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Xanax is FDA-approved to treat generalized anxiety disorder (GAD) and panic disorder and can provide fast relief for your symptoms of anxiety. Xanax typically works within 30 minutes) so it can be helpful in managing panic attacks or acute episodes of heightened anxiety.
However, Xanax (and benzodiazepines in general) are not recommended for long-term use in treating these disorders since they have a potential for misuse and addiction, and have been linked to an increased risk of dementia. Other medications like Vistaril (hydroxyzine) and Inderal (propranolol) can also treat physical symptoms of anxiety quickly and don’t have the same risks.
Xanax is FDA-approved to treat generalized anxiety disorder (GAD) and panic disorder and can provide fast relief for your symptoms of anxiety. Xanax typically works within 30 minutes) so it can be helpful in managing panic attacks or acute episodes of heightened anxiety.
However, Xanax (and benzodiazepines in general) are not recommended for long-term use in treating these disorders since they have a potential for misuse and addiction, and have been linked to an increased risk of dementia. Other medications like Vistaril (hydroxyzine) and Inderal (propranolol) can also treat physical symptoms of anxiety quickly and don’t have the same risks.
Xanax dosage for anxiety
Recommended Xanax dosages for anxiety per the FDA are as follows—but remember that ultimately the dosage will depend on your circumstances and your doctor’s advice. Everyone responds to medications differently, and some people may experience relief from a lower dose, while others might need a higher dose to feel the same effect.
Starting dosage Maximum dosage
For generalized anxiety disorder 0.25 mg to 0.5 mg, 3 times a day 4 mg a day total, in divided doses
For panic disorder .5 mg, 3 times a day 10 mg a day total, in divided doses
Your doctor will start you on a low dose, and if needed, slow and carefully increase it, likely in three or four day intervals. If you’re taking Xanax as needed, this will likely be for panic attacks or other highly anxiety-inducing scenarios where you need some extra help to calm down.
Remember that Xanax is only meant for short-term use since it can be habit-forming, has a high risk for dependence, and a risk for misuse and addiction. Many psychiatrist’s primary choice for treating anxiety are antidepressant medications like SSRIs (selective serotonin reuptake inhibitors).
For other options, check out these alternatives to Xanax.
What are the risks of taking Xanax?
Taking Xanax comes with risks. Here are some precautions and considerations you should take into account before taking it.
Risk of misuse and addiction
The risk of dependency and misuse is typically the biggest concern among providers. Xanax has a high rate of abuse and addiction because it works so quickly to make you feel better. The combination of Xanax's rapid onset and its short duration of effects contribute to the drug’s potential for misuse. People may find themselves building up a tolerance and seeking out more frequent, higher doses to get the same desired effects or even to alleviate the withdrawal symptoms they feel.
Part of this is because Xanax has a short half-life, which refers to the amount of time it takes for your body to metabolize or get rid of half the original dose of medication. Once the Xanax levels in your blood drop, you might experience a rebound effect of your initial symptoms returning, possibly even more intensely. Then, you might feel like you need to take more of it to relieve those symptoms, and the cycle continues. The risk for misuse and addiction of Xanax is even higher in people with a history of substance abuse.
It’s crucial that Xanax prescriptions should only be obtained from a doctor and you should closely follow their dosing instructions.
Drug interactions
Many medications interact with Xanax in potentially harmful ways. Using Xanax with other central nervous system depressants is especially dangerous since this increases the risk of low blood pressure and trouble breathing due to respiratory depression. his can be dangerous and even fatal.
Examples of these medications include:
Opioids
Certain prescription cough medications
Other benzodiazepines
Sleep medications
Muscle relaxants
Barbiturates
Antipsychotics
Alcohol is not a medication, but it is a central nervous system depressant, which also makes it highly dangerous to combine with Xanax.
Other medications that can interact with Xanax are:
Certain antifungal medications
Certain antibiotics
Certain antidepressants
Antihistamines (allergy medications)
St. John's wort (a herbal supplement)
This is not an exhaustive list of CNS depressants or other medications that can result in drug interactions. Before prescribing Xanax, your doctor will ask you about other prescriptions, over-the-counter medications, and supplements that you’re taking to make sure you can take Xanax safely.
