Xanax (Alprazolam) Side Effects In Men, Women, & Elderly

What Is Xanax?

Xanax is the brand name of the generic medication alprazolam.¹ It is a benzodiazepine, which is a group of medications that are used to treat anxiety disorders and symptoms of anxiety, including panic attacks and panic disorder. Xanax is the most widely prescribed psychiatric medication in the United States.

Common Side Effects of Xanax (Alprazolam)

Side effects are common when taking Xanax and range in severity.¹ The most common side effects (e.g., drowsiness and lightheadedness) are connected to Xanax’s effects on the central nervous system.² You should report any side effects to your healthcare provider, and continually assess how Xanax makes you feel to determine if it’s the right medication for you.

Side effects of Xanax include:¹

• Drowsiness
• Dizziness
• Low energy
• Headache
• Memory impairment
• Slow or slurred speech
• Weight gain
• Depression

Severe Side Effects of Xanax

Some side effects caused by Xanax can be dangerous and should be brought to the attention of your healthcare provider. These side effects can make it dangerous to drive or operate heavy machinery, which should be avoided while under the influence of Xanax. If you experience any serious side effects, contact your healthcare provider. If you experience urinary problems or seizures, seek medical attention right away.

Severe side effects of Xanax include the following:²

• Sedation
• Double vision
• Difficulty concentrating
• Weight loss
• Memory loss
• Involuntary muscle movements
• Muscle weakness
• Loss of coordination
• Jaundice
• Skin itchiness
• Urinary retention
• Loss of bladder control
• Changes in menstrual cycle
• Seizures

Addiction

Benzodiazepines like Xanax can lead to addiction.⁴ Addiction is a condition where a person has a hard time controlling their use of a substance or medication and may continue to take it even though it has negative effects on their life. Anyone who takes Xanax can potentially become addicted, but people who misuse it have a much greater chance.

Misusing Xanax can involve taking it without a prescription or taking it in ways other than how it was prescribed, such as taking more of it, crushing it up and snorting it, or mixing it with alcohol or drugs.

Because of the risk of addiction with Xanax, the medication is not right for everyone. Anyone with a past or current history of substance use should avoid Xanax.² If you do take Xanax, it’s important to stay away from alcohol, recreational drugs, and any other addictive medications.

If you notice yourself taking more Xanax over time, or if you have difficulty controlling your use, talk to your healthcare provider. With help, Xanax addiction can be treated.

Long-Term Side Effects of Xanax

Xanax is intended to be prescribed as a short-term treatment for anxiety and panic attacks.⁵ It is much better to use for clear bursts of anxiety symptoms than when an individual feels consistently anxious throughout the day. Taking Xanax for longer periods of time can increase the risk of developing dependence and addiction. It can also lead to cognitive issues, like memory problems. This can increase the risk of accidents and injuries (e.g., car accidents).

Long-term side effects of Xanax include:⁵

• Physical dependence
• Addiction
• Cognitive impairments like increased reaction time, loss of muscle control, and memory problems

Xanax Side Effects In Elderly

Elderly people may be especially sensitive to side effects while taking Xanax.² This is because it takes them longer to metabolize Xanax, which can cause higher concentrations of it in the blood. This can put them at risk for severe side effects like sedation and cognitive problems, and increase the likelihood of accidents and injuries. Because of this, providers usually start older adults at a lower dose.

Xanax side effects in elderly include:^5,6

• Sedation
• Cognitive impairment
• Impaired driving
• Increased risk of hip fractures and other injuries

Xanax Side Effects In Women

Women may experience changes to their menstrual cycle as a side effect of taking Xanax.² Women who take oral contraceptives (birth control pills) should alert their provider before taking Xanax. This is because oral contraceptives increase the concentration of Xanax in the body and decrease how quickly it’s eliminated.

