolam.Anxiolytic - Antipanic

Xanax, a triazolo 1,4 benzodiazepine analog, binds with high affinity to the GABA benzodiazepine receptor complex. Considerable evidence suggest that the central pharmacologic/therapeutic actions of Xanax are mediated via interaction with this receptor complex.

Orally administered it is readily absorbed in man with peak plasma concentrations occurring 1 to 2 hours following administration. The half life range is 6 to 20 hours following single dose administration. With multiple doses, given 3 times daily, steady state is reached within 7 days. Xanax and its metabolites are excreted primarily in the urine. Degradation occurs mainly by oxidation yielding the primary and secondary metabolites which are active and appear to have half-lives similar to alprazolam but are present at only low levels in the plasma. Xanax is 80% protein bound.

Xanax 500 mcg (0.5 mg), administered 3 times a day for 14 days, did not affect prothrombin times or plasma warfarin levels in male volunteers administered sodium warfarin orally.



Indications

For the management of anxiety disorders or the short-term symptomatic relief of symptoms of excessive anxiety. Anxiety or tension associated with the stress of everyday life usually does not require treatment with Xanax.

Xanax is indicated for the treatment of Generalized Anxiety Disorder (GAD) and is also indicated for the management of panic disorder with or without agoraphobia. Back to top of page


Contraindications

Hypersensitivity to Xanax or other benzodiazepines. Xanax is also contraindicated in pregnancy, in infants and in patients with myasthenia gravis and acute narrow angle glaucoma.

Warnings

Xanax is not recommended for use in patients whose primary diagnosis is psychosis or depression.

Occupational Hazards:
As with other CNS depressant drugs, patients should be cautioned against activities requiring mental alertness, judgment and physical coordination such as driving or operating machinery, particularly in the early phases of treatment and until proper adjustment to side effects has been established. Alcohol and benzodiazepines should never be mixed when driving because of the unpredictable CNS depressant effects of this combination. Back to top of page

Pregnancy:
Safety in pregnancy has not been established, therefore its use is not recommended. Studies have suggested an increased risk of congenital malformations associated with the use of the benzodiazepines, such as chlordiazepoxide, diazepam, and also meprobamate, during the first trimester of pregnancy. Since
Xanax is a benzodiazepine derivative, its administration is rarely justified in women of childbearing potential. If the drug is prescribed to a woman of child bearing potential she should be warned to consult her physician regarding the discontinuation of the drug if she intends to become or suspects that she is pregnant.

Lactation: Back to top of page
Studies in rats have indicated that
Xanax and its metabolites are secreted into the milk. Therefore, nursing should not be undertaken while a patient is receiving the drug.

Safety and efficacy of alprazolam in patients under the age of 18 years has not been established.


Precautions

Elderly and debilitated patients, or those with organic brain syndrome, have been found to be prone to the CNS depressant activity of benzodiazepines even after low doses. Manifestations include ataxia, over sedation and hypotension. Therefore, medication should be administered with caution to these patients, particularly if a drop in blood pressure might lead to cardiac complications. Initial doses should be low and increments should be made gradually, depending on the response of the patient, in order to avoid over sedation, neurological impairment and other possible adverse reactions.

Xanax should not be administered to individuals prone to drug abuse. Caution should be observed in all patients who are considered to have potential for psychological dependence. Withdrawal symptoms have been observed after abrupt discontinuation of benzodiazepines. These include irritability, nervousness, insomnia, agitation, tremors, convulsions, diarrhea, abdominal cramps, vomiting and mental impairment. Since these symptoms may be similar to those for which the patient is being treated, it may appear that he has suffered a relapse upon discontinuation. It is suggested that alprazolam should be withdrawn gradually if the individual is suspected of having become dependent, or the drug perhaps has been used in prolonged high doses.

Suicidal tendencies may be present in patients with emotional disorders, particularly when depressed and that protective measures and appropriate treatment may be necessary and should be instituted without delay.

Xanax should not be used in patients suspected of having psychotic tendencies since excitement and other paradoxical reactions can result from the use of anxiolytic-sedatives in these patients. As with other benzodiazepines, alprazolam should not be used in individuals with physiological anxiety or normal stress of daily living but only in the presence of disabling manifestations of an appropriate pathological anxiety disorder.