Withdrawal
Withdrawal occurs when your body becomes dependent on Xanax, and then you experience uncomfortable symptoms when you stop using the medication. Compared to other benzodiazepines, Xanax may result in the most severe withdrawal symptoms. These symptoms can range from bothersome and mild to severe and dangerous. On the mild end, you may have rebound anxiety or insomnia, irritability, sweating, tremors, nausea, and headaches. Seizures are a more dangerous potential withdrawal symptom.
This is why it’s so important to gradually taper off your medication rather than stopping it cold turkey. When you come off of Xanax gradually, you will minimize your risk of withdrawal symptoms and keep yourself safe.
Pregnancy and breastfeeding risks
Taking Xanax during pregnancy, especially in the later stages of pregnancy, can pose risks such as sedation and respiratory depression. Another risk is neonatal withdrawal, which means the baby can experience withdrawal symptoms after being born.
Since Xanax can pass through breast milk, the FDA advises against breastfeeding while taking Xanax. Whether you’re pregnant or breastfeeding, it’s important to talk with your doctor, especially your OB/GYN, to determine the safety of your unique situation and to see if the benefits outweigh the risks.
Side effects of Xanax
As with all prescription medications, Xanax does come along with potential side effects. According to the FDA, drowsiness and lightheadedness are the most common adverse effects of Xanax.
More Xanax side effects include:
Drowsiness or sleepiness
Dizziness or lightheadedness
Trouble concentrating
Headaches
Nausea
Constipation
Feeling irritable
Talkativeness
Changes to appetite (increased or decreased appetite)
Changes to weight (gaining weight or losing weight)
Changes to libido (increased or decreased libido) and/or sexual dysfunction
Changes in salivation (increased saliva or decreased with dry mouth)
Trouble urinating
Joint pain
These side effects may be worse when you first start the medication and lessen with time. If your side effects worsen or are not tolerable, make sure to tell your doctor. Some side effects could be a sign of something more serious. If you experience any of the following adverse effects, seek medical attention.
Confusion
Trouble with balance and coordination
Slurred speech
Shortness of breath
Seizures
Yellow eyes or skin
Rash
Is Xanax right for me?
Xanax can be effective for treating certain conditions but it can be habit-forming and comes with negative consequences that should be seriously considered. Whether you’re curious about Xanax for sleep, anxiety, or both, only a doctor can determine if the medication is right for you. They will take your medical history and symptoms into account before deciding to prescribe you Xanax.
If you’re looking for a psychiatrist, consider Talkiatry. We’re a national psychiatry practice that treats insomnia, anxiety disorders, and more. Our psychiatrists will work with you to find a treatment plan that best fits your needs. To get started, complete our free online assessment to get matched with a psychiatrist.
FAQs
Here are more answers to your questions about Xanax.
Does Xanax make you tired?
Yes, Xanax can make you tired. Drowsiness is one of the most common side effects of Xanax, so it should never be taken with alcohol or other medications that have an affect on your nervous system.
Is Xanax better than Ambien?
One medication is not inherently “better” than the other. However, Ambien (the brand name for zolpidem) is FDA-approved for the short-term treatment of sleeplessness, while Xanax is not. Ambien is primarily prescribed for insomnia, whereas Xanax is primarily prescribed for anxiety. Neither medication is ideal for long-term use. Talk to your doctor if you have concerns about either medication.
What are alternatives to Xanax for sleep problems?
There are many options for treating sleep problems. Aside from Xanax and other benzodiazepines, examples of prescription sleep medications include
Non-benzodiazepines AKA “Z drugs”
Dual orexin receptor antagonists (DORAs)
Melatonin receptor agonists
Anti-seizure medications or sedating antidepressants
Over-the-counter sleep aids are also an option, but you should check with your doctor first. You can also take a non-medical approach to insomnia treatment by implementing lifestyle changes and/or seeking therapy, especially cognitive behavioral therapy for insomnia (CBT-I).
The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
