As you age, even though you may have taken a medication for decades, your body may react differently to it later in life. One reason for this is that your metabolism has slowed down. Some medicines need to be processed by your liver to benefit your health; slower digestion and liver function mean it may take longer for a drug to get into your bloodstream. Later, remnants of the medicine need to be eliminated from your body by the liver and kidneys. Slowdowns at this stage mean it may take longer for a drug to leave your body, so its effect lasts longer.
Studies also show that certain medications are less safe for older people, and it is important that you work with your provider or pharmacist to use medications that are safe for your age. The American Geriatrics Society’s Beers Criteria lists medications that may not be safe in older people and can be used as a tool when you talk with your provider or pharmacist about using safe medications.
What is Xanax?
Xanax is a brand of alprazolam, a powerful benzodiazepine that is used to treat anxiety and panic disorders by decreasing abnormal excitement in the brain. The medication comes in the form of a tablet that quickly dissolves in the mouth, an extended-release tablet, or a concentrated oral solution.
Benzodiazepines can have therapeutic anti-anxiety, anti-convulsant, muscle relaxing, and sedative effects. Xanax works by increasing the effects of a brain chemical called gamma-aminobutyric acid (GABA), which promotes calmness and produces a relaxed feeling. The drug decreases the level of excitement in the brain to treat anxiety and panic disorders.
Alprazolam is among the most prescribed benzodiazepine drugs in the U.S. and is among the benzodiazepines most often found in the illegal market, according to the Drug Enforcement Administration.
Xanax is often prescribed for mental health disorders related to anxiety. It can be used to treat general anxiety, panic disorder, social anxiety disorder, and phobias. It can also be used to treat seizures. For people who suffer from anxiety, it can create a sense of relief to focus on their lives without issues of anxiety or phobias plaguing them. When used as prescribed, it can calm people down and make them feel relaxed.
Xanax can also reduce physiological symptoms of anxiety and fear, such as a racing heart or hyperventilation. These drugs are so often prescribed because they work well on anxiety and they’re cheap.
However, many people use Xanax for nonmedical reasons, taking it in larger doses or more frequently than prescribed because it can create a euphoric feeling, especially at higher doses. Xanax tends to start acting quickly after a person takes it, and the euphoric effects of the drug will usually manifest themselves within about an hour after taking it.
A tendency has grown in some social circles to view Xanax, as a type of “alcohol” in pill form. It’s become socially acceptable among these groups of friends to get together and share Xanax with one another. Of the 30.5 million people who used benzos in 2015, 17.1% misused them. Misusing Xanax or combining it with other substances like alcohol can amplify its effects, but the results can also be deadly.
Along with recreational use, many people rely on Xanax to deal with issues like situational anxiety without having to commit to therapy, which can be expensive and time-consuming. Xanax is popular in America, for example, because there is a tendency for people to love things that are looked at as a quick fix. Xanax isn’t a long-term medication, so some people “take it when they need it” for relief. The temporary relief they feel can help in a fast-paced world with constant exposure to negative world news, stressful jobs, and uncertainty.
Xanax side effects in the elderly
Several major medical and psychiatric organizations, including the American Geriatrics Society, advise against using benzodiazepines such as Xanax in older adults. Despite these recommendations, Xanax and other benzodiazepines continue to be massively prescribed to a group with the highest risk of serious adverse effects from these medications.
Studies have shown that benzodiazepines like Xanax can impair cognition, mobility, and driving skills in older people, as well as increase the risk of falls. A recent study also found an association between benzodiazepine use in older people and increased risk of Alzheimer’s disease.
The study reported that people who had taken a benzodiazepine for three months or less had about the same dementia risk as those who had never taken one. Taking the drug for three to six months raised the risk of developing Alzheimer’s by 32%, and taking it for more than six months boosted the risk by 84%.
The risk of Xanax dependence among elderly persons also increases with age and is more common among patients with medical conditions that require multiple medications and among patients who have depression and alcohol dependence.
Xanax dependence, in general, can be more problematic among elderly persons, because tolerance to alcohol and benzodiazepine decreases with age.
