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How Does Xanax Work in the Brain?

Xanax is the brand name for the drug alprazolam. It belongs to a class of drugs called benzodiazepines (also known as benzos) that have a calming effect on the central nervous system (CNS). They do this by strengthening the activity of certain neurotransmitters in the brain. But how does Xanax work in the brain? What are its effects on a person’s cognitive functions?

What Are Neurotransmitters?

A neurotransmitter is a chemical messenger that carries, boosts, and balances the signals between nerve cells (neurons) and the target cells all over the body. The target cells may be in muscles, glands, or other neurons. There are literally billions of neurotransmitter molecules constantly working to keep our brains functioning. Neurotransmitters manage:

  • Breathing
  • Heartbeat
  • Learning and concentration levels
  • Psychological functions such as fear, pleasure, joy, and overall mood


Xanax is a sedative, which means it affects the brain by changing certain nerve communications in the central nervous system to your brain. This is how they relax your body by slowing down your brain activity. 

Sedatives make the neurotransmitter called gamma-aminobutyric acid (GABA) work overtime. This is the neurotransmitter responsible for slowing down the brain. By increasing its activity in the CNS, sedatives such as Xanax permit GABA to cause a much stronger effect on the activity in the brain. GABA reduces the activity in the areas of the brain that are responsible for:

  • Memory
  • Emotions
  • Reasoning
  • Vital functions such as breathing

What is Xanax Used For?

Xanax is used primarily to treat anxiety and panic disorders. It can also be prescribed for:

  • Sleep disorders
  • Alcohol withdrawal
  • Seizure control
  • Muscle relaxation
  • Causing amnesia for uncomfortable procedures
  • Given before surgery

Sedatives work in a straightforward way. When an individual feels anxious, the brain is overstimulated. Upon use, Xanax increases the effects of GABA so the brain sends messages to counteract the overstimulation. This, in turn, reduces the symptoms of anxiety.

Side Effects

Some of the immediate side effects of Xanax are:

  • Sleepiness
  • Dizziness
  • Blurry vision
  • Slower reaction time
  • Loss of depth perception
  • Trouble focusing or thinking
  • Slower breathing
  • Speaking slowly

Long-term use can lead to:

  • Anxiety
  • Fatigue
  • Frequent forgetfulness or amnesia
  • Liver dysfunction or failure from overdose or tissue damage
  • Depression symptoms such as hopelessness or suicidal thoughts
  • Dependence on sedatives that can lead to irreversible effects or withdrawal symptoms after abruptly ending use

How Does Xanax Work in the Brain? Signs of Dependence on Xanax

You may have developed dependency if you notice that you’re taking Xanax regularly and feel like you can’t stop taking it. This may be particularly obvious if you’re using more than your prescribed dose or a safe amount.

Dependence also becomes more noticeable when you need a higher dose to experience the same effect. This happens when your body becomes used to the drug and needs more to feel the desired effect. It means that you have developed a tolerance to the drug.

Is Xanax Addictive?

Yes, Xanax can be addictive. In fact, you can get addicted even if you use this medication as prescribed by your doctor. Also, if you have a history of drug or alcohol abuse, you are more likely to develop an addiction. Even though certain people have a genetic inclination to become addicted to drugs, there is no doubt that factors in the environment can play a big part. Common environmental influences are:

  • Low economical and social status
  • Accessibility to Xanax or other drugs
  • Peer pressure

Common Signs of Addiction

Regardless of the substance, there are certain signs of addiction. Some general warning signs that you or a loved one has an addiction include:

  • An urge or craving to use that’s so strong it’s hard to think about anything else
  • Tolerance (needing to use more of the drug to achieve the same “high”)
  • Taking the drug more frequently or taking it over longer periods of time
  • Spending a lot of time getting the drug, using it, and recovering from use
  • Continuing to use the drug despite its negative effect on work, home, or school
  • Continuing use although it is causing social and personal relationship problems
  • Abandoning important hobbies or activities to use the drug
  • Continuing to use in situations that can cause harm
  • Using the drug even though it is causing physical or mental problems
  • Being unable to stop using the drug without the help of a professional
  • Experiencing symptoms of withdrawal when substance use ends

Identifying Addiction in Others

Loved ones often try to hide their addiction. You may even wonder if it’s drugs or something like a stressful life change or situation, or a demanding job. Nevertheless, the way an individual behaves while living with an addiction, can shift widely. You may notice changes in:

  • mood
  • behavior
  • appearance
  • performance at work or school

But other factors can cause these changes to occur. That’s why addiction is a challenging diagnosis best left to professionals. However, if your loved one is dealing with certain hardships or asks you for help, it may be useful to start a conversation regarding how and where to get help.

Treatment for Xanax Addiction

If you have decided to stop using Xanax or want to help a loved one, you should know that withdrawal symptoms may happen when the Xanax dosage is reduced for any reason. Symptoms including seizures have been reported after using Xanax only briefly for the treatment of anxiety. 

