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By Kajal Jain

M. Pharm

05 January 2023
Medically reviewed by
XANAX FOR ANXIETY
Table of Contents

Occasional Anxiety is a part of the regular routine. Usually, people worry about money, health, or family problems. But Anxiety disorders are more than temporary fear, worry, or uneasiness. The Anxiety disorder does not go away quickly and can worsen over time. Current year data states nearly 25.5% were categorized as having low Anxiety, 7.1% population were categorized as having medium Anxiety, and 4.1% as having high Anxiety.

People suffering from Anxiety often look for “quick and easy” ways to overcome intense feelings. And taking medication is one such route that provides quick relief than any therapy. But medicines also have downsides and adverse effects, so looking for the correct anxiolytic drug is crucial.

Xanax is one of the most prescribed Anxiety drugs, containing Alprazolam as its active constituent. This drug appears to be a very effective anti-anxiety agent. Still, it is also something you need to strongly think about before you decide to utilize this type of medication. Further, you would know more about Xanax treating Anxiety.

What Is Xanax?

Xanax, also known as Alprazolam, is a benzodiazepine class tranquilizer often used to treat panic attacks and Anxiety. It is the most prescribed psychiatric medication in the U.S., with more than 48.5 million prescriptions written because of its fast onset of action. 

The U.S. Food and Drug Administration (FDA) approved Alprazolam in 1981. It may take a minimum of 10 minutes and usually no longer than an hour for this drug to start working. Like other benzo drugs, Xanax isn't just an anxiolytic drug but also a Muscle Relaxant, Sedative, Anticonvulsant, and Hypnotic.

Xanax is used for all types of Anxiety disorder, such as social or generalized anxiety disorder, but it is one of the few medicines prescribed for panic disorder. The safety and effectiveness of Xanax have not been established for adolescents and children under age 18.

How Does Xanax Work?

Benzodiazepines enhance specific brain chemicals while preventing other chemicals from being released. Xanax is a benzo drug that quickly relieves Anxiety symptoms often seen in Seasonal Affective Disorder (SAD) and other Anxiety disorders. It works specifically by binding to GABA receptors in your brain. 

This slows down your brain activity and reduces anxiety, fear, and feelings of terror. It might also leave you feeling sleepy, relaxed, and calm. The clinical effectiveness of one immediate-release Xanax tablet is often much shorter; most people notice the effects wearing off within four to six hours.

Does Xanax Help With Anxiety?

Xanax is FDA-approved medicine to treat Anxiety and panic disorder. When an individual experiences excessive Anxiety or stress, the brain increases specific nerve signals leading to Anxiety. During this period, the brain produces an unbalanced amount of chemical signals, feelings of fear, and Anxiety, increasing brain activity and restricting the ability to calm the mind.

Xanax is intended only for short-term treatment of Anxiety, it is essential to follow other treatment options for long-term control of Anxiety. Therapies are the gold standard for treating anxiety, including cognitive therapy, cognitive-behavioral therapy, and applied relaxation.

If an individual takes Xanax tablets more than prescribed, there is a probability of getting adverse effects that lead to some medical emergencies.
Xanax is considered the most potent and strongest short-acting benzodiazepine for anxiety and is often prescribed by physicians.
Xanax takes 1 - 2 hours to reach peak levels in the bloodstream whereas the extended-release form of Xanax reaches 10 hours.

How Long Does Xanax Take To Work?

Xanax reaches peak levels in the blood 1-2 hours after taking medicine. For younger healthy adults, half the dose of Xanax has left the body somewhere between 6.3 to 26.9 hours. The average is around 11 hours.

It takes a little longer for Xanax to leave the body of healthy elderly people. Half the dose of Xanax has left the body in elderly people somewhere between 9 to 26.9 hours. The average is around 16 hours for this group.

However, people stop feeling the effects of Xanax before eliminating it from the body, which is why it is prescribed more than once a day. It is essential to take it as prescribed. Taking too many doses can lead to dependence and accidental overdose. 

