Xanax Side Effects: An Overview
Xanax is the brand name for alprazolam, a prescription medicine belonging to a group of medicines called benzodiazepines. It is primarily used for certain anxiety and panic disorders.
Although Xanax can help reduce severe anxiety symptoms when prescribed appropriately, it can also cause side effects. Some are relatively common and may improve as the body adjusts to treatment, while others can be serious and require urgent medical attention.
Understanding Xanax side effects is particularly important because benzodiazepines can cause tolerance, dependence and withdrawal problems, especially when they are taken for longer periods or differently from how they were prescribed.
Important: Xanax should only be taken exactly as prescribed by a qualified healthcare professional. Do not increase your dose, take it more frequently, or stop suddenly without medical advice.
What Is Xanax?
Xanax is the brand name for alprazolam, a benzodiazepine that affects activity in the central nervous system.
It enhances the effects of gamma-aminobutyric acid (GABA), a neurotransmitter involved in reducing excessive nervous-system activity.
This can produce effects such as:
- Reduced anxiety
- Relaxation
- Drowsiness
- Reduced nervous-system activity
Because of these effects, Xanax can be effective for certain patients but also carries risks, including sedation, impaired coordination and dependence.
If you want to understand how Xanax works before looking at its potential adverse effects, read our guide to what Xanax is used for and how it works.
What Are the Most Common Xanax Side Effects?
Some of the more commonly reported side effects associated with alprazolam include:
- Drowsiness
- Dizziness
- Fatigue
- Difficulty concentrating
- Problems with coordination
- Memory difficulties
- Slurred speech
- Changes in appetite
- Dry mouth
- Constipation
Not everyone experiences these effects, and their severity can vary.
Drowsiness and impaired coordination can be particularly important because they may affect activities requiring alertness, such as driving or operating machinery.
1. Drowsiness and Sleepiness
Feeling sleepy is one of the better-known effects of Xanax.
Because alprazolam reduces activity in the central nervous system, some people may feel:
- Sleepy
- Less alert
- Slower to react
- More relaxed
- Tired during the day
If you feel unusually sleepy after taking Xanax, avoid driving or performing activities that require full concentration until you know how the medicine affects you.
2. Dizziness and Poor Coordination
Xanax can cause dizziness or problems with coordination.
This may increase the risk of falling, particularly in older adults.
If you experience significant dizziness, sit or lie down somewhere safe and speak with a healthcare professional if the symptom is persistent or severe.
3. Memory and Concentration Problems
Benzodiazepines can affect memory and cognitive function.
Some people may notice:
- Forgetfulness
- Difficulty concentrating
- Confusion
- Slower thinking
- Problems remembering events
These effects may be more concerning if they interfere with work, education, driving or everyday activities.
If anxiety itself is affecting your concentration or daily functioning, our guide to what anxiety feels like explains some of the symptoms people commonly experience.
4. Fatigue and Weakness
Some people taking Xanax may experience tiredness or weakness.
This can be particularly noticeable when treatment is first started or after a dose change.
If fatigue is persistent or interferes with normal activities, discuss it with your prescriber rather than changing the dose yourself.
5. Xanax and Appetite Changes
Changes in appetite can occur in some people taking alprazolam.
However, Xanax should not be used as a weight-loss medication.
Unexpected or significant changes in weight or appetite should be discussed with a healthcare professional.
Serious Xanax Side Effects
Although serious reactions are less common, it is important to recognise warning signs.
Seek urgent medical attention if you experience symptoms such as:
- Severe difficulty breathing
- Extreme sedation or inability to stay awake
- Loss of consciousness
- Severe confusion
- Serious allergic reaction
- Significant problems with coordination
- Unusual behavioural or mental changes
The risk of dangerous sedation and breathing problems becomes particularly important when Xanax is combined with other central nervous system depressants.
Xanax and Breathing Problems
One of the most important safety concerns is excessive central nervous system depression.
The risk can increase when Xanax is combined with opioids, alcohol or other medicines that cause sedation.
Combining these substances can result in profound sedation, respiratory depression, coma or death.
For this reason, patients should tell their healthcare professional about all medicines, supplements and substances they use.
Never combine Xanax with alcohol or other sedating medicines unless a healthcare professional has specifically advised that the combination is appropriate.
For authoritative information about the serious risks associated with benzodiazepines and their combination with opioids, see the FDA’s benzodiazepine safety information.
Can Xanax Cause Dependence?
Yes. Xanax can cause physical dependence, particularly when used regularly over an extended period.
Dependence is not necessarily the same thing as addiction.
A person who becomes physically dependent may experience withdrawal symptoms if the medication is suddenly stopped.
This is one reason Xanax should not be discontinued abruptly after regular use.
Xanax Withdrawal Symptoms
Stopping Xanax suddenly after regular use can result in withdrawal symptoms.
Possible symptoms include:
- Anxiety
- Irritability
- Restlessness
- Difficulty sleeping
- Tremors
- Sweating
- Difficulty concentrating
- Sensitivity to light or sound
- Muscle aches
In severe cases, benzodiazepine withdrawal can cause seizures and other serious complications.
For this reason, someone who has been taking Xanax regularly should speak with their healthcare professional before stopping treatment.
A clinician may recommend gradually reducing the dose rather than stopping suddenly.
Xanax Long-Term Side Effects
Long-term benzodiazepine use requires careful medical supervision.
