Xanax, otherwise known by its generic name Alprazolam, belongs to the class of medications called benzodiazepines. It is used primarily for short-term anxiety/panic disorders. Xanax is a controlled medication by the FDA due to its risk for dependence. It should be taken only when prescribed by a physician. You must take the medication only as directed and reach out to your physician for any changes in dosing.
What Is Xanax (Alprazolam) & How Is It Used?
Xanax is a medication that is a benzodiazepine, commonly referred to as a benzo. It works as an inhibitory drug that binds to inhibitory channels in the brain and upregulates them. It works on a GABA receptor, creating a similar effect to how alcohol affects the body by targeting GABA receptors. Providers prefer to use this medication for a short time due to its addictive potential. Xanax is a controlled medication by the FDA and requires a prescription. Speak to your doctor to decide if Xanax may be right for you.
On-Label Uses of Xanax (Alprazolam)
Xanax is a controlled substance due to its addictive potential. Providers generally use Xanax at low doses and for a short duration of time. Xanax is FDA approved for generalized anxiety disorder (GAD) and panic disorder. However, it is rarely used for general anxiety disorder that does not include panic attacks. This is because there are better medical options for GAD, including SSRI (selective serotonin reuptake inhibitor) medication.
Xanax is approved to treat the following conditions:
Off-Label Uses of Xanax (Alprazolam)
Off-label uses mean that the medication has not been approved by the FDA for its use. However, smaller studies show positive results of using Xanax outside of GAD and panic Disorders. Providers may elect to use Xanax as an off-label medication if the first line of treatment is not beneficial.
Other off-label uses of Xanax to treat disorders may include:1
Common Xanax (Alprazolam) Dosage: How & When to Take Them
If your doctor prescribes Xanax for you, you must know how to take the medication appropriately. Xanax comes in immediate-release tablets, extended-release tablets, orally disintegrating tablets, and solutions.2 Most likely, the doctor will prescribe extended-release tablets. These tablets work by slowly releasing medication to maintain a certain amount during the day. Many people will elect to take Xanax in the evening or before falling asleep.1
What If You Miss a Dose?
Xanax is usually prescribed as an as needed medication. This means that patients can take the medication if they feel their anxiety is high and need medication. There is a maximum dose that your doctor will prescribe you. It is necessary to discuss with your doctor when you should take your medication. Take your medication only as prescribed, as it is crucial not to overdose. You should not take two doses simultaneously or close together.
What If I Overdose?
Anyone who suspects an overdose of Xanax should seek emergency medical attention by calling 9-1-1 or going to an emergency department. There is no special treatment to reverse overdose symptoms, but the medical team can monitor vitals and ensure safety as an overdose can cause serious side effects and possibly even death.
Someone who has overdosed on Xanax may exhibit these symptoms:1
- Being confused and unresponsive
- Lightheadedness
- Unsteadiness with loss of balance and coordination
- Abnormal or slow heart rate
- Respiratory Depression, with shallow and poor breathing
- Fainting, loss of consciousness, or even coma
Can Xanax (Alprazolam) Kill You?
Xanax is a controlled substance by the DEA due to its addictive and dangerous side effects. In higher doses, Xanax is a respiratory depressant. This means that patients who take too much Xanax and very high doses risk having their breathing slow and possibly stop. You must get immediate medical attention and call 911 in case of an emergency where breathing becomes an issue or if someone becomes unresponsive while taking Xanax.
Xanax (Alprazolam) Warnings & Associated Risks
The decision to start Xanax should be made with your medical provider. Before starting any medication, you must talk to your doctor about your other medications and other medical conditions. It is also important to discuss whether or not you plan to get pregnant, are pregnant, or if you are actively breastfeeding. It is essential to discuss your allergies as well. All patients should understand that Xanax is a sedating medication and can create severe side effects when it interacts with other medications.
You should talk to your doctor about your risk. Patients with a substance use disorder or history of substance abuse should use Xanax cautiously. Patients with a history of suicidal ideation or who are at risk for suicide should discuss how to use Xanax safely and the risk and benefits of Xanax. Black box warnings for Xanax include additional harmful risks when used with opioids.
Common Side Effects of Xanax (Alprazolam)
It is common to experience side effects when taking Xanax. Patients should expect to feel the effect of Xanax about one hour after taking a dose. Common side effects of Xanax can make you feel drowsy, uncoordinated, and unable to speak clearly. Because Xanax acts on the same receptor as alcohol, the side effects of Xanax are similar to the effects of drinking. Below is a list of some common, rare, and severe side effects associated with Xanax, but it does not include all the possibilities.
Common Xanax side effects can include:1
- Drowsiness
- Slurred speech
- Imbalance
- Nausea/vomiting
- Muscle weakness
Serious Xanax side effects that need immediate attention include:1
- Trouble breathing
- Extreme Drowsiness
- Withdrawal
Rare Xanax side effects can include:1
- Depression
- Swelling of hands and feet
- Stuffy nose
Before starting any medication, you should talk with your doctor about the possible side effects and determine if the medication is right for you.
Xanax (Alprazolam) Withdrawal
Xanax is a physiologically dependent medication and should be used with caution as it carries the risk of possible addiction. People that have taken Xanax for an extended period may have withdrawal symptoms if they stop the medication suddenly. Patients withdraw because the body gets used to Xanax medication, and when it is unavailable, the body will go into overdrive.3
Symptoms of Xanax withdrawal can include:3
- Hyperactivity
- Agitation
- Nausea/vomiting
You should discuss your desire to no longer take Xanax with your doctor before you stop taking Xanax. Doctors may recommend you use a tapering dose of medications instead of abruptly stopping. You must discuss any withdrawal symptoms that you are having with your physician to prevent further harm or risk of hospitalization.
Interactions With Xanax (Alprazolam)
Please note: Taking certain medications, herbs, or supplements alongside Xanax can change how Xanax works in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Xanax is metabolized by an enzyme called CYP3A4.1 Medications that affect this enzyme can increase the concentration of Xanax in the body and cause toxicity. This will cause Xanax to stay in your system for a longer time, thus increasing the potential risk for harmful side effects. It is essential to discuss with your doctor whether or not your other medications affect your Xanax use.
Substance interactions to avoid with Xanax include:1
- Alcohol
- Opioid medications
- Antifungal
- Antidepressants
- Antibiotics
Things to avoid while taking Xanax include:1
- Driving
- Operating machinery
Questions to Ask Your Health Team About Xanax (Alprazolam)
It is essential to discuss mediation changes with your doctor before they occur. If your doctor recommends starting Xanax medication, you must understand why they chose it over other medications for anxiety. Similarly, it is important to discuss your risk factors when using Xanax. You must understand how the medication works, what the dosage of the medication is, and what side effects you should look out for before taking Xanax.
Questions to ask your care team about whether Xanax is right for you include:
- Am I at risk for Xanax toxicity?
- Am I at increased risk for addiction?
- Is it safe to take Xanax with my other medications?
- Will Xanax or Alprazolam be covered by my insurance?
- Does my medical history increase my risk of side effects?
- How long can I expect side effects to last?
- What side effects should I seek immediate medical attention for?
- How often should I see you for checkups while taking Xanax?
- Should I let my therapist know I am taking this medication?
- What should I do if I want to stop taking Xanax?
Final Thoughts
Xanax can effectively treat several symptoms and mental health conditions. Before taking Xanax, talk to your doctor, therapist, or psychiatrist to learn about the benefits and risks and to determine a treatment plan specific to your needs.
