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How does Xanax make you feel?

Medically reviewed by Sally Chao, MD. Last updated on July 5, 2021.

Official answer

by Drugs.com

When taken as prescribed, Xanax (alprazolam) can help people with anxiety disorders or panic attacks by promoting a feeling of calm. Xanax is in a class of drugs called benzodiazepines, known on the street as benzos and by other names. It works by slowing the activity of your central nervous system, which may help you feel calm and free from worry and panic.

Xanax is a depressant and boosts the effects of a chemical in the brain called gamma-aminobutyric acid, which results in calmness and feeling relaxed. For many people, the drug helps curb anxiety and promote sleep.

It can also make you feel drowsy and lightheaded and may make you less mentally alert, so operating machinery and motor vehicles is not recommended while taking Xanax until you know how it makes you feel.

Other side effects of Xanax can include:

  • Dry mouth
  • Irritability
  • Impaired memory
  • Libido changes
  • Constipation

Signs of a Xanax overdose can include:

  • Extreme sleepiness
  • Problems with coordination
  • Confusion
  • Decreased use of reflexes
  • Coma

An overdose can result in death.

Xanax is often prescribed for the temporary relief of anxiety symptoms, but it isn't recommended for long-term use, as this can lead to addiction and serious side effects related to withdrawal, including seizures.

It's also a drug that's often abused. It's not an opioid, but it is sometimes mixed with them and has been found in many patients who overdose on opioids.

Xanax effects happen fast

Xanax is intended to be taken only for a short time. It acts quickly to relieve anxiety, but can become habit-forming if taken over a long period. The effects of Xanax happen fast, usually within an hour. Xanax is short-acting, and half of it is gone within about 11 hours. Xanax is typically taken three times a day.

Usually, Xanax is taken to treat transitory feelings of anxiety or until the effect of an antidepressant such as selective serotonin reuptake inhibitors (SSRIs) kicks in. SSRIs can take up to six weeks to be fully effective.

Mixing Xanax with other drugs or alcohol

Despite its benefits, Xanax can be dangerous. It's not good to mix Xanax and alcohol, as both are central nervous system depressants and slow the activity of the brain. Mixing alcohol and Xanax can raise your risk of experiencing more severe side effects of the drug, such as dizziness, slowed breathing and extreme sleepiness.

It's also not recommended for people with addiction problems and suicidal tendencies.

People who should not take Xanax also include:

  • Those who are prescribed certain antifungal medications, such as itraconazole or ketoconazole
  • Those who have an allergy to alprazolam, the active ingredient in Xanax, or any of the other ingredients in Xanax
  • Those who have an allergy to other benzodiazepine medications

Those taking nefazodone, fluvoxamine or cimetidine should avoid taking Xanax or make sure their dosage is adjusted before use, as these medications can raise the concentration of Xanax in the body and raise the risk of experiencing side effects.

If your doctor prescribes Xanax, be sure you mention all the other drugs you are taking and the dose because this can affect how the Xanax will react in your system and how the drugs you are already taking will react to Xanax. This includes opiate medications for cough or pain.

Xanax is especially dangerous when taken with opioids. Opioids are typically prescribed to relieve pain. A 2016 study in Pain Medicine found that overdose death rates among patients taking opioids and benzodiazepines together were 10 times higher than among those only taking opioids.

Because of the dangers of mixing these drugs, in 2020 the U.S. Food and Drug Administration (FDA) began to require "black box" warnings on the labels of benzodiazepines and opioids that warn of the dangers of using these drugs together. The Centers for Disease Control and Prevention recommends that doctors avoid prescribing Xanax and other benzodiazepines with opioid pain medication.

Potential for abuse

Xanax is a controlled substance. The active ingredient alprazolam is a Schedule IV controlled substance, which is less likely to be abused than a Schedule III drug, but it still has the potential for abuse.

For people who become addicted to Xanax or stop taking the drug suddenly, getting off the drug can be as difficult as breaking any drug habit. Symptoms of withdrawal can include:

  • Increased sensory perception
  • Concentration impairment
  • Loss of the sense of smell
  • Brain fog
  • Tingling
  • Muscle cramps
  • Muscle twitches
  • Diarrhea
  • Blurred vision
  • Decreased appetite
  • Weight loss

Other withdrawal symptoms can include anxiety and insomnia.

Bottom line

Xanax is an effective but potentially dangerous drug. It is safe when taken as prescribed for the temporary relief of anxiety and panic attacks, but it isn't a long-term solution. It can also be addictive and abused. The FDA warns doctors to prescribe Xanax carefully, and advises the smallest dose for the shortest period.

References
  1. National Institute on Drug Abuse (NIDA).  Benzodiazepines and Opioids. February 3, 2021. Available at: https://www.drugabuse.gov/drug-topics/opioids/benzodiazepines-opioids. [Accessed June 7, 2021].
  2. U.S. Food and Drug Administration (FDA). Xanax. September 2016. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf. [Accessed June 7, 2021].
  3. U.S. National Library of Medicine DailyMed. Label: XANAX-alprazolam tablet. June 6, 2021. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=388e249d-b9b6-44c3-9f8f-880eced0239f. [Accessed June 7, 2021].
  4. Reissig CJ, Harrison JA, Carter LP, Griffiths RR. Inhaled vs. oral alprazolam: subjective, behavioral and cognitive effects, and modestly increased abuse potential. Psychopharmacology (Berl). 2015;232(5):871-883. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326558/
  5. Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A Review of Alprazolam Use, Misuse, and Withdrawal. J Addict Med. 2018;12(1):4-10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/
  6. Anxiety and Depression Association of America (ADAA). SSRIs and Xanax. May 26, 2021. Available at: https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/ssris-and-benzodiazepines-general-anxiety. [Accessed June 7, 2021].
  7. U.S. National Library of Medicine MedlinePlus. Alprazolam. May 15, 2021. Available at: https://medlineplus.gov/druginfo/meds/a684001.html. [Accessed June 24, 2021]
  8. Dasgupta N, Jonsson Funk M, Proescholdbell S, et al. Cohort Study of the Impact of High-Dose Opioid Analgesics on Overdose Mortality. Pain Medicine. 2016 January;17(1):85-98. https://doi.org/10.1111/pme.12907

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