From the FDA Drug Label
Benzodiazepines, even when used as recommended, may produce emotional and/or physical dependence. The benzodiazepines, including alprazolam, produce additive CNS depressant effects when co-administered with other psychotropic medications, anticonvulsants, antihistaminics, ethanol and other drugs which themselves produce CNS depression Alprazolam is a downer drug because it is a benzodiazepine that can cause central nervous system depressant activity, leading to effects such as mild impairment of task performance to hypnosis.
- It can produce emotional and/or physical dependence, even when used as recommended.
- It can also produce additive CNS depressant effects when co-administered with other psychotropic medications or substances that produce CNS depression 1.
From the Research
Downer drugs, also known as depressants, should be used with caution due to their potential for dependence, addiction, and severe side effects, and alternative treatments such as cognitive behavioral therapy (CBT) and mindfulness-based interventions should be considered as first-line treatments for anxiety and insomnia. A downer drug is a substance that slows down the central nervous system activity, reducing alertness and stimulation. Common examples include benzodiazepines (like Xanax, Valium, and Klonopin), barbiturates, alcohol, and opioids (such as morphine, heroin, and prescription painkillers like oxycodone) 2. These substances typically produce effects like relaxation, sedation, reduced anxiety, decreased inhibition, slowed breathing, and impaired coordination. They work by enhancing the effects of the neurotransmitter GABA in the brain, which inhibits brain activity, or by mimicking endorphins as in the case of opioids.
Some of the key points to consider when prescribing downer drugs include:
- The potential for dependence and addiction, particularly with long-term use 2
- The risk of severe side effects, such as respiratory depression, unconsciousness, and even death, especially when combined with other substances 2
- The importance of considering alternative treatments, such as CBT and mindfulness-based interventions, which have been shown to be effective in reducing anxiety and insomnia symptoms 3, 4
- The need for careful monitoring and follow-up to minimize the risks associated with downer drug use 2
In terms of alternative treatments, CBT and mindfulness-based interventions have been shown to be effective in reducing anxiety and insomnia symptoms, and may be considered as first-line treatments for these conditions 3, 4. These interventions can be delivered in a variety of formats, including individual and group therapy, and may be adapted for use in digital formats, such as online CBT programs 4. Overall, a comprehensive approach to treating anxiety and insomnia should consider the potential benefits and risks of downer drugs, as well as the availability of alternative treatments, in order to provide the best possible outcomes for patients.