Is Xanax a Good Long-Term Anxiety Solution?

Xanax is a short-acting benzodiazepine. Like other benzodiazepines, it is only meant to be used as a short-term solution and should not be taken for longer periods. Though it is effective in some cases, it is also considered addictive. It should only be taken under the close supervision of a healthcare expert.

Certain people are at higher risk for misusing Xanax, including

  • Young adults 18 to 35 years old
  • Non-Hispanic whites 
  • Someone who has a current psychiatric disorder
  • Someone with a personal or family history of substance abuse

Is Xanax A Controlled Substance?

Benzodiazepines like Xanax have a low potential for abuse and addiction among people with Anxiety. It is a Schedule IV Stimulant, a designation that the Drug Enforcement Agency (DEA) uses for drugs with a low potential for abuse. This means you always need a prescription from a licensed doctor to buy Xanax online from an online pharmacy or from a local drug store because it bears a risk of dependence and misuse.

Other Schedule IV drugs include Valium, Ativan, and Ambien. However, long-term treatment in higher dosages with Xanax increases the risk of dependence, especially for people treated with panic disorder. Taking this medication exactly as prescribed can reduce the potential for abuse.

Misuse can lead to addiction, i.e., when you cannot discontinue taking a drug, even though it might cause harm. With dependence, your body relies on a drug to function as usual. Dependence can lead to withdrawal symptoms if you suddenly stop taking medication.

Xanax Dosage For Anxiety

Xanax dosage strengths are 0.25 mg, 0.5 mg, 1 mg, and 2 mg for oral tablets. Xanax reaches its highest level in the body 1-2 hours after a dose and may start helping symptoms sooner. 

Besides the immediate-release tablets, it is also available as extended-release tablets (Xanax XR) in 0.5 mg, 1 mg, 2 mg, and 3 mg strengths. The extended-release pill takes longer to reach peak effect, about 9 hours and lasts longer in the body. The generic alprazolam oral solution and orally disintegrating tablet are also available. 

The initial dosage of Xanax, i.e., 0.25 mg, should be taken one or more times a day. The 2 mg tablet is sometimes referred to as a “Xanax bar” because of its rectangular or “bar” shape. The term “Xanax bar” can also refer to illegal medicine that does not actually contain Xanax.

  • Alprazolam Tablet: Taken orally one to three times daily with water or another liquid. Tablets are available in 0.25mg, 0.5mg, 1mg, and 2mg doses.
  • Alprazolam XR: Taken once daily in the morning with water or another liquid. Tablets are available in 0.5 mg, 1mg, 2mg, and 3mg doses.

Please do not drink alcohol while taking this medication; do not take it after eating a fatty meal. Your provider will work with you to determine the appropriate dosage based on your needs. For example, while doses for anxiety disorders typically start at 0.25 mg to 0.5 mg 3 times daily, dosing for panic disorder may start at 0.5 mg to 1 mg once daily.

Indication

Initial dosage

Standard dosage

Maximum dosage

Generalized anxiety disorder

0.25 mg taken 3 times daily

0.25–0.5 mg taken 3 times daily

4 mg per day

Panic disorder

0.5 mg taken 3 times daily

0.5–3 mg taken 3 times daily

Not specified

Possible Side Effects Of Xanax

The side effects of Xanax (Alprazolam) are similar to other benzodiazepines. The main concern is sedation. Xanax can cause extreme fatigue, not unlike alcohol use. It may also cause concentration problems, memory loss, poor motor skills, and lack of coordination.

While many medications tell you not to operate machinery or drive until you know how the drug affects you, with Alprazolam, you absolutely need to follow that advice.

