If your anxiety has started to impact your work and relationships or if it has manifested into panic attacks, it may be time to seek medication. Xanax is commonly prescribed to treat generalized anxiety and panic disorders when used with psychotherapy.
However, it won’t be the end-all-be-all of treatment. Xanax is prescribed for short-term use because of its addictive nature. For this reason, it’s been classified as a controlled substance.
Before taking any drug—let alone a controlled substance—it’s important to learn about its effects and how long it’ll last. Here, we explain what Xanax should and should not feel like, how long Xanax lasts, and how to take it responsibly.
What does Xanax feel like?
Xanax is the brand name of a generic medication called alprazolam. Xanax belongs to a group of prescription drugs called benzodiazepines (benzos for short), which include other medications like Valium (diazepam), Ativan (lorazepam), and Klonopin (clonazepam).
Benzodiazepines work by slowing down the brain and central nervous system (CNS). Taking Xanax doesn’t cause a “high” like some drugs do. When the central nervous system calms down, people with depression, anxiety, and panic disorders feel a calming effect that helps relieve their symptoms.
Xanax is the most commonly prescribed psychotropic medication in the U.S. It works for many people, but it can also become habit-forming and has numerous side effects.
Xanax side effects
Here’s a list of some of the most common side effects of Xanax:
- Trouble concentrating
- Upset stomach
- Blurred vision
- Memory problems
- Decreased sex drive
- Slurred speech
Xanax may cause more serious side effects that require medical attention. Seek medical advice immediately if you have suicidal thoughts, hallucinations, seizures, or feelings of hostility. Although rare, some people have allergic reactions to Xanax that can cause difficulty breathing, swelling of the face or throat, and hives, which require immediate medical help.
Alcohol use, when combined with Xanax, can be dangerous, cause side effects to worsen, or create new health problems. Using alcohol while taking Xanax can cause seizures, aggression, drowsiness, impaired coordination, and confusion. The combination of alcohol and Xanax can also lead to unconsciousness, coma, or even death.
Do not take Xanax while pregnant or breastfeeding. Xanax can cause fetal abnormalities, and it passes through breast milk, which can affect small infants.
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How long does it take Xanax to kick in?
Xanax works quickly in comparison to other psychotropics. It’s a short-acting drug easily absorbed by the body. Xanax starts working within one hour after it is taken.
How long does Xanax last?
Although it starts working fast, the effects of Xanax wear off quickly, in about five hours. Therefore, it’s typically taken multiple times a day.
The standard dose of Xanax for adults with anxiety disorders is 0.25-0.5 mg three times per day, according to the Food and Drug Administration (FDA). The standard dose of Xanax for adults with panic disorders is 0.5 mg taken three times per day to begin. The dosage is slowly increased as needed. Although dosing can vary widely and tends to be higher for panic disorders, the lowest effective dose should be used.
Xanax XR is an extended-release version of Xanax that only needs to be taken once per day. Xanax and Xanax XR are essentially the same medication and differ only in how long they work. They have the same side effects and treat the same conditions, such as anxiety disorders, panic disorders, and anxiety caused by depression.
Xanax XR stays effective in the body for up to 11 hours. Patients take Xanax XR only once per day because it lasts longer than Xanax.
How long does Xanax stay in your system?
The amount of time it takes for the amount of medication to decrease by half in your body is called its half-life. Even though a dose wears off relatively quickly, the half-life of Xanax is about 11 hours. On the other hand, the half-life of Xanax XR can be up to 15 hours. Many factors can affect the Xanax half-life, including:
- Age: Younger people will metabolize Xanax faster than older adults. Xanax may have a shorter half-life for them.
- Race: Studies show that the half-life of Xanax is increased by 15%-25% in Asians than in Caucasians.
- Weight: Xanax will typically last longer for people who are overweight because the body has to work harder to process the drug.
- Metabolism: Having a fast metabolism means that the body will process Xanax quicker, decreasing the amount of time that it’s effective. Underlying health conditions, like liver disease, can affect your body’s ability to metabolize drugs like Xanax.
- Dose: Higher doses of Xanax will be effective for a longer length of time, increasing its half-life.
- Expired medication: Xanax can expire after two to three years. Consuming an expired product could decrease Xanax’s half-life.
- Drug-drug interactions: Taking Xanax with certain medications can cause an interaction that can affect the efficacy of one or the other drug, and/or worsen side effects of one or the other drug.
Medicines that could potentially affect the half-life of Xanax include:
- Nizoral (ketoconazole), antifungal
- Sporanox (itraconazole), antifungal
- Luvox (fluvoxamine), SSRI used to treat OCD
- Serzone (nefazodone), antidepressant
- E.E.S. (erythromycin), antibiotic
This list of medications is not comprehensive. A healthcare professional can give you a complete list of drugs that may interact negatively with Xanax.
Xanax withdrawal symptoms
Xanax is a short-term solution because of its addictive qualities. Withdrawing from it can be an uncomfortable experience because of potential side effects. Some drugs that cause an emotional high have a comedown effect. However, Xanax calms the central nervous system and creates feelings of calmness, which means there’s no comedown effect.
Just because Xanax doesn’t have a comedown per se doesn’t mean that withdrawing from it won’t cause side effects. Here’s a list of some of the most common withdrawal symptoms that could happen when a person stops taking Xanax:
- Blurred vision
- Increased heart rate
The best way to avoid experiencing Xanax withdrawal is to follow instructions given by a medical professional. Quitting “cold turkey” can cause serious side effects, such as seizures and suicidal thoughts, which can start one to two days after the last dose. A medical professional should supervise a Xanax withdrawal by slowly tapering off the medication.
Xanax has high levels of drug abuse. It’s the most common benzodiazepine that leads to emergency room visits due to drug misuse, according to a study in the Journal of Addiction Medicine.
When people develop an emotional and physical dependence on Xanax and can’t function without it, they have a substance use disorder.
Here are some indications of a substance use disorder from Xanax:
- Combining Xanax with other drugs, like opiates or alcohol
- Cognitive impairment
- Strong cravings for Xanax
- Isolation from friends and family
Xanax addiction treatment
Quitting Xanax can be challenging. Quitting “cold turkey” is dangerous and can cause serious health problems, like seizures. A psychiatrist or other medical professional should treat a substance use disorder to assure a gradual and safe taper off of the medication.
If you use Xanax recreationally, are addicted to Xanax, or know someone who’s misusing it, the Substance Abuse and Mental Health Services Administration (SAMHSA) could be a resource for you. Call its national helpline at 1-800-662-4357 to speak to someone who can direct you to local treatment centers, support groups, and organizations that facilitate inpatient detox and psychotherapy.
Are there safer, non-habit-forming alternatives to Xanax?
Not all medications are as habit-forming as Xanax. “Safer options to treat anxiety disorders may include serotonin reuptake inhibitors (SSRIs), Buspar (buspirone), and Vistaril (hydroxyzine),” says Lukasz Junger, a board-certified psychiatric mental health nurse practitioner and assistant medical director at Mountainside Treatment Center.
These medications might take longer to start working but are a viable option for many people. Talking with your doctor is the best way to learn more about Xanax and whether it’s the right medication for you.