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Xanax: uses, dosage, side effects and composition

Description and composition of Xanax

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Xanax is a medication used to treat anxiety and panic disorders as approved by the FDA. It has other indications that are not approved by the FDA.

It contains alprazolam as its active ingredient. It also contains inactive ingredients called excipients in sufficient quantities.

Alprazolam belongs to a class of medications called Benzodiazipines. Benzodiazipines are central nervous system depressants and they bring about calmness, drowsiness and sleep when taken in their recommended doses.

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Xanax comes in different strengths and in different oral dosage forms. The commonly available oral dosage forms of it include the following:

  • Concentrate of 1mg/ml
  • Tablets:
    • Normal tablets:  0.25mg, 0.5mg, 1mg, and 2mg
    • disintegrating tablets: 0.25mg, 0.5mg, 1mg, and 2mg
    • Extended release tablets: 0.5mg, 1mg, 2mg and 3mg

Uses of Xanax

Xanax is used for the treatment of the following conditions:

  1. Anxiety disorders (FDA approved indication)
  2. Panic disorder (FDA approved indication)
  3. Depression
  4. Insomnia
  5. Alcohol withdrawal
  6. Other uses

1. Anxiety disorders

One of the main uses of Xanax is for the treatment of anxiety disorders, which includes generalized anxiety disorder, panic disorder, social anxiety disorder, and obsessive-compulsive disorder.

Generalized anxiety disorders is characterized by persistent and excessive worry about a variety of everyday situations.

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In people with generalized anxiety disorders, this medication works by decreasing the symptoms of anxiety, including worry, nervousness, and muscle tension as it enhances the inhibitory activity of GABA.

2. Panic disorders

Panic disorders are characterized by recurrent panic attacks, which are sudden, intense episodes of fear or discomfort.

Alprazolam is used to treat panic disorders by reducing the frequency and intensity of panic attacks.

It helps to relax the muscles and decrease feelings of anxiety, making it easier for patients to manage their panic symptoms.

3. Depression

Alprazolam is also used for the treatment of depression, especially when it is accompanied by anxiety.

Depression is a common mental health disorder that can cause feelings of sadness, loss of interest in life and things one used to enjoy, and decreased energy levels.

In depressed patients, Alprazolam works by enhancing the effects of neurotransmitters in the brain that are responsible for regulating mood, leading to an improvement in symptoms of depression.

4. Insomnia

Alprazolam can also be used to treat insomnia, or difficulties in falling asleep.

It helps to reduce anxiety and nervousness, which can cause difficulties in falling or staying asleep.

Drowsiness is a common side effect of this medication. This effect is often utilized in treating people with insomnia.

5. Alcohol withdrawal

Alprazolam is also used for the treatment of alcohol withdrawal.

Alcohol abuse can lead to physical dependence and withdrawal symptoms such as tremors, agitation, and anxiety.

Alprazolam helps to relieve these symptoms by reducing nervousness and relaxing the muscles, making it easier for patients to manage their withdrawal symptoms.

6. Other uses of Xanax (not FDA approved)

Xanax has a number of other uses which include the following: treatment of premenstrual syndrome, acute stress reactions, and post-traumatic stress disorder (PTSD).

Additionally, it is sometimes used as a muscle relaxant to treat conditions such as muscle spasms and tremors.

How Xanax works

The exact way through which Xanax works is not known. However, it is believed to work by enhancing the inhibitory activity of GABA in the brain. 

GABA is an inhibitory neurotransmitter that slows down the activities of nerve cells in the brain, helping to calm the brain and reduce feelings of anxiety.

Its enhancement leads to a reduction in anxiety, nervousness, and other symptoms associated with these conditions. 

Dosage of Xanax

1. Adult dose for anxiety

The recommended starting dose of Xanax for adults with anxiety is 0.25 to 0.5mg, taken three times a day.

This can be increased gradually to a maximum of 4mg per day, as needed.

It is important to never exceed the recommended dose, as overdosing can lead to serious side effects and dependence.

Additionally, it is important to never suddenly stop taking this medication, as it can cause withdrawal symptoms.

2. Adult dose for panic disorder

The recommended starting dose of Xanax for adults with panic disorder is 0.5mg of immediate release or orally disintegrating tablets, taken three times a day.

Three times a day is equivalent to 8 hourly dosing schedule.

This dosage can be increased gradually to a maximum of 10 mg per day, as needed.

Please note the difference in the dosage for the two conditions (anxiety and panic disorders).

Note also that the maximum daily dosage differs in the two conditions.

Side effects of Xanax

Just like every medication, Xanax has got some side effects. Some of these side effects are mild and quickly resolve as you continue taking the medication.

However, you can experience serious and life-threatening side effects while taking alprazolam as well, especially when you take an overdose or combine it with some medications not recommended by your doctor.

In situations where you experience serious and life-threatening side effects while on any medication, including alprazolam, seek immediate medical help.

