From the FDA Drug Label
DOSAGE AND ADMINISTRATION Dosage should be individualized for maximum beneficial effect. The dose may be increased to achieve a maximum therapeutic effect, at intervals of 3 to 4 days, to a maximum daily dose of 4 mg, given in divided doses. Panic Disorder The successful treatment of many panic disorder patients has required the use of alprazolam tablets at doses greater than 4 mg daily. In controlled trials conducted to establish the efficacy of alprazolam tablets in panic disorder, doses in the range of 1 to 10 mg daily were used Treatment may be initiated with a dose of 0.5 mg three times daily.
The appropriate dose of Xanax (alprazolam) for a panic attack is 0.5 mg to 10 mg daily, with treatment initiated at a dose of 0.5 mg three times daily and increased as needed to achieve a therapeutic effect, with a maximum daily dose of 4 mg for anxiety disorders, but higher doses may be required for panic disorder, up to 10 mg daily 1.
- The dose should be individualized and increased gradually to minimize the risk of adverse responses.
- The lowest possible effective dose should be employed and the need for continued treatment reassessed frequently.
From the Research
The appropriate dose of Xanax (alprazolam) for a panic attack typically ranges from 0.25 to 0.5 mg taken as needed, as recommended by recent clinical guidelines 2. For severe panic attacks, doses up to 1 mg may be prescribed. The medication should begin working within 15-30 minutes and effects last about 4-6 hours. Patients should not exceed their prescribed maximum daily dose, which is usually 4 mg divided throughout the day. It's essential to use the lowest effective dose for the shortest duration possible due to risks of dependence and tolerance, as highlighted in a recent review of benzodiazepines 3. Xanax works by enhancing the effect of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity, thereby reducing anxiety and panic symptoms. Some key points to consider when prescribing Xanax include:
- Side effects may include drowsiness, dizziness, and impaired coordination, so patients should avoid driving or operating machinery after taking it.
- This medication should only be used under medical supervision, as it can be habit-forming and may cause withdrawal symptoms if stopped abruptly.
- Patients with a history of substance abuse, respiratory conditions, or certain other medical conditions may require different dosing or alternative medications, as discussed in a study on the use of benzodiazepines in panic disorder 4.
- Cognitive-behavioral therapy (CBT) is also a recommended treatment for panic disorder, as supported by empirical evidence 5. Overall, the treatment of panic disorder should be individualized, taking into account the patient's specific needs and medical history, as emphasized in a review of treatment options for panic disorder 2.