If you have a certain kind of anxiety disorder, your doctor might suggest Xanax as a treatment option for you. It’s a prescription drug used to treat the following conditions in adults:
- panic disorder
- generalized anxiety disorder
Xanax comes as a tablet that you swallow. It contains the active ingredient alprazolam. (An active ingredient is what makes a drug work.)
While usually prescribed short term, your doctor will determine how long you’ll need to take Xanax.
For more information about Xanax, including details about its uses, see this in-depth article on the drug.
Like other drugs, Xanax can cause mild to serious side effects. Keep reading to learn more.
Note: Xanax is a controlled substance in the United States. This means it has an approved medical use, but may be misused* for other purposes. It also means the federal government, doctors, and pharmacists may pay close attention to how the drug is prescribed and used.
* With misuse, a drug is taken in a way other than how it’s been prescribed.
Xanax vs. Xanax XR
There are two kinds of Xanax tablets.
One form of Xanax tablets is immediate release. This means all the medication is released into your system soon after the tablet dissolves. It’s typically taken three times per day.
The other form, Xanax XR, comes as extended-release (XR) tablets. This means the drug is released slowly into your system over a period of time. Xanax XR is used to treat panic disorder only. It’s typically taken once daily.
There are some differences in the side effects of Xanax and Xanax XR. This article focuses on Xanax only. To learn more about Xanax XR’s side effects, talk with your doctor or see the drug’s prescribing information.
Below are a few of the more common side effects reported by people taking Xanax in studies. These side effects can vary depending on the condition the drug is being used to treat.
More common side effects in people taking Xanax for generalized anxiety disorder include:
- drowsiness
- feeling lightheaded
- dry mouth
- low blood pressure
- increased saliva production
More common side effects in people taking Xanax for panic disorder include:
- drowsiness
- fatigue (low energy)
- changes in appetite
- irritability
- trouble with balance and coordination
While these are the most common side effects of Xanax, they may not happen to you. Keep reading to learn about mild and severe side effects of this drug.
Xanax can cause mild side effects. The kinds of side effects you can have may vary depending on the condition you’re using Xanax to treat.
Examples of mild side effects that have been reported with Xanax when used for generalized anxiety disorder include:
- drowsiness
- feeling lightheaded
- dry mouth
- low blood pressure
- increased saliva production
- dermatitis (inflammation of the skin) or skin allergy
- dizziness
- trouble staying still
- mild allergic reaction*
Examples of mild side effects that have been reported with Xanax when used for panic disorder include:
- drowsiness
- fatigue (low energy)
- irritability, rage, or aggressive behavior
- memory loss
- changes in appetite
- trouble speaking
- changes in sex drive
- skin rash
- confusion
- menstruation disorders, such as heavier periods or painful cramping
- trouble urinating
- trouble with balance and coordination
- changes in weight*
- constipation*
- mild allergic reaction*
In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Xanax unless your doctor recommends it.
Xanax may cause mild side effects other than those listed above. See the drug’s prescribing information for details.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Xanax, visit MedWatch.
* To learn more about this side effect, see the “Side effects explained” section below.
Serious side effects have been reported with Xanax. These include:
- seizures
- hallucinations
- liver problems
- risk of severe harm or death if taken with opioids*
- risk of withdrawal and dependence*
- risk of misuse and addiction†
- severe allergic reaction‡
If you develop serious side effects while taking Xanax, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
* Xanax has a
† Xanax has a
‡ To learn more about this side effect, see the “Side effects explained” section below.
Yes, a side effect of Xanax is sleepiness, which can occur even with typical doses. To prevent excessive sleepiness, be sure to take Xanax exactly as your doctor prescribes. They may recommend that you avoid driving or operating machinery until you know how this drug affects your body.
Combining Xanax with other substances such as opioids and alcohol can increase the risk of sleepiness. Talk with your doctor before taking other prescription or nonprescription drugs with Xanax. And if you drink, ask your doctor if there’s a safe amount of alcohol you can consume while taking this drug.
Note: There’s a boxed warning about the risks of taking Xanax with opioids. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.
Below are answers to some frequently asked questions about side effects of Xanax.
What are the symptoms of a Xanax overdose?
