What is the use of Xanax (alprazolam) for treating panic attacks?

From the Guidelines

Xanax (alprazolam) is a highly effective medication for treating panic attacks, and its use is recommended for acute relief of symptoms, with a typical starting dose of 0.25-0.5 mg taken as needed, as supported by the study 1.

Key Considerations for Xanax Use

• The effects of Xanax begin within 15-30 minutes and last 4-6 hours, making it a useful option for rapid relief of panic attack symptoms.
• For ongoing treatment, doctors may prescribe 0.5-1 mg up to three times daily, adjusting based on individual response, as noted in the study 1.
• While effective, Xanax should be used cautiously due to potential side effects like drowsiness and dizziness, and risks of dependence and withdrawal if used regularly for more than 2-4 weeks, as highlighted in the study 1.

Important Precautions and Alternatives

• Patients should never stop taking Xanax abruptly and should always take it exactly as prescribed, avoiding alcohol and discussing all other medications with their doctor to prevent dangerous interactions.
• The study 1 recommends psychotherapy with or without an anxiolytic or an antidepressant for the treatment of anxiety, after eliminating medical causes, suggesting that Xanax may be used in conjunction with other therapies for optimal results.
• Alternative treatments like cognitive behavioral therapy and lifestyle modifications should be pursued as longer-term solutions, with Xanax used as a short-term solution or occasional rescue medication, as implied by the study 1.

From the FDA Drug Label

CLINICAL STUDIES ... Panic Disorder Support for the effectiveness of alprazolam tablets in the treatment of panic disorder came from three short-term, placebo-controlled studies (up to 10 weeks) in patients with diagnoses closely corresponding to DSM-III-R criteria for panic disorder The average dose of alprazolam tablets was 5-6 mg/day in two of the studies, and the doses of alprazolam tablets were fixed at 2 and 6 mg/day in the third study. In all three studies, alprazolam tablets were superior to placebo on a variable defined as "the number of patients with zero panic attacks" (range, 37-83% met this criterion), as well as on a global improvement score

Xanax (alprazolam) is used to treat panic disorder, with studies showing its effectiveness in reducing the number of panic attacks per week and improving global improvement scores. The average dose used in these studies was 5-6 mg/day. Key benefits of using Xanax for panic attacks include:

• Reduction in the number of panic attacks per week
• Improvement in global improvement scores
• Efficacy in achieving zero panic attacks in a significant percentage of patients (range, 37-83%) 2

From the Research

Use of Xanax for Panic Attacks

• Xanax, also known as alprazolam, is a high-potency benzodiazepine used for the short-term management of panic disorder 3.
• It has been shown to be effective in blocking panic attacks and is comparable to antidepressants in its effects, but with a more rapid onset of action 3.
• Alprazolam has been found to be effective in reducing the frequency and severity of panic attacks, as well as improving phobic fears, avoidance behavior, and anxiety 4.
• The use of Xanax for panic attacks is often recommended for short-term treatment, as it can be associated with physical dependency and withdrawal symptoms 5, 3.
• Other treatment options, such as selective serotonin reuptake inhibitors (SSRIs) like sertraline and paroxetine, are also available and may be preferred for long-term treatment due to their efficacy and tolerability 5, 6, 7.

Efficacy and Safety

• Studies have shown that alprazolam is effective in reducing panic attacks and improving symptoms of anxiety and depression 3, 4.
• However, the use of Xanax can be associated with adverse effects, such as intoxication, dependence, rebound, and withdrawal symptoms 3.
• The benefits of benzodiazepine treatment, including Xanax, may outweigh the risks for patients with panic disorder, but careful consideration and monitoring are necessary 3.

Alternative Treatment Options

• SSRIs, such as sertraline and paroxetine, are alternative treatment options for panic disorder and have been shown to be effective and well-tolerated 5, 6, 7.
• These medications may be preferred for long-term treatment due to their efficacy and lower risk of physical dependency compared to benzodiazepines 5, 6, 7.