These drugs are not effective in patients with characterological and personality disorders or those with obsessive compulsive disorders. Xanax is not recommended for the management of depressive or psychotic disorders.

If treatment is necessary in patients with impaired hepatic or renal function, therapy should be initiated at a very low dose and the dosage increased only to the extent that it is compatible with the degree of residual function of these organs.

If Xanax is administered for repeated cycles of therapy, periodic blood counts and liver function tests are advisable. Back to top of page

Since benzodiazepines may occasionally exacerbate grand mal seizures, caution is required when used in epileptic patients and an adjustment may be necessary in their anticonvulsive medication. Abrupt withdrawal of Xanax should be avoided.

Benzodiazepines may potentiate or interact with effects of other CNS acting drugs such as alcohol, narcotics, barbiturates, nonbarbiturate hypnotics, antihistamines, phenothiazines, butyrophenones, MAO inhibitors, tricyclic antidepressants and anticonvulsants. Therefore, if alprazolam is to be combined with other drugs acting on the CNS, careful consideration should be given to the pharmacology of the agent involved because of the possible additive or potentiating effects. Patients should also be advised against the simultaneous use of other CNS depressant drugs and should be cautioned not to take alcohol during the administration of alprazolam.


Adverse Effects Back to top of page

The most frequently reported are drowsiness, coordination difficulties with dizziness. Release of hostility and other paradoxical effects such as irritability, excitability and hallucinations are known to occur with the use of benzodiazepines. Other side effects less frequently reported, listed by body systems, include the following:

Neurologic:
Blurred vision, headache, seizures, slurred speech, difficulty in depth perception.

Psychiatric:
Agitation, mental confusion, depression, irritability, nervousness, sleep disturbances, euphoria, lethargy, stupor.

Gastrointestinal:
Dry mouth, nausea, nonspecific gastrointestinal disturbances, vomiting.

Musculoskeletal:
Muscle spasm, muscle weakness.

Cardiovascular:
Hypotension, palpitations, tachycardia.

Dermatologic:
Pruritus, rash.

Genitourinary:
Incontinence, change in libido.

Hematologic:
Decreased hemoglobin and hematocrit, increased and decreased WBC.

Hepatic:
Elevations of alkaline phosphatase, bilirubin, AST (SGOT), ALT (SGPT).

Miscellaneous:
Increased and decreased blood sugar levels.


Overdose Back to top of page

Symptoms:
Manifested as an extension of
Xanax pharmacologic activity. Varying degrees of CNS depressant effects such as somnolence and hypnosis can occur. Other manifestations may include muscle weakness, ataxia, dysarthria and particularly in children paradoxical excitement. In more severe cases diminished reflexes, confusion and coma may ensue. It should be remembered when treating an overdose that multiple agents may have been ingested. Fatalities with benzodiazepines rarely occur except when other drugs, alcohol or aggravating factors are involved.

Treatment:
Vomiting may be induced if the patient is fully awake. Vital signs should be monitored and general supportive measures should be employed as indicated. Gastric lavage should be instituted as soon as possible. I.V. fluids may be administered and an adequate airway should be maintained.

Experiments in animals have indicated that cardiopulmonary collapse can occur with massive i.v. doses of alprazolam. This could be reversed with positive mechanical respiration and the i.v. infusion of levarterenol.

Animal experiments with Xanax and related compounds have suggested that hemodialysis and forced diuresis are probably of little value.


Dosage

Must be individualized and carefully titrated in order to avoid excessive sedation or mental and motor impairment. As with other anxiolytic-sedatives, short courses of treatment should be the rule for the symptomatic relief of excessive anxiety and the initial course of treatment should not last longer than 1 week without reassessment. If necessary, drug dosage can be adjusted after 1 week. Prescriptions should be limited to short courses of therapy.

Adults:
Initially: Back to top of page
0.25 mg (250 mcg) given 2 or 3 times daily. If required, increases may be made in 0.25 mg (250 mcg) increments according to the severity of symptoms and patient response. It is recommended that the evening dose be increased before the daytime doses. Very severe manifestations of anxiety may require larger initial daily doses. The optimal dosage is one that permits symptomatic control of excessive anxiety without impairment of mental and motor function. Exceptionally, it may be necessary to increase dosage to a maximum of 3 mg daily, given in divided doses.

