Xanax is one of the most commonly prescribed medications for generalized anxiety disorder and panic disorder. It can also help with social anxiety and other needs. It works because it’s a sedative that calms your brain and nerves.
Is Xanax right for your anxiety symptoms? Talk to an anxiety specialist on Klarity Health in 24 hours or less and find out.*
Providers on Klarity Health are independent practitioners with clinical autonomy; a diagnosis, treatment, or prescription is not guaranteed.
Providers on Klarity Health are independent practitioners with clinical autonomy; a diagnosis, treatment, or prescription is not guaranteed.
Xanax is a prescription medication approved by the U.S. Food and Drug Administration in 1981 to manage panic and anxiety disorders. An extended-release version, Xanax XR was approved in 2003. Its active ingredient is alprazolam, which became available as a generic medication in 2007.
Alprazolam is in the benzodiazepine drug class. Benzodiazepines are depressants that slow down your central nervous system (CNS) and help you relax.
Xanax is the most commonly prescribed benzodiazepine for anxiety disorders, the short-term relief of anxiety symptoms, and panic disorders in the U.S. That includes panic disorders that are or aren’t accompanied by agoraphobia (a fear or places or situations that make you feel helpless, trapped, or embarrassed).
It’s intended for short-term rather than long-term use. It’s also a Schedule IV controlled substance, which means it may misused, abused, or caise addiction, but has a lower change of abuse than Schedule I, II, or III controlled substances.
Xanax is also used off-label (for something it’s not FDA-approved for) for insomnia, premenstrual syndrome, and depression at a provider’s discretion.
As a benzodiazepine, or benzo, Xanax affects one of the brain’s GABA-A receptors. GABA is a CNS neurotransmitter (or chemical messenger) and is an abbreviation for the neurotransmitter gamma-aminobutyric acid. GABA naturally reduces the excitability of neurons in your brain. And Xanax increases the amount of GABA available to the brain to make you feel more calm and less anxious.
People with anxiety who take Xanax or alprazolam report that it makes them feel “normal” (as opposed to anxious)
Xanax is FDA-approved to treat:
– Generalized anxiety disorder (GAD) in adults
– Panic disorder in adults who do or don’t have agoraphobia (strong fear and avoidance of places or situations that cause panic and where you feel trapped, helpless or embarrassed)
Providers may also legally prescribe Xanax for uses that aren’t FDA-approved (off-label). The most common off-label uses are depression, insomnia, and premenstrual syndrome.
Before you can take Xanax, you need a prescription. To get a prescription, you need to work with a licensed healthcare provider who can prescribe medication, diagnose you with anxiety, and who thinks Xanax is medically necessary for you. Providers who can write prescriptions include medical doctors (MDs), physician assistants/associates (PAs), and nurse practitioners (NPs).
You can find a licensed, board-certified provider to get an anxiety diagnosis and create a treatment plan for you that may include medication, like Xanax, on Klarity Health.
Once you have a Xanax prescription, you can fill it at any pharmacy — online or local — that has Xanax in stock.
Standard release Xanax comes in .25-, .5-, 1- and 2-milligram oral tablets. The dosage for GAD is from .25 to .5 milligrams 3 times a day. Your dose can be adjusted every 3 or 4 days if needed. Never take more than 4 milligrams a day divided across 3 doses throughout the day.
If you’re taking standard-release Xanax for panic disorder, the typical dose is .5 milligrams 3 times a day. You can increase it by 1 milligram a day every 3 or 4 days if recommended. Some people take up to 10 milligrams a day for panic disorder, but the average daily dose is 5 or 6 milligrams.
Xanax XR comes in .5-, 1-, 2-, and 3-milligram oral tablets. You take one dose a day and in the morning. The typical starting dose for GAD or panic disorder is .5 to 1 milligram a day. If needed you can increase the dose every 3 or 4 days by 1 milligram. The recommended maintenance dose is between 3 and 6 milligrams a day. 10 milligrams is the maximum dose.
If you and your provider decide to have you stop taking Xanax, you want to taper off of it gradually so you don’t have withdrawal symptoms. Your provider can work with you on a schedule to taper off and minimize withdrawal symptoms as needed.
Xanax can cause common and serious side effects and interact with other medications and some people shouldn’t take it.
The most common side effects of Xanax include sleepiness, trouble saying words clearly (dysarthria), memory problems, problems with coordination, dry mouth, changes in sex drive (libido), constipation, and nausea.
The most common side effects when taking Xanax XR are problems with coordination, low blood pressure, dysarthria, memory impairment, and impacts on libido.
Less commonly Xanax and Xanax XR cause serious side effects. They can also interact with other medications and shouldn’t be used by some people. Before taking Xanax in any form, talk to your provider or pharmacist and read the medication guide.
Xanax and Xanax XR are controlled substances that have a boxed warning, the FDA’s most serious warning because of their risks when used with opioids and for abuse, misuse, and addiction, and dependence and withdrawal reactions.
