Alprazolam and benzodiazepine prescribing - Rob Shieff

Rob Shieff talks about the removal of alprazolam (Xanax) from the New Zealand pharmaceutical schedule and issues around benzodiazepine prescribing. Rob is a general adult psychiatrist practising in Auckland. His special interest is in the evaluation and management of anxiety and mood disorders. Rob has considerable experience in psycho-pharmacology and in delivering evidence based forms of psychotherapy.

Topics

Why alprazolam (Xanax) is being discontinued in New Zealand.
How is withdrawal of this product being staggered to limit disruption to patients?
Practical measures for prescribers.
Key points for treatment of anxiety disorders in primary care.
Main indications for starting a benzodiazepine.
Information to share with a patient before initiating this type of treatment.
Tips on switching a patient from alprazolam if withdrawal is not currently an option.
Are there any other suitable funded alternatives?
Tips for weaning patients off benzodiazepines.

Take home messages

Don’t write any new prescriptions for alprazolam.
As of 1 September 2017 alprazolam will not be brought into New Zealand.
Educate patients about the tapering and either: Replace completely with Diazepam and start tapering out. Find an alternative either non-pharmacological or antidepressant.