Bipolar Medication Information: Xanax

Patient Expert

Xanax is an antianxiety drug approved by the FDA for treating Generalized Anxiety Disorder and Panic Disorder. It and its generic version, alprazolam, are also often prescribed off-label for people with bipolar disorder, even if they don't have those specific anxiety disorders as well, usually to treat anxiety and insomnia.

The FDA-approved information about Xanax emphasizes the risk of emotional and physical dependence, especially at doses of 4mg/day or higher. To minimize withdrawal symptoms, the dosage should be tapered off slowly when discontinuing this drug (more below).

Some of the other most important things to know about Xanax are:

  • Your prescribing doctor must know about all other prescription and over-the-counter drugs you take, and about your alcohol use. Drinking alcoholic beverages can cause problems when you take Xanax.

  • Use of Xanax along with certain other drugs, including Prozac (fluoxetine), oral contraceptives, and certain antifungal drugs is contraindicated. (This is not a complete list.)

  • Xanax is not recommended for use while pregnant or nursing. Fetal abnormalities are possible, especially when Xanax is taken during the first trimester. Newborn infants may go through withrawal. Alprazolam is excreted in breast milk, which can cause problems for infants.

  • Smoking can decrease the amount of Xanax in your system by up to 50%.

  • The concentration of Xanax and the length of time it takes to clear the system is higher in Asians than in Caucasions.

The most common side effects of Xanax and alprazolam include drowsiness, dry mouth, weight gain/loss, irritability, fatigue/tiredness, impaired coordination, slurred speech, memory impairment, increased or decreased appetite, dizziness, headache, blurred vision, confusion, impaired coordination, nausea/vomiting, diarrhea, increased/decreased libido, and sexual problems. (This is not a complete list.)

It should be noted that in clinical studies, some of the side effects occurred with the same or even higher frequency in patients taking placebo, making it difficult to tell whether Xanax actually caused them.

Discontinuing Xanax/alprazolam can cause withdrawal symptoms that can be very problematic. These can include impaired concentration, muscle cramps or twitching, numbness, tingling or burning sensations, diarrhea, blurred vision, loss of appetite and weight loss, anxiety (which could be a return of the disorder it was treating), insomnia, headaches, fatigue/tiredness, sweating, very rapid heartbeat, cognitive or memory problems, depression, confusion and tremor. (This is not a complete list.) On rare occasions, seizures have occurred.

The one thing the prescribing information emphasizes is that Xanax should not be discontinued abruptly. Even if you just miss a dose, you could feel some withdrawal effects. Never stop taking Xanax on your own - do it under a doctor's care.

For more information, see Xanax XR Oral.