Xanax Overdose: Symptoms, Dangers, & What to Do

What Is Xanax & How Is it Used?

Xanax, with the active ingredient alprazolam, is a medication that belongs to the class of drugs known as benzodiazepines. It acts on the central nervous system (CNS) by amplifying the effect of a natural chemical in the body (GABA), leading to reduced anxiety, sedation, and muscle relaxation. The drug’s mechanism of action involves the potentiation (increased activity) of the inhibitory neurotransmitter GABA, which results in calming effects on the brain and nerves.

Xanax is primarily used for the acute treatment of generalized anxiety disorder and the treatment of panic disorder with or without agoraphobia in adults. It is designed to alleviate symptoms associated with excessive anxiety and worry. Additionally, Xanax can be used for the short-term relief of symptoms of anxiety, acting quickly to reduce heightened levels of distress and to help in conditions where anxiety significantly impairs daily functioning.¹

Can You Overdose on Xanax?

Yes, it is possible to overdose on Xanax. Overdose of Xanax can result in central nervous system depression ranging from drowsiness to coma. In severe cases, an overdose involving Xanax, especially when combined with other central nervous system depressants like opioids or alcohol, may be fatal. In fact, Xanax is linked with a significant portion of drug overdose deaths, being involved in 26% of cases in the US.²

Xanax can make you feel sedated or drowsy, and it may impair your memory, coordination, and motor skills. These effects caution against driving or operating heavy machinery while under the influence of Xanax. The medication is also associated with other side effects such as dysarthria (trouble saying words clearly), changes in sex drive (libido), constipation, and nausea, reflecting its impact on various body systems beyond its intended use for anxiety and panic disorders.

What Is the Typical Xanax Dosage?

The typical starting dosage of Xanax for the acute treatment of generalized anxiety disorder (GAD) is 0.25 mg to 0.5 mg, administered three times daily. Depending on your response, your doctor may adjust the dosage every 3 to 4 days. The maximum recommended daily dosage is 4 mg, divided into doses. However, the precise dosage can vary significantly among individuals, depending on their medical conditions, treatment response, and other medical issues.¹

What Is the Maximum Amount of Xanax You Can Take?

The maximum recommended dosage of Xanax is 4 mg per day for the treatment of anxiety disorders. However, in certain clinical situations, doses greater than 4 mg per day may be prescribed to some patients, particularly those with panic disorder.

Such high doses are typically approached with caution, considering the individual’s response to the medication and the risk of adverse effects. It’s important to note that exceeding the recommended dosage increases the risk of dependency, withdrawal symptoms, and other serious side effects. Any dosage adjustment should be made under the close supervision of a healthcare provider.¹

What Is a Toxic Level of Xanax?

A toxic level of Xanax can vary widely among individuals, depending on factors such as the individual’s metabolism, age, weight, and concurrent use of other substances. Overdosage of Xanax can lead to symptoms ranging from excessive drowsiness to coma, with severe cases potentially resulting in respiratory depression, diminished reflexes, and even death.

The risk of toxicity increases with doses higher than the maximum recommended amount and is exacerbated by the concurrent use of alcohol, opioids, or other central nervous system depressants. The specific threshold for toxicity is individualized and can be influenced by your overall health status and tolerance to benzodiazepines.

Symptoms of a Xanax Overdose

Xanax overdose can result in a range of symptoms, with the severity depending on various factors such as the dosage consumed and individual characteristics. The dosage that can lead to an overdose varies among individuals and is influenced by factors such as tolerance, age, weight, and existing health conditions.

Symptoms of an overdose may initially manifest as drowsiness, confusion, and impaired coordination, progressing to more serious symptoms over time. Immediate medical attention is crucial if an overdose is suspected to prevent potentially life-threatening complications.

Common symptoms of a Xanax overdose can include:¹

• Drowsiness
• Confusion
• Diminished reflexes
• Dizziness
• Blurred vision
• Slurred speech
• Weakness
• Impaired coordination

Serious symptoms of a Xanax overdose include:¹

• Coma
• Severe respiratory depression
• Hypotension (low blood pressure)
• Ataxia (loss of control over bodily movements)
• Hypoventilation (slow and inadequate breathing)
• Respiratory depression
• Hypotonia (reduced muscle tone)
• Cardiac arrest
• Seizures (particularly in the context of withdrawal or mixed overdoses with drugs that lower the seizure threshold)
• Death (in extreme cases and especially when combined with other CNS depressants like opioids or alcohol)

What Can Cause a Xanax Overdose?

A Xanax overdose occurs when an individual consumes a dosage of Xanax that is harmful to the body, which can happen in two primary ways: taking more than the prescribed dosage or combining Xanax with other substances. Overdoses can result from both accidental and intentional overconsumption. For example, someone might take an extra dose, forgetting they’ve already taken their prescribed dose, or intentionally take more to achieve a stronger effect.

Taking More Than the Prescribed Dosage

Individuals may take more Xanax than prescribed, either accidentally or on purpose. Accidental overdose can occur if the patient forgets they’ve already taken their dose and takes another or if they misunderstand the dosage instructions. Intentional overdose might happen in an attempt to achieve a heightened effect of calm or euphoria or in cases of misuse where the individual is trying to self-medicate beyond the prescribed limits. This behavior not only increases the risk of overdose but also dependence and withdrawal symptoms.

Taking Xanax With Other Substances

The risk of a Xanax overdose escalates significantly when it is taken with other substances, especially those that also depress the central nervous system. This includes both prescribed medications, over-the-counter drugs, herbal treatments, and recreational substances. The interaction between Xanax and these substances can amplify the effects of both, leading to dangerous levels of sedation, respiratory depression, or even death.

