Xanax (Alprazolam) Side Effects

Xanax (alprazolam) is a prescription medication classified as a benzodiazepine that is commonly used to treat anxiety disorders, symptoms of anxiety, and panic disorder. This page will explain the short- and long-term side effects of Xanax, including how Xanax affects the brain and body and whether Xanax side effects are reversible.

Xanax Side Effects

Individuals who take Xanax for a short period of time to address a medical issue are far less likely to experience serious side effects of Xanax than individuals who use or misuse the drug on a long-term basis.

Moreover, those who misuse benzodiazepines commonly take them with other drugs; generally, the benzodiazepine drug (e.g., Xanax) is not their primary drug of use.  This can complicate any effects that are associated with long-term Xanax misuse.

What Are the Short-Term Effects of Xanax?

The short-term effects of Xanax are typically short-lived. If the individual only uses Xanax for a short period of time, it will not result in any significant issues in most cases. All drugs are associated with potential side effects that can occur in some individuals, and some of the side effects of Xanax include:

  • Nausea.
  • Paradoxical anxiety (with the drug actually producing the symptoms it is designed to control).
  • Lethargy.
  • Confusion.

In some individuals, Xanax use may produce an allergic reaction, such as swelling of the lips, hives, anxiety, or rapid heartbeat. These individuals should immediately stop using the drug and consult a physician. Xanax side effects and allergic reactions are relatively rare when the drug is used according to the prescription instructions.

When used in conjunction with other drugs that are central nervous system depressants (e.g., other benzodiazepines, alcohol) or narcotic pain medications, the side effects of Xanax may be amplified, whereas when used in conjunction with drugs that have opposite mechanisms of action, such as cocaine or other stimulants, it may result in adverse reactions.

Mixing Xanax with other drugs can create negative drug interactions that can produce atypical effects not normally associated with either drug.

According to professional sources, such as the four-volume set The Neuropathology of Drug Addictions and Drug Abuse, the short-term effects of Xanax use and misuse include:

  • Sedation.
  • A significant reduction in anxiety or the subjective experience of perceived stress.
  • Lightheadedness.
  • A reduction in the speed of thinking processes.
  • A reduction in reflex actions.
  • A reduction in impulse control.
  • A reduction in the ability to make rational decisions.
  • Decreases in rates of respiration, heart rate, and blood pressure.
  • A rapid development of tolerance.

What Are the Long-Term Side Effects of Xanax?

The continued use of Xanax or any benzodiazepine results in alterations in the central nervous system and the peripheral nervous system. When the drug is used for medicinal reasons such as for the control of seizures or anxiety, doses are typically controlled, and the long-term effects of these alterations are not as significant as the long-term alterations that occur in individuals who misuse Xanax.

People who misuse Xanax typically:

  • Take higher amounts of the drug than individuals who are prescribed it.
  • Use it in conjunction with other drugs.
  • Take it more frequently, often bingeing on the drug.

It should be noted that every medication changes the body or brain in some way. Medications alter the functioning of a person’s system according to their specific mechanism of action. When the system is altered artificially by the use of a medication or misuse of a drug, there are going to be potential long-term changes.

Some of the changes associated with long-term use or misuse of Xanax include:

  • Changes in the neuropathways of the brain.
  • Potential changes in behavior.
  • Susceptibility to chronic conditions or diseases as a result of the drug’s mechanism of action.
  • Increased tolerance that can lead to the development of physical dependence.

Xanax Side Effects in Elderly Individuals

According to research studies , elderly individuals may be prescribed benzodiazepines for the treatment of anxiety or for sleep at a higher rate than would be expected. The potential effects of Xanax misuse are enhanced in older individuals due to differences in the metabolism of older people compared to younger people.

Xanax may have a longer duration (remain in the system longer) in elderly individuals than it does in younger individuals. This can lead to numerous potential risks for this group. Elderly individuals may be at an increased risk for:

  • Cognitive issues, such as problems with attention and the ability to form new memories.
  • Increased sedation and lethargy that can result in problems with coordination, decreased reflex actions, and accidents.
  • Cardiac and respiratory issues.
  • Gastrointestinal issues, such as diarrhea, which can lead to dehydration.
  • Atypical neurological effects, such as tremors, headache, vertigo, and double vision.
  • Psychological issues, such as anxiety and depression.

Elderly individuals are often on numerous medications, and there may be numerous interactions that can exacerbate the above effects. The use of prescription medications may also be something that elderly individuals are more comfortable with, and they may rely on medications for issues that do not require them. This can result in significant issues, including the rapid development of tolerance and potential physical dependence on Xanax.

How Xanax Affects the Brain

The changes in the neuropathways of the brain that occur as a result of long-term Xanax misuse include, but are not limited to:

  • A decrease in the number of neuron receptors for inhibitory neurotransmitters like gamma-aminobutyric acid (GABA), referred to as down regulation.
  • An increase in the number of neurons that are associated with neurotransmitters that produce the opposite effects of Xanax, referred to as upregulation.
  • Significant alterations in the pathways of the so-called reward center of the brain associated with the reinforcing effects of the drug, leading to positive associations with use of the drug.
  • Tertiary effects due to other variables, such as changes in behavior, alterations in appetite, and changes in the sleep cycle.