Elderly and Debilitated Patients:
The initial dosage is 0.125 mg (125 mcg) 2 or 3 times daily. If necessary, this dosage may be increased gradually depending on patient tolerance and response.


Supplied Back to top of page

Xanax:
0.25 mg:
Each scored white, ovoid-shaped tablet, coded "Upjohn 29," contains: Alprazolam 0.25 mg (250 mcg). Gluten-free. Bottles of 100 and 1000.

0.5 mg:
Each scored, peach, ovoid-shaped tablet, coded "Upjohn 55," contains: Alprazolam 0.5 mg (500 mcg). Gluten-free. Bottles of 100 and 1000.

1 mg:
Each scored, lavender, ovoid-shaped tablet, coded "Upjohn 90" contains: Alprazolam 1 mg (1000 mcg). Gluten-free. Bottles of 100.

Xanax TS:
2 mg:
Each white, triscored tablet (3 scores), with the number "2" on one side and Xanax on the other side contains: Alprazolam 2 mg. The tablets can be broken into 4 equal parts of 0.5 mg. Bottles of 100. 

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J Food Prot. 2008 May;71(5):1007-14.

PMID: 18522037 [Xanax - indexed for MEDLINE]

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[Anxiety level and addiction to first-time prescriptions of anxiolytics: a psychometric study]

Barthelmé B, Poirot Y.

Presse Med. 2008 Nov;37(11):1555-60. Epub 2008 May 23. French.

PMID: 18502091 [Xanax - indexed for MEDLINE]

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Influence of incorporation methods on partitioning behavior of lipophilic drugs into various phases of a parenteral lipid emulsion.

Sila-on W, Vardhanabhuti N, Ongpipattanakul B, Kulvanich P.

AAPS PharmSciTech. 2008;9(2):684-92. Epub 2008 May 22.

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GABA-A receptors and the response to CO(2) inhalation - a translational trans-species model of anxiety?

Bailey JE, Nutt DJ.

Pharmacol Biochem Behav. 2008 Jul;90(1):51-7. Epub 2008 Apr 9. Review.

PMID: 18485466 [Xanax - indexed for MEDLINE]

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Determination of illicit and medicinal drugs and their metabolites in oral fluid and preserved oral fluid by liquid chromatography-tandem mass spectrometry.

Concheiro M, de Castro A, Quintela O, Cruz A, López-Rivadulla M.

Anal Bioanal Chem. 2008 Jul;391(6):2329-38. Epub 2008 May 16.

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Citalopram-associated spontaneous ejaculations.

Virit O, Savas HA.

J Clin Psychopharmacol. 2008 Jun;28(3):360-1. No abstract available.

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Complete atrioventricular block associated with concomitant use of metoprolol and paroxetine.

Onalan O, Cumurcu BE, Bekar L.

Mayo Clin Proc. 2008 May;83(5):595-9.

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Alprazolam potentiates the antiaversive effect induced by the activation of 5-HT(1A) and 5-HT (2A) receptors in the rat dorsal periaqueductal gray.

de Bortoli VC, Nogueira RL, Zangrossi H Jr.

Psychopharmacology (Berl). 2008 Jun;198(3):341-9. Epub 2008 Apr 30.

PMID: 18446327 [Xanax - indexed for MEDLINE]

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[Dynamics of cardiovascular system functional state indices in patients with idiopathic mitral valve prolapse against the background of magnerot and alprazolam therapy]

Akatova EV, Sukhanova ED, Mel'nik OO, Martynov AI.

Klin Med (Mosk). 2008;86(3):55-8. Russian.

PMID: 18441707 [Xanax - indexed for MEDLINE]

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[Pharmacologic correction of psycho-emotive disorders in the rehabilitation of patients after removal of brain tumors]

Koval'chuk VV.

Vopr Onkol. 2007;53(6):704-10. Russian. No abstract available.

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Ultra rapid liquid chromatography as second dimension in a comprehensive two-dimensional method for the screening of pharmaceutical samples in stability and stress studies.

Huidobro AL, Pruim P, Schoenmakers P, Barbas C.

J Chromatogr A. 2008 May 9;1190(1-2):182-90. Epub 2008 Mar 13.

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Prediction of pharmacokinetic drug-drug interactions using human hepatocyte suspension in plasma and cytochrome P450 phenotypic data. II. In vitro-in vivo correlation with ketoconazole.

