Xanax Dosages, Side Effects, Risks, and Withdrawal

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What is the most important information I should know about Xanax? (alprazolam)?

You should not take alprazolam if:

  • you are taking ketoconazole, itraconazole, or another sedative, including alcohol; or
  • you are taking melatonin, kava kava, St. John's wort, valerian, or DHEA; or
  • you are allergic to benzodiazepines.

Xanax is the trade name for the anti-anxiety medication alprazolam. It is part of a group of prescription drugs called benzodiazepines. Xanax is also a controlled drug, which means it has the potential to cause dependence or to be misused. These medications are regulated by law and it is illegal to take Xanax without a prescription from a medical doctor.

Xanax, like other benzodiazepines, can produce dependence and addiction. This risk is higher among people to take higher doses for extended periods but may occur even at lower doses.

Xanax Effects and Dosage

The effects of Xanax depend on several factors. To ensure that you get the correct dose, you should clearly and honestly answer all of your doctor's questions.

You need to take the Xanax dose exactly as prescribed. If you feel that your current dosage isn't having the intended effect, talk to your healthcare provider.

The main effect of Xanax is feeling calmer. This effect can occur relatively quickly after the drug is taken. For people with anxiety disorders, taking Xanax can quickly offset the intense anxiety they experience (which can be debilitating).

Xanax is also available in an extended-release version called Xanax XR. There are several benefits to this version:

  • Only one dose per day
  • Reduced rebound effect
  • Potential for decreased misuse

Xanax Side Effects

Xanax has many side effects. If you experience side effects, let your healthcare provider know. In some cases, you might need medical attention or a prescription for an alternative medication.

  • Allergic reactions (including skin rash, itching or hives, swelling of the face, lips, or tongue)
  • Changes in appetite
  • Changes in sex drive
  • Confusion and forgetfulness
  • Depression
  • Difficulty sleeping
  • Difficulty speaking
  • Drowsiness
  • Feeling faint or lightheaded (which can increase the risk of falls)
  • Mood changes
  • Trouble passing urine
  • Feeling unusually weak or tired

Xanax is sedating and can make you feel sleepy, drowsy, and less alert. If you have been prescribed Xanax, it's very important for your safety and the safety of others that you do not drive or operate heavy machinery until you know how the drug makes you feel.

Xanax Risks

Xanax can interact with other drugs and medications. You should not take Xanax if you are taking another medication, including birth control, unless your provider has told you that it is safe.

There are some medications or substances that you should never mix with Xanax, including ketoconazole, itraconazole, and alcohol.

Herbs, nicotine, illicit drugs, dietary supplements, and non-prescription drugs all have the potential to be dangerous if taken with Xanax.

You should not take Xanax with grapefruit and grapefruit juice, or herbal or dietary supplements such as kava kava, melatonin, dehydroepiandrosterone (DHEA), St. John's wort, and valerian.

Xanax is not recommended if you are pregnant and/or breastfeeding. If you become pregnant while you are taking Xanax, contact your provider right away.


An overdose of Xanax is a significant risk, especially for people who are not taking the medication as prescribed or are mixing it with other substances. Overdoses of medications like Xanax can be fatal and require immediate medical attention.

If you or someone you love overdoses on Xanax, call 911 or go to the nearest emergency room.

Xanax Withdrawal

As with other benzodiazepines, withdrawing from Xanax carries significant risks and should only be done under the supervision of a physician.

The greatest risk of Xanax withdrawal is life-threatening seizures. Other withdrawal symptoms can include:

  • Aches and pains
  • Anxiety and panic attacks
  • Changes in mood
  • Delirium
  • Insomnia
  • Irritability
  • Muscle spasms
  • Nausea
  • Racing pulse
  • Visual disturbances

Do not try to quit or cut down on Xanax without telling your healthcare provider—even if you have been taking a low dose or only taking the medication for a short time.

Withdrawal symptoms may begin around eight to 12 hours after stopping Xanax. These symptoms usually last around a week, but some may experience protracted withdrawal symptoms for weeks or months.

In order to minimize withdrawal symptoms, your doctor will gradually taper your dose. Since Xanax is a short-acting benzodiazepine, your doctor may switch you to a longer-acting one, such as diazepam.

Xanax Addiction Treatment and Recovery

If you think you might have a dependence or addiction to Xanax, talk to your doctor. They can work with you to gradually lower your dose and help you recover. 

Other treatments may involve cognitive-behavioral therapy (CBT) to address negative thought patterns and increase coping skills. 

When you are quitting Xanax, utilizing self-help strategies to aid recovery can also be helpful. Some things that can help include:

  • Avoiding situations that trigger substance cravings
  • Getting support from family and friends
  • Using healthy habits such as eating a balanced diet and getting plenty of rest
  • Exercising regularly
  • Staying busy and enjoying hobbies to distract yourself from cravings
  • Managing stress with relaxation techniques such as deep breathing, yoga, or meditation

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

  6. Chapoutot M, Peter-Derex L, Bastuji H, et al. Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disordersInt J Environ Res Public Health. 2021;18(19):10222. doi:10.3390/ijerph181910222

By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.