How Does Xanax Use Affect the Brain?

Xanax can cause short-term and long-term damage to brain function. Some of the damage may be permanent. Learn more about Xanax and brain health.

Xanax, also known by the generic drug name alprazolam, is a commonly prescribed medication. It is the most commonly prescribed drug that can impact a person’s mental state. Doctors often use Xanax to treat people with severe anxiety or panic problems. However, the drug is not free of risk. Xanax is classified by the Drug Enforcement Administration as a Schedule IV controlled substance.

Additionally, as a benzodiazepine, Xanax has to get into the brain to work. The brain is the site of action for Xanax. Unfortunately, Xanax can have other effects on the brain that are not desirable. For example, Xanax can impact memory and thinking. Some of these effects may be long-term or permanent — even if the person stops taking the drug.

Short-Term Effects: Xanax and the Brain

Most formulations of Xanax are short-acting. Therefore, the drug starts working very quickly and reaches its peak effect within one to two hours. Some of the most common side effects of Xanax are related to its effect on the brain:

• Feeling sleepy or tired
• Feeling dizzy
• Memory problems, including amnesia for events that happen after taking the drug
• Mood problems

Xanax and Brain Chemistry Short-Term

Xanax works on the brain by enhancing the effect of a chemical called gamma-aminobutyric acid (GABA). Some doctors describe GABA as a natural tranquilizer. GABA halts brain signals that would otherwise excite the brain and lead to anxiety or panic. Higher levels of the chemical may cause a person to feel relaxed or sleepy. Xanax is a potent drug which is more powerful than some other benzodiazepines. Also, unlike some other benzodiazepines, Xanax may trigger the brain’s reward system. This possibility puts people at higher risk of developing an addiction to Xanax compared to other benzodiazepines.

Long-Term Effects: Xanax and the Brain

Long-term use of Xanax may lead to memory problems. Studies showed that people taking Xanax have more memory problems compared to people not using the drug. Doctors found that people who stopped Xanax use have memory problems that last four months. These memory problems may be permanent in some cases. Other long-term effects of benzodiazepines include:

• Visual-spatial problems
• Lowered IQ
• Problems processing information quickly
• Trouble learning new verbal skills
• Problems concentrating
• Delay in response time

However, it is important to note that most of the studies about the long-term effects of benzodiazepines on the brain were conducted with people who were taking the drug at the time. Therefore, it remains unclear if these effects are due to changes in the brain itself, or simply side effects of the drug that may go away if the drug were stopped.

Xanax and Brain Chemistry Long-Term

Over time, the brain starts to expect higher levels of GABA. Therefore, the brain may make less GABA on its own and start depending on the Xanax. This process can happen in as little as six weeks. A person may need stronger doses of Xanax to achieve the same calming effects as originally experiences. After some time this pattern leads to tolerance, dependence and can even lead to addiction.

If a person stops taking Xanax suddenly, they may experience worsened anxiety and panic attacks than before because the brain is not making as much GABA on its own. Doctors refer to this development as rebound anxiety. Likely due to rebound anxiety, Xanax is known to cause worse withdrawal symptoms than other benzodiazepines. Some of those withdrawal symptoms may last for months or years. Many withdrawal symptoms are related to Xanax’s effects on GABA in the brain, and can include:

• Feeling anxious or panicked
• Problems sleeping
• Feeling dizzy
• Mental status changes
• Mood changes
• Seizures

Editor – Thomas Christiansen

With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more