I am Dr. John, board certified in Internal Medicine and Geriatric medicine, and this
is Think your health.
What is Xanax?
Xanax is a prescription medication to treat anxiety and panic attacks. It can be also
used off label to treat acute episodes of vertigo. It belongs to a family of medications
called Benzodiazepines. The generic name for Xanax is Alprazolam.
How does Xanax work?
Xanax works on a specific receptor in your brain called GABA. These GABA receptors are
found in your nerve cells and when they receive chemical messages they help reduce or inhibit
nerve impulses. A medication like Xanax can bind to the GABA receptor on these nerve cells.
In this way Xanax, like other benzodiazepines has a calming effect on your brain.
How long does it take before Xanax works?
Benzodiazepines like Xanax are short acting and reaches a peak within 1-2 hours.
What are the dosage forms of Xanax?
It comes in tablet form and the doses are:
0.25mg, 0.5mg, 1mg and 2mg
The immediate release tablet of Xanax(Alprazolam) can be started at the lowest dose 3-4 times
a day and slowly increase the dose every 3-4 days depending on dose response and medication
tolerability. The extended-release form of Alprazolam is
started at 0.5mg to 1 mg daily and here again the dosing can be up titrated depending on
response and tolerability.
In older adults dosing and administration of Xanax should be done very cautiously. Why
is this? Xanax, like other benzodiazepines are listed as medication which are potentially
inappropriate.(Per Beer’s Criteria). This is because it can cause significant side effects
in the older adult which I will talk about later in this video.
Can Xanax be used during pregnancy?
No, as Alprazolam and its metabolites can cross the placenta and can cause harm to the
fetus.
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as anxiety, click right here:
10 facts you should know before taking Xanax:
1) I would strongly recommend not to drink alcohol and take Xanax at the same time as
it can worsen the side effects of this medication and cause harm.
2) Preferably Alprazolam should not be used for a long time. This has also to do with
how it works as it is short acting. It can be habit forming and you would be at a risk
for addiction especially if you do not follow the recommendations by your health care provider.
The problem with long term use is you will be exposed to the side effects of this medication.
3) Do not suddenly stop taking or quit cold turkey. This can lead to withdrawal symptoms
such as sweating, agitation, hallucinations and seizures and can be potentially fatal.
Your dose would have to be tapered of in conjunction with your health care provider over a few
weeks or even longer.
4) Would not recommend using Xanax as a sleeping pill if you have sleeping problems. Yes, a
side effect is drowsiness. However, as mentioned earlier this can lead to addictive behavior.
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5) Xanax does not cause direct liver problems, however, as this medication is metabolized
in the liver and if you have a pre-existing liver issue you will have to talk to your
health care provider about adjusting the dose or frequency as you might be faced with increased
side effects.
6) What are common side effects? (for immediate release tablets). All medications cause side
effects. Some individuals have no or only mild side effects. There are many more, here
I have listed only a sample
Drowsiness 41% Sedation 49%
Memory impairment 33% Depression 1-12%
Rash 11% Weight gain 27%
Weight loss 23% Libido problems 6-14%
Difficult urinating 12% Low blood pressure 5%
Confusion 10% GI problems such as nausea and vomiting 1-6%
Decreased appetite 33% Constipation 26%
Dry mouth 15% Headache 1%
Muscle pain 2% Dizziness 2-21%
Co-ordination problems 49%
7) If you recall I am very hesitant to prescribe this medication to older adults. One of the
reasons is when you age the amount of body fat increases, muscle mass decreases as well
as your bone density. Xanax is fat soluble. That means ultimately it is stored in your
fat cells. This is why the effects of Xanax last longer in individuals who are obese and
older.
8)Xanax can interact with grapefruit, discuss this with your doctor if grapefruit is part
of your diet.
9) In this video another word of caution concerning older adults. Xanax like other Benzodiazepines
can increase the risk of falls. Be very careful when getting up from bed, take your time especially
when going up and down stairs.
10) Xanax can interact with a number of medications and I am listing only a couple here. Talk
to you Pharmacist or your health care provider if you have concerns:
As you can see from some of the medications, if you are on opioid drugs some of the side
effects of Xanax can be potentiated and work with your doctor, especially if you are a
chronic pain patient about the safest combination in your case.
10)If you have been diagnosed with acute angle glaucoma or open angle glaucoma you should
not take this drug.
If you are interested in other videos click right here or here. Have a good day and think your Health!