Xanax (Alprazolam) Side Effects & Warnings

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS


Xanax is a central nervous system depressant that has sedative qualities. As a result, people who use Xanax can expect a number of standard side effects, including drowsiness and some loss of coordination. When Xanax is abused, these side effects can be much more severe.

Alprazolam (brand name Xanax) is a benzodiazepine prescription drug used to treat symptoms of panic disorder such as panic attacks. Xanax is also used for generalized anxiety disorder (GAD) and other anxiety-related disorders.

Xanax is available as an extended-release tablet, known as Xanax XR. The medication works by binding to the gamma-aminobutyric acid (GABA) receptors in the brain.

According to the Food and Drug Administration (FDA), Xanax helps to treat panic disorder with or without agoraphobia. Since Xanax is a Schedule IV controlled substance, it is considered to have some potential for abuse.

Xanax can be abused due to the fact that the drug affects the central nervous system (CNS), producing feelings of calm or relaxation. As a CNS depressant, when Xanax is combined with other drugs, serious side effects such as respiratory depression can occur.

Side Effects Of Xanax Use

Xanax may cause a number of side effects. While some common side effects may not be severe, others can lead to serious health problems.

Short-Term Side Effects

The National Alliance on Mental Illness (NAMI) states that short-term use of Xanax may cause possible side effects such as:

  • drowsiness
  • sedation
  • relaxed mood
  • impaired coordination
  • fatigue
  • lightheadedness
  • dry mouth
  • inability to concentrate

Long-Term Side Effects

Serious side effects can take place when long-term use of benzodiazepines occurs.

Some of the long-term side effects of alprazolam use may include:

  • anxiety
  • weight gain or loss
  • twitches
  • muscle cramps
  • depression
  • sleeping problems

Withdrawal Symptoms

Those who take large doses of Xanax or who take the prescription drug long-term may experience a number of withdrawal symptoms if the medication is abruptly stopped.

Some of the withdrawal symptoms can include:

  • changes in mental health
  • ringing in the ears
  • hallucinations
  • overexcitement
  • tremors or shakiness
  • suicidal ideation
  • sleeping difficulties

Warnings Of Xanax Use

There are warnings for certain groups of people who may take Xanax. 

For instance, women who are breastfeeding should avoid benzodiazepine use due to the fact that the drug may pass from the mother’s breast milk to the baby. If this occurs, the baby may suffer from a withdrawal syndrome or have significant weight loss.

In addition to this, those who suffer from conditions that result in breathing problems should consult their doctor. Those with chronic obstructive pulmonary disease (COPD) may more likely develop trouble breathing, including respiratory depression.

Drug Interactions

There are a number of medications that should not be taken with Xanax. Not only can allergic reactions possibly occur, combining medications can increase your risk of overdose, especially if other CNS depressants or benzodiazepines are combined with Xanax.

Other benzodiazepines include diazepam (Valium), lorazepam (Ativan), and clonazepam (Klonopin).

Several antidepressants should be avoided such as:

  • selective serotonin re-uptake inhibitors (SSRIs)
  • serotonin-norepinephrine re-uptake inhibitors (SNRIs)
  • fluoxetine (Prozac)
  • erythromycin (Erythrocin)
  • nefazodone (Serzone)
  • fluvoxamine (Luvox)
  • sertraline (Zoloft)

The following should not be taken with Xanax unless you’ve sought the medical advice of your healthcare provider:

  • antihistamines
  • supplements and vitamins
  • antifungals
  • opioids
  • St. John’s Wort
  • cimetidine (Tagamet)

Over-the-counter antifungals such as ketoconazole (Nizoral) and itraconazole (Sporanox) should be avoided as well.

Xanax Overdose

According to the United States Drug Enforcement Administration (DEA), some of the life-threatening effects of a Xanax overdose may include:

  • respiratory depression
  • severe sleepiness
  • seizures
  • decreased reflexes
  • psychosis
  • jaundice or yellowing of the skin
  • confusion
  • mania
  • coma
  • death

If you suspect a benzodiazepine overdose has occurred, seek medical attention immediately. The risk of overdose is increased when Xanax is mixed with other central nervous system depressants, including alcohol, opioids, and other benzodiazepines.

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  1. Department of Justice https://www.deadiversion.usdoj.gov/schedules/
  2. Drug Enforcement Administration (DEA) https://www.dea.gov/sites/default/files/2020-06/Benzodiazepenes-2020_1.pdf
  3. Food and Drug Administration (FDA) https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf
  4. National Alliance on Mental Illness (NAMI) https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Alprazolam-(Xanax)
  5. National Library of Medicine: MedlinePlus https://medlineplus.gov/druginfo/meds/a684001.html
  6. Substance Abuse and Mental Health Services Administration (SAMHSA) https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4131.pdf

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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