Thankfully, however, we are here to help you throughout the withdrawal and recovery processes. Located in California, Harmony Place offers a compassionate and comprehensive approach to addiction treatment. Our full continuum of care addresses the needs of our patients, from detoxification to residential and outpatient treatment. So, if you are ready to end Xanax abuse in your life, we are ready to assist you right now!

Detox and Withdrawal

Detoxification (detox) is a process that can help people safely stop taking Xanax while minimizing and managing withdrawal symptoms. Detox usually occurs in a hospital or rehabilitation facility under medical supervision.

Often, the use of Xanax diminishes over time. This is called tapering and the process can take up to 6 weeks (although it can sometimes take longer). Other medications can be prescribed to ease the withdrawal symptoms.

Withdrawal Symptoms

Unfortunately, symptoms of Xanax withdrawal can be more severe than withdrawal symptoms from other benzos. They include:

  • Anxiety
  • Tremors
  • Headaches
  • Aggression
  • Blurred vision
  • Mood swings and irritability
  • Oversensitivity to light and sound
  • Numbness and tingling in the hands, feet, or face
  • Suicidal thoughts
  • Nightmares
  • Depression
  • Paranoia
  • Seizures
  • Nausea

Withdrawal Timeline

Since there is no definitive guide to the symptoms, severity, and timeline of withdrawal, each individual may go through withdrawal differently. It depends on these factors:

  • Dosage
  • Severity of misuse
  • Any underlying mental health condition
  • The length of time using benzodiazepines
  • Using benzos without a prescription
  • Using other drugs at the same time
  • Misusing other drugs or alcohol

Furthermore, there are 3 possible phases for benzo withdrawal. Each phase has an estimated timeline. Individuals withdrawing from benzodiazepines should have the supervision and guidance of medical professionals. Never end drug use suddenly without consulting with a professional and developing a safe plan.

Phase 1. Immediate or Early Withdrawal

Early withdrawal symptoms are sometimes called “rebound symptoms”. They occur shortly after benzo use ends. The symptoms from short-acting benzodiazepines like Xanax may start sooner than from long-acting drugs.

Also, during the early stages of withdrawal, you might experience some of the symptoms of the condition that you were using Xanax to treat. As an example, the symptoms of anxiety or panic might return or intensify after stopping your use. Tapering off or using medication to ease symptoms can make these early symptoms more manageable.

Phase 2. Acute Withdrawal

After the early withdrawal symptoms, acute withdrawal will begin. Generally, this happens within a few days and symptoms usually last 5-28 days, although some may last for several months. Most of the withdrawal symptoms occur in this phase. At this time, the individual may need to be monitored by a physician and prescribed medication to manage the most severe symptoms.

Phase 3. Post Acute Withdrawal Symptoms (PAWS)

Most of the symptoms will subside after the acute phase but there may still be some lasting side effects. Xanax in particular is reported to have some symptoms that may last for up to 2 years. Published research has reported that an estimated 10-25% of people who used benzodiazepines for long periods may have withdrawal symptoms that last for 12 months or more.

PAWS might bring on its own set of symptoms including:

  • Anxiety
  • Insomnia
  • Depression
  • Mood swings
  • Loss of sex drive
  • Difficulty concentrating

These symptoms can be distressing and disrupt one’s quality of life. They can begin without any warning and be a significant cause of torment. The support of professional counseling and other therapies or medication can help manage these symptoms.

Treatment Programs

After a medically monitored detox, you will need to enter a treatment program. The program you enter depends on your needs after completing detox. Some people will be able to enter outpatient treatment, and some may need residential treatment.


Depending on the severity of your substance use disorder, an addiction treatment professional may determine that you need intensive, around-the-clock care. In this case, you may benefit from a residential program, which will allow you to live in the treatment facility. A residential facility offers a secure, structured environment with 24-hour medical availability and full days of structured therapy programming. By living at the treatment center, you can focus on getting yourself well, free of the distractions and triggers of the outside world. It is the highest level of care for addiction treatment.

Outpatient Programs

Outpatient programs are most effective for people who have a supportive, drug-free family at home. Also, they are an excellent continuation of treatment after a residential treatment program. 

Partial Hospitalization Program (PHP)

A PHP is the highest level of care in an outpatient program. It requires the most time in treatment of the outpatient levels. Typically, you will spend  5 days a week in treatment and attend full days of counseling but you won’t be living in the facility.

Intensive Outpatient Program (IOP)

Intensive outpatient programs generally provide therapeutic care 3 – 5 days a week for several hours a day. Many treatment centers give you the opportunity to schedule treatment sessions around work or school hours.

Outpatient Program (OP)

Regular outpatient programs include sessions 3 days a week for about 3 hours per day. Outpatient programs are a good step down from an IOP. The longer you continue treatment, the better your chances of a successful long-term recovery.

Finding Your Way to Harmony

Whether for yourself or a loved one, there is a way to find a successful balance, or harmony, in your life. At Harmony Place, we are experienced in the care and treatment of substance use disorders. Our staff of licensed therapists and addiction specialists will help guide you and your family through the ups and downs of addiction treatment. 

From residential treatment on through to aftercare and the support of our alumni group, we are with you every step of the way. Don’t let this moment slip away. Contact us now. We are waiting to help you.