ModerateBenzodiazepines. Short-to-medium-acting anxiolytics×SNRI (serotonin-norepinephrine reuptake inhibitor)
Updated · Methodology
Mechanism
Additive CNS depression (minimal for venlafaxine, mainly from alprazolam). High-dose venlafaxine (above 150 mg/day) also raises BP.
Symptoms
Sedation, fatigue, slowed reactions, impaired coordination. In older patients: fall and fracture risk. Driving and operating machinery: accident risk.
Management
On starting the combination, begin alprazolam at the minimum dose. For long-term anxiety treatment, prioritise antidepressant monotherapy with CBT and gradual benzodiazepine taper. In arterial hypertension, check BP 2 weeks after starting venlafaxine.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Xanax (alprazolam) prescribing information (2016)– ; DailyMed setid 388e249d-b9b6-44c3-9f8f-880eced0239f