By Naomi Carr
Last updated: 19 October 2023 & medically reviewed by Morgan Blair
Xanax (alprazolam) is a benzodiazepine used to treat various types of anxiety disorders. It can cause several side effects, including dizziness, drowsiness, sedation, and light-headedness, and in some cases may cause severe side effects, particularly if it is used for prolonged periods or unintended purposes.
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What is Xanax?
Xanax is the brand name for alprazolam, which is a benzodiazepine medication, also referred to as an anxiolytic, sedative, or tranquilizer. Xanax (alprazolam) is approved for the short-term treatment of various conditions and is classified as a Schedule IV controlled substance. It is reportedly the most common benzodiazepine to be prescribed and misused in the US.
What is Xanax used for?
Xanax (alprazolam) is approved to treat acute symptoms of anxiety disorders, including generalized anxiety disorder, panic disorder, and anxiety occurring alongside depression. It is also sometimes prescribed off-label to treat depression and premenstrual syndrome. Xanax (alprazolam) is not intended for long-term use due to its potential for abuse and addiction.
Why do people abuse Xanax?
Xanax (alprazolam) is a potent and fast-acting benzodiazepine that causes mild euphoria, sedation, and calming effects. Because of these effects, it is commonly misused and abused. It is also found to be commonly used alongside other substances, such as opioids, to enhance euphoric effects.
Additionally, Xanax (alprazolam) is found to impact dopamine and serotonin, which may reinforce use and increase the potential for abuse. Benzodiazepines, such as Xanax (alprazolam), are highly addictive with a risk for tolerance and dependence.
Because Xanax (alprazolam) is only intended for short-term use, it is common for symptoms, particularly anxiety, to return or rebound once treatment is stopped. Because of this, someone who has used a Xanax (alprazolam) prescription in the past might attempt to gain further prescriptions or illegally purchase more Xanax if they feel unable to manage their symptoms.
Similarly, someone with a Xanax (alprazolam) prescription might develop tolerance or dependence on the medication, which could cause them to use larger and more frequent doses to achieve the same effects and prevent withdrawal symptoms. Xanax (alprazolam) dependence can develop quickly and may cause more severe withdrawal symptoms than other benzodiazepines, contributing to its abuse potential.
Common side effects of Xanax
It is common to experience side effects when starting a new medication. Often, these effects will last a week or two and will reduce without the need for intervention. If side effects continue or become concerning, it is recommended to consult with the prescribing doctor.
Feeling unsteady or lightheaded
Impaired memory or concentration
Change in appetite and weight
Severe side effects of Xanax
Sometimes, severe or persistent side effects can occur, particularly if the medication is misused. In the event of severe side effects, it is advised to contact a doctor immediately.
Severe mood changes
Suicidal ideation or attempts
Abnormal or involuntary movements
Breathing difficulties or shortness of breath
Pain or tightness in the chest
Rash, hives, or blisters
Yellowing of the skin
Dizziness or unsteadiness leading to falls
Abusing Xanax (alprazolam), or using more than has been prescribed, can increase the risk of severe side effects, particularly breathing difficulties, oversedation, severe mood changes, suicidal ideation, and muscle weakness. The risk of tolerance, dependence, and addiction are also increased with its misuse.
Xanax (alprazolam) tolerance often develops after prolonged use and causes the effects of the medication to be reduced. Individuals may then increase their dosage or frequency of use, in an attempt to achieve the same effects.
Xanax (alprazolam) dependence also is more likely to occur after prolonged use, although dependence can occur within a few weeks. It causes the body to become dependent on the effects of the medication, resulting in withdrawal symptoms when the medication is stopped, including anxiety, muscle weakness, irregular heartbeat, and seizures. This can lead to continued use or misuse of the medication, to prevent withdrawal symptoms.
Addiction differs from tolerance and dependence but often occurs alongside their development. It can cause compulsive behaviors relating to drug-seeking and use and can cause detrimental effects on life quality and functioning.
Xanax (alprazolam) abuse, particularly when combined with other substances such as alcohol and opioids, increases the risk of overdose and fatalities.
Benzodiazepines, including Xanax (alprazolam), are one of the most common drugs found to be associated with intended and unintended overdoses in the US. Their effects on the central nervous system, such as sedation and reduced heart rate, contribute to the risk of overdose and death, especially when they are abused.
Extreme tiredness and weakness
Loss of coordination
Slowed or stopped breathing
Loss of consciousness
Because of its potency, Xanax (alprazolam) can cause an overdose in small doses. This causes a particular risk in individuals who relapse after stopping substance use and begin taking the drug again at their previously used dose.
When starting and stopping Xanax (alprazolam) treatment, doctors will often taper the prescription gradually, to prevent side effects and withdrawal symptoms. However, if the drug is not used as prescribed or is abused, the risk of side effects and withdrawal symptoms are increased.
Xanax (alprazolam) abuse, dependence, and addiction are best treated with a medical detox, which can allow for safe cessation. Detox can take place in a hospital or rehab center, where professionals can monitor and treat withdrawal symptoms and dangerous effects that occur.
Psychotherapy can be provided to help reduce addictive behaviors, treat underlying mental health conditions, manage the underlying emotional distress or trauma contributing to substance abuse, and teach coping strategies to manage cravings and triggers.
Ongoing treatment can be beneficial for many individuals going through the recovery process to promote and maintain abstinence. This can include support groups, psychotherapies, and holistic approaches.