Don't Panic, But Xanax Might Not Be Your Best Choice For Panic Disorder

Woman Dependent On Xanax
Female that is trapped inside a pill bottle of Xanax (alprazolam) and is trying to overcome her dependence on it.

Is Xanax a Long-Term Treatment for Panic Disorder? Why Might You Want to Consider a Medication Other Than a Benzo for Anxiety?

Albert Hernandez

October 11, 2021
 Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 20, 2022
  6 min read

October 11, 2021
 Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 20, 2022
  6 min read


Our practice sees patients all throughout the beautiful Southwest, from El Paso, TX to Albuquerque, NM. When I am meeting new patients who have anxiety disorders, they often fear making a change to a medicine regimen that may have helped them at one point. I have many patients that have been prescribed Xanax in the past and they swear it’s the only thing that helps them manage anxiety.

To be sure, Xanax (generic name: alprazolam) and other benzodiazepines can be effective for treating anxiety symptoms in some short-term situations, like:

  • Panic associated with a specific event
  • Anxiety around travel
  • Life upheavals, like death, divorce, or other trauma
  • Breakthrough panic attacks

However, there are reasons why you might not want to take benzodiazepines (sometimes called “benzos”) as a daily long-term treatment. To look at why Xanax might not be the most effective long-term treatment for panic disorder and other anxiety disorders, let’s review how the body uses it.

How Xanax Works

Xanax and other benzodiazepines seem to affect specific neurotransmitters (brain chemicals) in your central nervous system. We don’t know exactly how Xanax works to decrease symptoms of anxiety. We do know that Xanax, like other benzodiazepines, has a depressant effect on the body’s central nervous system. When Xanax has this effect on your central nervous system, you can feel calmer. 

In the short term, Xanax can be effective for sleep problems associated with anxiety. The overall tranquilizing impact that Xanax has on your central nervous system can improve other symptoms of anxiety, too. 

You and your behavioral health provider may find the Xanax is effective for your panic disorder or other anxiety disorder. However, due to some of the side effects and long-term concerns of benzodiazepine use, you and your provider may explore other treatment options. 

Potential Drawbacks of Xanax as a Long-Term Anxiety Treatment 

The calming effect that Xanax and other benzodiazepines have on your central nervous system doesn’t just tackle the symptoms of anxiety. Because your central nervous system regulates your muscles, your breathing, and your thinking, benzos can have unintended consequences. Some people experience problems with their memory when taking alprazolam. Many people initially experience drowsiness or lack of coordination when they are started on Xanax. For this reason, patients are usually told not to drive or use certain types of equipment until they see how Xanax is impacting them.

Bars and tablets of Xanax (alprazolam).

The central nervous system depressant effect of Xanax can go so far as to cause breathing problems, especially if a patient takes too much of the medication. It is possible to overdose on benzodiazepines and stop breathing. This is a medical emergency and can lead to death. Mixing alcohol and benzos can be very dangerous, as well, because of how both substances impact your central nervous system. If you consume alcohol while taking Xanax, you could experience a decrease in your respiratory rate that is also a medical emergency.

Many patients find that the effects of Xanax decrease over time. While patients no longer feel the sleepiness or slowed reflexes that they experienced at the beginning of treatment, the ability of Xanax to calm their anxiety symptoms is also reduced. Therefore, patients find that they require higher and higher doses of their benzodiazepine to experience the same symptom relief. This increasing need can cause physical dependence on Xanax. This is particularly worrying for patients who are at risk for addiction. 

A person should not suddenly stop Xanax without making a plan with their prescriber. If you suddenly stop taking Xanax, you might have uncomfortable or dangerous withdrawal symptoms. 

Although some patients will require long-term Xanax treatment, due to the listed side-effects and potential for addiction, for many patients, it will be safer to use benzodiazepines in the short-term only.

If Xanax Isn’t the Best Treatment for My Anxiety, What Is?

What if you’re saying to yourself, “Okay, I get that benzos might have some side effects that are more than I want to deal with. But they’re the only medication that has ever worked for my panic attacks.” Or maybe your cousin in El Paso says that alprazolam helps her with her social anxiety. You thought you wanted to give Xanax a shot for your anxiety, but now you’re not so sure?

Working with a board-certified behavioral health expert is key to figuring out the right medication regimen for you.

Woman that is holding a Xanax (alprazolam) tablet above her head and looking for other treatment options.

There are other medications that don’t have the dependence and impairment issues of Xanax and other benzodiazepines. You and your prescriber may find that a non-controlled substance, such as a selective serotonin reuptake inhibitor (SSRI), like Paxil or Zoloft, or a serotonin-norepinephrine reuptake inhibitor (SNRI), like Cymbalta, is a better option for your anxiety.  

If your behavioral health provider prescribes an SSRI or SNRI for your anxiety, you might be started on a lower dose and gradually moved up to your maintenance dose. Although it can take a few weeks and even trying some different medications to find the right meds for you, the benefits of SSRI/SNRIs versus benzodiazepines are significant. The risk of dependence and addiction are much lower for SSRI/SNRIs.

Although there are potential side effects for SSRI/SNRIs, you and your behavioral health expert can work together to find a medication that isn’t known for particular side effects that you’re concerned about. SSRI/SNRIs don’t carry the same risk of lowering your breathing rate and therefore causing sedation or even death that Xanax has.

Many of my patients who thought they would always need Xanax have found relief from their anxiety with a different medication. If you are located in El Paso, New Mexico, or one of the other areas we serve, and you are looking for relief from anxiety, I would love for you to join them. Click here to fill out our brief application for treatment.

Disclaimer: This post is for informational purposes only. It does not replace instructions from your licensed prescriber. Please consult your healthcare provider for guidance on your specific medication regimen.

Tags: xanax, panic disorder, anxiety, anxiety attacks, panic attacks

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