Benzodiazepines like Xanax can help some patients manage their anxiety, but it’s important to be aware of what problem Xanax usage looks like.
Albert Hernandez
July 8, 2022
Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 20, 2022
6 min read
In my practice, some of my patients with anxiety disorders take anxiolytic (anti-anxiety) medications in the benzodiazepine class. Also called benzos, anxiolytics like Xanax (generic name: alprazolam) and Valium (generic name: diazepam) work on anxiety by relaxing the patient’s entire central nervous system (CNS). While benzos can be very effective for relieving anxiety in the short term, due to this CNS depressant effect, benzos like Xanax have a high addiction potential. They also have the capacity to cause dangerous side effects. With this in mind, I remind patients that for the treatment of generalized anxiety disorder (GAD) or panic disorder, alprazolam is usually not a sufficient treatment by itself. The treatment of GAD or panic disorder usually requires the addition of an antidepressant medication, such as a Paxil.
Without an antidepressant on board, a person with an anxiety disorder might end up relying too heavily on their benzodiazepine. Patients who are prescribed a benzo might wonder, “How can I tell if I’m taking too much Xanax?” If you’re not sure if you’re taking too high of an alprazolam dose, I’d ask you to consider your relationship with this medication. What might your day look like with less Xanax?
Does even the thought of cutting back on your daily Xanax dose make you break into a sweat like you're trekking through a Texas or New Mexico desert? Don’t sweat it out alone like you’re in the El Paso or Albuquerque midday sun. Instead, realize that learning more about how to recognize if your benzodiazepine dose is therapeutic or problematic can help to set your mind at ease.
"If you recognize some of the signs of problem usage of Xanax in yourself, it could be useful to learn about alternative and/or supplemental treatments for your anxiety disorder."
Daily Maximum Xanax Dose for Anxiety Disorders
While the daily maximum limit of Xanax for a person with GAD is 4 mg daily, and the max limit for a patient with panic disorder is 6 mg daily, every person is unique.
There is no clear-cut answer to how much of a benzo will be too much for you. The right amount of alprazolam is the dose that will help you manage your anxiety disorder without troublesome side effects or behaviors that indicate addiction. Let’s delve deeper into signs that your Xanax usage may be unhelpful or harmful.
How To Recognize a Problem With Your Xanax Usage
Although Xanax and other benzos have their place in the treatment of anxiety disorders, they are central nervous system depressants. In addition to their anxiolytic or anxiety-reducing effect, benzos can cause issues for patients. These issues can include interfering with your functioning due to loss of coordination, slowed reaction times, and mental fogginess. Benzos may also cause physical and psychological dependence. Whether or not a patient is on the max daily dose of Xanax, here are some warning signs I like to make patients aware of. If you are identifying with any of these scenarios in relation to your Xanax use, that’s a problem.
- Sedation: If you find that you are often sedated, you are likely not on the correct dose of alprazolam. Bringing your anxiety level down shouldn’t mean being so relaxed that you are sleepwalking through life, or unable to participate in activities like driving or working.
- Alcohol: Mixing alcohol and Xanax is also a problem. Because both substances depress your central nervous system, they can amplify each other’s effects. If you drink alcohol while taking your benzo, you might become so impaired that you can’t function. You also run the risk of slowing your breathing down to the point where you’re not breathing at all. This is a serious emergency that can result in death.
- Dosage changes: Another way you might notice a problem with your alprazolam is that you are requiring frequent dosage changes. Needing more and more Xanax to get the same effect means that you may be approaching too high of a dose of Xanax without having your anxiety symptoms truly under control.
- Constant checking with the pharmacy: If you find yourself calling the pharmacy too soon, wanting your refill of Xanax before it’s due, this indicates that you might be misusing your benzo. You may be taking more alprazolam than your provider has prescribed. It can be dangerous if you are taking more Xanax than you are supposed to. This behavior can also be indicative of increasing dependence on your benzodiazepine, which is a concerning situation.
Adding an Antidepressant For The Treatment of Your Anxiety Disorder
Whether or not you find yourself in a situation where you’re concerned about your Xanax intake, your provider might decide to add an antidepressant to your GAD or panic disorder treatment. A selective serotonin reuptake inhibitor (SSRI), like Paxil, is a common choice in the treatment of anxiety disorders. Although SSRIs can have some side effects, like appetite changes or sleep disturbances, these side effects are usually mild.
SSRIs help to manage anxiety symptoms without the sedation issues that benzos can cause. And patients don’t have to worry about becoming addicted to SSRIs. Although it can take a few weeks for antidepressants to take full effect, as opposed to the instant impact of a benzo, they can be a better fit for daily management of panic disorder or GAD. Therefore, many patients who have an anxiety disorder will be best served by taking an antidepressant daily and using their benzo only intermittently, for breakthrough symptoms or panic attacks.
To determine if you’re on the right dose of a benzodiazepine, you and your behavioral health provider will look at how well your anxiety is controlled, what side effects you are experiencing, and whether you are showing dependent behaviors toward your medication. Most patients will not get the maximum benefit from alprazolam alone; instead, Xanax will be best utilized for their breakthrough anxiety symptoms. The majority of patients find that their anxiety disorder should be treated with an antidepressant, as well.
When you work with a behavioral health expert with experience treating anxiety disorders, you will be able to manage your anxiety with the safest, most effective medication regimen. If you live in El Paso, Las Cruces, Albuquerque, or any of the other areas we serve, consider coming to Upper Valley Behavioral Health for your anxiety treatment. Complete our application for treatment today.
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.