Potential concerns can include:
- Physical dependence
- Tolerance
- Cognitive effects
- Memory problems
- Persistent drowsiness
- Falls and injuries
- Withdrawal symptoms when treatment is reduced
Long-term treatment may sometimes be clinically appropriate, but the benefits and risks should be regularly reviewed by a healthcare professional.
Does Xanax Cause Weight Gain?
Weight changes are not considered one of the primary effects of Xanax, but some people may notice changes in appetite, activity levels or weight while taking medication.
If you experience unexplained or significant weight gain or loss, consider discussing it with your healthcare professional.
It is also important not to use Xanax specifically to influence body weight.
Does Xanax Make You Sleepy?
Yes, Xanax can cause drowsiness and sedation.
This is one reason people should be cautious about driving, cycling, operating machinery or performing other activities requiring alertness after taking it.
The degree of sleepiness can vary depending on factors such as:
- Individual sensitivity
- Dose
- Other medicines
- Alcohol consumption
- Age
- Other health conditions
If excessive sleepiness occurs, contact your healthcare professional for advice.
Xanax and Alcohol: Why Is the Combination Dangerous?
Combining Xanax with alcohol can increase central nervous system depression.
Both substances can cause sedation, and taking them together can make the effects considerably more dangerous.
Potential consequences include:
- Extreme sleepiness
- Poor coordination
- Confusion
- Loss of consciousness
- Breathing difficulties
- Coma
- Death
Avoid alcohol while taking Xanax unless your healthcare professional has specifically told you otherwise.
Xanax Interactions With Other Medicines
Xanax can interact with other medicines.
Examples can include medicines that:
- Cause sedation
- Affect breathing
- Influence liver enzymes responsible for metabolising alprazolam
- Have effects on the central nervous system
Particular caution is required with opioid medicines because the combination can increase the risk of severe sedation and respiratory depression.
Always provide your prescriber or pharmacist with a complete list of medicines and supplements you are taking.
Who May Need Extra Caution With Xanax?
Xanax may require particular consideration in people with certain medical circumstances.
Examples include people with:
- Breathing problems
- Liver disease
- A history of substance misuse
- Older age
- A history of falls
- Other medicines that cause sedation
This does not necessarily mean that Xanax cannot be prescribed, but it may mean that additional monitoring or a different treatment approach is appropriate.
How Long Do Xanax Side Effects Last?
The duration of side effects varies between individuals.
Some effects, such as drowsiness or dizziness, may occur relatively soon after taking the medicine and gradually wear off.
However, the duration can depend on:
- Dose
- Frequency of use
- Individual metabolism
- Age
- Other medicines
- Liver function
- Whether the person is new to benzodiazepines
If side effects are severe, persistent or getting worse, contact a healthcare professional.
When Should You Seek Medical Help?
Contact a healthcare professional if Xanax side effects are persistent or interfere with your daily activities.
Seek urgent medical attention for symptoms such as:
- Difficulty breathing
- Extreme sedation
- Loss of consciousness
- Severe confusion
- Serious allergic symptoms
- Seizures
If someone has taken Xanax together with opioids, alcohol or another sedating substance and is difficult to wake or having trouble breathing, seek emergency medical help immediately.
How Can Xanax Side Effects Be Reduced?
Do not attempt to change your Xanax treatment independently.
Instead:
Take it exactly as prescribed
Follow the instructions provided by your prescriber.
Avoid alcohol
Alcohol can increase sedation and other risks.
Be careful with other medicines
Tell your healthcare professional about all medicines and supplements you take.
Do not drive if impaired
If Xanax makes you sleepy, dizzy or less alert, avoid driving and potentially dangerous activities.
Never stop suddenly after regular use
Speak with your healthcare professional about a safe discontinuation plan.
Frequently Asked Questions About Xanax Side Effects
What are the most common side effects of Xanax?
Common effects can include drowsiness, dizziness, fatigue, impaired coordination and problems with concentration or memory.
Can Xanax make you tired?
Yes. Drowsiness and fatigue can occur because Xanax reduces activity in the central nervous system.
Can Xanax cause dizziness?
Yes. Dizziness and impaired coordination are recognised potential effects.
Can Xanax affect memory?
Yes. Benzodiazepines can affect memory and cognitive function, particularly in some people.
Can Xanax cause dependence?
Yes. Regular use can result in physical dependence. This is why Xanax should be used exactly as prescribed and should not be stopped abruptly after regular use.
What happens if you suddenly stop Xanax?
Sudden discontinuation after regular use can cause withdrawal symptoms. Severe withdrawal can include seizures, so medical guidance is important.
Can you drink alcohol while taking Xanax?
Alcohol can increase Xanax’s sedative effects and may create serious risks. It is safest to avoid combining them unless specifically advised otherwise by a healthcare professional.
Is Xanax addictive?
Xanax has a risk of misuse, addiction and physical dependence. The risk can be higher when it is used differently from prescribed, at higher doses or for longer than recommended.
Can Xanax cause breathing problems?
Xanax can contribute to respiratory depression, particularly when combined with opioids or other central nervous system depressants.
Final Thoughts
Xanax side effects range from relatively common effects such as drowsiness and dizziness to potentially serious problems involving excessive sedation, breathing difficulties and dependence.
Because alprazolam is a benzodiazepine, it should be taken exactly as prescribed. Combining it with alcohol, opioids or other sedating substances can be particularly dangerous.
If you are experiencing troublesome side effects, do not simply increase, decrease or stop your medication without professional guidance. A healthcare professional can assess your symptoms and determine whether your treatment needs to be changed.
Understanding the benefits and risks of Xanax is an important part of using prescription anxiety medication safely.