Can Xanax Make Anxiety Worse?

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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What Is Xanax?

Xanax, known generically as alprazolam, is a prescription medication belonging to the benzodiazepine class of drugs. It’s most commonly recognized for its potential to alleviate specific symptoms of various health conditions. The drug impacts the central nervous system, promoting a sense of calmness. Xanax is typically prescribed for short-term use due to its potential for dependency and side effects. In some cases, misuse can lead to addiction, highlighting the importance of strictly adhering to prescribed usage guidelines.

Why Is Xanax Used to Treat Anxiety?

Xanax is used to treat anxiety because it enhances the effects of a natural chemical in the body called gamma-aminobutyric acid (GABA). GABA has an inhibitory function on the nervous system, meaning it can slow down or stop certain nerve signals in the brain, leading to feelings of calm and relaxation. This reduction in nerve signaling can help alleviate the excessive worry, restlessness, and fear associated with anxiety disorders. It is advised to use Xanax as a short-term treatment and under the close supervision of a healthcare provider.

Can Xanax Make Anxiety Worse?

While Xanax is designed to alleviate anxiety, it can paradoxically worsen it in certain situations. This is particularly possible during withdrawal, or when the medication’s effects wear off, a phenomenon known as “rebound anxiety.” Additionally, long-term use can lead to tolerance, requiring higher doses for the same effect, which can exacerbate anxiety when the drug isn’t available. Furthermore, misuse or abrupt discontinuation can provoke severe withdrawal symptoms, including increased anxiety. Therefore, Xanax should be used under strict medical supervision, and any changes in dosage or discontinuation should be done gradually and under a healthcare provider’s guidance.

Side Effects

Here are the main side effects of using Xanax regularly.


This medication works by slowing activity in the brain to allow for relaxation and a decrease in anxiety and panic symptoms. However, this calming effect can also lead to feelings of tiredness or sleepiness. This drowsiness can impact your ability to drive or operate machinery safely. It can also affect your performance at work or school and general daily activities.


Xanax impacts the central nervous system by slowing brain activity to reduce anxiety. This slowing effect can also lead to a sensation of lightheadedness or feeling faint. It happens because Xanax can lower your blood pressure and slow your heart rate, disrupting your body’s sense of balance and stability. Additionally, Xanax can cause drowsiness, which can contribute to feelings of lightheadedness. If this symptom becomes bothersome or persistent, it’s advisable to seek medical attention as adjustments to the dosage or a change in medication may be necessary.

Dry Mouth

This occurs because Xanax, like other benzodiazepines, can affect the salivary glands and reduce saliva production, leading to a feeling of dryness in the mouth. This can also make swallowing difficult and may alter the sense of taste. A prolonged dry mouth is not just uncomfortable; it could lead to oral health problems like tooth decay and gum disease since saliva helps neutralize acids and cleans the mouth.


Xanax slows the processes of the central nervous system, which can, in turn, slow the functioning of the digestive system. This slower transit time in the digestive tract can lead to constipation. In addition, Xanax can affect the autonomic nervous system, which controls involuntary functions, including digestion. Reduced activity in this system can decrease intestinal motility, leading to constipation. Lifestyle modifications or other treatments may be suggested to manage this side effect.

Memory Problems

Xanax impacts the central nervous system and has a sedative effect, which can interfere with the cognitive processes involved in memory formation. Particularly, it can cause difficulties with episodic memory, which is the memory of personal experiences and specific events. This is often more noticeable with higher doses or prolonged use. In extreme cases, Xanax can cause anterograde amnesia, which is the inability to form new memories after the point of drug administration.


While Xanax is primarily used to induce calmness and reduce anxiety, some individuals may paradoxically experience increased feelings of irritability or agitation. This could be due to the brain’s response to the drug’s alterations in the GABA neurotransmitter system, which is designed to induce relaxation. Furthermore, as the effects of Xanax wear off, withdrawal symptoms may begin to emerge, including irritability. It’s also important to note that chronic use of Xanax can lead to dependence, and irritability can be a prominent symptom during withdrawal.

How to Manage the Adverse and Side Effects of Xanax

Here are some effective strategies for dealing with Xanax usage.

Regular Consultation With a Healthcare Provider

Establishing and maintaining open communication with your healthcare provider is crucial when taking a medication like Xanax. Your provider needs to know about all the symptoms you’re experiencing, any side effects you’re noticing, and any changes in your condition. This is important because it allows your provider to monitor your progress, adjust your dosage if necessary, and determine if Xanax continues to be the most effective treatment for you. It’s also essential for your provider to be aware of any other medications or substances you’re taking as these can interact with Xanax, potentially leading to increased side effects or decreased effectiveness.

Gradual Dose Changes

Xanax is a medication that can create physical dependence, meaning your body can become used to its presence and may react negatively if it’s abruptly removed or the dosage is significantly altered. If you need to stop taking Xanax or change your dosage, it should be done gradually under the supervision of a healthcare provider. This process, often called “tapering,” helps avoid or minimize withdrawal symptoms, including rebound anxiety, a return of anxiety symptoms often more intense than before starting the medication. Each person’s tapering schedule can be different, based on factors like the length of time on the medication and the dosage.

