*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Xanax is a medication commonly used for the treatment of generalized anxiety disorder and panic disorder. When taken to help treat symptoms of anxiety, Xanax can ease muscle or chest tightness, can reduce racing thoughts and shortness of breath. However, the way Xanax makes you feel can depend on a number of factors, including age, dosage, frequency with which you take it and more.
If you want to discuss your current prescription with a provider or are considering a prescription for Xanax, an online psychiatry platform can be a good place to start. Platforms like Talkiatry and Brightside Health offer psychiatric assessments and prescription consultation, and can answer any questions you have about taking Xanax.
Boxed Warning: Risks of Alprazolam (Xanax) include misuse, addiction, withdrawal and even death
Alprazolam, the active ingredient in Xanax, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA).
- Taking Xanax, a benzodiazepine, with other opioid medications increases your risk for serious side effects that include severe sedation, slower breathing, coma, and death. Xanax should not be taken with an opioid unless there are no other options.
- Taking Xanax can lead to misuse (abuse) and addiction of the medication, which can increase your risk of overdose and death.
- Using Xanax can lead to physical dependence and this risk increases the longer you take Xanax. If you suddenly stop taking Xanax, you can experience withdrawal. Withdrawal can be life threatening. Xanax should only be discontinued by gradual tapering of the dose.
Xanax is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
What Is Xanax Used For
Xanax, generically known as alprazolam, falls under a broader category of prescription medications known as benzodiazepines. Benzodiazepines are widely prescribed medications to treat anxiety disorders and insomnia. Benzos, including Xanax, are very effective in the treatment of panic disorder, generalized anxiety disorder, and in reducing symptoms of anxiety in situations of short-term stress, such as flying in an airplane.
Xanax is prescribed for short-term use and, in most instances, in combination with a family of drugs called selective serotonin reuptake inhibitors (SSRIs). This combination allows for both medications to augment the effects of each other. It can also help patients discontinue Xanax use, as it is not intended for long-term use in most cases.
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What Does Xanax Feel Like?
How Xanax and other anti-anxiety medication makes you feel depends on many factors, such as your age, the dose taken, and whether you are taking other medications or mood altering substances. Generally, however, Xanax’s intended effects should make you feel calm and reduce feelings and symptoms of anxiety rather than sleepy or otherwise lousy.
When used as prescribed, Xanax can calm you down from immediate stressors, and give you a sense of control by decreasing racing thoughts, muscle tension, feelings of impending doom, shortness of breath, and increased heartbeat, among other symptoms.
Xanax is a fast-acting medication, and many start feeling effects within an hour.
Prescribed Use
When Xanax is used as prescribed you may feel calm and in better control with better mental clarity and a better ability to make decisions.
When used as intended, Xanax could make you feel the following:
- Ease of muscle tension
- Better sleep
- Ease of chest tightness
- Reduced feelings of fear
- Reduced racing thoughts
- Resolved symptoms of a panic attack such as pounding or racing heart, trembling, difficulty breathing among others
Recreational Use
When used without a medical indication, Xanax may make you feel like you’re having a euphoric experience or a feeling like you are “high.” Misuse of Xanax can lead to significant adverse effects and negative outcomes in a person’s life, including blacking out, and even experiencing memory loss if used at higher doses. Misusing Xanax can lead to an increased risk of developing an addiction to this medication in addition to potentially overdosing on Xanax if taken not as prescribed. Dangerous withdrawal effects may also occur when Xanax is suddenly stopped.
According to one study, misuse of prescription drugs accounted for more than 17 percent of overall Xanax use.1 The researchers defined misuse as any other way besides as prescribed by a physician. This includes using the medicine without a prescription or more frequently or longer than prescribed.
Xanax With Alcohol
Taking Xanax and alcohol together is dangerous. Xanax and alcohol work on the same receptors in the brain creating the same effects, so when used together, this combination can potentiate the effects, potentially causing an overdose or unwanted or harmful side effects. When alcohol and Xanax are mixed, individuals can experience increased effects of anxiety reduction, sedation, lethargy and decreased motor reflexes. As a person takes even higher doses of both substances, they could become unconscious or pass out quickly.
Xanax mixed with alcohol can potentially be life threatening. Taking too much of one or both of these drugs can shut down areas in the brain that control our breathing and heart function.. An individual may stop breathing, and can die as a result.
When high-dose Xanax or other benzodiazepines and alcohol are abruptly discontinued, the body can go into serious withdrawals. Withdrawal symptoms associated with Xanax and other benzodiazepines (or alcohol) include anxiety and insomnia, increased blood pressure, increased heart rate, and, possibly, seizures.1
Xanax With Other Drugs
Other than alcohol, there are other drugs that should be avoided when taking Xanax due to its compounding effect as depressants of the central nervous system (CNS). Another reason for avoiding these combinations is that medications can interact with Xanax by blocking or reducing the metabolism in the liver, which is responsible for eliminating these drugs.
