A Case Report :Alprazolam Therapy in A Dextra Fronto-Parietal Meningioma Patient With Anxiety Disorders
Efektivitas Alprazolam Pada Pasien Meningioma Fronto-Parietal Dextra Dengan Gangguan Cemas
-
(1) Prajogo Wibowo Universitas Hang Tuah Surabaya
Indonesia
(2) * Prawesty Diah Utami
Universitas Hang Tuah Surabaya
Indonesia
(*) Corresponding Author
Abstract
Meningiomas in the frontoparietal lobe may cause anxiety disorders and panic attacks. While alprazolam is one of the most widely used medications for anxiety disorders, long-term use may result in adverse side effects (withdrawal and rebound effects). This case study aims to describe the efficacy of long-term alprazolam administration in patients with meningiomas for regulating anxiety disorders. Case report :The asymmetrical face is the primary concern of a 65-year-old female when she is anxious. The results of the physical assessment and laboratory tests are within normal ranges. However, The HARS procedure showed moderate anxiety, and the CT scan revealed a meningioma in the right frontoparietal lobe. To regulate patient anxiety disorders, doctors give alprazolam 0.5 mg per day single dose for 4 months and tapering off for 3 months. Conclusion: Long-term administration of alprazolam in these patients can reduce the patient's anxiety disorder without causing withdrawal or rebound effects. A low dosage of alprazolam, a mild level of anxiety illness, and a slow tapering off phase were factors that contributed to the effectiveness of alprazolam treatment to suppress anxiety symptoms in this situation.
References
Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine, 12(1), 4–10. doi: 10.1097/ADM.0000000000000350 DOI: https://doi.org/10.1097/ADM.0000000000000350
Ballenger, J. C., Burrows, G. D., Dupont, R. L., Lesser, I. M., Noyes, R., Pecknold, J. C., Rifkin, A., & Swinson, R. P. (1988). Alprazolam in Panic Disorder and Agoraphobia: Results From a Multicenter Trial: I. Efficacy in Short-term Treatment. Archives of General Psychiatry, 45(5), 413–422. doi: 10.1001/archpsyc.1988.01800290027004 DOI: https://doi.org/10.1001/archpsyc.1988.01800290027004
Chowdhury, Z. S., Morshed, M. M., Shahriar, M., Bhuiyan, M. A., Mohd, S., Islam, A., Shahdaat, M., & Sayeed, B. (2016). The Effect of Chronic Alprazolam Intake on Memory , Attention , and Psychomotor Performance in Healthy Human Male Volunteers. Behavioural Neurology, 2016, 1–9. Retrieved from https://www.hindawi.com/journals/bn/2016/3730940/ DOI: https://doi.org/10.1155/2016/3730940
Goebel, S., & Mehdorn, H. M. (2012). Development of anxiety and depression in patients with benign intracranial meningiomas : a prospective long-term study. Supportive Care in Cancer •, 1(1), 1–9. doi: 10.1007/s00520-012-1675-5 DOI: https://doi.org/10.1007/s00520-012-1675-5
Hussain, T., Shafat, M., & Bhat, J. A. (2015). Frontal lobe meningioma masquerading as depressive disorder. African Journal of Psychiatry (South Africa), 18(6). doi: 10.4172/2378-5756.1000328 DOI: https://doi.org/10.4172/2378-5756.1000328
Kalasauskas, D., Keric, N., Ajaj, S. A., Cube, L. von, Ringel, F., & Renovanz, M. (2020). Psychological burden in meningioma patients under a wait-and-watch strategy and after complete resection is high—results of a prospective single center study. Cancers, 12(12), 1–13. doi: 10.3390/cancers12123503 DOI: https://doi.org/10.3390/cancers12123503
Klerman, G. L. (1988). Overview of the Cross-National Collaborative Panic Study: I. Efficacy in Short-term Treatment. Archives of General Psychiatry, 45(5), 407–412. doi: 10.1001/archpsyc.1988.01800290021003 DOI: https://doi.org/10.1001/archpsyc.1988.01800290021003
Loe, M. L., & Maliawan, S. (2019). Spontaneous recovery of Medial Prefrontal Syndrome following Giant Olfactory Groove Meningioma resection: A case report. Bali Medical Journal, 8(2), 380. doi: 10.15562/bmj.v8i2.1454 DOI: https://doi.org/10.15562/bmj.v8i2.1454
Louvet, S., Ischayek, M., & Danoff, R. (2015). The Current Role of Long-Term Benzodiazepines for the Treatment of Generalized Anxiety. 20 Osteopathic Family Physician, 7(1), 19–25. Retrieved from https://ofpjournal.com/index.php/ofp/article/view/364
Ogbonna, C. I., & Lembke, A. (2017). Tapering Patients Off of Benzodiazepines. American family physician, 96(9), 606–610. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29094883/
Ramdan, I. M. (2018). Reliability and Validity Test of the Indonesian Version of the Hamilton Anxiety Rating Scale ( HAM-A ) to Measure Work-related Stress in Nursing Design of Study and Participants. Journal Ners, 14(1), 33–40. Retrieved from https://e-journal.unair.ac.id/JNERS/article/view/10673 DOI: https://doi.org/10.20473/jn.v13i2.10673
Slater, P., Bunting, B., Hasson, F., Al-Smadi, A. M., Omar Salem Gammouh, A. A., & Jordan, D. (2019). An Examination of Factor Structure of the Hamilton Anxiety Rating Scale in a An Examination of Factor Structure of the Hamilton Anxiety Rating Scale in a Non-Clinical Persian Sample. International Journal of Research in Nursing, 10(1.9), 1–10. doi: 10.3844/ijrnsp.2019.1.9 DOI: https://doi.org/10.3844/ijrnsp.2019.1.9
Subramoniam, M., Ting, M. B., Farah, T., & Ugur, U. (2015). Psychiatric aspects of brain tumors: A review. World Journal of Psychiatry, 5(3), 273–285. doi: 10.5498/wjp.v5.i3.273 DOI: https://doi.org/10.5498/wjp.v5.i3.273
Trevizol, A. P., Cerqueira, R. D. O., Brietzke, E., & Cordeiro, Q. (2019). New-onset psychiatric symptoms following ntracranial meningioma in a patient with schizophrenia: A case study. Revista Brasileira de Psiquiatria, 41(1), 91–92. doi: 10.1590/1516-4446-2018-0055 DOI: https://doi.org/10.1590/1516-4446-2018-0055
Verster, J. C., & Volkerts, E. R. (2004). Clinical Pharmacology, Clinical Efficacy, and Behavioral Toxicity of Alprazolam: A Review of the Literature. CNS Drug Reviews, 10(1), 45–76. doi: 10.1111/j.1527-3458.2004.tb00003.x DOI: https://doi.org/10.1111/j.1527-3458.2004.tb00003.x
Yakhmi, S., Sidhu, B. S., Kaur, J., & Kaur, A. (2015).Diagnosis of frontal meningioma presenting with psychiatric symptoms. Indian Journal of Psychiatry, 57(1), 91–93. doi: 10.4103/0019-5545.148534 DOI: https://doi.org/10.4103/0019-5545.148534
