Review of the impact of short-term use of alprazolam on cognitive, psychomotor, and quality-of-life impairments associated with anxiety disorders.

Anxiety disorders are often associated with impairments in memory, attention, decision-making, and psychomotor function, leading to a reduced quality of life (QoL). Alprazolam, commonly prescribed for acute anxiety disorders, has generated interest regarding its potential impact on anxiety-associated cognitive and psychomotor impairment, especially since effects of short-term use have not been well studied. This review summarizes clinical evidence on the short-term (up to 8 weeks) effects of alprazolam on cognitive performance, psychomotor function, and QoL outcomes in individuals with anxiety disorders. A comprehensive search guided by the participants, intervention, comparisons, and outcomes (PICO) framework identified relevant studies in humans that compared alprazolam with placebo or active comparators. From 1210 articles screened, 10 studies met the inclusion criteria and assessed the short-term impact of alprazolam use on cognition (4), psychomotor function (3), and/or QoL (5). Three of the four studies evaluating cognitive function showed that alprazolam use in adults with panic disorder did not result in any major cognitive impairment. Two of the three studies assessing psychomotor performance demonstrated that short-term alprazolam use either improved or preserved performance. One study recommended gradual upward dose titration to minimize potential negative effects. All five studies found alprazolam enhanced patients' QoL. In conclusion, short-term alprazolam use in anxiety disorders appears to conserve cognitive function and psychomotor performance, with a positive impact on QoL. Elucidating alprazolam's effects on cognitive and psychomotor symptoms, beyond its established anxiolytic action, could support more precise identification of patient groups most likely to derive therapeutic benefit.