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Xanax (alprazolam) is part of a group of medications called benzodiazepines. It's FDA approved to treat anxiety and panic disorder. It works quickly, but its effects don't last long.

All benzodiazepines have significant risks, including dependence and misuse. Despite the risks, Xanax is effective at treating anxiety in the short term for some people. But how does Xanax work? And how does it compare with other anxiety medications? We'll answer these questions here.

What is Xanax?

Xanax is a benzodiazepine. It's FDA approved to treat generalized anxiety disorder and panic disorder. It's sometimes prescribed for off-label uses too. These include insomnia (trouble sleeping) and other anxiety disorders, such as social anxiety disorder.

Xanax, like all benzodiazepines, has many risks. This is why all benzodiazepines are controlled substances. These are substances that have a higher risk for dependence and misuse. And there are restrictions on how they're prescribed and refilled.

Xanax is available as an immediate-release (IR) tablet (including an orally disintegrating tablet) and an oral liquid. It's also available as an extended-release (XR) tablet that's approved only for panic disorder. All forms are available as generics.

How does Xanax work?

Xanax works by attaching to certain gamma-aminobutyric acid (GABA) receptors (binding sites). GABA is a chemical that's formed in the body naturally. It slows down nerve signals, giving it a calming effect.

When Xanax attaches to GABA receptors, it makes it easier for GABA to attach too. This increases GABA activity, amplifying its calming effects on the body. This can relieve symptoms of anxiety and relax your body physically. But it can also cause drowsiness, dizziness, and problems with coordination.

Your liver breaks down Xanax after you take it. If you have existing liver damage, you may need a lower Xanax dose. Or you may need a different anxiety medication.

Does Xanax start working immediately?

Xanax works quickly, within about 30 minutes of taking a dose. But the effects of Xanax IR don't last long. That's why it's usually taken several times a day.

Xanax XR doesn't work as quickly. But it lasts longer in the body. This is why Xanax XR is taken only once a day.

Eating a high-fat meal immediately before taking Xanax ER may cause the dose to be absorbed faster. But Xanax IR or ER doses do not need to be taken with food. If you're experiencing nausea with Xanax, however, taking it with food might help.

How do you know if Xanax is working?

If you're taking Xanax for anxiety, you'll know it's working if your anxiety symptoms lessen 30 to 60 minutes after taking it. You may feel calmer, relaxed, and even drowsy.

Keep in mind that Xanax isn't a cure for anxiety. It can treat symptoms quickly, but it isn't as good at treating anxiety over the long term as other medications. More on this below.

How does Xanax compare with other anxiety medications?

Xanax typically isn't used alone to treat anxiety. Treating anxiety may require long-term use of medications, and benzodiazepines aren't usually safe to use for a long time because of their risks. This includes severe drowsiness, falls, and accidental injuries.

Xanax can also cause dependence, misuse, and overdose. Taking Xanax exactly as prescribed can decrease these risks. Avoiding other substances that have similar side effects, such as alcohol or opioids, can also lower your risk of severe Xanax risks.

First-choice medications for anxiety and panic disorder are called antidepressants. They also work for several other mental health conditions, including depression. The two groups of antidepressants that are most often used to treat anxiety are:

• Selective serotonin reuptake inhibitors (SSRIs), such as escitalopram (Lexapro) and paroxetine (Paxil)

• Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor XR) and duloxetine (Cymbalta)

These medications aren't controlled substances. They don't carry the same risk as Xanax for dependence and misuse. But their calming effect doesn't kick in as quickly as it does with Xanax. It can take up to 2 months for SSRIs or SNRIs to kick in fully.

Because SSRIs and SNRIs can take awhile to work, your prescriber may recommend a benzodiazepine in the short term to help relieve your anxiety symptoms. The right medication for you will depend on what symptoms you're experiencing and what type of anxiety you have.

There isn't a cure for anxiety, but it's often possible to control your symptoms and improve your quality of life. Besides medication, therapy is also an option for treating anxiety. It can be used on its own or combined with medications.

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