Overdose is a serious concern when taking Xanax. There’s a boxed warning for this. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
Side effects of taking too much Xanax include:
- drowsiness
- confusion
- trouble with balance and coordination
- weakened reflexes
- coma*
- death*
Overdoses can occur when taking Xanax alone, but they commonly occur when people combine Xanax with alcohol. Combining Xanax with other medications and illegal substances can also increase the risk of overdose.
* Xanax has a
Does Xanax cause any long-term side effects?
No, Xanax is not known to cause any long-term side effects. Your doctor will prescribe Xanax at the lowest dose and for the shortest amount of time that’s effective for treating your condition. Once you stop taking Xanax, any side effects you may have had from the drug should go away.
If you have bothersome side effects that last long and you’re concerned, talk with your doctor or pharmacist. They can help you manage side effects. If needed, your doctor can suggest other treatments for your condition.
Do older adults have a higher risk of side effects from Xanax?
Yes, adults ages 65 years and older may have a higher risk of certain side effects of benzodiazepines. (This is the drug group that Xanax belongs to.) Older adults may have higher levels of Xanax in their body because their kidneys don’t work as well.
An important side effect to consider in older adults is trouble with balance and coordination. Xanax can increase the
Doctors usually prescribe lower doses of Xanax for older adults and may increase the dose slowly if needed.
Does Xanax cause any sexual side effects?
Yes, Xanax may cause sexual side effects. These include a change in sex drive. Some people report an increased sex drive, but others report a decrease.
Other side effects of Xanax that may cause sexual problems include:
- sexual dysfunction, such as impotence
- menstruation disorders, such as heavier periods or painful cramping
Are mood changes such as anger a side effect of Xanax?
Mood changes such as anger are a rare side effect of Xanax. According to studies, the following behavioral changes were reported in rare cases:
- agitation
- rage
- irritability
- aggressive or hostile behavior
The connection between anger and mood disorders, such as panic disorder and generalized anxiety disorder, isn’t well studied. One study reported that people with mood disorders may have greater feelings of anger and may not respond as well to mood disorder treatments. People who experience greater feelings of anger may also report worse mood disorder symptoms.
Learn more about some of the side effects Xanax may cause.
Risk of withdrawal and dependence
Xanax has a
As with other benzodiazepines (the drug group Xanax belongs to), people can become dependent on Xanax. Dependence occurs when your body gets used to a drug and needs it to function like usual. This can happen if you take high doses of Xanax or take it long term.
If you become dependent on Xanax, stopping it abruptly or taking a much smaller dose than you’re used to can cause withdrawal symptoms. (These are side effects caused by suddenly stopping a drug.)
Withdrawal symptoms from stopping or taking a much smaller dose of Xanax may include:
- seizures (which can sometimes be life threatening)
- trouble concentrating
- anxiety
- trouble sleeping
- headache
- nausea
Other possibly life threatening symptoms that may occur from stopping Xanax include:
- sudden and severe mental health problems
- hallucinations (seeing or hearing things that aren’t really there)
- losing touch with reality
- suicidal thoughts and behaviors
What might help
To reduce your risk of dependence and withdrawal symptoms, your doctor will lower your dose of Xanax slowly when stopping it. How slowly your dosage will be lowered and when you can stop Xanax depends on how you react to dosage changes. If withdrawal symptoms appear, your doctor will slow down your taper of the drug.
If you have withdrawal symptoms from lowering your dose or stopping Xanax, be sure to tell your doctor.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Textline at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
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Risk of severe harm or death if taken with opioids
Xanax has a
Combining Xanax (or any other benzodiazepine) with an opioid can cause severe drowsiness, trouble breathing, coma, or death. But there may be times your doctor cannot avoid prescribing both drugs for you. If this is the best alternative for your condition, they’ll limit your doses and treatment duration to the minimum.
What might help
While doctors try to avoid prescribing opioids and Xanax together, sometimes other options are not as effective for treating your condition. If you need to take Xanax and opioids at the same time, your doctor will explain the risks. They’ll also monitor you closely for signs of breathing trouble and severe sleepiness as these may require emergency medical care.
Due to the risk of extreme sleepiness, your doctor may recommend that you avoid driving or operating heavy machinery until you know how the combination of Xanax and opioids affects you.
Constipation
Constipation is a mild side effect of Xanax. Doctors suggest that dehydration and the use of benzodiazepines such as Xanax can cause constipation.