Substances that can increase the risk of a Xanax overdose when used together include:

• Alcohol: Combining Xanax with alcohol increases the sedative effects of both substances, potentially leading to excessive sedation, respiratory depression, and overdose.
• Opioids: The concomitant use of benzodiazepines and opioids can cause profound sedation, respiratory depression, coma, and death due to their synergistic effects on decreasing central nervous system activity.
• Other CNS Depressants: This includes sedatives, hypnotics, and tranquilizers, which, like Xanax, suppress activity of the central nervous system (CNS) and can amplify each other’s effects, raising the overdose risk.

Taking Xanax With Other Medications

Mixing Xanax with other medications without a healthcare provider’s guidance can be perilous. Providers can help mitigate these risks by adjusting dosages, changing medications, or closely monitoring you. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and herbal supplements, to avoid dangerous interactions.

Medications that can increase the risk of a Xanax overdose when taken together include:¹

• Other central nervous system (CNS) depressants: The concurrent use of Xanax with other CNS depressants, including alcohol, psychotropic medications, anticonvulsants, and antihistaminics can lead to additive CNS depressant effects, significantly increasing the risk of profound sedation, respiratory depression, coma, and potentially fatal overdose outcomes.
• Opioids: Combining Xanax with opioids increases the risk of respiratory depression (slowed breathing) due to actions in the central nervous system that control breathing activity. This combination can result in deep sedation, slowed breathing, coma, and potentially death.
• Strong inhibitors of CYP3A (except ritonavir): Xanax is broken down in the bloodstream by a body chemical called cytochrome P450 3A (CYP3A). Some medications may interact in a way that increases the concentration of Xanax in the bloodstream. This may lead to an increased risk of overdose due to heightened effects of Xanax.

Developing Tolerance to Xanax

Tolerance to Xanax is when the body gets used to the medication, making the same dose less effective. This forces the person to require higher doses to manage their symptoms, which increases the risk of adverse effects, dependence, and overdose. Higher doses can severely depress the central nervous system and may be fatal, especially when combined with other CNS depressants like opioids or alcohol.

Can a Xanax Overdose Cause Complications?

Most people who overdose on Xanax do not make a full recovery without complications. Recovery depends on various factors, including whether other medications, recreational or illicit drugs, or alcohol have been ingested concurrently. Additionally, the timing of receiving medical treatment plays a crucial role in determining the outcome of the overdose. Prompt medical intervention can mitigate the severity of complications and improve the chances of recovery.

Can You Become Addicted to Xanax?

Xanax carries a high risk of both psychological and physical addiction, with potentially serious health consequences. Factors that put individuals at risk of misusing Xanax and potentially becoming addicted include certain behaviors such as taking higher doses than prescribed, using it for non-medical purposes, or developing a tolerance to its effects.

Additionally, individuals who experience strong psychological effects from Xanax, such as euphoria or relief from anxiety, may be more prone to misuse and addiction. Therefore, close monitoring and appropriate counseling are essential when prescribing Xanax, particularly for patients at elevated risk of addiction.

Seeking Emergency Help for Xanax Overdose

If you or someone you know may have overdosed on Xanax, it is critical to seek immediate medical attention. Contact Poison Control (1-800-222-1222) or emergency services to get evaluated immediately. Poison Control can offer guidance on whether it’s necessary to visit an emergency room based on the specific details of the overdose.¹

Here is information important to share when seeking treatment for a Xanax overdose:

• Current signs and symptoms being experienced
• The regular dosage amount of Xanax taken
• Any other medications or substances that have been consumed
• The time of the last dose of Xanax
• Any known allergies to medications or substances
• Previous medical history, particularly related to liver or kidney issues
• Information on any past incidents of overdose or substance misuse

Xanax Overdose Treatment

Emergency treatment for a Xanax overdose should be initiated as quickly as possible to reduce the risks associated with overdose, which can include severe respiratory depression, coma, or death.

Poison Control can provide initial advice. But if someone is showing signs of severe overdose, such as difficulty breathing, loss of consciousness, or severe confusion, go to an emergency room immediately. The duration and specifics of treatment can vary significantly depending on the severity of the overdose and the individual’s overall health.

Emergency treatment for an overdose on Xanax might include:

• Monitoring of vital signs (heart rate, blood pressure, and breathing)
• Providing supportive care for symptoms
• Administration of flumazenil, a benzodiazepine receptor antagonist, in certain cases
• Gastric lavage or activated charcoal to prevent further absorption of the drug if the overdose was very recent

Next Steps After a Xanax Overdose

After a Xanax overdose, whether treated or completed, it’s crucial to take steps to prevent future incidents. For those continuing Xanax use, closely adhering to prescribed dosages and schedules is essential to avoid another overdose. The approach to preventing future overdoses may differ based on whether the overdose was accidental or intentional.

For unintentional overdoses, focus on medication management and understanding the risks of concomitant substance use. In cases of intentional overdose, addressing underlying issues such as mental health disorders and considering medication alternatives or adjustments is critical.

If the Overdose on Xanax Was Unintentional

Recovering from an unintentional Xanax overdose requires careful consideration of medication use and lifestyle choices. If continuing Xanax is deemed necessary, strict adherence to prescribed dosages and close monitoring by healthcare providers is paramount. For some, alternative treatments that pose less risk of overdose may be considered.

Next steps to consider after an intentional Xanax overdose include:

• Seek psychotherapy: Engaging in psychotherapy can provide support for mental health issues that may contribute to suicidal thoughts or self-harm behaviors, offering strategies for coping and healing.
• Consult your psychiatrist: Discussing the event with a psychiatrist can help evaluate whether Xanax or another anxiety medication is appropriate, including considerations for dosage adjustments or alternative treatments.
• Establish a support network: Building a network of support with family, friends, and mental health professionals can provide the necessary emotional support and intervention if suicidal thoughts recur.