Maximum Dosing of Alprazolam for Panic Disorder

Dependency Risk Stratification

• The American Family Physician notes that seizure risk is associated with alprazolam discontinuation or dose reduction, with 8 of 1,980 patients developing seizures during discontinuation or dose reduction, and 5 clearly related to abrupt changes 1

Special Population Considerations

• The National Comprehensive Cancer Network (NCCN) guidelines recommend that elderly patients, those with debilitating disease, and those with advanced liver disease should start at 0.25 mg 2-3 times daily rather than standard dosing 2
• The NCCN guidelines also note that elderly patients are especially sensitive to benzodiazepine effects, and should be started at lower doses 3
• The American Family Physician guidelines similarly emphasize that elderly patients are especially sensitive to benzodiazepine effects, and should be treated with caution 1