anxious girl

Keeping Your Anxiety Under Control (Alprazolam ER)

Alprazolam ER, sold as Xanax XR, is an oral benzodiazepine. This type of drug can produce a dramatic calming effect that helps with severe anxiety, although you must be careful as the drug is prone to abuse.

A big benefit of extended-release drugs like alprazolam ER is that they don’t have to be taken often. They are usually taken once or twice a day. (Learn More)

Alprazolam is a serious prescription drug, with its own set of risks and side effects. While it can help many users, talk to your doctor about these potential downsides.

Make sure you understand the signs of an allergic reaction, and watch out for serious side effects like suicidal thoughts. If you are not sure how serious a symptom is, call a doctor immediately. If you think your symptom is immediately dangerous, call 911. (Learn More)

Benzodiazepine are only one class of anti-anxiety medication, and they are generally only used in the short term. If they are proving ineffective or causing serious side effects, or you have been on benzos for a long time, your doctor may decide an SSRI or SNRI drug is a better fit for you. In rare cases, you may be prescribed a TCA — an older type of antidepressant that can help some users but can also have more serious side effects than the alternatives.(Learn More)

For anxiety disorders, combining medication with positive lifestyle change and therapy can help you manage symptoms even better. An integrated treatment approach that involves all these components can help you gain better control of your anxiety and improve your quality of life. (Learn More)

Controlling Anxiety With Alprazolam ER

Extended-release alprazolam (sold as Xanax XR) is an oral benzodiazepine used to treat anxiety.

Benzodiazepines act on the brain and nerves to produce a calming effect. While beneficial to many patients in need, this same effect makes the medication prone to abuse, so patients and prescribers must bear that in mind.

One of the big benefits of extended-release anti-anxiety medications is that they require less planning on the part of the user. Instead of needing to take a drug three or four times a day, these types of medications only need to be taken once or twice per day. Always follow your prescribed dose exactly as set out by your doctor.

In a 2011 analysis of studies done regarding various forms of Xanax, including Xanax XR, the FDA concluded that alprazolam ER is indeed more effective than placebos in treating panic disorders, and it has a place in treating patients who require treatment for their anxiety.


Risks and Side Effects

Alprazolam ER will not suit everyone who suffers from anxiety, as it has risks and side effects, like any other prescription drug. Some people may find it is less effective than alternatives (discussed below).

Benzodiazepines are generally only used for short-term treatment of anxiety. A different set of medications tend to be prescribed for long-term treatment.

Before taking alprazolam ER, talk to your doctor about its various risks and side effects. These downsides do not mean the drug cannot represent an overall positive effect. But familiarize yourself with the risks so you can make an informed decision and understand if any side effects you experience represent an emergency.

The following are some of alprazolam ER’s potential side effects:

  • Fatigue and drowsiness
  • Insomnia
  • Nausea, upset stomach, diarrhea, and vomiting
  • Appetite and weight changes
  • Loss of interest in sex
  • Dizziness and lack of balance or coordination
  • Blurred vision
  • Memory problems
  • Irritability
  • Swelling in the hands and feet
  • Muscle weakness
  • Increased sweating
  • Dry mouth and sore throat

As with any prescription drug, even these common side effects can sometimes manifest in serious ways. If they greatly impact your life or seem to be especially severe, talk to your doctor about them as soon as possible.

If you experience certain symptoms, it could be a sign of something serious. Contact your doctor immediately if you experience:

  • Suicidal or depressive thoughts.
  • Increased energy, racing thoughts, and a desire to take risks.
  • Confusion, agitation, hostility, and hallucinations.
  • Uncontrolled muscle movements, tremor, or seizures.
  • Pounding heartbeat or fluttering in your chest.

Signs of an allergic reaction to alprazolam ER include hives, difficulty breathing, and swelling of your face, lips, tongue, or throat. If you experience these symptoms, call 911 immediately.

Finally, talk to your doctor about any supplements and drugs (both illicit and prescription) you take or intend to take, as some can react dangerously to alprazolam ER.

Discuss any medical conditions you have, as alprazolam can tax parts of the body that may lead to dangerous consequences if they are already weakened by other conditions.

doctor prescribing medication

Considering Alternatives

If alprazolam is proving ineffective or you are having a serious reaction to it, there are alternatives available. Most people who need to take anti-anxiety medications will switch medications multiple times throughout their lives. You and your doctor can test to see which works best for you. Your experience with a drug may also change over time, requiring your treatment to adapt to that change.

There are a variety of anti-anxiety medications. Most of these medications are antidepressants, but they are frequently prescribed to address anxiety.

  • SSRIs: While technically antidepressants, SSRIs (selective serotonin reuptake inhibitors) are often prescribed to address ongoing anxiety. This class of drug includes citalopram, fluvoxamine, sertraline, and more. They stop nerve cells in the brain from reabsorbing serotonin.
  • SNRIs: Serotonin and norepinephrine reuptake inhibitors (SNRIs) work by reducing your brain’s reabsorption of the chemicals serotonin and norepinephrine. There is some evidence they may be safer than SSRIs, although many doctors still choose to prescribe SSRIs first. SNRI drugs include duloxetine and venlafaxine.
  • Tricyclic antidepressants: An older class of antidepressant, tricyclic antidepressants (TCAs) are usually only prescribed for patients who have not had the desired results from newer drugs, which usually have fewer side effects. These drugs include amitriptyline, imipramine, and nortriptyline.
  • Benzodiazepines: Alprazolam is part of this drug class. Benzodiazepines, often called benzos, which are sedatives that can reduce the physical symptoms of anxiety. They are very effective in the short term, but again, they have limited viability for long-term use and can be addictive. Most doctors avoid prescribing benzodiazepines except for very serious anxiety problems.

Supplemental Treatments

In addition to any prescribed medication, the value of lifestyle changes and therapy should not be underestimated in their ability to reduce anxiety. Therapy, where you work with a mental health professional to discuss your problems, can help you identify stressors in your life as well as ways to manage your anxiety better.

While most people know what generally causes their anxiety, a mental health professional can help you get to the root causes of your issues. Their assistance can be an excellent supplement to treatment with medication.

Lifestyle changes — like a balanced diet, regular exercise, and avoiding toxic behaviors like drug abuse — can all reduce stress and anxiety. Broadly speaking, a physically healthier life tends to lead to a mentally and emotionally healthier one.

Again, it is worth noting that these treatments aren’t meant to cure anxiety. Most mental illnesses are very complex and lifelong. However, gaining better control over your symptoms, especially when the supplemental treatments have no real downsides beyond cost and time, can dramatically boost your quality of life.


Alprazolam – Drug Summary. Prescribers’ Digital Reference.

Xanax XR: Professional. (April 18, 2018). RxList.

Xanax XR: Side Effects. (April 18, 2018). RxList.

Alprazolam ER. WebMD.

Xanax. (March, 2011). FDA.

Everything You Need to Know About Anxiety Medications. (November 13, 2018). Medical News Today.

Anxiety Medication. (June 2019). HelpGuide.

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