Alprazolam discontinuation in panic disorder: A biopsychosocial analysis and case review

William James McCann (1993)

Benzodiazepines (BZs) have become the major pharmacological therapy for anxiety. Alprazolam (Xanax) in particular has recently been described as "indicated" for panic disorder and is currently one of the most widely prescribed of the benzodiazepines. Many reports have indicated problems in the discontinuation of the benzodiazepines, and alprazolam in particular, and a benzodiazepine discontinuation syndrome (BZDS) is being researched. A review of the literature relating to the BZDS was conducted to explore the hypothesis that a somatic focus has dominated the approach to the understanding and treatment of BZDS which has contributed to a clinically narrow approach to its amelioration. A biopsychosocial (BPS) analysis of alprazolam discontinuation in individuals diagnosed with panic disorder (with or without agoraphobia) is presented as a focused example to demonstrate how an analysis of this type can contribute to multi-systems thinking. Based on this analysis, a PBS approach to benzodiazepine discontinuation is presented.