While it’s possible to have constipation with Xanax, some people may have diarrhea.
What might help
Following your doctor’s instructions for taking Xanax and not taking more than you’re prescribed can help prevent constipation.
Eating foods with a higher fiber content, drinking plenty of liquids, and getting regular exercise can help relieve constipation. Since Xanax is recommended as a short-term treatment, once you stop taking the drug, your constipation should go away.
If Xanax is causing you bothersome constipation, talk with your doctor or pharmacist. They may recommend over-the-counter laxatives to help relieve this side effect.
Weight gain or weight loss
Changes in appetite and weight can happen when taking Xanax. You may gain or lose weight, but Xanax is not a weight loss drug.
Weight changes may also be a symptom of panic disorder and generalized anxiety disorder, the conditions Xanax is used to treat.
What might help
If you’re concerned about weight changes while taking Xanax, talk with your doctor. They can offer suggestions, such as nutrition changes or exercise recommendations, to help you reach or maintain a healthy weight. And since Xanax is recommended as a short-term treatment, changes in weight may be resolved after you stop taking the drug.
Allergic reaction
Like most drugs, Xanax can cause an allergic reaction in some people. Symptoms can be mild to serious and can include:
- skin rash
- itchiness
- flushing (temporary warmth, redness, or deepening of skin color)
- swelling under your skin, usually in your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:
- an antihistamine you swallow, such as Benadryl (diphenhydramine)
- a product you apply to your skin, such as hydrocortisone cream
If your doctor confirms you’ve had a mild allergic reaction to Xanax, they’ll decide whether you should continue taking it.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Xanax, they may have you switch to a different treatment.
Keeping track of side effectsDuring your Xanax treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.
Your side effect notes can include things such as:
- what dose of the drug you were taking when you had the side effect
- how soon you had the side effect after starting that dose
- what your symptoms were
- how it affected your daily activities
- what other medications you were taking
- any other information you feel is important
Keeping notes and sharing them with your doctor will help them learn more about how Xanax affects you. They can then use this information to adjust your treatment plan if needed.
Some important things to discuss with your doctor when considering treatment with Xanax include your overall health and any medical conditions you may have.
Boxed warnings
Xanax has three
Risk of misuse and addiction. With misuse, a drug is taken in a way other than how it’s prescribed. Misuse can lead to addiction, in which a drug is taken even if it’s causing harmful effects. Misusing Xanax can cause addiction, overdose, and possibly death. For details, see the “Xanax and misuse” section below.
Risk of withdrawal and dependence. Taking Xanax can lead to dependence. (This is when your body gets used to a drug and needs it for you to function as usual.) Stopping Xanax suddenly or lowering your dose too fast can cause withdrawal symptoms. (These are side effects caused by suddenly stopping or taking too little of a drug.) With Xanax, these symptoms can be life threatening, such as seizures and suicidal thoughts and behaviors. To learn more, see the “Side effects explained” section above.
Risk of severe harm or death if taken with opioids. Taking Xanax or other benzodiazepines with opioids can result in severe drowsiness, trouble breathing, coma, and death. For more information, refer to the “Side effects explained” section above.
Other warnings
Xanax may not be right for you if you have certain medical conditions. (This is known as a drug-condition interaction.) Other factors may also affect whether Xanax is a good treatment option for you.
Talk with your doctor about your health history before starting Xanax. Factors to consider include those described below.
Liver problems. If you have liver problems, your doctor may prescribe a lower dose of Xanax for you. Because your liver helps to remove Xanax from your system, the drug can build up in your system if you have liver problems. This can increase your risk of side effects from Xanax. Tell your doctor about any liver problems you may have. If needed, they may slowly increase your dose and monitor your side effects. If you have an increase in side effects, they’ll lower your dose.
History of depression. Tell your doctor if you have a history of depression. To prevent an overdose, your doctor may limit how many tablets of Xanax you’ll receive. Benzodiazepines such as Xanax may worsen symptoms of depression and increase the risk of suicidal thoughts and behaviors. Doctors also report that people with depression that’s treated with Xanax may also have increased episodes of mania. With mania, you have high energy, abnormally elevated mood, or extreme changes in emotions.
Breathing problems. Doctors report an increase in deaths among people with severe breathing problems who were taking Xanax. If you have severe breathing problems and take Xanax, your doctor will need to monitor you closely for worsening of this condition. If signs and symptoms of worsening breathing occur, your doctor will have you stop taking this drug.
