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Psychiatry & Medication

Xanax and Alcohol

 May 14, 2020

By  Natalie Kirilova

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The Bottom Line

  • Xanax and alcohol should not be taken in combination.
  • Alprazolam, a generic for Xanax is FDA-approved for anxiety.
  • Fits short-term treatment only.
  • Available in tablets.

Is there an interaction of Xanax and alcohol?

Xanax is a medication from the benzodiazepines (benzo) group. It is prescribed to treat anxiety and panic attacks in adults. The mechanism of how it affects these mental health conditions is linked to the reuptake of certain neurotransmitters in the brain. It is believed to increase the levels of dopamine and serotonin which then results in sedation. 

Alcohol at low doses provides mild sedation in individuals, while with high doses individuals may experience extreme sedation and relaxation. Xanax and alcohol have similar mechanisms of action. Both affect certain neurotransmitters, however, alcohol is linked to increasing the effects of glycine alongside dopamine and serotonin.

Benzo medications have the potential for severe side effects when taking them alongside other medications. 

When taking Xanax and alcohol together in small doses, the potential for severe side effects is minimized as these two are quickly metabolized, unlike when Xanax and alcohol are taken in higher doses.

Xanax and alcohol is a dangerous interaction, as it may lead to slower elimination of the medication from the body, and cause a dangerous buildup of it in the system.

According to the Neuropathology of Drug Addictions and Substance Misuse guide, the risks of mixing benzo drugs like Xanax and alcohol include:

  • Euphoria. This effect reduces anxious feelings when Xanax and alcohol are taken in smaller doses. With higher doses, individuals may experience extreme sedation.
  • Lightheadedness. Those who take Xanax and alcohol may experience fatigue or lightheadedness which results from decreased blood pressure. It may be dangerous if an individual suddenly stands up after laying down or sitting. Also, when Xanax and alcohol are taken together, an individual is most likely to feel more tired, lose concentration as well as memory.
  • Aggression or irritability. Taking this benzo medication alone may be relatively safer (in side effects) than in conjunction with alcohol when it comes to aggressive behaviors. Xanax and alcohol consumption in those who have a medical history of anger are more likely to quickly experience aggression and irritability. 
  • Cognitive issues. Individuals who regularly take Xanax and alcohol in combination may struggle with cognitive issues. At lower doses, they may have a feeling of “spaced out”, while at higher doses of Xanax and alcohol, individuals may experience long-lasting disconnection from reality.

If taking Xanax and alcohol in combination in the long-term, that may cause lasting changes in the brain including:

  • Cardiovascular and respiratory issues. These two substances may alter the life-sustaining functions of heart rate and respiration. Xanax and alcohol have the potential for shutting down certain areas in the brain which are in charge of breathing. While unlikely, such incidents are to be fatal.
  • Increased probability of unconsciousness. Xanax and alcohol in high doses may lead to a comatose state.
  • Increased risk of liver and kidney damage. Xanax and alcohol slower kidney and liver functions. Combining them prevents their fast metabolization, and they stay longer in the system.
  • Overdose incidents. Overdose events have been reported when taking Xanax and alcohol together.
  • Increased potential for certain side effects. Individuals who mix Xanax and alcohol may acquire allergic reactions to Xanax and alcohol alone or in combination.
  • Psychosis. These two substances may increase the risk of experiencing hallucinations or delusions.
  • Physical dependence. Both Xanax and alcohol have the potential for abuse and dependence in individuals who take them regularly. 

Before taking this benzo medication, disclose your full medical history to your doctor. Inform the doctor if you have had a history of substance abuse.

Can you drink alcohol while taking Xanax? 

It is contraindicated to drink alcohol while taking Xanax. Mixing them in large doses may be deadly.

What is Xanax? 

Xanax is a benzo medication used for anxiety in adults. A doctor may also prescribe it to deal with panic disorders as well as chemotherapy-induced nausea. The generic form of Xanax is Alprazolam. It works by affecting neurotransmitters in the brain, serotonin, and dopamine, which boosts levels then alleviates the symptoms of anxiety.

If fits short-term treatment of anxiety. Available in tablets of 0.25mg, 0.5 mg, 1 mg, and 2 mg strengths.

What conditions is Xanax taken for? 

The conditions that Xanax is used for are anxiety, panic disorder, and chemotherapy-induced nausea.

Can Xanax be taken for Anxiety?

Xanax is most well-known as a medication for anxiety disorder treatment. A doctor may occasionally prescribe it for anxiety caused by depression or for generalized anxiety disorder(GAD). Benzo medications have the potential for abuse and dependence when taken for over 6 weeks. Your medical history should be closely studied prior to assigning a treatment plan and administering this medication.