If you take Xanax, consider reporting any negative side effects to the FDA by visiting MedWatch or calling 1-800-FDA-1088.
Brand-name Xanax is on the pricier side. 100 tablets of standard-release Xanax (roughly a one-month supply if you’re taking it 3 times a day) costs between $583 and $1,600 without insurance. Those costs are from drugs.com and reflect its discount card.
60 tablets of Xanax XR, will cost less — from $673 to $1,650 for 60 tablets, but you only take it once a day. So you’re looking at $350 to $825 a month.
The most affordable option is generic alprazolam. It runs from $29 to $297 for 100 tablets of the standard release formula. 100 extended-release tablets cost you between $47 and $112 for 60 tablets.
Most insurance companies cover Xanax. If you have insurance, you’ll pay less. Your insurance company may want prior authorization or for you to use the generic. You can use a prescription or drug discount card from SingleCareRx, drugs.com, GoodRx, WellRx, and others to save whether you have insurance or not.
If you prefer brand-name Xanax, Viatris, one of the makers of branded Xanax, offers a Xanax Savings Card where you could pay just $4 for 30-day supply.
Xanax is the most prescribed benzodiazepine for anxiety. Clinical studies have shown that it’s effective for GAD and panic disorder. There are other medications for treating anxiety. But few comparative studies have been done that look at one versus another.
Another benzodiazepine is Ativan (lorazepam), which is FDA approved to manage anxiety disorders and the short-term relief of the symptoms of anxiety. Xanax is thought to be stronger than Ativan, but Ativan may work better for some people. And Ativan doesn’t have as many withdrawal symptoms and has a lower risk for abuse than Xanax.
Other benzodiazepines used for anxiety include Klonopin (clonazepam) and Valium (diazepam). Klonopin is FDA approved to treat panic disorders. Valium for anxiety disorders and short-term relief of anxiety symptoms.
Selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and norepinephrine and dopamine reuptake inhibitors (NDRIs) are antidepressants sometimes used off-label to treat anxiety. Medications include Zoloft (sertraline), Prozac (fluoxetine), Lexapro (escitalopram), Effexor (venlafaxine), Cymbalta (duloxetine), and Wellbutrin (bupropion). They tend to be best if your anxiety symptoms are more mental than physical or if you have both anxiety and depression. And they don’t have the risk for dependence that benzodiazepines do.
Zoloft, Prozac, Lexapor, Effexor, and Wellburtin are all approved to treat MDD. Cymbalta is approved to treat depression.
Other medications, including BuSpar (buspirone) and gabapentin, are often used to treat anxiety. BuSpar is FDA-approved to treat GAD. Gabapentin is used off-label for anxiety.
This isn’t a complete list of all your options. The best way to find out how Xanax might compare to other anxiety medications and which may work best for you is to talk to your healthcare provider.
All the medications listed here can have side effects, some serious. Some possible side effects include, but aren’t limited to, nausea, dizziness, dry mouth, fatigue, insomnia, sweating, headache, and weight changes. Klonapin and Valium are controlled substances that may lead to misuse, abuse, or addiction. Gabapentin is considered a controlled substance in some states.
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Reviews from real patients who see healthcare providers on Klarity Health.
Providers on Klarity Health are licensed, board-certified, and offer a personalized approach to your unique anxiety treatment needs. See detailed profiles for each provider and find an approach that’s best for you. (Costs for treatment options may vary.)
Your journey to reduced anxiety symptoms starts with an initial consultation. Your provider will work with you to recommend the anxiety treatment plan for you and that may or may not include prescription medication and/or therapy.
Your initial anxiety consultation is just the beginning. You and your provider will follow up to make sure you’re doing okay and are reaching your goals. You stay on track with ongoing support from your provider(s) and medication refills if needed.
If you have questions or need assistance, the Klarity Health Patient Support team is there to help. Along with your provider, they’re committed to making sure you have the best care and support throughout treatment.
You’re unique. And your needs are too. You deserve treatment from a provider committed to you. That’s why you can find an anxiety specialist on Klarity Health and access:
from a licensed, board-certified healthcare professional.
or off through treatment tailored to you.**
online or in person and that’s supportive and comes with no hidden fees.
**Your provider will discuss treatment options with you, which may or may not include medication and/or therapy. If both therapy and medication are recommended, you’ll see a different provider for each service.
*Appointments are generally available within 24 hours. Free initial consultations are available only with select providers. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.
The information provided in this article is for educational purposes only and should not be construed as medical advice. Controlled substances, like Xanax, Ativan, Klonapin, and Valium, may not be appropriate for all patients and any mention of these medications is for educational purposes only, not for marketing or encouraging self-diagnosis. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage. Not all providers on Klarity Health prescribe all medications, particularly medications that are controlled substances.
If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.