Xanax for an Anxiety-Filled World
Xanax for an Anxiety-Filled World
Introduction to Xanax
Xanax is a benzodiazepine medication, typically used to treat anxiety. The generic name of Xanax is alprazolam.
This medication can be used safely when taken as prescribed and monitored by a medical professional. However, there is risk of addiction and abuse with this medication. Learn more about the history of Xanax, misconceptions, side effects, and treatment options for addiction.
Classification and Typical Uses
Xanax is an anti-anxiety medication that is classified as a benzodiazepine. It is sold under the following brand names:
As it is a benzodiazepine, alprazolam acts by slowing down unbalanced chemicals in the brain that cause nervousness or anxiety, while at the same time increasing levels of gamma-aminobutyric acid (GABA), a chemical that is naturally produced by the body to reduce the effects of stress, lowering anxiety levels and improving overall mood.1
Xanax was first patented in Germany by J.B. Hester of the Upjohn Company in 1970. In 1976, Xanax was patented in the United States. Within two years, sales of the drug soared. Alprazolam is now the most commonly prescribed benzodiazepine in the U.S.2
The most familiar brand name of alprazolam, Xanax, was approved by the Food and Drug Administration (FDA) in 1981.3 Use of benzodiazepines, including Xanax, has experienced a steady climb in popularity, including an increase in the number of adults who received prescriptions for benzodiazepines of 67% between 1996 and 2013.4
Xanax and other benzodiazepines are currently under scrutiny along with other prescription medications as a part of the overall effort to control the opioid epidemic in the United States.
More About Benzodiazepines
Proper Use of Xanax
Alprazolam is used to treat anxiety and may be prescribed for the following diagnoses:
Borderline personality disorder
Obsessive compulsive disorder (used to supplement other drug therapies that have not been effective)
Xanax has also been used to treat the following physical conditions:
Dysautonomia (dysfunction of the autonomic nervous system)
Alprazolam is a prescription medication that is always used under the supervision of a physician. When a person begins to take Xanax, the dose is usually started at low levels, usually 0.25 or 0.5 mg, and gradually increased until at a level that manages the person’s symptoms.
Ending Xanax Use
When the person is ready to stop taking Xanax, the dosage is gradually decreased to avoid symptoms of withdrawal. People struggling with panic disorder may require higher doses of alprazolam than people with other diagnoses, up to 4 mg per day.6
Side Effects of Xanax
There are many side effects associated with Xanax. Some of the more common side effects include:
changes in sleep patterns
difficulty paying attention/confusion
changes in weight
muscle or joint pain
changes in appetite
constipation or diarrhea
trouble with menstruation
These side effects usually disappear as the body gets used to the drug. More serious side effects require medical attention.
Serious side effects include:
severe depression or suicidal thoughts
muscle jerking, tremor, or seizures
urinating less than normal or not at all
pounding heartbeat or a fluttering feeling in the chest
It is possible to take an overdose of alprazolam, although most overdoses occur when alprazolam is taken together with other drugs, such as opioids or alcohol.
Symptoms of overdose include:
loss of consciousness/coma
Misconceptions About Xanax
Many people who use or abuse Xanax are under the impression that taking a few extra pills is harmless. Many physicians prescribe them so they must be safe, right? Alprazolam and other benzodiazepine medications can be extremely harmful when not taken according to the physician’s instructions. Here are a few common misconceptions about Xanax:
Misconception: It’s Safe to Take an Extra Pill When Anxiety is High
In fact, it is possible to overdose on Xanax and other benzodiazepines. The dose of alprazolam can be safely increased gradually, but not in large amounts all at once. Taking extra medication puts a person at risk of overdose. Symptoms of overdose can be severe and even life-threatening. People who take alprazolam by prescription should not deviate from their prescribed doses.
Misconception: Xanax is Safe to Take With Alcohol
Both alcohol and Xanax are depressants, meaning that they slow down bodily functions. Xanax actually intensifies the effects of alcohol, so taking both together can cause a person to lose consciousness, slip into a coma, or stop breathing. People who are taking prescription Xanax should avoid alcohol.7
Misconception: It’s Safe to Mix Xanax and Adderall
People who take Adderall may have periods of anxiety or may have trouble sleeping, and it might be tempting to take Xanax to try to fix these problems. However, while Adderall works to stimulate the nervous system, alprazolam works to slow it down. Because the drugs have opposite effects, taking Xanax and Adderall together could cause both drugs to be less effective. This might cause some people to take more of each drug to increase the effects, putting them at risk of overdose.8
Misconception: It’s Safe to Take Xanax For a Long Time
Xanax and other benzodiazepines were designed to treat anxiety and other conditions for a short length of time, up to several weeks. After alprazolam has been used for this length of time, the brain adapts to the medication, and chemical levels return to where they were before the medication was started, rendering alprazolam less effective and making anxiety symptoms worse.9 This is referred to as alprazolam dependence or tolerance. Other side effects could also worsen when Xanax is used over a long period.
Rates of Abuse
The prevalence of benzodiazepine use in the United States has not changed significantly over the past few years, being at 4% to 5% of the general population in 2016. Benzodiazepine, including Xanax, is more likely to be prescribed to older adults and twice as likely to be prescribed to women.
Similar to other benzodiazepines, the use and misuse of alprazolam have not shown significant changes over the past five years. A small increase in use was recorded in 2016, with use declining again in 2017 and 2018.10
Combining Opioids and Benzodiazepines
In spite of the dangers of combining benzodiazepines and opioids, people who are already taking opioids are more likely to be prescribed benzodiazepines also.11 Most people take benzodiazepines as prescribed, but people who have histories or family histories of substance abuse disorders are more likely to misuse these drugs.
People who misuse alprazolam do so by taking prescribed medication more often or at larger doses than prescribed, combining Xanax with alcohol or other drugs, or taking alprazolam recreationally for the relaxing “high” that the drug offers. Of these, combining Xanax or other benzodiazepines with other substances is the most common and most deadly form of abuse.
In 2016, benzodiazepines were involved in 46.9% of all emergency room visits for nonmedical use of prescription drugs but were the sole drug involved in only 6.5% of those visits.12
Symptoms of Withdrawal
Withdrawal symptoms from Xanax can occur after a short period of use of the medication. Because Xanax and other alprazolam medication are fast-acting, they become intertwined in the body’s chemical make-up more quickly than other benzodiazepines.
Withdrawal from alprazolam can be more severe as a result, even when the dose is decreased gradually as directed. Certain symptoms of withdrawal from Xanax are called “Xanax withdrawal syndrome.” These symptoms involve a rebounding and sometimes increase in severity of the anxiety that the person had before beginning alprazolam therapy.13
Symptoms of Xanax withdrawal syndrome can include:
One of the most common ways to treat Xanax withdrawal syndrome is to use other prescription medications, including the following:
This medication has been found to be the most effective benzodiazepine for treatment of Xanax withdrawal syndrome, due to its long half-life. Other benzodiazepines with shorter durations in the body’s system have not been as effective in relieving withdrawal symptoms.
An anti-seizure medication, carbamazepine, has been shown to improve sleep disturbances, anxiety, and mood fluctuations that can occur during Xanax withdrawal syndrome. Studies involving other anti-seizure medications also show promise in treating Xanax withdrawal.
This high blood pressure medication helps to slow the racing heart rate that sometimes occurs with Xanax withdrawal syndrome. As it does not offer other benefits like reduction in anxiety or improvement of sleep disturbances, clonidine is usually used in combination with other medications.14