Woman with multiple bottles of Xanax (alprazolam) spinning around her head for possible overdose.
Albert Hernandez
July 8, 2022
Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 20, 2022
6 min read
Albert Hernandez
July 8, 2022
Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 20, 2022
6 min read
In my practice, some of my patients with anxiety disorders take anxiolytic (anti-anxiety) medications in the benzodiazepine class. Also called benzos, anxiolytics like Xanax (generic name: alprazolam) and Valium (generic name: diazepam) work on anxiety by relaxing the patient’s entire central nervous system (CNS). While benzos can be very effective for relieving anxiety in the short term, due to this CNS depressant effect, benzos like Xanax have a high addiction potential. They also have the capacity to cause dangerous side effects. With this in mind, I remind patients that for the treatment of generalized anxiety disorder (GAD) or panic disorder, alprazolam is usually not a sufficient treatment by itself. The treatment of GAD or panic disorder usually requires the addition of an antidepressant medication, such as a Paxil.
Without an antidepressant on board, a person with an anxiety disorder might end up relying too heavily on their benzodiazepine. Patients who are prescribed a benzo might wonder, “How can I tell if I’m taking too much Xanax?” If you’re not sure if you’re taking too high of an alprazolam dose, I’d ask you to consider your relationship with this medication. What might your day look like with less Xanax?
Does even the thought of cutting back on your daily Xanax dose make you break into a sweat like you're trekking through a Texas or New Mexico desert? Don’t sweat it out alone like you’re in the El Paso or Albuquerque midday sun. Instead, realize that learning more about how to recognize if your benzodiazepine dose is therapeutic or problematic can help to set your mind at ease.
"If you recognize some of the signs of problem usage of Xanax in yourself, it could be useful to learn about alternative and/or supplemental treatments for your anxiety disorder."
Daily Maximum Xanax Dose for Anxiety Disorders
While the daily maximum limit of Xanax for a person with GAD is 4 mg daily, and the max limit for a patient with panic disorder is 6 mg daily, every person is unique.
There is no clear-cut answer to how much of a benzo will be too much for you. The right amount of alprazolam is the dose that will help you manage your anxiety disorder without troublesome side effects or behaviors that indicate addiction. Let’s delve deeper into signs that your Xanax usage may be unhelpful or harmful.
How To Recognize a Problem With Your Xanax Usage
Although Xanax and other benzos have their place in the treatment of anxiety disorders, they are central nervous system depressants. In addition to their anxiolytic or anxiety-reducing effect, benzos can cause issues for patients. These issues can include interfering with your functioning due to loss of coordination, slowed reaction times, and mental fogginess. Benzos may also cause physical and psychological dependence. Whether or not a patient is on the max daily dose of Xanax, here are some warning signs I like to make patients aware of. If you are identifying with any of these scenarios in relation to your Xanax use, that’s a problem.
- Sedation: If you find that you are often sedated, you are likely not on the correct dose of alprazolam. Bringing your anxiety level down shouldn’t mean being so relaxed that you are sleepwalking through life, or unable to participate in activities like driving or working.
- Alcohol: Mixing alcohol and Xanax is also a problem. Because both substances depress your central nervous system, they can amplify each other’s effects. If you drink alcohol while taking your benzo, you might become so impaired that you can’t function. You also run the risk of slowing your breathing down to the point where you’re not breathing at all. This is a serious emergency that can result in death.
- Dosage changes: Another way you might notice a problem with your alprazolam is that you are requiring frequent dosage changes. Needing more and more Xanax to get the same effect means that you may be approaching too high of a dose of Xanax without having your anxiety symptoms truly under control.
- Constant checking with the pharmacy: If you find yourself calling the pharmacy too soon, wanting your refill of Xanax before it’s due, this indicates that you might be misusing your benzo. You may be taking more alprazolam than your provider has prescribed. It can be dangerous if you are taking more Xanax than you are supposed to. This behavior can also be indicative of increasing dependence on your benzodiazepine, which is a concerning situation.
Adding an Antidepressant For The Treatment of Your Anxiety Disorder
Whether or not you find yourself in a situation where you’re concerned about your Xanax intake, your provider might decide to add an antidepressant to your GAD or panic disorder treatment. A selective serotonin reuptake inhibitor (SSRI), like Paxil, is a common choice in the treatment of anxiety disorders. Although SSRIs can have some side effects, like appetite changes or sleep disturbances, these side effects are usually mild.
SSRIs help to manage anxiety symptoms without the sedation issues that benzos can cause. And patients don’t have to worry about becoming addicted to SSRIs. Although it can take a few weeks for antidepressants to take full effect, as opposed to the instant impact of a benzo, they can be a better fit for daily management of panic disorder or GAD. Therefore, many patients who have an anxiety disorder will be best served by taking an antidepressant daily and using their benzo only intermittently, for breakthrough symptoms or panic attacks.
To determine if you’re on the right dose of a benzodiazepine, you and your behavioral health provider will look at how well your anxiety is controlled, what side effects you are experiencing, and whether you are showing dependent behaviors toward your medication. Most patients will not get the maximum benefit from alprazolam alone; instead, Xanax will be best utilized for their breakthrough anxiety symptoms. The majority of patients find that their anxiety disorder should be treated with an antidepressant, as well.
When you work with a behavioral health expert with experience treating anxiety disorders, you will be able to manage your anxiety with the safest, most effective medication regimen. If you live in El Paso, Las Cruces, Albuquerque, or any of the other areas we serve, consider coming to Upper Valley Behavioral Health for your anxiety treatment. Complete our application for treatment today.
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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