In general, elderly patients are more susceptible to the side effects of Xanax. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
• Being forgetful
• changes in patterns and rhythms of speech
• clumsiness or unsteadiness
• difficulty with coordination
• discouragement
• drowsiness
• feeling sad or empty
• irritability
• lack of appetite
• lightheadedness
• loss of interest or pleasure
• relaxed and calm
• shakiness and unsteady walk
• sleepiness
• slurred speech
• tiredness
• trouble concentrating
• trouble performing routine tasks
• trouble sleeping
• trouble speaking
• unsteadiness, trembling, or other problems with muscle control or coordination
• unusual tiredness or weakness
Less common
• Blurred vision
• body aches or pain
• burning, crawling, itching, numbness, prickling, “pins and needles, or tingling feelings
• changes in behavior
• chills
• clay-colored stools
• confusion about identity, place, and time
• cough
• dark urine
• decrease in the frequency of urination
• decrease in urine volume
• diarrhea
• difficult or labored breathing
• difficulty in passing urine (dribbling)
• difficulty with concentration
• difficulty with moving
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• dry mouth
• ear congestion
• environment seems unreal
• fainting
• feeling of unreality
• feeling warm
• fever
• general feeling of discomfort or illness
• headache
• inability to move the eyes
• inability to sit still
• increased blinking or spasms of the eyelid
• irregular heartbeats
• itching or rash
• joint pain
• lack or loss of self-control
• loss of bladder control
• loss of coordination
• loss of memory
• loss of voice
• mood or mental changes
• muscle aches, cramps, pain, stiffness, or weakness
• nausea
• need to keep moving
• painful urination
• problems with memory
• restlessness
• runny or stuffy nose
• seeing, hearing or feeling things that are not there
• seizures
• sense of detachment from self or body
• shaking
• shivering
• sneezing
• sore throat
• sticking out of the tongue
• stomach pain
• sweating
• swollen joints
• talkativeness
• tightness in the chest
• trouble with balance
• twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
• uncontrolled twisting movements of the neck, trunk, arms, or legs
• unpleasant breath odor
• unusual dullness or feeling of sluggishness
• unusual facial expressions
• unusually deep sleep
• unusually long duration of sleep
• vomiting of blood
• yellow eyes or skin
Rare
• Actions that are out of control
• attack, assault, or force
• chest pain
• continuing ringing or buzzing or other unexplained noise in the ears
• decreased awareness or responsiveness
• deep or fast breathing with dizziness
• ear pain
• false or unusual sense of well-being
• fast, irregular, pounding, or racing heartbeat or pulse
• feeling jittery
• feeling unusually cold
• generalized slowing of mental and physical activity
• hearing loss
• hoarseness
• lack of feeling or emotion
• loss of control of the legs
• loss of strength or energy
• nightmares
• numbness of the feet, hands, and around the mouth
• severe sleepiness
• shakiness in the legs, arms, hands, or feet
• sleep talking
• swelling
• talking, feeling, and acting with excitement
• thoughts of killing oneself
• uncaring
• unusual weak feeling
• voice changes
Incidence not known
• Light-colored stools
• upper right abdominal or stomach pain
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
• Change in consciousness
• confusion
• lack of coordination
• loss of consciousness
• sleepiness or unusual drowsiness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
• Absent, missed, or irregular menstrual periods
• decreased appetite
• decreased interest in sexual intercourse
• decreased sexual performance or desire abnormal ejaculation
• difficulty having a bowel movement (stool)
• inability to have or keep an erection
• increased appetite
• increased in sexual ability, desire, drive, or performance
• increased interest in sexual intercourse
• increased weight
• loss in sexual ability, desire, drive, or performance
• stopping of menstrual bleeding
• watering of the mouth
• weight loss
Less common
• Blistering, crusting, irritation, itching, or reddening of the skin
• change in taste bad unusual or unpleasant (after) taste
• cracked, dry, or scaly skin
• double vision
• feeling of warmth
• heavy bleeding
• menstrual changes
• pelvic pain
• redness of the face, neck, arms, and occasionally, upper chest
• seeing double
• stomach bloating and cramping
• sudden sweating
• unexplained runny nose or sneezing
Rare
• Acid or sour stomach
• belching
• bigger, dilated, or enlarged pupils (black part of the eye)
• change in color vision
• difficulty seeing at night
• feeling of constant movement of self or surroundings
• feeling of relaxation
• heartburn
• hives or welts
• increased sensitivity of the eyes to sunlight
• indigestion
• redness of the skin
• sensation of spinning
• stomach discomfort or upset
Incidence not known
• Blistering, peeling, or loosening of the skin
• red, irritated eyes
• red skin lesions, often with a purple center
• sores, ulcers, or white spots in the mouth or on the lips
• swelling of the breasts or breast soreness in both females and males
• unexpected or excess milk flow from the breasts
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
