What Does Xanax Do To The Brain?

How Xanax Works in the Brain

Xanax, also known by its generic name alprazolam, is classified as a benzodiazepine. These drugs are central nervous system (CNS) depressants that produce a calming effect. Specifically, Xanax enhances the action of the inhibitory neurotransmitter GABA (gamma-aminobutyric acid) in the brain.

GABA works to regulate neuronal excitability throughout the central nervous system. When GABA binds to its receptors on neurons, it reduces their excitability and makes them less likely to fire action potentials. This has a calming and anxiety-reducing effect.

Xanax amplifies the effects of the natural GABA in the brain by bonding to GABA-A receptors on neurons. This causes an influx of chloride ions into neurons, hyperpolarising the cell and reducing excitability even more than GABA alone. In essence, it suppresses abnormal brain activity related to anxiety symptoms.

Areas of the brain particularly rich in GABA receptors include the amygdala, which processes fear and anxiety responses. Xanax binding to these receptors in the amygdala is thought to help short-circuit anxiety reactions and panic. It also impacts regions like the hippocampus involved in memory formation.

Short-Term Effects of Xanax on Brain Function

When taken as prescribed for acute anxiety or panic attacks, Xanax has several noticeable effects on brain function and neurotransmitter levels in the short-term:

Sedation

By enhancing the calm, inhibitory effects of GABA, Xanax causes central nervous system depression in the brain. This produces feelings of sedation, relaxation and reduced alertness.

Anxiolysis

Xanax directly impacts neural circuits involved in the fear response like the amygdala. This allows it to powerfully reduce feelings of anxiety within 30 minutes to 1 hour after ingestion.

Reduced neuronal excitability

By binding to GABA receptors, Xanax hyperpolarises neurons to make them less prone to firing action potentials. This decreases overall excitability in neural circuits related to anxiety.

Reduced memory formation

Due to impacts on the hippocampus, single doses of Xanax may subtly impair new declarative memory formation in the hours after use.

The combination of sedation, anxiolysis and decreased excitability help relieve acute symptoms of anxiety and panic attacks. However, effects are generally temporary, wearing off within 4-8 hours as the drug is metabolised and cleared from the body.

Long-Term Effects of Xanax Dependency on Brain Chemistry

While beneficial for acute relief of anxiety, regular and long-term use of Xanax can lead to tolerance, addiction and disruption of brain chemistry:

Tolerance

Continued exposure causes downregulation of GABA receptors in the brain to compensate for increased inhibitory input. This reduces Xanax's effects over time, requiring higher doses.

Physical dependence

Prolonged regular use leads to neuroadaptations that cause withdrawal symptoms if stopped abruptly. These can range from rebound anxiety to seizures.

Chemical imbalance

Altering the balance between inhibitory and excitatory neurotransmitters disrupts normal functioning over the long-run. This includes decreased natural GABA and glutamate dysregulation.

Impaired cognition

Studies link long-term benzodiazepine use to subtle declines in processing speed, memory consolidation and executive functioning from chronic impairment of the hippocampus.

Increased depression risk

Prolonged use may elevate risk of developing depression from altered neurotransmitter and neural plasticity changes in brain regions like the prefrontal cortex.

Dysregulated stress response

Abnormally activating or inhibiting the amygdala's response to threats via Xanax can disrupt natural coping mechanisms over the long run.

Ideally, Xanax is prescribed short-term for acute symptoms only to avoid dependence and disruption of the brain's delicate neurochemical balance over time. Withdrawal must also be carefully managed if cessation is attempted after prolonged use.

Xanax Withdrawal and Post-Acute Withdrawal Syndrome

Abrupt cessation of Xanax after regular use can produce uncomfortable and in some cases dangerous withdrawal symptoms as the brain readjusts:

- Rebound anxiety and panic attacks

- Insomnia

- Muscle pains and stiffness

- Nausea, vomiting, or diarrhea

- Increased sensitivity to light, sound, and physical touch

- Hallucinations and delusions (rare)

- Seizures (in extreme cases from abrupt cessation after very long-term high dosage use)

Symptoms peak within 1-4 days and usually subside within 2-4 weeks as receptor sensitivity returns to normal. However, long-term users may experience post-acute withdrawal syndrome (PAWS) for months longer as the brain heals.

PAWS is characterised by mood changes, cognitive difficulties, low motivation, and excessive stimulus sensitivity from residual dysregulation of neurotransmitter systems. Relapses are also higher risk during this readjustment period due to cravings and psychological dependence. Tapering slowly over weeks or months minimises withdrawal danger and discomfort whenever possible.

Using Xanax Responsibly and Safely

Due its impacts on brain chemistry, Xanax carries dependence risks if taken regularly or at high doses for prolonged periods. To use it as safely as possible for the acute treatment of anxiety symptoms:

- Only take Xanax "as needed" for panic attacks or severe anxiety episodes, not on a daily scheduled basis.

- Never exceed the prescribed dose and duration without medical guidance.

- Store securely away from children and don't share your medication.

- Avoid mixing with alcohol or other CNS depressants which multiply sedative effects dangerously.

- Communicate openly with your doctor about treatment goals, side effects, and plans for eventual dose reduction.

- Undergo periodic medical evaluations to prevent issues like escalating tolerance or new mood difficulties.

- Consider alternative therapies like psychotherapy for underlying anxiety to avoid dependence on medication alone.

With responsible use as a short-term acute treatment and medical oversight, Xanax can safely help manage anxiety when used judiciously. However, risks of both physical and psychological addiction mean it is crucial to avoid regular or improper long-term use that could disrupt the brain's important neurochemical functions.