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How Effective is Alprazolam for Anxiety?

Anxiety causes chemical imbalances that are known to respond well to medicinal treatments. That's why doctors prescribe medications to treat anxiety, and why most people prefer medications to therapy (since anxiety medicines are essentially instant and require less work). But medications also have their downsides, so finding the right anxiety medicine is crucial.

Alprazolam is the most prescribed anxiety drug on the market today. You may know it by its trade name,**_ Xanax_**. Alprazolam appears to be very effective for anxiety, but it's also something you need to strongly think about before you decide to utilize this type of medication.

How Severe is Your Anxiety?

Drugs are usually only recommended for those with severe anxiety that are unable to control it with other means. If you haven't yet, take our free 7 minute anxiety severity test to score your anxiety symptoms, compare its severity to others, and learn more about how to control it.

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Using Alprazolam For Anxiety

Alprazolam is one of the most prescribed medications in the world. One might say that it's prescribed too often, because most people are given Alprazolam by doctors, not psychologists, and no medicine should be a person's first choice when they're trying to control their anxiety. Medicines need to be a last resort, after you've tried non-medicinal options. Take my free 7 minute anxiety test to find out more about the options for you.

Why to Avoid Medicine

The main reason to avoid Xanax and other anxiety medications unless you need them is because they don't cure your anxiety. They merely dull it. Eventually, if you stop taking the medicine, your anxiety will always come back.

That's clearly a problem. These medications already have trouble with side effects, tolerance, and addiction (more on that later), but perhaps their greatest problem is that they dull anxiety without helping a person truly fix the problem. Eventually you'll quit the medication, your anxiety will come back, and you'll find yourself suffering. That's why you need to make sure that you never depend on medicine alone.

What is Alprazolam?

Alprazolam is a drug in the benzodiazepine class. Like other benzodiazepines, Alprazolam isn't just an anxiolytic. It's also a:

  • Sedative
  • Hypnotic
  • Muscle Relaxant
  • Anticonvulsant

All of these other properties have both benefits and weaknesses for reducing anxiety. Alprazolam is one of the most prescribed medicines because it works quickly. It may take as little as 10 minutes and usually no longer than an hour for the Alprazolam to start working.

Alprazolam is used for all types of anxiety, but it's one of the few medicines prescribed for panic disorder. Most other benzodiazepines (including Alprazolam) are used primarily for generalized anxiety disorder and social anxiety disorder.

Alprazolam binds to GABA receptors to produce these anxiolytic qualities. Alprazolam is also generally not prone to allergic reactions, which is another reason it is prescribed so frequently.

Alprazolam As An Anxiety Treatment

There is no denying that Alprazolam works. It's been prescribed for severe anxiety and panic for decades, and appears to show some fairly strong success rates. Xanax and the generic drugs all seem to work well for most anxiety disorders, and continue to provide relief for many months if necessary.

The problem isn't generally that Alprazolam doesn't work. The problem is that it is prescribed without any other treatment, and with issues like panic attacks, you need to be able to control them otherwise when you stop taking the medication, the panic attacks will not only come back - they may come back stronger.

Taking Alprazolam for anxiety can also cause both psychological and physical dependence.

  • Physical Dependence Over time, your body adapts to the use of Alprazolam and other benzodiazepines. This adaptation can actually cause the medicine to stop working. For some people it occurs in about 6 months. Others take roughly 2 years. But at some point, your body will very likely adapt to the drug until it no longer works.
  • Psychological Dependence When you depend on medicine as a treatment, you start to "need" it as your way of coping with anxiety, because your mind doesn't know any other way to cope. Psychological dependence is when you don't necessarily need it physically (although you may), but because you don't know any other way to cope with anxiety, you'll want to go back to the drug if you have any anxiety and will have more anxiety if the drug is not available.

Dependence - especially physical dependence - can also lead to withdrawal symptoms, and in some cases these can be very severe. In many ways, Alprazolam has the same withdrawal symptoms as alcoholism, including not only anxiety and panic attacks, but also memory loss, muscle ache, headache, sweating, sleep problems, nausea, hallucinations, and even seizures. There is even a small risk of suicide.

If you wean off of the drug slowly over time you can decrease the likelihood of these withdrawal symptoms, but long term use of Alprazolam, even if it stops working, will increase the risk that withdrawal occurs. Perhaps even more unusual is that the withdrawal symptoms may also come and go over time after you stop taking the medicine.

Alprazolam Side Effects

The side effects of Alprazolam are similar to other benzodiazepines. The main concern is sedation. Alprazolam can cause extreme fatigue, not unlike alcohol use. It may also cause concentration problems, poor motor skills, memory loss, and lack of coordination. While many medicines tell you not to operate machinery or drive until you know how the drug affects you, with Alprazolam you absolutely need to follow that advice.

Other side effects include:

  • Lack of inhibitions/lack of fear.
  • Dizziness/vertigo.
  • Dry mouth.
  • Trouble breathing.
  • Memory loss.
  • Changes in sex drive.

Upset stomach/nausea, and headaches may also occur. Combining Alprazolam with other drugs of abuse can also be fatal. Alprazolam should absolutely not be taken with alcohol.

Overall Thoughts on Alprazolam For Anxiety

Despite what many people will tell you, anxiety drugs are not inherently bad. For those that have not seen success with other treatments, or those whose anxiety is so severe they need immediate relief simply to get through their day, anxiety medications may not be a terrible idea. They have side effects, but they're generally not too dangerous, and Alprazolam is an example of one of the few medicines that could have an impact on your life.

But anxiety drugs should not be used as a first choice, nor should they ever be the only choice. You should first make sure to try coping treatments and psychological interventions to learn how to cure your anxiety without medication, and if you do decide to take Alprazolam or any anxiolytic, you need to make sure that you're also working on treatments that will keep your anxiety away if you stop taking the drug in the future.

If you want to learn more about how to cure anxiety without the use of medications, make sure you take my anxiety test now. It's an incredibly important tool for learning more about your symptoms and providing you with non-medicinal treatment recommendations.

Start the test here.


Klosko, Janet S., et al. A comparison of alprazolam and behavior therapy in treatment of panic disorder. Journal of consulting and clinical psychology 58.1 (1990): 77.

Marks, Isaac M., et al. Alprazolam and exposure alone and combined in panic disorder with agoraphobia. A controlled study in London and Toronto. The British Journal of Psychiatry 162.6 (1993): 776-787.

Chouinard, G., et al. Alprazolam in the treatment of generalized anxiety and panic disorders: a double-blind placebo-controlled study. Psychopharmacology 77.3 (1982): 229-233.

Author: Micah Abraham, BSc Psychology, last updated Sep 28, 2017.

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