Kidney problems. If you have a history of kidney problems, your body may have trouble eliminating Xanax. This means the drug could build up in your blood, which could increase your risk of side effects. Tell your doctor if you have kidney problems. They may prescribe a lower dose of Xanax for you.
Allergic reaction. If you’ve had an allergic reaction to Xanax or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.
Older age. For adults ages 65 years and older, doctors will usually prescribe a lower dose of Xanax to start. Older adults have an increased risk of side effects from this drug. For example, because Xanax can cause trouble with balance and coordination, it can increase the risk of falls and bone fractures in older adults.
Alcohol and Xanax
Taking Xanax with alcohol can cause serious side effects, which are included in the drug’s boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
Combining Xanax and alcohol increases the risk of misuse and addiction. With misuse, a drug is taken in a way other than how it’s prescribed. Misuse can lead to addiction, in which a drug is taken even if it’s causing harmful effects.
This combination of Xanax and alcohol can lead to serious side effects. These include:
- trouble breathing
- overdose
- death
Before your doctor prescribes a benzodiazepine such as Xanax, they’ll assess your risk of misuse and addiction. If you think you have a substance abuse issue, talk with your doctor. They can help you get treatment.
If you have alcohol-related liver disease, your doctor may need to prescribe a lower dose of Xanax. With liver problems, your body can’t eliminate Xanax as well, which can lead to the drug building up in your blood. This can increase your risk of side effects.
Pregnancy and breastfeeding while taking Xanax
Xanax may not be safe to take during pregnancy depending on how far along the pregnancy is. Babies born to people who took benzodiazepines such as Xanax in the later stages of pregnancy have experienced withdrawal symptoms and extreme drowsiness. This is called neonatal sedation and withdrawal syndrome (NOWS).
Babies with NOWS may have:
- trouble breathing
- extreme fatigue (low energy)
- low muscle tone
- overactive reflexes
- irritability
- restlessness
- shaking
- excessive crying
- trouble feeding
A pregnancy registry is available for people taking Xanax during pregnancy. Reporting effects of Xanax during pregnancy helps researchers to better understand the drug’s risks if used when pregnant. Your doctor can register you by calling the National Pregnancy Registry for Psychiatric Medications at 866-961-2388.
Before starting Xanax, tell your doctor if you’re pregnant or considering pregnancy.
Breastfeeding is not safe while taking Xanax. Some reports show that babies may have intense drowsiness and withdrawal symptoms when receiving breast milk from someone taking this medication.
Tell your doctor if you’re breastfeeding or planning to breastfeed before starting Xanax. They can talk with you about the benefits and risks, and help you determine the best way to feed your baby.
Xanax belongs to a group of drugs called benzodiazepines, which have a
With misuse, a drug is taken in a way other than how it’s been prescribed. This may include taking tablets more often or taking a higher dose than prescribed. In the case of Xanax, combining it with other substances such as alcohol is another way it can be misused.
Misusing Xanax can cause addiction, overdose, and possibly death. (Addiction is when a drug is taken even if it’s causing harmful effects.) Combining Xanax with illegal drugs, alcohol, or other medications can increase the risk of serious side effects such as trouble breathing.
Before your doctor prescribes Xanax for you, they’ll evaluate your risk for misuse and addiction. If you have a history of abusing certain drugs or substances, Xanax may not be the right drug for you.
Symptoms of misuse may include:
- anxiety
- aggression
- confusion
- paranoia
- suicidal thoughts and behaviors
- seizures
- trouble breathing
- death
Your doctor will tell you about the risks of misusing Xanax, as well as which symptoms suggest misuse. If you have symptoms of misuse, talk with your doctor right away.
While side effects with Xanax are common, they usually don’t last long. But some side effects can be serious. If you’re concerned about side effects of Xanax, talk with your doctor or pharmacist. Some questions you may want to ask include:
- How do the side effects of Xanax compare with other anxiety medications such as selective serotonin reuptake inhibitors?
- Can taking Xanax cause Alzheimer’s disease?
- Can taking Xanax worsen my depression?
To learn more about Xanax, check out these articles:
- Xanax (alprazolam)
- Dosage for Xanax: What You Need to Know
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
