Medical Reviewer

Identifying Xanax Overdose Signs & Symptoms

Last Medical Review On: June 16, 2025
Updated On: June 16, 2025
5 min read
Written by:

Amanda Stevens, B.S.

Medical Review by:

Dr. Po-Chang Hsu, M.D., M.S.

Blue Xanax pills, enough for an overdose

Key Points

  • Xanax is the brand name for a generic benzodiazepine known as alprazolam.
  • Xanax is FDA-approved to treat panic disorder and other anxiety disorders
  • The DEA has classified Xanax as a schedule IV controlled substance due to its risk of abuse and addiction. 
  • Xanax carries a high risk of overdose, including fatal overdose, especially when combined with other substances like alcohol, other benzos, and opioids
  • Signs of a Xanax overdose include slurred speech, loss of coordination, extreme sleepiness, slowed heart rate, fainting, and coma. 
  • A Xanax overdose can be treated, sometimes using a reversal agent known as Flumazenil.
  • There are natural ways to address symptoms of anxiety and panic, including evidence-based therapeutic modalities, coping strategies, and lifestyle changes.
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    What Are Signs Of Xanax Overdose?

    Signs of a Xanax overdose include slow heart rate, extreme drowsiness, slurred speech, muscle weakness, loss of coordination, shallow breathing, light-headedness, fainting, or coma. Benzodiazepine overdose can be fatal, especially when mixed with other substances like alcohol or other benzodiazepines that can slow your breathing or cause you to become drowsy. Signs of a Xanax overdose should be treated like a medical emergency. Call 911 or go to the nearest emergency room, and call the poison control helpline.

    What Is Xanax?

    Xanax is the brand name for the generic drug alprazolam. Xanax is a benzodiazepine used primarily to treat anxiety and panic disorders. It’s part of a group of drugs known as central nervous system depressants. CNS depressants slow down the nervous system and can be dangerous or life-threatening if not taken as prescribed.

    Xanax is FDA-approved to treat panic and anxiety disorders. It is sometimes used off-label to treat other conditions such as insomnia.

    The U.S. Drug Enforcement Administration (DEA) has classified Xanax as a Schedule IV controlled substance.[1] It is only available by prescription and carries a risk of addiction and substance abuse.

    How is Xanax prescribed?

    Xanax is typically prescribed on a short-term basis for the management of anxiety disorders, especially panic disorder. Long-term use of Xanax may result in an increased risk of addiction as well as a higher risk of adverse side effects, including benzodiazepine overdose.

    Xanax is prescribed at the lowest dose necessary to have the intended calming effects. For anxiety, your doctor may start you on a 0.25 milligram dose to be taken three times per day.[2] For panic disorder, 0.5 mg may be the starting dose. If your symptoms don’t respond, your healthcare provider may increase your dose gradually.

    If you’re prescribed Xanax for symptoms of anxiety disorders, only take it as prescribed by a medical professional. Don’t take more of the medication than prescribed, even if you don’t think it’s working. Notify your doctor instead. Taking more than the prescribed dose or taking it for longer than prescribed can lead to adverse effects, including overdose.

    Side Effects of Xanax

    Side effects of Xanax can range from uncomfortable to severe. It’s best to inform your doctor immediately if you experience severe or persistent side effects. Common side effects of Xanax include: [3]

    • Decreased appetite
    • Problems with coordination
    • Lightheadedness
    • Forgetfulness
    • Drowsiness
    • Sadness or an empty feeling
    • Slurred speech
    • Trouble focusing
    • Irritability
    • Clumsiness
    • Unusual fatigue or weakness
    • Changes in speech or difficulty talking
    • Dry mouth
    • Diarrhea
    • Constipation
    • Excessive sweating
    • Weight loss or gain
    • Headache
    • Nausea and/or vomiting
    • Insomnia
    • Blurry vision
    • Swelling of hands or feet
    • Muscle weakness
    • Hypomania
    • Worsening depression

    Symptoms Of A Xanax Overdose

    A Xanax overdose can be dangerous to health and life, particularly when taken with other substances like alcohol. Always take only as directed by a physician. Signs and symptoms of Xanax overdose include: [4 ]

    • Irritability
    • Nervousness
    • Excitement
    • Trouble sleeping
    • Muscle pain or weakness
    • Shakiness or trembling
    • Unsteady walk
    • Loss of coordination
    • Dizziness or faintness
    • Hallucinations
    • Drowsiness
    • Loss of consciousness
    • Unusual fatigue

    If you or a loved one is experiencing any of the symptoms above after taking Xanax, seek medical attention right away. Call 911 or go to the nearest emergency room. You can also call the poison control helpline.

    Xanax Overdose Risk Factors

    Certain factors may increase the risk of overdose, including fatal overdoses. Some of these overdose risk factors may include:

    • Mixing Xanax with alcohol
    • Mixing Xanax with other benzos or opioids like fentanyl
    • Mixing Xanax with other substances, including other prescription medications or illicit drugs
    • Taking a large amount of Xanax
    • Taking Xanax with another central nervous system depressant
    • Xanax addiction or substance use disorder

    A handful of blue xanax pills to overdose on

    Treating Xanax Overdose

    Someone experiencing an overdose of Xanax requires immediate medical attention. Doctors may intubate the patient to treat respiratory depression. [5] They may also use a drug called Flumazenil to reverse sedation caused by Xanax. The use of this drug is also dangerous, though, and can result in seizures, cardiac dysrhythmias, and death in rare circumstances.

