Alprazolam-induced panic disorder.

The Food and Drug Administration indication of alprazolam for the treatment of panic disorder tacitly suggests that it does not induce panic attacks. This suggestion is amplified by the history of alprazolam as the first medication approved for panic disorder. Moreover, alprazolam acutely decreases anxiety symptoms, including panic, and is widely used for this indication. Although dependence, withdrawal, and rebound anxiety from alprazolam have been noted, alprazolam has not previously been reported to cause frank panic attacks. We observed a patient with panic attacks induced by alprazolam, presumably a severe rebound effect.