Xanax (Alprazolam)

Xanax treats depression, anxiety disorders, panic attacks, etc. This is a strong drug, so during treatment you must strictly follow the instruction and recommendations of the doctor to avoid side effects.

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Anti-anxiety drug Xanax. Administration Features

Xanax is a strong prescription sedative, a powerful tranquilizer (anxiolytic) that is used in medical practice to treat depression, anxiety disorders, and insomnia. It is available in tablets of different shapes and colors depending on the dosage: 0.25 mg, 0.5 mg, 1 mg, 2 mg.

Xanax contains alprazolam (belongs to the benzodiazepine class), which has a calming effect, can eliminate nervous tension, and helps relieve the symptoms of panic attacks.

The drug is also often used to relieve negative symptoms of alcohol withdrawal syndrome.

Indications for Xanax use

The main indications for the use of Xanax are:

  • Anxiety disorders accompanied by a feeling of anxiety, tension, agitation, insomnia, a sense of danger, irritability, and somatic symptoms;
  • Mixed anxiety-depressive disorders;
  • Neurotic reactive-depressive disorders accompanied by depressive affect, increasing loss of interest in the surrounding world, feelings of anxiety, psychomotor agitation, insomnia, appetite disturbances, changes in body weight, somatic disorders, feelings of inferiority or guilt;
  • Anxiety states, mixed anxiety-depressive states, neurotic reactive-depressive disorders developing against the background of somatic diseases;
  • Panic disorders, combined with or without phobic symptoms.

Administration method and dosage

The optimal dose of alprazolam is determined individually in each specific case, depending on the severity of the symptoms and the intensity of the clinical effect. The average daily dose meets the needs of most patients and is 0.5-4 mg per day. In some cases, it is allowed to increase the level of doses.

But it should be carried out with caution in order to prevent the development of side effects.

In general, patients who have not previously been treated with psychotropic drugs require lower doses than patients who have experience with tranquilizers, antidepressants, and hypnotics. Elderly patients, as well as debilitated patients, should take small doses of alprazolam since an overdose can cause the development of excessive sedation or ataxia.

The doctor should periodically assess the patient’s condition and then adjust the dose.


After taking Xanax orally, the maximum concentration of alprazolam in the plasma is observed after 1-2 hours. The average half-life is 12-15 hours. Alprazolam mainly undergoes oxidation. The main metabolites of the drug include alpha-hydroxyalprazolam and the benzophenone derivative alprazolam.

The content of these compounds in plasma remains at a very low level.

Alprazolam and its metabolites are excreted from the body with urine.

Recommendations for stopping therapy

The dose of the drug should be reduced gradually. It is recommended to reduce the daily dose by no more than 0.5 mg every 3 days. In some cases, it is necessary to lower the dose more slowly.

Features of use

Research has not proven the effectiveness of long-term Xanax usefor the treatment of anxiety. However, patients with panic attacks were effectively treated with Xanax for 8 months. Thus, the doctor must periodically evaluate the effectiveness of the drug in each specific case.

When taking alprazolam, a person may experience addiction and psychophysical dependence. This especially applies to patients with alcoholism or drug addicts, as they are prone to addiction.

Interaction with other medicinal products

Alprazolam potentiates the effect of other psychotropic compounds, anticonvulsants and antihistamines, alcohol, and other drugs that have a depressing effect on the CNS.

The pharmacokinetic interaction of benzodiazepines with other medications is well known. For example, the clearance of alprazolam and some other benzodiazepines can be slowed down when taking cimetidine or macrolide antibiotics.

It is recommended to reduce the dose when taking Xanax simultaneously with cimetidine and macrolides, such as erythromycin, as well as with fluvoxamine, fluoxetine, propoxyphene, sertraline, diltiazem, and oral contraceptives.

It is not recommended to use Xanax simultaneously with ketoconazole or other azole antifungal agents.

Side effects

Negative effects are usually observed at the very beginning of Xanax therapy and gradually disappear with further use of the drug or when the dose is reduced. Patients with anxiety, anxiety-depressive syndrome, and neurotic depression often experience drowsiness and dizziness.

Less commonly reported effects are headache, depression, blurred vision, insomnia, nervousness/anxiety, tremors, weight changes, memory impairment, incoordination, gastrointestinal disturbances, and autonomic manifestations.

Along with this, undesirable phenomena such as dystonia, irritability, anorexia, fatigue, muscle weakness, changes in libido, menstrual disorders, urinary incontinence, and liver dysfunction may also occur. An increase in intraocular pressure is very rare.