Side effects of Xanax in women include the following:²

• Changes in menstrual cycle

Pregnant & Breastfeeding Women

Xanax is risky to take during pregnancy.¹ According to the United States Food and Drug Administration (FDA), there is a risk of congenital abnormalities when women take Xanax during the first trimester of pregnancy.² Therefore, it’s recommended that pregnant women avoid taking the medication, especially during the first trimester. If you become pregnant or intend to become pregnant, talk to your provider right away.

Xanax is also secreted into breast milk in small amounts, so it’s important to talk to your provider if you plan to breastfeed. Overall, when it comes to taking medication during pregnancy, each case is unique. It is best to speak with your healthcare provider and weigh the pros and cons.

Warnings & Interactions to Avoid While Taking Xanax

Certain substances and medications should be avoided while taking Xanax. Alcohol and certain medications can negatively interact and may increase the likelihood of severe side effects. The combination of these different substances can increase the risk of respiratory depression (a condition involving slow and delayed breathing), low blood pressure, and possibly death.³

Due to the risk of breathing problems, people with pulmonary disease should avoid Xanax entirely.

Things to avoid or use more carefully while taking Xanax include:^2,3

• Alcohol
• Certain antidepressants, including Prozac (fluoxetine), Luvox (fluvoxamine), and Serzone (nefazodone)
• Opioids like Vicodin (hydrocodone) and OxyContin (oxycodone)
• Antihistamines
• Muscle relaxers
• Antifungal medications, including itraconazole and ketoconazole
• Certain anticonvulsant medications, including Tegretol (carbamazepine) and Dilantin (phenytoin)
• St. John’s Wort
• Cimetidine, a medication to treat acid reflux
• Certain antibiotics, including rifampin and clarithromycin

Because there is a risk of developing dependence and addiction while taking Xanax, anyone with a personal or family history of substance use issues should be cautious about taking this medication.² Be sure to talk to your healthcare provider about your history, as they may determine that Xanax is not right for you or may monitor you more closely.

Xanax Withdrawal

Benzodiazepines like Xanax can cause withdrawal when a person has been taking it over an extended period of time and suddenly stops or decreases the dose.¹ This is because Xanax causes physical dependence, where a person’s body becomes accustomed to taking the medication.

When the medication is no longer available, the body goes into withdrawal. Xanax withdrawal can happen after taking the medication for a few months, but depends on the dose.⁷ Symptoms of Xanax withdrawal include anxiety, increased heart rate and blood pressure, sweating, tremors, insomnia, and sensory sensitivity. In severe cases, Xanax withdrawal may cause seizures, delirium, and psychosis.

This is more likely to happen if a person abruptly stops taking the medication. Because of the risk of severe withdrawal symptoms, it is important to follow your healthcare provider’s recommendations and discuss your desire to stop taking the medication with them, rather than stopping “cold turkey.”

If you experience any withdrawal symptoms, seek medical attention right away. Xanax withdrawal can be dangerous and you should be monitored by a medical professional.^1,7 Don’t attempt to stop on your own. Your provider can gradually taper you off of the medication, which will minimize withdrawal symptoms. Don’t hesitate to reach out to your provider if you have any questions or concerns.

Questions to Ask Your Health Team About Xanax Side Effects

Having an open conversation with your treatment team is important. Before taking Xanax, be sure to write down any questions you have for your healthcare provider(s). These questions may include how to take the medication and how to respond if you have any adverse reactions. Also, don’t hesitate to call your treatment team at any point if you have questions.

Questions to ask your care team about whether Xanax is right for you include:

1. When should I take Xanax?
2. How much should I take?
3. What should I do if I don’t feel better after taking Xanax?
4. What should I do if I experience side effects?
5. Can I stop taking Xanax when I want to, or do I need to wean off of it?
6. Are there any other medications or substances that I should avoid when taking Xanax?

Final Thoughts

Being aware of the different Xanax side effects is important. This will help you work with your treatment team on determining whether Xanax is the right medication for you. Knowing about the medication you are taking can help you feel more in control of your treatment and recovery.