    Preventing Xanax Overdose

    Preventing Xanax overdose in the first place may be easier and more effective than treating an overdose once it occurs. Here are some tips for preventing an accidental overdose from Xanax:

    • Talk to your doctor about the risks and benefits of taking Xanax for an anxiety disorder or panic disorder.
    • Tell your doctor if you have a history of addiction or substance abuse.
    • Tell your doctor if you have a history of depression and/or suicidal thoughts or behaviors.
    • Tell your doctor about any other medications you’re taking, including prescription medications, over-the-counter medications, recreational drugs, or supplements.
    • Follow your doctor’s instructions carefully when taking medications, especially any controlled substances.
    • If you miss a dose of Xanax, take it as soon as possible unless it’s close to time for your next dose. Never take two doses at once.

    Non-Medication-Based Anxiety Relief

    Perhaps the most effective way to prevent an overdose of Xanax is by avoiding this habit-forming drug entirely. If you are diagnosed with panic disorder or another anxiety disorder, consider non-pharmacological treatments such as therapy, coping strategies, and/or lifestyle changes.

    Non-Pharmacological Treatments for Anxiety

    Therapy with a licensed mental health care professional has been proven effective in reducing symptoms of panic disorder and other anxiety disorders. Your provider may use evidence-based treatments such as cognitive behavioral therapy (CBT) or exposure and response prevention therapy. Over time, you can learn to manage anxiety and panic symptoms without relying on addictive substances like Xanax.

    Coping Mechanisms for Anxiety

    Anxiety disorder symptoms can disrupt your everyday life, causing problems at home, work, and school. Untreated anxiety may lead to further complications, including low self-esteem, substance misuse, and the development of other mental health conditions. A trained mental health professional can teach you coping strategies to use daily to keep anxiety and panic at bay. These techniques may include:

    • Deep breathing exercises
    • Progressive muscle relaxation
    • Meditation
    • Mindfulness practices
    • Grounding techniques
    • Guided imagery
    • Aromatherapy
    • Writing in a journal
    • Identifying anxiety triggers
    • Cognitive reframing
    • Social support

    Lifestyle Changes

    Anxiety is the direct result of the body’s fight-or-flight response being activated. When no immediate threat is present, this response can cause uncomfortable and distressing symptoms. By sending the body regular messages that you’re safe and taken care of, you can learn to mute fight-or-flight mode. Lifestyle changes, such as adopting a nutritious diet and engaging in regular exercise, can be beneficial. Other ways to deactivate the fight-or-flight response include learning stress management techniques, such as deep breathing and mindfulness exercises.

    Consider Xanax Alternatives

    Xanax is a powerful drug that carries a significant risk of addiction and abuse. If you or a loved one has a history of substance abuse or dependency, it may be wise to look for other anxiety medications that are less habit-forming. Mental health treatment with a certified therapist or psychologist can also be effective in managing anxiety symptoms and panic attacks. Certain lifestyle changes, such as adopting a healthier diet, exercising regularly, and getting sufficient sleep, may also help naturally reduce symptoms of anxiety.

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    Frequently Asked Questions About Xanax Overdose

    01

    How much Xanax does it take to overdose?

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    It’s impossible to say how much Xanax can make any individual overdose, since various factors can contribute to an overdose. Some of these factors include the person’s weight and height, individual tolerance, and any other substances present in their system at the time of taking Xanax. 

    01

    How common is overdose from benzodiazepines like Xanax?

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    According to the CDC, benzodiazepines were involved in a smaller proportion of overdose deaths compared to opioids. In 2023, most overdose deaths involved opioids, particularly synthetic opioids like fentanyl. Benzodiazepines may be present in some cases, especially when combined with opioids like fentanyl, but they are not the primary substance in the majority of overdose deaths. [6]

    01

    Do I need rehab for Xanax addiction?

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    Yes. Medical detox may be required for a benzodiazepine dependency. Xanax withdrawal can cause severe symptoms, so medication-assisted detoxification is often recommended. After detox, many people need ongoing rehabilitation services, including inpatient, outpatient, and aftercare services. 

    01

    Can Narcan reverse a Xanax overdose?

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    No. Narcan is used to treat opioid overdose, not overdoses resulting from Xanax or other benzodiazepines. Still, Narcan may be effective if Xanax has been taken in combination with opioid drugs. 

    Sources
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    [01]

    [1] Drug scheduling. DEA. (n.d.-a). https://www.dea.gov/drug-information/drug-scheduling

    [02]

    [2] Alprazolam: Uses, dosage, side effects. Drugs.com. (n.d.-a). https://www.drugs.com/alprazolam.html

    [03]

    [3] [5] George, T. T. (2023a, April 24). Alprazolam. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK538165/

    [04]

    [4] Mayo Foundation for Medical Education and Research. (n.d.). Alprazolam (oral route). Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/alprazolam-oral-route/description/drg-20061040

    [05]

    [6] U.S. Department of Health and Human Services. (2025i, June 11). Drug overdose deaths: Facts and figures. National Institutes of Health. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#Fig9

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