From the Guidelines
The recommended dosage of Xanax (alprazolam) for anxiety is 0.25 to 0.5 mg orally 3 times daily, with gradual increases as needed, as stated in the most recent and highest quality study 1. When considering the treatment of anxiety with Xanax, it's crucial to tailor the dosage to the individual patient's needs and factors such as age, liver disease, and debilitating conditions.
- For anxiety disorders, the typical starting dose is 0.25 to 0.5 mg taken three times daily.
- In elderly patients, patients with debilitating disease, and those with advanced liver disease, the usual starting dose of alprazolam is 0.25 mg orally 2 or 3 times daily for treatment of anxiety, as noted in 1.
- Dosage adjustments should occur gradually, usually increasing by no more than 0.5 mg every 3-4 days, to minimize the risk of side effects and dependence. The importance of gradual dosage reduction when decreasing or discontinuing alprazolam therapy cannot be overstated, especially in elderly patients who are especially sensitive to the effects of benzodiazepines, as highlighted in 1 and 1.
- Xanax has significant potential for dependence and withdrawal, so treatment should be as brief as possible, typically not exceeding 2-4 weeks.
- Patients should never stop taking Xanax abruptly as this can cause severe withdrawal symptoms; dosage should be tapered gradually under medical supervision.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Dosage should be individualized for maximum beneficial effect. While the usual daily dosages given below will meet the needs of most patients, there will be some who require doses greater than 4 mg/day. Treatment for patients with anxiety should be initiated with a dose of 0.25 to 0. 5 mg given three times daily. 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. 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. Depending on the response, the dose may be increased at intervals of 3 to 4 days in increments of no more than 1 mg per day.
The dosages of Xanax are:
- Anxiety Disorders: 0.25 to 0.5 mg three times daily, up to a maximum daily dose of 4 mg.
- Panic Disorder: 1 to 10 mg daily, with a mean dosage of approximately 5 to 6 mg daily.
- Dose Titration: 0.5 mg three times daily, increased by no more than 1 mg per day at intervals of 3 to 4 days.
- Elderly patients, advanced liver disease, or debilitating disease: the usual starting dose is 0.25 mg 2
From the Research
Dosage Information
- The recommended daily dosage of alprazolam (Xanax) is 0.5 to 4.0 mg 3.
- Alprazolam achieves peak serum levels in 0.7 to 2.1 hours and has a serum half-life of 12 to 15 hours 3.
- For the treatment of anxiety disorders, the dosage of alprazolam may vary, but it is generally used in conjunction with other measures such as psychological treatments, antidepressants, or other drugs 4.
- In the case of panic disorder, alprazolam may be used, especially in treatment-resistant cases, but with caution due to the risk of dependence and withdrawal effects 5.
Usage Guidelines
- Alprazolam is indicated for the treatment of anxiety disorders and symptoms of anxiety, including anxiety associated with depression 3.
- It is also being investigated for the treatment of panic disorders 3.
- The use of alprazolam should be limited to a few days, occasional or intermittent use, or courses not exceeding 2 weeks to minimize the risk of adverse effects 4.
- Long-term prescription of alprazolam is occasionally required for certain patients, but it should be done with caution and careful patient selection 4.