Psychotic Symptoms after Long Term Using Diazepam and Alprazolam Medication; Depend Syndrome of Alprazolam

Alprazolam and Diazepam two most prescribed benzodiazepine in the Kosovo have been potential for addictive use. Both drugs are rapidly absorbed and enter the brain tissue rapidly, leading to reinforcement. Alprazolam has a short half – life that may lead to more withdrawal symptoms than Diazepam. In experimental conditions, they are among the most reinforcing benzodiazepines. Each causes a withdrawal syndrome, but Alprazolam withdrawal may be more severe and may occur after a shorter period of use. Adverse effects from their use are rare, yet negative consequences may be seen with some regularly. Alprazolam deserves special caution, because of its relative newness great popularity-reinforcing capabilities relatively sense withdrawal syndrome, and reports of addiction and negative consequences of use.

Catatonia due to alprazolam withdrawal

A 50-year-old man with multiple psychiatric comorbidities including major depressive disorder and general anxiety disorder presented to the emergency room (ER) with altered mental status, immobility and mutism. The patient was unresponsive to commands and unable to provide any history. In the ER he was given a provisional diagnosis of cerebrovascular accident (CVA). Vital signs on admission were stable. On physical examination, he exhibited grimacing, muscle rigidity and areflexia. Workup for CVA and infectious aetiology was unremarkable and the patient’s urine toxicology screen was negative. History from the patient’s family revealed that 4 days prior to presentation, the patient had discontinued his prescribed dose of alprazolam 1 mg four times per day. The patient was diagnosed with catatonia due to benzodiazepine withdrawal and had gradual return to baseline with administration of lorazepam 1 mg intravenous three times per day.