How Long Does Xanax Last?

With more than 20 percent of the United States population suffering from anxiety disorders, it’s no wonder that many people are looking to ease their symptoms.

More than 40 million adults in the United States are diagnosed with an anxiety disorder, making it the most common mental illness in the country.

Although anxiety disorders can have many treatment options, stigma still surrounds mental health conditions, resulting in less than 40 percent of those struggling receiving treatment.

Xanax is a brand name, fast-acting drug used to treat anxiety and panic disorder on a short term basis.

More than 44 million prescriptions are written for Xanax each year, making it the eighth most prescribed medication in the United States and the most prescribed drug in its class. However, Xanax is highly addictive and not without risk.

What is Xanax?

Xanax is a short-acting tranquilizing medication, also referred to as a sedative-hypnotic or anxiolytic medication.

Xanax belongs to a family of drugs called benzodiazepines, which also includes medications like Ativan, Klonopin, and Valium.

The generic form of Xanax is called alprazolam, and the drug comes in the form of oral tablets of varying strengths.

Xanax is available in both an immediate-release and extended release formulas.

xanax pills and packaging image

What is Xanax used to treat?

Xanax is FDA-approved for the treatment of anxiety disorders, short-term relief of anxiety symptoms, anxiety associated with depression, and panic disorder.

Unlike some other benzodiazepines, Xanax is not used to treat insomnia.

Xanax is most commonly prescribed to treat anxiety, including generalized anxiety disorder.

The medication is approved by the FDA for short term anxiety treatment, and it is recommended to be used for no longer than six weeks due to its habit-forming and addictive nature.

Despite this, some people are prescribed Xanax by their doctors for a long amount of time, which can lead to substance abuse.

Xanax is considered appropriate for use as an “emergency” or “rescue” medication during a particularly stressful or anxious time, such as following the death of a loved one, and can also be used to treat panic attacks on an acute basis.

Long term use of the drug can increase your risk of certain side effects of xanax, especially physical and psychological dependence, and can lead to withdrawal symptoms when the medication is stopped.

Quitting cold turkey is especially difficult so tapering off your use is well advised. If you do become addicted you should try to go to a rehabilitation center.

If there is a rehab specifically for drug use, it would be a great treatment center to go to. 

What is anxiety and what causes it?

Anxiety is the body’s natural response to stress and is defined by fear or apprehension about what is to come.

Although we all experience anxiety at some point in our lives, anxiety becomes a problem and is described as an anxiety disorder when the feelings are extreme, last longer than six months, and interfere with your life.

There are eight main types of anxiety disorders, including:

  • Generalized anxiety disorder
  • Panic disorder
  • Phobia
  • Social anxiety disorder
  • Obsessive-compulsive disorder
  • Separation anxiety disorder
  • Illness anxiety disorder
  • Post-traumatic stress disorder.

Symptoms of generalized anxiety can include an increased heart rate, rapid breathing, restlessness, trouble concentrating, and difficulty falling asleep.

A more acute form of anxiety, called an anxiety attack, has symptoms that include feeling faint or dizzy, shortness of breath, dry mouth, sweating, chills or hot flashes, apprehension and worry, restlessness, distress, fear, numbness or tingling

How does Xanax treat anxiety?

Xanax works on neurotransmitters in the brain called gamma-aminobutyric acid (GABA), which are partially responsible for the regulation of sleep and feelings of both relaxation and anxiety.

When a patient takes Xanax, the medication acts on the GABA receptors to slow down the central nervous system. Once the medication has bonded to the GABA receptors, neuron activity is inhibited, which means that you begin to feel reduced anxiety, fear, and terror.  

Xanax takes effect within about an hour, which is what makes it so effective in treating acute symptoms of anxiety and panic symptoms. 

How long does Xanax last?

How long does Xanax stay in your body depends greatly on which form of the medication you are prescribed, as the medication is available in both immediate-release and extended-release forms.

Both the immediate-release and extended-release forms of Xanax begin working in about an hour.

The immediate-release version of Xanax will have lasting effects for about five hours, while the extended-release form of the medication will work for about eleven hours. 

How much does Xanax cost?

As is the case with any prescription medication, the name brand form of Xanax costs considerably more than the generic form of alprazolam.

Patients can save considerably by choosing the generic form of the prescription drug. 

Costs of Xanax Compared to Alprazolam (Immediate-release, 100 pills)

0.25 mg tablet
0.5 mg tablet
1 mg tablet
2 mg tablet

The costs of the extended-release version of the medication are noticeably higher, ranging from $28.84 for 60 tablets of 0.5 mg strength to $233.05 for 60 tablets of 3 mg strength.

What are the benefits of using Xanax?

While Xanax is not without its drawbacks, use of the medication does provide several benefits.

Because Xanax produces anti-anxiety effects very quickly, it can provide noticeable results within the first week of treatment.

Anxiety medications that are prescribed for long term use, such as Lexapro, may take several weeks for patients to experience relief.

For acute anxiety symptoms or particularly severe symptoms requiring rapid relief, Xanax is a good choice when used correctly and when steps are taken to avoid dependency.

Xanax is sometimes prescribed in conjunction with a slower-acting antidepressant or anti-anxiety medication, such as Zoloft, in order to provide relief more quickly while the long-term medication begins to work.

