Does oral alprazolam affect ventilation? A randomised,double-blind,placebo-controlled trial

Abstract

The respiratory effects of benzodiazepines have been controversial. This investigation aimed to study the effects of oral alprazolam on ventilation. In a randomised, double-blind cross-over protocol, 20 healthy men ingested 1 mg of alprazolam or placebo in random order, 1 week apart. Ventilation was unobtrusively monitored by inductance plethysmography along with end-tidal PCO₂ and pulse oximetry 60–160 min after drug intake. Subjects were encouraged to keep their eyes open. Mean ± SD minute ventilation 120 min after alprazolam and placebo was similar (6.21 ± 0.71 vs 6.41 ± 1.12 L/min, P = NS). End-tidal PCO₂ and oxygen saturation did also not differ between treatments. However, coefficients of variation of minute ventilation after alprazolam exceeded those after placebo (43 ± 23% vs 31 ± 13%, P < 0.05). More encouragements to keep the eyes open were required after alprazolam than after placebo (5.2 ± 5.7 vs 1.3 ± 2.3 calls, P < 0.05). In a multiple regression analysis, higher coefficients of variation of minute ventilation after alprazolam were related to a greater number of calls. Oral alprazolam in a mildly sedative dose has no clinically relevant effect on ventilation in healthy, awake men. The increased variability of ventilation on alprazolam seems related to vigilance fluctuations rather than to a direct drug effect on ventilation.

Keywords

benzodiacepin anxiolythic ventilation apnea hypoventilation control of breathing anxiety

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