What Is Xanax?

December 9, 2023

Xanax, also known as alprazolam, is a medication commonly used to treat anxiety and panic disorders. It is available by prescription only, and patients who use it have their health closely monitored to reduce the risk of developing dependence. Xanax is frequently prescribed as an extended-release tablet, and it is also available in immediate-release tablets, oral solutions, and injections. Patients who take Xanax orally usually start with a dose between 0.25 to 0.5 milligrams, and tablets are taken up to three times per day. Before prescribing Xanax, doctors will ask the patient about any history of narrow-angle glaucoma, kidney disease, asthma, epilepsy, or depression. Xanax may not be safe for patients with these conditions.

Class Of Medication

Xanax belongs to a class of medication known as benzodiazepines, which act on the central nervous system. They bind to the gamma-aminobutyric acid-A (GABA-A) receptors in the brain, making the brain's nerves less sensitive to stimulation and producing a calming effect. Benzodiazepines are used to treat seizures, anxiety disorders, acute panic attacks, and sleep disorders. They are helpful in symptom management for patients undergoing alcohol withdrawal, and they are used in operating rooms to promote amnesia and relaxation before surgery. Some types of benzodiazepines are also prescribed as muscle relaxants. Lorazepam, clonazepam, estazolam, midazolam, oxazepam, and temazepam are among the more common benzodiazepines currently used in the United States. All benzodiazepines are classified as controlled substances because they can cause dependence in patients who use them. These medications are considered safe when prescribed for a short period such as on the day of an operation, and doctors safely prescribe them as short-term insomnia remedies for up to two weeks. Patients who take benzodiazepines for longer than two to four weeks are more likely to become dependent on the medication. Patients should discuss the risks and benefits of this class of medication with their doctor, and they might also wish to ask about alternative medications.

Xanax Uses And Benefits

Xanax is primarily used to treat panic disorders and anxiety disorders, including anxiety caused by depression. The medication acts on certain chemicals in the brain believed to be unbalanced in patients who have anxiety or panic disorders. Xanax helps reduce the frequency of panic attacks and improve symptom management. Some doctors prescribe it as a treatment for depression as well. In addition to these uses, doctors frequently use Xanax as an 'off-label' treatment for patients who have insomnia, irritable bowel syndrome, essential tremor, ringing in the ears, or severe premenstrual syndrome. Patients who have these conditions should check with their healthcare provider about all possible medication options that could improve their symptoms. If the doctor and patient agree that Xanax is the right medication for the patient's needs, the patient will likely be asked to attend regular follow-up appointments for monitoring, especially if Xanax is to be used long-term. Patients with cancer are often prescribed Xanax to reduce anxiety; these patients should ask their healthcare team about whether it is safe for them to take Xanax with the opioid medications that are sometimes necessary for pain relief during cancer treatment.

Potential Side Effects

Xanax use could cause many potential side effects on both mental and physical health. Patients taking this medication have frequently reported feeling irritable, sad, discouraged, and empty during treatment with Xanax. In terms of physical health effects, the most common side effects include shakiness, coordination difficulties, loss of appetite, drowsiness, slurred speech, and changes in speech patterns. Patients have also experienced trouble with concentration and memory while using Xanax. Less common potential side effects include diarrhea, blurry vision, behavior changes, runny nose, restlessness, difficulty with urination, and hallucinations. In rare cases, Xanax may cause nightmares, chest pain, hearing loss, and a fast heart rate. Some patients have experienced suicidal thoughts while on this medicine, and Xanax might cause some patients to appear uncaring and display a lack of emotion. Patients and their families should discuss all potential side effects with the patient's healthcare team, and any side effects should be brought to the attention of the doctors as quickly as possible.

Risks To Consider

As a controlled substance, Xanax carries a risk of emotional and physical dependence, and patients should discuss this risk with their healthcare team. Patients are more likely to become dependent on this medicine if it is taken at higher doses or for a long period. Patients who are pregnant or breastfeeding should not take Xanax, and it is not approved for pediatric use. Xanax may not be appropriate for individuals who have certain psychiatric conditions or for those with lung disease or severe liver or kidney problems. Patients who have been prescribed Xanax 'off-label' for the treatment of insomnia should be aware the medication reduces the time one spends in deep sleep, and this could mean that an individual feels less refreshed upon waking in the morning. If Xanax is discontinued abruptly, the patient may develop rebound insomnia that could be worse than their initial sleeping issues. Xanax needs to be discontinued gradually under medical supervision to reduce the chance of experiencing withdrawal symptoms.

Potential Medication Interactions

Potential medication interactions are known to exist between Xanax and over 450 other medications. Xanax is known to have severe interactions with sodium oxybate, ketoconazole, indinavir, triazolam, estazolam, and ribociclib, and these medications should not normally be taken together. Xanax also has serious interactions with clozapine, fluvoxamine, lefamulin, and eliglustat. Moderate interactions have been recognized between Xanax and fluoxetine, some types of stimulants, and certain forms of azole antifungals, and the medication also interacts with ethyl alcohol. Patients taking Xanax should ask their doctor and pharmacist to check for potential medication interactions before the drug is prescribed and again before it is dispensed. In particular, individuals who take herbal supplements should know Xanax will interact with kava, and kava usage must be discontinued before starting Xanax.

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