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  • Xanax is a short-acting benzodiazepine (benzo), also known by its generic name alprazolam. Benzodiazepines are among the most common medications prescribed for anxiety and panic disorders in older adults. 

    However, use of benzodiazepines is not recommended in older adults and is associated with several adverse effects. Along with an increased risk of injuries, alprazolam may be a risk factor for dementia and Alzheimer’s disease.

    Effects Of Xanax On The Elderly

    Alprazolam is in a class of controlled substances called benzodiazepines, which are central nervous system (CNS) depressants. Benzos slow nerve activity in the CNS by increasing the effect of the neurotransmitter gamma aminobutyric acid (GABA). This lowers anxiety and increases sedation. 

    Other benzodiazepines include:

    • valium (diazepam)
    • ativan (lorazepam)
    • klonopin (clonazepam)

    Side Effects Of Xanax

    According to the Food and Drug Administration (FDA), the elderly may be more sensitive to the side effects of benzodiazepines

    These side effects may include:

    • drowsiness
    • lightheadedness
    • depression
    • headache
    • confusion
    • dizziness
    • impaired coordination

    Older adults who are prescribed alprazolam should be started on the lowest possible dose (0.25 mg) and increased slowly as needed. This can help prevent some of the more serious adverse effects.

    Metabolism In The Elderly

    A younger adult taking alprazolam will process the drug much quicker than an elderly person. Alprazolam will peak in a younger individual’s bloodstream within the first two hours of taking it. 

    Within 11 hours, the total concentration of alprazolam in their blood will reduce to half (half-life). In older adults, the half-life of alprazolam is about 16 hours. This longer half-life can lead to a toxic amount of alprazolam in their system if they take it too frequently.

    Falls & Fractures

    Benzodiazepines account for a large number of avoidable emergency room visits. Many older adults taking alprazolam experience falls and fractures as a result of impaired coordination and confusion. 

    The risk of falls and fractures is highest in the first two weeks of taking alprazolam and with each increased dose. 

    Risk Of Dementia & Alzheimer’s Disease

    Alzheimer’s is a progressive disease that affects behavioral and cognitive functions, especially memory. Alzheimer’s may be a cause of dementia, which is the loss of cognitive abilities that is severe enough to interfere with your life. 

    Several studies have shown benzos to be a risk factor for dementia and Alzheimer’s in geriatric patients. However, early symptoms of dementia mimic symptoms of anxiety and insomnia, which is a possible reason for this association.

    Does Xanax Cause Alzheimer’s?

    Although it does not cause it, several studies have found benzodiazepines may increase the risk of Alzheimer’s. This association may be linked to the longer half-life of alprazolam in the elderly. 

    Taking alprazolam long-term can lead to a large accumulation of the drug in your system. This increases the likelihood of memory impairment and may lead to irreversible effects on cognition and memory.

    Alternative Treatments

    Benzodiazepines are most commonly used to treat anxiety because they are effective from the first dose. However, the benefits of any treatment program must outweigh the risks. 

    Alprazolam can be a high-risk medication for younger individuals but can be even more dangerous in older people. 

    Alternative treatments may include:


    Many individuals being treated for anxiety may be successful using an antidepressant. Antidepressants have to be taken long-term to work but they are much safer, especially in the elderly population.


    Buspar is the brand name for buspirone, a non-addictive and less potent medication that is effective for anxiety. 

    Caregivers of elderly individuals may choose to discuss alternative treatment options with healthcare professionals.

    Learn more about Xanax Alternatives

    Xanax Withdrawal & Rebound Anxiety

    Alprazolam is intended for short-term treatment of anxiety and panic disorders.  Long-term use can lead to physical dependence and addiction. Physical dependence means your body needs the drug to function or you may experience withdrawal symptoms

    You should seek medical attention for benzo withdrawal because it can become life-threatening. 

    Withdrawal symptoms include:

    • seizures
    • muscle cramps
    • diarrhea
    • blurred vision
    • loss of appetite
    • pins and needles
    • muscle twitch

    Older adults also have a higher risk for rebound anxiety when they stop taking alprazolam. Rebound anxiety is the return of intense anxiety that is greater than before they started taking alprazolam. 

    Xanax Addiction Treatment 

    If you’re dependent on or addicted to alprazolam, it is not recommended to suddenly stop this medication. Medical detox can help you taper off alprazolam and give you access to further treatment options. 

    Aftercare may include long-term inpatient or outpatient programs, which are beneficial for long-term recovery from addiction. 

    If you or a loved one is seeking addiction treatment, please contact Ark Behavioral Health to speak with a specialist. 

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.
    Medically Reviewed by
    Kimberly Langdon M.D.
    on June 30, 2022
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