Lu C, Hatsis P, Berg C, Lee FW, Balani SK.

Drug Metab Dispos. 2008 Jul;36(7):1255-60. Epub 2008 Apr 1.

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Alprazolam (Xanax) use among southern youth: beliefs and social norms concerning dangerous rides on "handlebars".

Peters RJ Jr, Meshack AF, Kelder SH, Webb P, Smith D, Garner K.

J Drug Educ. 2007;37(4):417-28.

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Prediction of metabolic clearance using fresh human hepatocytes: comparison with cryopreserved hepatocytes and hepatic microsomes for five benzodiazepines.

Hallifax D, Galetin A, Houston JB.

Xenobiotica. 2008 Apr;38(4):353-67.

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Pharmacology of neuropeptide S in mice: therapeutic relevance to anxiety disorders.

Leonard SK, Dwyer JM, Sukoff Rizzo SJ, Platt B, Logue SF, Neal SJ, Malberg JE, Beyer CE, Schechter LE, Rosenzweig-Lipson S, Ring RH.

Psychopharmacology (Berl). 2008 May;197(4):601-11. Epub 2008 Mar 3.

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Evidenced-based pharmacologic treatment of borderline personality disorder: a shift from SSRIs to anticonvulsants and atypical antipsychotics?

Abraham PF, Calabrese JR.

J Affect Disord. 2008 Nov;111(1):21-30. Epub 2008 Mar 4. Review.

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Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes.

Tsavaris N, Kosmas C, Kopterides P, Vadiaka M, Kosmas N, Skopelitis H, Karadima D, Kolliokosta G, Tzima E, Loukeris D, Pagouni E, Batziou E, Xyla V, Koufos C.

Eur J Cancer Care (Engl). 2008 Mar;17(2):167-73.

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Protective effect of alprazolam against sleep deprivation-induced behavior alterations and oxidative damage in mice.

Singh A, Kumar A.

Neurosci Res. 2008 Apr;60(4):372-9. Epub 2007 Dec 23.

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[Alprazolam use improves psychological status and reduces hospitalization costs in patients with paroxysmal supraventricular tachycardia underwent radiofrequency catheter ablation]

Zhu YJ, Liu ZY, Chen Y, Zheng P, Zhu JH, Tao QM, Zheng LR, Wang QQ, Shi MJ, Qiu YG.

Zhonghua Xin Xue Guan Bing Za Zhi. 2007 Oct;35(10):919-22. Chinese.

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The quality of hemodialysis in patients with mental retardation.

Weng CH, Yen TH, Chen KH, Hung CC, Wu JH, Yang CW, Chang CT.

Ren Fail. 2008;30(1):63-5.

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Effect of Jin-3-needling therapy on plasma corticosteroid, adrenocorticotrophic hormone and platelet 5-HT levels in patients with generalized anxiety disorder.

Yuan Q, Li JN, Liu B, Wu ZF, Jin R.

Chin J Integr Med. 2007 Dec;13(4):264-8.

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Depression, anxiety and substance use in medical students in the Republic of Macedonia.

Mancevska S, Bozinovska L, Tecce J, Pluncevik-Gligoroska J, Sivevska-Smilevska E.

Bratisl Lek Listy. 2008;109(12):568-72.

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Relative influences of adjunctive topiramate and adjunctive lamotrigine on scanning and the effective field of view.

Mills KC, Drazkowski JF, Hammer AE, Caldwell PT, Kustra RP, Blum DE.

Epilepsy Res. 2008 Feb;78(2-3):140-6. Epub 2007 Dec 21.

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Determination of benzodiazepines in oral fluid using LC-MS-MS.

Moore C, Coulter C, Crompton K, Zumwalt M.

J Anal Toxicol. 2007 Nov-Dec;31(9):596-600.

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Opioid receptors are involved in the sedative and antinociceptive effects of hesperidin as well as in its potentiation with benzodiazepines.

Loscalzo LM, Wasowski C, Paladini AC, Marder M.

Eur J Pharmacol. 2008 Feb 12;580(3):306-13. Epub 2007 Nov 13.

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Pregabalin in benzodiazepine withdrawal.

Biermann T, Bleich S, Kornhuber J, Hillemacher T.

Pharmacopsychiatry. 2007 Nov;40(6):292-3. No abstract available.