Cognitive & Behavioral Side Effects

The potential behavioral problems that can be associated with use of Xanax can be numerous and depend on the context in which the drug is regularly used. Alterations in the pathways of the brain can extend to other areas of the brain that are not associated with the drug’s medicinal effects, particularly in those who misuse of the drug.

There are numerous potential cognitive and behavioral issues that can occur as a result of chronic Xanax misuse, and these can include:

  • Long-term issues with attention and concentration.
  • Issues with the ability to form new memories and retain information.
  • Issues with problem-solving and judgment.
  • Issues with impulse control, especially controlling emotions.
  • An increased susceptibility to stress.
  • Cravings to use Xanax.
  • Physical dependence on Xanax.
  • The development of a substance use disorder.
  • Behavior alterations, such as not being able to control use of the drug and continuing to use the drug in spite of experiencing negative consequences.
  • Other psychological issues, such as anxiety, depression, and stress.
  • Increased vulnerability to be the victim of a crime or to commit a crime.

How Xanax Affects the Body

Regardless of whether a person uses Xanax as prescribed by their physician or they misuse the drug, there can be serious physical consequences of long-term Xanax use. One such effect on the body, as Xanax is taken over time, is the development of physical dependence on the drug.

There are no reliable estimates of the number of individuals who develop physical dependence on benzodiazepines. In fact, the research suggests that many individuals who have developed physical dependence on a benzodiazepine like Xanax may be unaware that they have done so. It is important to remain under a doctor’s supervision if you are prescribed Xanax.

For people who misuse Xanax, the development of physical dependence can be a serious and potentially dangerous issue. This is because many of these individuals begin to use Xanax and other drugs to avoid the early signs of the withdrawal syndrome, which will often include:

  • Anxiety.
  • Aches and pains.
  • Nausea.
  • Jitteriness.
  • Fever or chills.
  • Other flulike symptoms.

When individuals begin to experience these symptoms, they may become desperate and use Xanax in dangerous situations or take extreme measures to get drugs to treat the symptoms of withdrawal.

Withdrawal from benzodiazepines like Xanax is known to produce seizures in some individuals, and seizures can produce significant brain damage and can even be fatal. Because Xanax is often used in conjunction with other drugs and it has a relatively short half-life, individuals may begin to experience mild withdrawal symptoms within 24 hours after discontinuing it if they have developed significant physical dependence on it.

Other potential physical vulnerabilities associated with long-term misuse of Xanax include the following:

  • Respiratory issues can develop as a result of chronic respiratory suppression produced by the drug. Respiratory issues can exacerbate any of the above issues and increase vulnerabilities for the development of other potential health conditions, including contracting many infectious diseases.
  • Long-term benzodiazepine misuse is associated with potential cardiac problems, including blood pressure issues, heartbeat irregularities, and an increased potential for heart attack and stroke.
  • Other organ systems, such as the liver and kidneys, can be damaged by chronic misuse of Xanax and polysubstance misuse.
  • People with substance use issues are at an increased risk to develop numerous other physical health issues, including different forms of cancer.
  • People with substance use issues have significantly higher early mortality rates than individuals who do not misuse drugs or alcohol.

Are the Side Effects of Xanax Reversible?

When a person takes any medication for a significant length of time, there are changes that occur in the central nervous system, and these changes will remain to some extent, even after extended abstinence.

This is why individuals who have substance use disorders and have developed physical dependence on a substance will often experience a more rapid decline during a relapse, even after a long period of abstinence, than they did when they originally started using their substance of choice.

Extended abstinence can weaken the changes to the pathways in the brain, and new alterations in the brain can help to circumvent these older issues, but for most individuals with prior substance use disorders, especially with severe and chronic substance use disorders, there are always some residual effects even after years of abstinence.

The actual extent of any residual effects will vary significantly from person to person, and will be contingent on various factors, including how long they used the drug, how much of it they typically took, whether they mixed it with other drugs, their own metabolism, and other physical factors.

Many of the cognitive and behavioral issues that occur as a result of Xanax misuse will also resolve to some extent. Respiratory issues, cardiac issues, and problems in other organ systems can also resolve, depending on the extent of damage.

Damage to an individual’s career, personal relationships, and educational goals may or may not be reversible, depending on the situation. Long-term treatment is designed to help individuals cope with these issues and institute positive changes.

How to Quit Xanax Safely

If you or your loved one is struggling with Xanax misuse, treatment programs are available. Due to the potentially serious risks associated with Xanax withdrawal, a medical detox is recommended to ensure a person’s safety and comfort.

While a medical detox program can greatly help a person begin their recovery process, further treatment may be necessary to support long-term recovery.

Substance use treatment beyond detox for Xanax misuse can help clients:

  • Remain abstinent.
  • Develop new goals and coping methods.
  • Build a support system.
  • Obtain a new outlook on life.

Continued participation in treatment is one of the most important factors for a successful recovery. Participating in treatment-related activities following detox can help a person institute lasting positive changes.

At Recovery First—a drug rehab near Miami, FL—we offer several levels of addition treatment which include inpatient and outpatient programs customized for your individual needs.

Call us at to learn more about the treatment admissions process, how to pay for rehab, and what your insurance coverage for rehab is. To instantly verify your insurance coverage for substance use treatment, simply complete the secure .

You are not alone. Please reach out for help today. Our compassionate admissions navigators are available 24/7 to answer your questions and support your first steps toward recovery.

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