How Is Xanax Used to Treat Social Anxiety Disorder?

Xanax is sometimes prescribed for social anxiety disorder.
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Xanax (alprazolam) is a medication used primarily to treat panic disorder but also used in the treatment of social anxiety disorder (SAD). Xanax was first approved in the United States in 1981 and has become a commonly prescribed medication for anxiety.

Xanax for Social Anxiety Disorder

If you've been diagnosed with social anxiety disorder, the first line of medication treatment is usually selective serotonin reuptake inhibitors (SSRIs). However, Xanax may be prescribed as a short-term option to help manage symptoms of anxiety. In this way, it's not a "first-line" treatment, but rather a complement to other treatment options.

If your doctor has given you a prescription for Xanax, it is likely to treat the symptoms you experience that come on quickly. This isn't a long-term treatment option, but rather a short-term solution to panic or anxiety that you experience in specific situations.

Xanax will not permanently cure your anxiety; rather, it helps to reduce your symptoms, often so that you can better participate in other forms of treatment, such as psychotherapy. Because Xanax starts working quickly, it will give you some immediate relief if you are suffering from severe bouts of anxiety.

How Xanax Works

Xanax provides fast relief of anxiety symptoms often seen in SAD and other anxiety disorders. It works specifically by binding to GABA receptors in your brain. This inhibits neuron activity (slows down your brain activity), and has the effect of reducing anxiety, fear, and feelings of terror—it might also leave you feeling sleepy, relaxed, and calm.

Xanax has a half-life of 11 hours. Half-life refers to how long it takes the body to eliminate half of the ingested dose. The clinical effectiveness of one immediate release Xanax (alprazolam) pill is often much shorter, with most people noticing a wearing off of the clinical effectiveness by 4 to 6 hours.

How Xanax Is Prescribed

Xanax is generally prescribed for a limited time. A doctor who prescribes this medication for longer than 8 weeks should check on the status of your anxiety to see if other treatment options might be more suitable.

Xanax is taken in pill form and typical dosages of Xanax are 2 to 4 mg per day. If you have been prescribed Xanax, your doctor will probably start at a lower dose and adjust it upward to achieve optimal effects.

Xanax for SAD vs. Other Disorders

Xanax is most commonly prescribed for panic attacks, which occur as part of panic disorder and agoraphobia. It might also be used in the case of simple phobias for situations that rarely occur, such as a person who has a fear of flying. Xanax is helpful for panic-inducing situations as it can be used as needed before an event.

In the case of social anxiety disorder, Xanax is more commonly prescribed for cognitive symptoms such as worrying about performance or the judgment of others. In this case, Xanax can be taken about an hour before a performance event.

Who Should Not Take Xanax

You should not take Xanax if you have a hypersensitivity to benzodiazepines, have acute narrow-angle glaucoma, or are pregnant or breastfeeding. Xanax has also not been shown effective for people under age 18.

People with liver or kidney problems also should not take Xanax. As this medication is processed by these organs, if they are not working correctly, Xanax may build up in your body leading to the possibility of overdose or heavy sedation.

Risks and Side Effects of Taking Xanax

There are several factors to keep in mind when taking Xanax. Good communication with your doctor can help you determine what's normal and when to be concerned.

Xanax Side Effects

The most common side effects of taking Xanax are sedation and drowsiness. In general, benzodiazepines such as Xanax have fewer side effects than other longer-term medications for anxiety. Avoid driving, operating machinery, and participating in hazardous activities until you know how you react to Xanax.

Medication Interactions

A number of medication interactions can potentially occur with Xanax. It is important that your doctor is aware of all the medications you are currently taking. In addition, the effects of Xanax may be intensified if combined with alcohol.

Dependence and Withdrawal

There is a risk of emotional and physical dependence when taking Xanax. Withdrawal symptoms are possible if the medication is abruptly stopped and may include the risk of seizures.

Be sure to follow your doctor's directions for stopping Xanax or changing the dosage. Over time, there is a risk of your brain producing less GABA naturally, which may make Xanax less effective. If you have a history of substance abuse or addiction, Xanax may not be the best treatment option.

Obtaining a Xanax Prescription

If you've suffered for a long time with anxiety, you may wonder how to get prescribed Xanax and if it could help. While it is something that you can ask your doctor about, ultimately he or she will make the decision about the best treatment options for your situation.

It is important not to use Xanax obtained from someone else. Not only is it illegal to take a medication without a prescription, but it can be dangerous. Besides the risk of dependence and withdrawal, combining Xanax with other substances that subdue your nervous system such as painkillers, antihistamines, and alcohol can be dangerous.

Xanax should only be taken under the advice of a prescribing physician. In addition, Xanax can cause feelings of euphoria when taken in too large of doses, or by people who don't have anxiety. For all of these reasons, stay clear of taking a medication such as Xanax that was not prescribed for you.

What to Do If Xanax Does Not Work

If you find that prescription Xanax is not helping your anxiety, talk to your doctor. He or she will be able to either adjust the dose or choose a different medication. Remember that Xanax should form just one part of a larger treatment plan most likely including talk therapy such as cognitive-behavioral therapy (CBT). Xanax is not a replacement for other treatments, it's part of a larger plan.

A Word From Verywell

If you have been prescribed Xanax for your social anxiety you may feel nervous and unsure about taking the medication. These feelings are normal and to be expected. Talk with your doctor about your concerns, to ensure that the treatment plan you devise is optimal for your situation.

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Additional Reading
  • Blanco C, Raza MS, Schneier FR, Liebowitz MR. The evidence-based pharmacological treatment of social anxiety disorder. Int J Neuropsychopharmacol. 2003;6(4):427-442.
  • Blanco C, Schneier FR, Schmidt A, et al. Pharmacological treatment of social anxiety disorder: a meta-analysis. Depress Anxiety. 2003;18(1):29-40.
  • Canton J, Scott KM, Glue P. Optimal treatment of social phobia: systematic review and meta-analysis. Neuropsychiatr Dis Treat. 2012;8:203-215.
  • Davidson JR. Pharmacotherapy of Social Anxiety Disorder: What Does the Evidence Tell Us? J Clin Psychiatry. 2006;67 Suppl 12:20-6.
  • Pfizer. Xanax Prescribing Information