Xanax (Alprazolam) Side Effects

Xanax (alprazolam) is a type of benzodiazepine approved by the Food and Drug Administration to treat panic and anxiety disorders. Clinicians also prescribe it off-label to treat depression. Like all medications, Xanax can cause side effects.

For people with generalized anxiety disorder, Xanax is commonly prescribed alongside an antidepressant to relieve the nervousness that antidepressants initially cause in some people. However, experts do not recommend using Xanax for an extended time.

If you're taking Xanax, be aware of the potential side effects, and know when to contact your doctor or healthcare professional.

Common Xanax Side Effects

Xanax is one of the most commonly prescribed benzodiazepines in the United States. However, many side effects are associated with it, including:

• Drowsiness or fatigue
• Dizziness
• Dysarthria (slurred or slow speech)
• Headache
• Memory impairment
• Depression

Although mild side effects are common, keep a close eye on any you experience, and stay in contact with your healthcare professional,

Severe Side Effects

You shouldn't use benzodiazepines for more than two to four weeks. Chronic, long-term use of Xanax risks serious effects and health issues, including:

• Decreased motor coordination
• Impaired concentration
• Memory loss
• Poor reaction time
• Slower processing of information
• Agoraphobia
• Loss of sex drive
• Increased anxiety and depression
• Social phobia

If you experience any of these, contact your healthcare provider immediately.

Potential for Addiction

One study found that, after four to eight months of treatment with benzodiazepines, 40% of patients became dependent on them. Xanax falls into this category and thus poses a risk for addiction.

The problem typically arises when a patient develops a tolerance to the drug over time. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) lists the following as the criteria for drug tolerance:

• You feel diminished effects of a drug over time when taking the same amount.
• You require larger amounts of the drug over time to feel the same effects.

Because this tolerance might compel you to increase your dose, Xanax can be highly addictive. Xanax has a high "misuse liability," meaning individuals often develop a physical dependence on it.

Those who chronically use benzodiazepines such as Xanax non-orally (such as via injection) experience significant respiratory distress and a tranquilizing effect on the central nervous system (CNS).

Xanax Warnings and Interactions

Before taking Xanax, tell your doctor about pre-existing health conditions, any history with addiction, and other medications you're taking.

Liver Function

Xanax is metabolized by the liver. If you have liver disease or your liver isn't fully functioning, you must be closely monitored for liver damage while taking Xanax. Your doctor might order a blood test to measure your liver function before you start Xanax, or might choose not to prescribe it for you at all.

Substance Use Disorder

Given Xanax's high potential for misuse and/or addiction, it's important to consult your doctor before taking it if you have a substance use disorder or a history of substance misuse. Those with substance use disorders may be at higher risk of developing an addiction to Xanax.

People who are withdrawing from opiates sometimes self-medicate with Xanax. Likewise, people with addictions to other benzodiazepines such as Valium (diazepam) and Ativan (lorazepam) are also more likely to misuse Xanax because they produce a similar sedating effect.

Self-medicating with Xanax or mixing it with other substances has life-threatening consequences, including overdose. Be sure to talk to a healthcare professional before taking Xanax with other substances.

People Over Age 65

People over age 65 should exercise caution when taking Xanax. Older adults have a greater risk for negative side effects, particularly if they combine Xanax with other medications affecting the central nervous system. These effects include:

• Unsteady gait
• Memory problems
• Loss of balance
• Cognitive impairment
• Risk of falling
• Risk of motor vehicle collision

If you're an older adult, your doctor or healthcare professional should monitor you closely if you're taking Xanax.

Pregnancy and Breastfeeding

Xanax can harm a developing fetus if taken during pregnancy. Potential effects include:

• Respiratory and feeding difficulty
• Convulsions
• Hypotonia (floppy baby syndrome)
• Neonatal drowsiness
  
• Low birth weight
• Irritability
• Withdrawal symptoms

High doses of Xanax taken in the third trimester are associated with fetal benzodiazepine syndrome. This includes floppy baby syndrome, withdrawal symptoms, and problems regulating temperature.

An infant can be exposed to Xanax through breastmilk. The potential side effects in a a baby include sedation, poor temperature regulation, and lethargy.

Other Medications

Do not take Xanax with other CNS depressants, such as Valium, Klonopin (clonazepam), alcohol, barbiturates, tricyclic and tetracyclic drugs, dopamine receptor antagonists, opioids, and antihistamines. This can result in excessive sedation, respiratory depression, and in some cases, overdose.

Effects of Xanax Withdrawal

Though tapering off Xanax may help with the intensity of withdrawal, certain symptoms are still common when you discontinue Xanax. Patients who experienced anxiety prior to starting Xanax may feel more anxious after stopping it,. This is known as "rebound anxiety."

Other common effects of withdrawal include:

• Malaise
• Dizziness
• Insomnia
• Tachycardia (fast heart rate)
• Severe sleep disturbance

One study found that 15 out of 17 patients with panic disorder experienced a "reoccurrence or increase" in their panic attacks after tapering off Xanax.

Similarly, people with post-traumatic stress disorder (PTSD) who gradually discontinued Xanax experienced effects such as irritability, nightmares, worsened anxiety, hyper-alertness, rage, and homicidal ideation.

Multiple case studies have reported delirium and psychosis in patients who discontinued Xanax. These withdrawal effects have not been linked to any other benzodiazepine.

If you have experienced these or any other concerning side effects as a result of withdrawing from Xanax, seek medical attention right away.

Tapering Off Xanax

Tapering off a drug means that you gradually reduce the dosage until you stop taking it altogether. This process can help minimize the severity of withdrawal effects.

Consult with your doctor if you are tapering off Xanax; they will provide you with specific instructions on how to do so safely. Generally, you can expect to decrease your Xanax dosage by no more than 0.5 mg every three days.

Effects of Xanax Overdose 

Overdose can happen when a person takes larger doses of Xanax than prescribed, they take it more frequently than prescribed, they inject the drug, and/or they mix it with other CNS depressants.

Signs of an overdose vary with the person. However, the following are common:

• Trouble breathing
• Confusion
• Dizziness
• Blurred vision
• Impaired motor skills
• Bluish lips or fingernails
• Tremors
• Coma

Other serious complications from overdose include pneumonia, muscle damage, brain damage, and even death.

Anyone experiencing an overdose requires immediate medical attention. Once at the hospital or with emergency services, they are often given intravenous fluids, respiratory support, and/or medications to help combat the effects.

A Word From Verywell

It's important to be aware of the side effects you may experience when taking Xanax. Though the side effects listed here are the most common, you might experience other effects unique to you. Always follow your doctor's guidelines and discuss any concerns. If you're unsure about taking Xanax, ask your doctor about alternatives.