title: Severe withdrawal symptoms after discontinuation of alprazolam in eight patients with combat-induced posttraumatic stress disorder.
abstract: Eight patients with combat-induced chronic posttraumatic stress disorder (PTSD) receiving long-term alprazolam therapy for anxiety or depression (maximum dose of 2-9 mg/day for 1-5 years) had alprazolam therapy withdrawn. Most of the patients underwent gradual medication withdrawal. All patients had a prior history of alcohol abuse or benzodiazepine dependence. During withdrawal, all patients had severe reactions including anxiety, sleep disturbance, rage reactions, hyperalertness, increased nightmares, and intrusive thoughts; and 6 of the 8 patients had homicidal ideation. As a result of this report, the authors suggest that the potential for severe withdrawal reactions, even with gradual tapering, should be considered before prescribing alprazolam therapy for this group of patients.
authors.affiliation: Psychiatry Service, American Lake Veterans Administration Medical Center, Tacoma, Wash 98493.
authors.forename: S C
authors.initials: SC
authors.lastname: Risse
authors.forename: A
authors.initials: A
authors.lastname: Whitters
authors.forename: J
authors.initials: J
authors.lastname: Burke
authors.forename: S
authors.initials: S
authors.lastname: Chen
authors.forename: R M
authors.initials: RM
authors.lastname: Scurfield
authors.forename: M A
authors.initials: MA
authors.lastname: Raskind
mesh_terms: D000328:Adult; D000525:Alprazolam / Q000009:adverse effects*; D001008:Anxiety Disorders / Q000188:drug therapy / Q000523:psychology; D001569:Benzodiazepines; D003130:Combat Disorders / Q000188:drug therapy* / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D006708:Homicide; D006801:Humans; D008297:Male; D011889:Rage; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000209:etiology*; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D001569:Benzodiazepines; D000525:Alprazolam