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.
10 facts you should know before taking Xanax:
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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.
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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.
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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.
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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.
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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:
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Drowsiness 41%
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Sedation 49%
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Memory impairment 33%
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Depression 1-12%
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Rash 11%
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Weight gain 27%
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Weight loss 23%
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Libido problems 6-14%
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Difficult urinating 12%
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Low blood pressure 5%
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Confusion 10%
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GI problems such a nausea and vomiting 1-6%
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Decreased appetite 33%
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Constipation 26%
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Dry mouth 15%
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Headache 1%
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Muscle pain 2%
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Dizziness 2-21%
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Co-ordination problems 49%
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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 you are obese and older.
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8)Xanax can interact with grapefruit, discuss this with your doctor if grapefruit is part of your diet.
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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.
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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:
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Methadone,Clozapine, Metoclopramide, Oxycodone, Simvastatin, Spironolactone, Clarithromycin, Itraconazole, Ketoconazole.
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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.
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BONUS)If you have been diagnosed with acute angle glaucoma or open angle glaucoma you should not take this drug.
