Moderate
Probable
Description
Alprazolam and gabapentin produce additive CNS depression, increasing the risk of sedation, dizziness, and psychomotor impairment.
Mechanism
GABA-A potentiation (alprazolam) combined with alpha-2-delta calcium channel modulation and GABAergic enhancement (gabapentin) produces additive CNS inhibition.
Clinical Significance
Excessive sedation and ataxia are common with this combination; fall and fracture risk is substantially elevated.
Management
Use caution; reduce doses of both agents and advise against activities requiring alertness until tolerance to sedation is established.