Healthy Lifestyle

Living a healthy lifestyle is integral to managing anxiety and can help reduce reliance on medication. Regular exercise releases endorphins, natural mood lifters, and can also improve sleep, which can be disrupted by anxiety. A balanced diet is crucial, too, as certain foods may contribute to anxiety. For example, caffeine and alcohol can trigger or worsen anxiety symptoms in some people. Furthermore, lack of sleep can exacerbate anxiety and other mental health conditions. Thus, it is important to get adequate sleep time.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is a type of psychological treatment that has been extensively researched and shown to be effective in treating anxiety disorders. CBT addresses negative patterns and distortions in the way we look at the world and ourselves. The therapy helps individuals challenge and change their thought patterns and behaviors that lead to anxious feelings, thereby reducing anxiety. This can be particularly beneficial for those taking medications like Xanax as CBT can provide tools and techniques to manage anxiety, potentially reducing dependence on medication over time.

Mindfulness and Relaxation Techniques

Practices such as yoga, meditation, and deep-breathing exercises can be effective in managing anxiety symptoms. Mindfulness involves focusing on the present moment and accepting it without judgment. This can help reduce the worry about future events that often characterize anxiety. Similarly, deep-breathing exercises can help calm the body’s physiological response to anxiety, reducing symptoms like rapid heart rate and shallow breathing. Yoga combines physical postures, breathing exercises, and meditation, making it a holistic practice for anxiety management. These techniques, when practiced regularly, can provide a natural counter to the stress response and might reduce the reliance on medication over time.

Support Networks

Support networks can include friends, family, support groups, or mental health professionals. Regularly connecting with people who understand and can offer encouragement can provide a sense of stability and belonging. This can help alleviate feelings of anxiety. Support networks can also provide a safe space to share experiences and coping strategies. Speaking with others who are going through similar experiences can provide reassurance, reduce feelings of isolation, and provide practical advice.

Frequently Asked Questions

How Long Can I Safely Take Xanax?

The length of time you can safely take Xanax varies depending on individual factors, including your overall health, the nature of your anxiety, and your response to the medication. Xanax is generally prescribed for short-term use, often for a few weeks to a few months, due to the risk of dependence and withdrawal. It’s crucial not to continue or discontinue Xanax use without discussing it with your healthcare provider.

What Should I Do if I Miss a Dose of Xanax?

If you miss a dose of Xanax, take the missed dose as soon as you remember unless it’s close to the time for your next dose. In that case, skip the missed dose and continue with your regular medication schedule. Do not take a double dose to make up for the missed one as this can increase the risk of side effects. If you frequently forget doses, discuss this with your healthcare provider, who can provide strategies and means of maintaining the required schedule.

How Long Do the Effects of Xanax Last?

Xanax is a fast-acting medication, typically starting to work within an hour after ingestion. Its peak effects are usually felt within one to two hours. The duration of its effects can vary depending on the individual and the dose taken. On average, however, the effects of Xanax last about four to six hours for immediate-release forms. Extended-release forms of the medication are designed to provide longer-lasting relief, with effects typically lasting about 11-16 hours. It’s important to remember that these times can vary based on individual factors, including metabolism, age, overall health, and the presence of other drugs or alcohol in the system.

Can Xanax Lead to Addiction?

Yes, Xanax can lead to addiction. This medication belongs to the benzodiazepine class of drugs, which can cause physical dependence and addiction, especially when used for an extended period or at high doses. People who use Xanax can develop a tolerance to the drug, needing higher doses to achieve the same effects, which can lead to a cycle of increased use and dependence.

Addiction is characterized by a compulsive need to use the drug despite negative consequences. Symptoms can include unsuccessful efforts to cut down or control use, spending a lot of time obtaining, using, or recovering from the drug, and continuing use despite physical or psychological problems caused or exacerbated by the drug.

Does Xanax Permanently Cure Anxiety?

Xanax does not permanently cure anxiety. It is a medication that can help manage the symptoms of anxiety disorders, providing temporary relief. Xanax works by calming the nervous system, reducing feelings of anxiety and panic. However, it does not address the underlying causes of anxiety, and when the medication wears off, the symptoms can return. Long-term management of anxiety often involves a combination of medication and psychotherapy, which can help individuals learn strategies to manage and reduce anxiety over time.

Xanax, when used appropriately, offers significant benefits in managing anxiety and panic disorders. However, its potential for misuse and addiction underscores the need for careful management and supervision. It’s a slippery slope from therapeutic use to dependency.

If you find yourself struggling with Xanax addiction, remember you are not alone, and you can reach out for assistance. At Defining Wellness Centers, we provide comprehensive, tailored treatment programs to help you navigate the journey to recovery, ensuring you regain control and wellness in your life. Don’t hesitate to contact us. Our team is on standby, ready to provide more information about our services. We can help start your journey toward recovery today.

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