The following are the common side effects associated with alprazolam:

  1. Drowsiness
  2. Dizziness
  3. Cognitive dysfunction
  4. Depression
  5. Difficult in urinating
  6. Dysarthria
  7. Dry mouth
  8. Light-headedness
  9. Ataxia
  10. Constipation
  11. Fatigue
  12. Headache
  13. Memory impairment
  14. Menstrual disease: absent, missed, or irregular menstrual periods.
  15. Nervousness
  16. Skin rash
  17. Tremor
  18. Weight gain or loss
  19. Anxiety
  20. Blurred vision
  21. Diarrhea
  22. Insomnia
  23. Decreased libido
  24. Increased appetite

1. Drowsiness

One of the most common side effects of alprazolam is drowsiness. This can make it difficult for one to concentrate, stay awake, and complete everyday tasks.

In some cases, drowsiness can be severe enough to make it dangerous to drive or operate heavy machinery.

Whether severe or not, if you experience drowsiness while taking alprazolam, you should avoid engaging in activities that require a lot of mental alertness and concentration.

2. Dizziness

Another common side effect of alprazolam is dizziness. This can occur when you stand up too quickly, or when you engage in activities that require a lot of physical coordination.

In some cases, dizziness can be severe enough to cause you to fall or lose your balance.

Just as we recommended under drowsiness, if you experience dizziness while taking alprazolam, you should avoid engaging in activities that require a lot of physical activity.

3. Cognitive dysfunction

Patients placed on alprazolam can be disoriented in time and space. If this happens, please know that it is one of the side effects of this medication.

Alprazolam can also cause memory problems, especially in the elderly.

This can make it difficult to remember things, such as the names of people, the location of objects, or recent events.

If you experience memory problems while taking alprazolam, you should discuss this with your doctor, as it may be a sign that the dose is too high.

4. Depression

Another side effect of alprazolam is depression.

While this medication is used to treat anxiety, it can also have the opposite effect and make you feel more sad, hopeless, and unmotivated.

If you experience depression while taking alprazolam, you should speak with your doctor, as they may need to adjust your dose or switch you to a different medication entirely.

5. Difficult in urinating

Alprazolam can make it difficult for those taking it to pass urine.

6. Dysarthria

People on alprazolam can experience difficult or unclear articulation of speech that is otherwise linguistically normal.

This side effect is medically called dysarthria.

7. Dry mouth

Producing little saliva is one the side effects of alprazolam. This leads to dry mouth among those taking the medication.

8. Light-headedness

If you’re taking alprazolam, it might make you feel woozy or like you might faint.

If you do feel this way and you are on this medication, note that it is normal and the feeling is expected to wear off as you continue taking the medication.

But then, seek immediate medical attention if it is serious.

9. Ataxia

Alprazolam use is associated with impaired balance or coordination (clumsy voluntary movement) in some patients.

If you are among those who experience ataxia while on this medication, speak to your doctor immediately if it is serious or of concern to you.

10. Constipation

Alprazolam can make you constipated. It is therefore recommended that you consume things that will counteract this effect.

Eating foods rich in fibre and consuming enough fluid is highly recommended here, if you do have constipation while taking alprazolam.

11. Fatigue

Taking alprazolam can make you have feelings of tiredness, weakness, and exhaustion that can be physical, mental, or both.

You may also experience lack of energy and difficulty in performing everyday tasks and activities, even after getting enough sleep.

12. Headache

You may have headache if you are on alprazolam as it is one of its common side effects.

If it becomes persistent, consult your doctor; he may recommend that you take acetaminophen to calm the headache.

Other side effects associated with alprazolam are:

  1. Memory impairment
  2. Menstrual disease: absent, missed, or irregular menstrual periods.
  3. Nervousness
  4. Skin rash
  5. Tremor
  6. Weight gain or loss
  7. Anxiety
  8. Blurred vision
  9. Diarrhea
  10. Insomnia
  11. Decreased libido
  12. Increased appetite

If you experience any of these side effects while taking alprazolam, especially if they are serious or persistent, you should talk to your doctor, as they may need to adjust your dose or switch you to a different medication entirely.

Xanax use in pregnancy

Xanax is contraindicated in pregnancy.

It is in pregnancy category D.

Taking it during pregnancy  can lead to adverse pregnancy, spontaneous abortion, low birth weight and giving birth to a baby who be needing immediate medical attention after delivery.

Can a breastfeeding woman take Xanax?

It is not recommended to take Xanax while nursing a baby.

This is because this medication is secreted in the breast milk, although in a small amount, but it can be harmful to your baby especially if your baby has an impaired ability to metabolize it.

In this situation, your baby may demonstrate sedation and poor feeding that can be harmful.

Since you wouldn’t know if your baby can properly metabolise alprazolam, it is better avoided during breastfeeding.

For more information on the use of alprazolam during pregnancy and breastfeeding, please read ACOG Guidelines on Psychiatric Medication Use During Pregnancy and Lactation

Contraindications of Xanax

Xanax should not to be taken by patients who are hypersensitive or allergic to it or other benzodiazepines.

Patients with acute narrow angle glaucoma should not take it also.

Alcohol should be avoided totally by patients on this medication. This is because both of them cause depression. Taking two of them together can cause severe sedation, respiratory depression, loss of consciousness, or death.

Patients who are taking other medications know to cause central nervous system depression should have their dose of alprazolam adjusted. You can get the list for these medications from your pharmacist.

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