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If you’re living with an anxiety disorder, your doctor may prescribe Xanax (alprazolam) or Xanax XR, the long-acting version. Xanax, pronounced ZAN-ax, is used to treat Panic Disorder, Generalized Anxiety Disorder (GAD), and anxiety associated with depression. Doctors sometimes prescribe it for other uses. It’s in a class of drugs called benzodiazepines and it’s the top-selling drug of its kind in the U.S.  

Depending upon the dosage, Xanax relieves anxiety, causes sedation and improves sleep. It also prevents muscle spasms and seizures.

How is Xanax taken?
It comes as a tablet in .25 MG, .5 MG, 1MG and 2MG and as a concentrated liquid solution. Higher dosages are typically prescribed for panic disorder. Regular Xanax may be taken three to four times a day; Xanax XR only once daily. Take alprazolam exactly as directed. Your doctor will probably start you on a low dose of alprazolam and gradually increase it. Keep this medication tightly closed and at room temperature and away from excess heat and moisture (not in the bathroom). Xanax is manufactured by Pharmacia and Upjohn, but generic versions are made by several manufacturers.

How does it work?
Alprazolam boosts the effects of GABA, a natural chemical that sends calming messages to your brain.

How fast does it work?
(Alprazolam) may provide relief of anxiety symptoms within one to two hours.

What side effects can it cause?
Side effects may occur during the beginning of treatment and subside over time.

Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
  
• light-headedness
  
• tiredness
  
• dizziness
  
• irritability
  
• talkativeness
  
• dry mouth
  
• increased salivation
  
• changes in sex drive or ability
  
• changes in appetite
  
• weight changes
  
• difficulty urinating

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• seizures
  
• seeing things or hearing voices that do not exist (hallucinating)
  
• severe skin rash
  
• yellowing of the skin or eyes
  
• memory problems
  
• confusion
  
• problems with coordination

Like all benzodiazepines, aprazolam can be habit-forming. Do not take a larger dose or take it more often or for a longer time than your doctor tells you to. Do not stop taking alprazolam without talking to your doctor. Suddenly stopping to take alprazolam or missing doses may worsen your condition and cause withdrawal symptoms (anxiousness, sleeplessness, irritability, and seizures), especially if the drug has been taken daily for more than two weeks. Withdrawal symptoms may be worse if you take more than 1 to 2 mg of alprazolam every day. Your doctor will decrease your dose gradually.

What else should you know about alprazolam?
Tell your doctor about other medications. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Tell your doctor

• about any drug allergies you have.
• if you have or have ever had glaucoma; depression; or lung, kidney, or liver disease.
• if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking alprazolam, call your doctor immediately.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking alprazolam.

Alprazolam may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. Alcohol can add to the drowsiness caused by this medication.

Talk to your doctor about drinking grapefruit juice while taking this medicine: it can interact with Xanax, increasing the medication levels in your bloodstream.

An overdose of Xanax, alone or after combining it with alcohol, can be fatal. Symptoms of overdose may include: confusion, coma, impaired coordination, sleepiness, slowed reaction time.

Related articles
Anxiety or anxiety disorder?
Understanding anxiety
Anxiety and bipolar disorder
Anxiety and depression

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Sources
FDA
US Drug Enforcement Administration
Pfizer pharmaceutical company
Medline Plus, National Library of Medicine
Jim Phelps MD, author psycheducation.org and Why Am I Still Depressed?

Page updated October 1, 2008