Other side effects include-

Common side effects

Serious side effects

Dry mouth

Shortness of breath

Dizziness/ vertigo

Increased heart rate

Upset stomach

Memory impairment

Trouble breathing

Depressive thoughts

Changes in sex drive

Severe allergic reaction

Headache

Maniac symptoms

Nausea

Blurred vision

Weight change

Hallucination

Impaired coordination

Life-threatening seizure

Precautions For Xanax

Before starting this medication, inform your doctor about your medical conditions or allergies, medications you are taking, whether you are pregnant or breastfeeding, or other significant information about your health. The following factors might affect the way you use this medication-

  • Alcohol and other medicines that cause drowsiness: People taking Xanax should not combine it with alcohol or other medicines, such as narcotic analgesics, that cause drowsiness. Doing so can cause additional drowsiness, reduced breathing, and other side effects, which can be dangerous and possibly fatal.
  • Store Xanax out of reach and sight of children and at room temperature.
  • You should not consume Xanax if you are sensitive to benzodiazepines or have acute narrow-angle glaucoma.
  • Liver function: Reduced liver function or liver disease may cause the body build-up of this medicine, causing side effects. Discuss with your doctor if you have any liver disorders.
  • Falls and fractures: Xanax can cause dizziness or drowsiness that may affect your balance and increase the risk of falling. This can result in fractures or other injuries. Your risk of falls increases if you drink alcohol or take other sedatives while taking this drug.
  • Kidney function: Reduced kidney function or renal disease may cause the body build-up of this medicine, causing side effects. Discuss with your doctor if you have any renal disorders.
  • If you are planning to get pregnant, you should not take this drug because there is a high potential for fetal harm and an increased risk of congenital abnormalities. Xanax can pass through breast milk, so it is recommended to avoid taking it during breastfeeding. 

Drug Interactions Of Xanax

Before taking Xanax, discuss all other active prescription medications with your doctor. You should avoid taking this drug if you are taking itraconazole, ketoconazole, or other drugs that inhibit metabolism via cytochrome P4503A, including, but not limited to:

  • Antidepressants including fluvoxamine, fluoxetine, and nefazodone
  • HIV protease inhibitors
  • Cimetidine
  • Macrolide antibiotics such as erythromycin
  • Azole antifungals including itraconazole and ketoconazole
  • Carbamazepine, phenytoin, and phenobarbital 
  • Oral contraceptives

These medications can have a dangerous drug interaction. Alprazolam may cause drowsiness, so caution should be used when combining it with other medicines that cause drowsiness. These could include:

  • Antihistamines such as diphenhydramine 
  • Opioid cough medications such as codeine cough syrup
  • Narcotic pain medication such as morphine, oxycodone, and hydrocodone
  • Sleeping medications such as zolpidem 
  • Other anti-anxiety medications, antipsychotic medications, certain anticonvulsant medications, and tricyclic antidepressant medications (such as amitriptyline)
  • St. John’s wort

Smoking cigarettes can decrease the level of medication in the blood. Speak to your doctor if you are a smoker or have recently quit smoking.

Share a list of all prescription and non-prescription medications, herbal supplements, or vitamins with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness. Let all doctors, surgeons, and physicians know if you are taking Xanax before having any surgery or laboratory tests. 

Bottom Line From Practical Anxiety Solutions

Xanax (Alprazolam) is a benzodiazepine drug, classified as a Schedule IV stimulant under the controlled substance act. It is highly productive in treating anxiety and panic disorder. It is often effective for these conditions, but there may be safer or better alternatives for helping with symptoms of anxiety or panic attacks. 

This medicine is intended only for short-term only because of the risk of abuse and addiction. The physical dependence on Xanax can occur with prolonged use of this medication.

This drug may also cause other side effects, but it shows its more significant impact if taken in the prescribed manner. Your healthcare provider will speak to you about safely using this medication.

  • Kolbe, V., Rentsch, D., Boy, D. et al. The adulterated XANAX pill: a fatal intoxication with etizolam and caffeine. Int J Legal Med 134, 1727–1731 (2020). From https://doi.org/10.1007/s00414-020-02352-7 Obtained pm 05/01/2023

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