Headaches as a Side Effect of Xanax (Alprazolam)
Yes, headaches are a recognized side effect of Xanax (alprazolam), occurring commonly during both active treatment and withdrawal from the medication.
During Active Treatment
Headaches appear among the most frequently reported adverse effects during alprazolam therapy:
- Headaches rank as one of the most common side effects alongside drowsiness, lightheadedness, dry mouth, and depression in patients taking alprazolam 1
- The incidence is significant enough to be consistently documented across clinical studies evaluating alprazolam's safety profile 1
During Withdrawal and Discontinuation
Headaches become particularly prominent when stopping or reducing alprazolam:
- Headache is a characteristic feature of benzodiazepine withdrawal syndrome, typically appearing within 1-4 days of discontinuation depending on the drug's half-life 2
- During alprazolam tapering, patients commonly experience headache as part of withdrawal symptoms, which can persist for 10-14 days in the full-blown withdrawal syndrome 2
- In a study of 17 panic patients discontinuing alprazolam, withdrawal symptoms were common and problematic, with headache being part of the constellation of symptoms experienced 3
Clinical Management Considerations
If headaches occur during alprazolam treatment:
- Standard headache treatments such as acetaminophen or NSAIDs may be used if not contraindicated 4
- Consider whether the headache represents a medication side effect versus an underlying condition requiring differential diagnosis 5
If headaches occur during discontinuation:
- Slow the taper rate—the standard 10% reduction every 3 days may be too rapid for many patients, as only 4 of 17 patients in one study completed withdrawal on this schedule 3
- Recognize that withdrawal phenomena appear more severe with short-acting benzodiazepines like alprazolam 2
- Distinguish between withdrawal headaches (typically resolve in 10-14 days) versus rebound anxiety symptoms that may persist 2
Important Caveats
- Headache is an extremely common symptom in the general population, making it difficult to definitively attribute causation to alprazolam in individual cases 6
- The risk-benefit profile must be carefully considered, as benzodiazepines carry risks of tolerance, dependence, and problematic withdrawal even at therapeutic doses 2, 3
- Relapse and withdrawal are important considerations when choosing alprazolam treatment, particularly for chronic conditions 3