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Development of HPTLC-UV absorption densitometry method for the analysis of alprazolam and sertraline in combination and its application in the evaluation of marketed preparations.

Venkateswarlu K, Venisetty RK, Yellu NR, Keshetty S, Pai MG.

J Chromatogr Sci. 2007 Sep;45(8):537-9.

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Hemoperfusion in the treatment of acute clozapine intoxication in China.

He JL, Xiang YT, Li WB, Cai ZJ, Ungvari GS.

J Clin Psychopharmacol. 2007 Dec;27(6):667-71.

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Connectivity analysis of EEG under drug therapy.

Alonso JF, Mañanas MA, Romero S, Riba J, Barbanoj MJ, Hoyer D.

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[Therapeutical strategies for essential tremor]

Gironell A.

Med Clin (Barc). 2007 Nov 3;129(16):632-7. Review. Spanish.

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Predominance of illicit drugs and poly-drug use among drug-impaired drivers in Sweden.

Holmgren A, Holmgren P, Kugelberg FC, Jones AW, Ahlner J.

Traffic Inj Prev. 2007 Dec;8(4):361-7.

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An effect-size analysis of pharmacologic treatments for generalized anxiety disorder.

Hidalgo RB, Tupler LA, Davidson JR.

J Psychopharmacol. 2007 Nov;21(8):864-72.

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Maximal inhibition of intestinal first-pass metabolism as a pragmatic indicator of intestinal contribution to the drug-drug interactions for CYP3A4 cleared drugs.

Galetin A, Hinton LK, Burt H, Obach RS, Houston JB.

Curr Drug Metab. 2007 Oct;8(7):685-93. Review.

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1,4-Benzodiazepine N-nitrosoamidines: useful intermediates in the synthesis of tricyclic benzodiazepines.

Fustero S, González J, del Pozo C.

Molecules. 2006 Aug 9;11(8):583-8.

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Cognitive style, alprazolam plasma levels, and treatment response in panic disorder.

Uhlenhuth EH, Starcevic V, Qualls C, Antal EJ, Matuzas W, Javaid JI, Barnhill J.

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Hermos JA, Young MM, Lawler EV, Rosenbloom D, Fiore LD.

J Trauma Stress. 2007 Oct;20(5):909-14.

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Appearance of double peaks in plasma concentration-time profile after oral administration depends on gastric emptying profile and weight function.

Metsugi Y, Miyaji Y, Ogawara K, Higaki K, Kimura T.

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Pregabalin: its efficacy, safety and tolerability profile in generalized anxiety.

Owen RT.

Drugs Today (Barc). 2007 Sep;43(9):601-10. Review.

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Modulation of human risky decision making by flunitrazepam.

Lane SD, Cherek DR, Nouvion SO.

Psychopharmacology (Berl). 2008 Feb;196(2):177-88. Epub 2007 Oct 5.

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Letter: In situ chemical ionization in ion trap mass spectrometrythe beneficial influence of isobutane as a reagent gas.

Bouchonnet S, Kinani S, Sablier M, Pirnay S.

Eur J Mass Spectrom (Chichester, Eng). 2007;13(3):227-32.

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Letter: Does the reagent gas influence collisional activation when performing in situ chemical ionization with an ion trap mass spectrometer ?

Bouchonnet S, Kinani S, Sablier M.

Eur J Mass Spectrom (Chichester, Eng). 2007;13(3):223-6.

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Benzodiazepines in generalized anxiety disorder: heterogeneity of outcomes based on a systematic review and meta-analysis of clinical trials.

Martin JL, Sainz-Pardo M, Furukawa TA, Martín-Sánchez E, Seoane T, Galán C.

J Psychopharmacol. 2007 Sep;21(7):774-82. Review.

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Different acute tolerance development to EEG, psychomotor performance and subjective assessment effects after two intermittent oral doses of alprazolam in healthy volunteers.

Barbanoj MJ, Urbano G, Antonijoan R, Ballester MR, Valle M.

Neuropsychobiology. 2007;55(3-4):203-12. Epub 2007 Sep 17.

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A rapid CZE method for the analysis of benzodiazepines in spiked beverages.

Webb R, Doble P, Dawson M.

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Ngwa G, Fritch D, Blum K, Newland G.

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Kauppila TJ, Talaty N, Kuuranne T, Kotiaho T, Kostiainen R, Cooks RG.

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