Xanax can negatively interact with the following drugs:
- Seizure medications
- Antihistamines
- Other anti-anxiety medications
- Sleeping medications
- Opioids
- Antifungals
- Oral contraceptive pills
- Grapefruit juice
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Side Effects of Xanax
Like any other medication, Xanax has a number of potential side effects. These will depend on different factors. If you are new to this medication, taking Xanax the first time can calm your anxiety, or can make you feel worse.
The higher the dose of Xanax, the higher the risk for side effects. Other factors that influence adverse effects include age and the frequency with which you take it.
Some of the most common side effects of Xanax are:
- Sleepiness
- Clumsiness
- Forgetfulness
- Drowsiness
- Impaired coordination
- Slurred speech
- Sedation
- Blurred vision
- Weight gain
- Decreased libido
- Constipation
What Shouldn’t You Feel While Taking Xanax
While taking Xanax as prescribed by your doctor, you should not feel drowsiness or fatigue, have slurred speech, difficulty with your motor movements (ie. walking) or feel like your cognitive function – attention, concentration, and memory – is impaired. If you feel this way, Xanax may not be the right medication for you. You should always consult your physician if you have any adverse effects, need to change dosage or change medication.
Xanax has the potential for overdose. Xanax overdose is dangerous because it can lead to coma and even death. An overdose of Xanax can start with early symptoms such as sleepiness, slowed or slurred speech, difficulty walking or standing, blurred vision, impaired ability to think, disorientation, and mood changes. They can later worsen into slowed breathing, low blood pressure, coma, shock, and death.
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When To Talk To Your Doctor
If you are under medical care, you must reach out to your doctor if the medication is not helping to decrease symptoms. Despite getting Xanax, if you continue to feel muscle tension, worry, a racing heart, trembling, and shortness of breath, you should immediately contact your doctor. Your doctor may choose to increase the dose of your medication or switch to something different.
Xanax Withdrawal
As a benzodiazepine, alprazolam comes at a risk of misuse, dependence , and addiction. Physical dependence on alprazolam can occur with prolonged use of the medication. Physical dependence occurs when the body becomes so used to the drug that it believes it cannot function without it and as a result, may go into withdrawals if the drug is reduced or stopped. Dependence can potentially lead to addiction. Do not stop taking alprazolam abruptly, and do not make any changes to dosage without consulting your healthcare provider. 2
When to Seek Emergency Medical Attention
The FDA has found that benzodiazepine drugs, such as alprazolam, can result in severe adverse reactions, including slowed or difficult breathing and death when used with opioid medications or other sedating medications.
Patients taking opioids with Xanax or other benzodiazepines, other sedating medications, or alcohol, and caregivers of these patients, should seek immediate medical attention if they start to experience unusual dizziness or lightheadedness, extreme sleepiness, slow or difficulty breathing, or unresponsiveness. 2
If no emergency medical attention is sought, the person can develop a state of stupor, coma, and death.
Questions to Ask Your Doctor About What Xanax Feels Like
Taking a new medication to help with anxiety or other conditions can be difficult. It’s important to talk with your doctor about your treatment plan, and ask any questions that may help inform your decisions about taking Xanax.
Questions to ask your medical care team before taking Xanax include:
- Is it safe to take Xanax?
- Will Xanax conflict with my other medications?
- Will I become addicted to Xanax?
- Do I have to take Xanax every day for it to work?
- Is Xanax going to make me sleepy?
- How fast can I expect Xanax to start working?
- Can I drink while taking Xanax?
- What are some Xanax alternatives to consider?
Final Thoughts
It is best to take Xanax when prescribed by your doctor to treat a medical condition. This medication has been researched extensively, and is effective and safe when followed by the guidance of a doctor. Misuse of Xanax, however, can lead to the risk of developing an addiction; therefore, it should not be used without an indication.
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For Further Reading
- Ativan Vs Xanax: Differences, Similarities, & Which to Take
- How to Get Prescribed Xanax: Everything You Need to Know
- Buspirone Vs Xanax: Differences, Similarities, & Which to Take
- Benzodiazepines Combined With Other Substances Increase Risks | Psychiatric News
- High Functioning Anxiety
- Valium Vs Xanax: Differences, Similarities, & Which to Take
Online Anxiety Test A few questions from Talkiatry can help you understand your symptoms and give you a recommendation for what to do next.
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