How do I know which dose of Xanax I should take?

The dose of Xanax that will be right for you varies depending on the condition being treated, food and drug administration recommendations, your age, the form of Xanax taken, other medical conditions you may have, and other medications you may be taking.

Both Xanax and its generic form, lorazepam, come in tablets of 0.25 mg, 0.5 mg, 1 mg, and 2 mg strengths.

The extended-release version of the medication is available in all of the aforementioned strengths as well as a 3 mg strength.

When beginning treatment of anxiety with Anthrax, patients should start with a dose of 0.25 mg to 0.5 mg taken three times daily, assuming that the medication is the immediate-release form of the drug.  

The maximum daily dose for treatment of anxiety is 4 mg daily. In patients suffering from panic disorder will likely require a higher dose to manage their symptoms.

The average daily dose prescribed for panic disorder is 6 mg daily, while up to 10 mg per day is the limit.

Regardless of the size of your dosage, Xanax should not be stopped abruptly if used regularly for more than two weeks, as stopping the medication without a gradual reduction can cause withdrawal symptoms.

Instead, your healthcare provider will help you to gradually lower your daily dose by approximately 0.5 mg every few days until you have been weaned off the medication.

How do I use Xanax to treat anxiety?

Xanax is an important and powerful tool to treat anxiety, just like Ativan, but unfortunately, it can be easily abused.

When using Xanax to treat anxiety, the medication should be taken for short term use only, as it can be habit-forming.

Xanax will work to provide immediate relief to your anxiety symptoms while a more appropriate long term medication, such as Lexapro, takes effect. 

Are there any side effects I should be aware of?

Side effects for Xanax are generally divided into three categories and include common, less common, and serious side effects. Common side effects include:

  • Ataxia
  • Cognitive dysfunction
  • Constipation
  • Difficulty in micturition
  • Drowsiness
  • Dysarthria
  • Fatigue
  • Memory impairment
  • Skin rash
  • Weight gain
  • Weight loss
  • Anxiety 
  • Blurred vision
  • Diarrhea
  • Insomnia 
  • Decreased libido
  • Increased appetite
  • Decreased appetite
  • Less common side effects include:
  • Hypotension
  • Sexual disorder
  • Muscle twitching
  • Increased libido
  • Serious side effects include:
  • Slowed breathing
  • Respiratory failure
  • Psychological and physical dependence
  • Serious allergic reaction (antihistamines may be needed)
  • Suicidal thoughts

Be on the lookout for signs of psychological and/or physical dependence on Xanax. Symptoms of dependence may include:

  • Anxiety
  • Depression 
  • Muscle weakness
  • Nightmares
  • Body aches
  • Sweating
  • Nausea
  • Vomiting 

If you experience an allergic reaction to Xanax, you should seek medical attention immediately. Symptoms of an allergic reaction include:

  • Rash or hives
  • Trouble breathing or swallowing
  • Swelling of lips, tongue, or face
  • Rapid heartbeat

Does Xanax come with any warnings for use?

Because Xanax has a high potential for psychological and physical dependence and the likelihood to become habit forming, the medication comes with several warnings for use.

First, Xanax has a higher risk of drug abuse among patients with a history of drug or alcohol use or alcohol withdrawal.

If you have suffered from addictive tendencies in the past, Xanax may not be right for you.

Patients with existing depression may notice a worsening of their symptoms with the use of Xanax, so make sure to tell someone if you notice your depression worsening or begin experiencing suicidal thoughts.

When used in combination with other central nervous system depressants, Xanax can be fatal due to respiratory depression, so drug interaction is crucial.

So, it is imperative that you tell your doctor about any prescriptions, over-the-counter medications, supplements, vitamins, or herbs you are taking for appropriate medical advice.

Generally, Xanax should only be prescribed for short periods of time. Continuous long term use is not recommended due to the potential for abuse, so any extension of use should be carefully considered by a medical professional.

Xanax should not be used by pregnant or breastfeeding mothers due to the potential for serious birth defects and life-threatening withdrawal symptoms for the infant.

Who should not take Xanax?

Due to the long list of adverse effects and the possibility for psychological and physical dependence, some groups of people should not take Xanax. These groups include:

  • People with narrow-angle glaucoma.
  • Children under the age of 18.
  • Senior citizens. Senior citizens are more likely to experience side effects like drowsiness or dizziness, which can increase their risk of suffering from a fall, leading to bone fractures. Senior citizens may require a substantially lower dose of Xanax.  
  • Pregnant women and breastfeeding mothers. Xanax can cause serious birth defects or life-threatening withdrawal symptoms in newborn babies. Pregnant and nursing women should not take Xanax.
  • Additionally, some people with certain medical conditions should not take Xanax. Make sure to tell your doctor if you have experienced any of the following:
  • History of allergic reaction to any benzodiazepine
  • Seizures or epilepsy
  • Kidney or liver disease
  • Asthma or other breathing disorder
  • Open-angle glaucoma
  • History of depression or suicidal thoughts or behavior
  • History of drug or alcohol addition
  • Use of narcotic/opioid medication

Finally, due to its depressive effects, you should not drink alcohol when taking Xanax.

References, Studies and Sources:

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings

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