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Can You Overdose on Xanax?


Xanax is the brand name for alprazolam. It’s a benzodiazepine that’s frequently prescribed for the treatment of panic disorder and other forms of anxiety. Benzodiazepines or “benzos” are a class of drugs that are recognized for being fast-acting but highly addictive. Apart from elderly adults with progressive, age-related illnesses and others receiving end-of-life treatments, Xanax and other benzos like it are often only prescribed for short-term use. Not only is this medication habit-forming, but it also has a high risk of overdose. If you or someone you love is currently taking Xanax, it’s important to understand the following:

  • Risk factors for Xanax overdose
  • Medications that are contraindicated with Xanax
  • Common symptoms of a Xanax overdose

and the factors that determine a lethal Xanax dosage.

Is a Xanax Overdose Possible?

Xanax overdoses are both possible and unfortunately common. This is due in large part to the addictive nature of this drug and the way in which it interacts with other medications and alcohol. Many people with underlying mental health disorders such as:

are prescribed Xanax to control their symptoms. However, when Xanax is used in a long-term capacity, gradual increases in tolerance can cause people to take more Xanax than they’ve been prescribed. People with increased tolerance to Xanax may even begin pairing this drug with other substances to heighten its effects. Taking Xanax when it hasn’t been prescribed, taking more of this drug than is recommended, and using it with other substances such as alcohol are all things that greatly increase the risk of a Xanax overdose. Given that aging adults don’t process Xanax as rapidly or efficiently as younger people do, seniors are at an elevated risk of overdose. Seniors using Xanax to treat Parkinson’s-related anxiety often become physically and psychologically dependent upon this drug. Fortunately, when overdose risks are high and when substance use disorder is imminent, there are alternative anxiety medications that can be used in lieu of Xanax. Moreover, these medications provide similar benefits and do not present the same dangers. 

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Lethal Dosage of Xanax

The lethal dose of Xanax can vary from person to person based upon a variety of factors including:

  • Individual tolerance
  • Other medications or substances being used
  • Bodyweight
  • Age
  • Pre-existing medical conditions
  • Heart health
  • The health of the individual’s filter organs

However, the typical Xanax dose ranges between just 0.25 and 0.5 milligrams per day. This can be split between several doses taken over the course of the day. 

Signs of an Overdose on Xanax

Given the drug’s impact on a person’s brain chemistry, regular Xanax use is virtually guaranteed to cause a variety of side effects. Many people who use Xanax for an extended period of time will eventually experience dizziness, drowsiness, blurry vision, mild headaches, and difficulty sleeping. These issues should not be confused with the mild symptoms of overdose such as:

  • Confusion and disorientation 
  • Decreases in coordination
  • Uncontrolled movements
  • Tremors
  • Elevated heart rate
  • Diminished reflexes

Identifying and addressing mild symptoms of a Xanax overdose early on is important. When people use Xanax regularly, this drug cannot be safely stopped without a managed tapering plan. Sudden cessation of Xanax can be just as dangerous as a Xanax overdose. Getting medical help is essential for effectively managing mild overdose symptoms without causing other problems.

The symptoms of a severe Xanax overdose include:

  • Seizures
  • Chest pain
  • Breathing difficulties

and coma. Whether moderate or severe, whenever a Xanax overdose is suspected, medical assistance should be received right away. 

Risks of Mixing Other Drugs With Xanax

Taking too much Xanax is one way to cause an alprazolam overdose. However, the dangers of Xanax overdose are especially high when this drug is paired with alcohol, opioids, and other substances that affect the same neuropathway. Alprazolam incites the release of gamma-aminobutyric acid (GABA). GABA is the “feel good” neurotransmitter that’s responsible for the feelings of relaxation and euphoria that both alcohol consumption and Xanax use incite. Alprazolam also inhibits the P450 3A cytochrome which controls the body’s ability to metabolize or break Xanax down. Taking any other drugs that affect this same cytochrome can additionally cause a person to overdose. Among some of the substances that affect the P450 3A cytochrome are:

  • Certain anti-fungal medications
  • Muscle relaxers
  • Sedatives
  • Certain OCD medications
  • Certain heartburn medications
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To reduce the risk of taking a lethal dose of Xanax, patients should always keep their doctors and pharmacists well-informed concerning any over-the-counter medications, natural supplements, prescription medications, and vitamins that they’re taking. This is the only way for prescribing doctors and pharmacists to know whether or not Xanax is contraindicated.

Treating a Potential Overdose

Whether mild or severe, any suspected Xanax overdose should be reported to medical professionals immediately. You can contact Poison Control to get guidance on mitigating overdose symptoms while waiting for emergency first responders to arrive. It’s always best to keep an overdosing person awake and alert until help arrives. Depending upon the severity of overdose symptoms, you can drive an overdosing person to the emergency room on your own or call an ambulance. Emergency first responders will often administer activated charcoal on the way to the hospital to absorb as much of the drug as possible before it enters the bloodstream.  Other mitigation strategies will be employed upon reaching the emergency room. Benzodiazepine antagonists can be used to reverse the effects of a potentially lethal dose of Xanax. Intravenous fluids and other intervention strategies can also be used to address dehydration, nutrient loss, and side effects.  If you or someone you love has been misusing Xanax, we can help. Get in touch with us today to learn more about substance use disorder and the different options for treating it.