Bipolar Disorder Treatment Medications Xanax (Alprazolam) Side Effects By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on April 04, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Tara Moore / Getty Images Table of Contents View All Table of Contents Common Side Effects Severe Side Effects Warnings and Interactions Withdrawal Effects Overdose Frequently Asked Questions 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. Benzodiazepines are sedatives that typically produce feelings of relaxation or sleepiness. 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. Never stop taking Xanax on your own; it has the most severe withdrawal effects of all benzodiazepines. Instead, speak with your clinician about tapering off Xanax gradually to avoid serious withdrawal effects. 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). If you or a loved one are dealing with substance abuse 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. 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 gaitMemory problemsLoss of balanceCognitive impairmentRisk of fallingRisk 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 difficultyConvulsionsHypotonia (floppy baby syndrome)Neonatal drowsinessLow birth weightIrritabilityWithdrawal 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. Breastfeeding isn't recommended while taking Xanax or other benzodiazepines. 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. If you or someone you're with is experiencing side effects from mixing Xanax and other substances, dial 911 and request an ambulance. The person's healthcare provider should be notified that they are in the emergency room. 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 breathingConfusionDizzinessBlurred visionImpaired motor skillsBluish lips or fingernailsTremorsComa Other serious complications from overdose include pneumonia, muscle damage, brain damage, and even death. If you or someone you know is experiencing signs of overdose from Xanax, call 911 immediately. 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. Frequently Asked Questions How long do side effects of Xanax last? You'll feel the effects of Xanax in about 10 minutes to an hour after taking a dose, and they'll peak by the two-hour mark and subside by four. However, Xanax remains in your system for about 11 hours, so you can feel side effects during this time. Does Xanax cause headaches? You might experience headaches while taking Xanax, after taking it, or as you taper off of it. Some people report a hangover-like feeling after taking Xanax. How do you quit Xanax without side effects? Don't stop taking Xanax suddenly. Instead, consult your healthcare provider before quitting it. They will show you how to safely taper down your dosage gradually to minimize withdrawal effects. 7 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. Guina J, Merrill B. Benzodiazepines I: Upping the care on downers: The evidence of risks, benefits and alternatives. J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017 Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A review of alprazolam use, misuse, and withdrawal. J Addict Med. 2018;12(1):4-10. doi:10.1097/ADM.0000000000000350 Louvet S, Ischayek M, Danoff R. The current role of long-term benzodiazepines for the treatment of generalized anxiety. Osteopath Fam Physician. 2015;7(1):1-5. Hasin DS, O’Brien CP, Auriacombe M, et al. DSM-5 Criteria for substance use disorders: recommendations and rationale. AJP. 2013;170(8):834-851. doi:10.1176/appi.ajp.2013.12060782 McElhatton PR. The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol. 1994;8(6):461-475. doi:10.1016/0890-6238(94)90029-9 Gahlinger PM. Benzodiazepine overdose. BMJ Best Practice. McKenzie RR Jr, Madadi P, Sharma TR. Alprazolam withdrawal delirium and brief reversible psychosis. Prim Care Companion CNS Disord. 2014;16:5. doi:10.4088/pcc.14l01668 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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