No Clear Role for Extended-Release Xanax

Nurse Practitioner, Aug 2003 by Risser, Nancy, Murphy, Mary

* No Clear Role for Extended-Release Xanax

The Medical Letter, Xanax XR for panic disorder. 2003;45(1157):43-44.

Therapy for panic disorder often includes benzodiazepines to provide rapid relief of symptoms, used together with antidepressant medications, which can take weeks to become effective. An extended release formulation of the benzodiazepine alprazolam (Xanax XR) is now available.

The Medical Letter consultants found only two published studies that showed extended-release alprazolam is effective. In one of these studies, extended-release alprazolam was less effective than immediate-release alprazolam or placebo in some measures. In the other study, response rates to placebo were 61%-81%, making drug effectiveness difficult to substantiate. Two 8-week long studies did not show superiority over placebo. Although extended-release alprazolam requires fewer doses per day than immediate-release alprazolam, clinical data showing that this new formulation is more effective to reduce anxiety between doses are not available. Cognitive behavioral therapy and antidepressants are preferred for long-term treatment of panic disorder. Xanax XR may provide immediate symptoms relief, but needs to be stopped as soon as possible to avoid physical or psychological dependence.