Xanax (alprazolam) is a mild tranquilizer that helps calm the nerves and brings about a feeling of relaxation. It is one of the most widely prescribed drugs in a class of medications called benzodiazepines.
Xanax tolerance may develop after taking the medication regularly. If this happens, you may notice that your current dose no longer works as effectively as it did previously.
Note that Xanax has a black box warning, which is the most serious warning from the Food and Drug Administration (FDA).
- Avoid taking Xanax with opioids. Mixing Xanax and opioids can increase the risk of severe sleepiness, respiratory depression, coma, and death.
- Using Xanax can lead to physical dependence and life threatening withdrawal if you stop taking Xanax suddenly.
- Taking Xanax can lead to misuse and addiction. Misuse increases the risk of overdose and death.
- Only take Xanax as your doctor prescribes. Talk with your doctor if you have any safety concerns related to this drug.
Xanax tolerance
Xanax is known to have the ability to cause tolerance.
If your body develops tolerance, or gets used to Xanax, you won’t get the same effects as before. Symptoms that Xanax used to help you address may crop up again, or you might feel like your symptoms aren’t being managed effectively.
If this happens, your doctor may recommend increasing your dosage or changing how you take the medication. They may also prescribe a different medication instead of Xanax.
Tolerance to any medication, including Xanax, happens at different rates for different people. For some people, it may happen quickly, while for others, it may happen more slowly. Among other factors, behavioral and genetic elements can impact tolerance.
Cross tolerance
Cross tolerance is tolerance to other drugs in the same class, even though you have not taken those drugs. In other words, if you develop a tolerance to Xanax, you may also have a tolerance to other benzodiazepines like chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan), or triazolam (Halcion).
If you experience cross tolerance with benzodiazepines, your doctor may prescribe an alternate medication from another class, such as selective serotonin reuptake inhibitors (SSRIs). Examples of SSRIs are sertraline (Zoloft), paroxetine (Pexeva, Paxil), and fluoxetine (Prozac).
Drug tolerance vs. drug dependence
It’s important to know that tolerance isn’t the same as dependence. The difference is how your body reacts to the drug’s absence or presence.
Tolerance
When you take medication, it causes certain cell receptors to activate. When you develop a tolerance, these receptors no longer respond to the drug like they did previously. In some situations, your body may even clear the drug from your system faster than it used to.
Dependence
When your body becomes used to the presence of the medication, it experiences withdrawal when the medication is no longer present (or abruptly reduced). Your body only functions normally with the medication present.
This can be an issue since the physical need for the drug can lead to addiction or substance use disorder.
It’s important not to stop taking Xanax abruptly, since doing so increases your risk of withdrawal symptoms. If you want to stop taking Xanax or decrease the amount you take, talk to your doctor about how to taper off safely.
Is Xanax addictive?
According to a 2018 review published in the Journal of Addiction Medicine, most addiction specialists consider Xanax to be highly addictive. The review indicates that withdrawal symptoms after stopping Xanax appear to be more severe than with other benzodiazepines.
It also noted that Xanax should be avoided during pregnancy and breastfeeding because it may cause withdrawal for the newborn.
When prescribed by a doctor, Xanax can still be beneficial for those with anxiety and panic disorders. The Xanax label notes that the risk of dependence is highest in people who take more than 4 milligrams (mg) of Xanax per day, or people who take Xanax for more than 12 weeks.