Is Xanax FDA approved for anxiety?

Alprazolam is approved for anxiety and panic disorder by the Food and Drug Administration(FDA). It should be prescribed only for short-term treatment. A doctor should always assess the applicability of this medication.  

Can Xanax be taken for Depression?

Xanax is not FDA-approved for depression, however, a doctor may use it off-label for depression. Depression requires long-term treatment, and this medication is usually effective only for short-term applications. Taking this medication for over 6 weeks may lead to abuse or dependence. Other modalities are available to treat depression.

Is Xanax FDA approved for depression?

Xanax is not FDA-approved for depression treatment.  

What research supports Xanax for anxiety?

There is extensive evidence on the efficacy of Xanax for anxiety. 

  • Alprazolam was studied against Midazolam for efficacy in reducing anxiety in ambulatory surgery patients. 45 outpatients scheduled for gynecological laparoscopic surgery were enrolled in a double-blinded trial. One group took oral Alprazolam 0.5 mg, the second group took Midazolam 7.5 mg. Both medications have been reported effective, however, five subjects from the Midazolam group experienced insomnia. The study suggested using Alprazolam as an alternative to Midazolam before and after surgery.
  • Alprazolam was studied for efficacy in the treatment of GAD and panic disorder. 50 subjects with a primary diagnosis of generalized anxiety or panic disorder were assigned to Alprazolam and the placebo. 30 subjects took Alprazolam 0.25 to 3 mg/day, and 20 subjects took placebo for 8 weeks. The results have demonstrated that Alprazolam significantly reduced anxiety scores over the placebo.

What do experts say about Xanax for anxiety?

Beth Salcedo, a psychiatrist, and The Ross Center’s medical director says “People who have asthma will get anxious when they start to get short of breath, so they often will feel better if they take something like a Xanax. Whatever is going on, the Xanax should help take the anxiety piece off the table so you can know what your physical symptoms are.”

What are the possible side effects of Xanax?

Side effects may occur at the beginning of treatment with Xanax, however they are likely to disappear after the patient becomes accustomed to the medication.

Common side effects when taking Xanax:

  • drowsiness;
  • lightheadedness;
  • ataxia;
  • fatigue;
  • memory loss;
  • blurred vision.

There are potential side effects when taking Xanax and alcohol:

  • extreme sedation;
  • spaced out state;
  • lightheadedness;
  • nausea.

Overdose incidents have been reported when taking Xanax and alcohol in combination.

Always speak to your doctor about the safe application of this benzo medication.

Can you take Xanax while pregnant or breastfeeding?

Xanax is not recommended while pregnant. Benzo medications are believed to cause harm to the fetus.

Benzo medications are excreted in human milk. Newborns to mothers who took Alprazolam when breastfeeding have been reported to lose weight. It is not recommended to use this medication for nursing mothers.

Can children take Xanax?

It is not known if Xanax is safe or effective in adults under 18. It is not recommended to use this medication in pediatrics.

How to take Xanax?

Dosage is tailored individually based on your medical history and treatment regimen.

The initial dosage of Xanax for anxiety is 0.25-0.5mg 3 times per day.

The initial dosage of Xanax for panic disorder is 4mg one time per day.

Do not increase the dosage without speaking to the doctor. If you believe you overdosed, seek emergency help immediately (call 911).

Are there alternatives to Xanax? 

Prescription medications as Alternatives to Xanax for Anxiety 

Xanax is a benzo medication FDA-approved for anxiety and panic disorder. However, it may not be a good fit for your particular case. Speak to your doctor about other prescription medications. Some of them are:

  • Klonopin
  • Valium
  • Lexapro
  • Prozac
  • Buspirone
  • Inderal
  • Cymbalta
  • Tofranil
  • Hydroxyzine
  • Zoloft

There are various alternatives. If you’d like to learn more about whether Xanax, another medication or treatment modality is right for you, we recommend that you speak with a licensed psychiatrist. Here are the best online psychiatry platforms so you can speak with someone right away!

Therapy as an Alternative to Xanax

Learn more about different therapy options for anxiety here

Energy & Holistic Modalities as an Alternative to Xanax

Learn more about different energy & holistics modalities for anxiety here

Tech & Devices as Alternative Treatments to Xanax

Learn more about tech & devices for anxiety hereDisclaimer: This website does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on our Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Natalie Kirilova


Natalie is a writer with a focus in medical research with over 10 years of experience

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