Xanax (also known as alprazolam) is one medication in a group of medications called benzodiazepines. It’s the most commonly prescribed medication in the U.S. that affects a person’s mental state. Benzodiazepines (sometimes called “Benzos”) are often prescribed for people with anxiety disorders such as generalized anxiety disorder or panic disorder.They are also sometimes used for short-term treatment in people who have severe insomnia, alcohol withdrawal, and prolonged seizures. Xanax is considered a short-acting benzodiazepine, which means that it doesn’t last as long as other benzodiazepine medications. This can be helpful if you only need the effect for a short period of time.
Benzodiazepines like Xanax reduce anxiety by attaching to a receptor in your brain called the GABA-A (gamma-aminobutyric acid-A) receptor. When Xanax binds to this receptor, it has a calming effect in the brain. Xanax is often prescribed for anxiety disorders because it can help relieve anxiety symptoms quickly. However, other anxiety medications and talk therapy are better long-term choices for treating anxiety because Xanax has side effects, a risk of overdose, and the potential for dependence.
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How long does it take Xanax to work?
For most patients, Xanax will start to work within one to two hours. These other treatments may take a few weeks to take effect, though. So Xanax and other benzodiazepines are sometimes used as a “bridge” until other treatments can have a chance to work.
If you are taking Xanax, you should be aware of its side effects. Possible side effects include:
Weight loss or weight gain
Nausea or vomiting
Low blood pressure
Some people should avoid Xanax because they may be more sensitive to its side effects or it might harm them. These groups include:
Children and teens
People who have misused alcohol or drugs
People with certain medical conditions such as respiratory illnesses
People who take Xanax should also be aware of the possibility of misusing or becoming dependent on it. Some people misuse Xanax because they like the way it makes them feel, which can lead to inappropriate use or overuse. When someone needs higher or more frequent doses of the medication to achieve the same effect, this is known as tolerance.
Building a tolerance to Xanax or other benzodiazepines can lead to dependence. A dependence means your body begins to rely on Xanax to function normally, and you can experience serious withdrawal symptoms if you stop taking it suddenly.
Certain people are at greater risk for misusing Xanax, including:
Young adults 18 to 35 years old
Someone who has a current psychiatric disorder
Someone with a personal or family history of substance abuse
Because of Xanax’s serious side effects and the risk of misuse and dependence, you should only take it under the supervision of a healthcare provider. If you and your provider decide that Xanax is right for you, take it at the lowest dose possible for the shortest time possible.
If you are taking Xanax, you should also avoid alcohol and certain drugs such as opioids (Vicodin, Oxycontin). These substances affect the brain in similar ways and can have an additive effect. They can lead to serious health complications such as breathing problems and sometimes even death. All of these substances have a high risk of misuse and dependence.
You might be taking other medications in addition to Xanax or another benzodiazepine. Certain medications, when taken with Xanax, can slow down or speed up the amount of time it takes Xanax to leave the body. Conversely, sometimes Xanax can slow down or speed up how long it takes other medications to leave the body.
Grapefruit juice (not a medication, but important to remember)
Xanax dosage starts at 0.25 mg, taken one or more times a day. Xanax pill strengths are available as 0.25 mg, 0.5 mg, 1 mg, and 2 mg. Xanax reaches its highest level in the body in 1-2 hours after a dose, and may start helping symptoms sooner.
The 2 mg tablet is sometimes referred to as a “Xanax bar” because it is a rectangular or “bar” shape, and is scored so it can be divided into 0.25 mg dose sizes. The term “Xanax bar” can also refer to illegal medication that does not actually contain Xanax.
Xanax also comes as an extended-release tablet, Xanax XR, which is available as 0.5 mg, 1 mg, 2 mg, and 3 mg tablets. The extended-release pill takes longer to reach peak effect, about 9 hours, and also lasts longer in the body.
Your provider will work with you to determine the appropriate dosage based on your needs. For example, while doses for anxiety disorders typically start at 0.25 mg to 0.5 mg 3 times per day, dosing for panic disorder may start at 0.5 mg to 1 mg once daily.
Living with an anxiety disorder can have a significant impact on your life. However, there are other treatments you can try before starting Xanax.
Other anti-anxiety medications. Several anti-anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs), can be safely used for a longer period of time than Xanax. SSRIs, taken daily, can help people with anxiety manage their symptoms. They are taken around the same time every day, not just when you feel anxious. However, it can take a few weeks before you notice your anxiety symptoms lessen on these medications.
Psychotherapy. Talk therapy, such as cognitive behavioral therapy, has also been shown to be helpful for treating anxiety and insomnia. With this type of therapy, your therapist helps you understand how your thoughts and emotions about your anxiety can worsen your symptoms. You and your therapist also explore more adaptive thoughts and behaviors to help ease your anxiety symptoms or sleep problems.
Other benzodiazepines. If you and your provider decide that a benzodiazepine is the right choice for you, your provider might try one with less risk of side effects and misuse than Xanax such as oxazepam (Serax). They might also limit the number of pills prescribed and use the medication for a short amount of time.