Xanax is the international brand name for alprazolam, a benzodiazepine used for anxiety and panic disorder. In South Africa alprazolam is dispensed as Alzam, Xanor, Biozane and Panix. It is a Schedule 5 medicine, causes drowsiness, and produces dependence with continued use.
What is Xanax?
Xanax contains alprazolam, a benzodiazepine. The name is familiar worldwide, but in South African pharmacies you are unlikely to be handed a box marked Xanax — the same ingredient is registered here as Alzam, Xanor, Biozane and Panix, all Schedule 5.
Alprazolam increases the effect of GABA, the brain’s principal calming signal, reducing nerve activity throughout the central nervous system. That produces rapid relief from anxiety, along with sedation and muscle relaxation.
What distinguishes alprazolam within its class is its timing. It acts quickly and, importantly, it is relatively short-acting compared with a benzodiazepine such as the diazepam in Betapam. That short action makes it effective for a panic attack — and it is also why alprazolam has a reputation for being harder to come off than its longer-acting relatives.
The reason is straightforward. When a short-acting medicine leaves the system, the drop is abrupt. That drop produces rebound anxiety between doses, which feels like the original problem returning and prompts the next tablet sooner. The cycle tightens quickly.
None of this makes a prescribed course wrong. It explains why the course is short, and why it is tapered rather than stopped.
What is Xanax commonly used for?
Alprazolam is prescribed for:
- Anxiety disorders, for short-term relief where symptoms are disabling.
- Panic disorder and panic attacks, where its speed is the point.
- Anxiety accompanying depression, briefly, while longer-term treatment takes effect.
- Situational anxiety, occasionally — before a procedure, for instance.
It relieves anxiety while it is in the system. It does not treat an anxiety disorder, and the distinction matters more here than almost anywhere else in this category.
The treatments that change the condition are different ones. Cognitive behavioural therapy has strong evidence in both anxiety and panic disorder, and its benefits persist after treatment ends. Where medication is used long term, an SSRI or SNRI antidepressant acts on the underlying condition and does not cause dependence — though it takes several weeks to work, which is the gap alprazolam is sometimes used to bridge.
For panic disorder in particular, there is a further consideration. Part of recovery involves learning that a panic attack, while frightening, passes without harm. Reaching for a fast-acting tablet at the first symptom can interrupt that learning, which is why treatment guidelines are cautious about relying on it.
How Xanax fits into this medicine category
Alprazolam is a short-acting benzodiazepine:
| Group | Examples | Role |
|---|---|---|
| Short-acting benzodiazepines | Alprazolam (Xanax, Alzam, Xanor) | Rapid relief; panic, acute anxiety |
| Longer-acting benzodiazepines | Diazepam (Betapam), chlordiazepoxide | Anxiety, spasm, alcohol withdrawal |
| SSRIs / SNRIs | Escitalopram, sertraline, venlafaxine | First-line long-term anxiety and panic treatment |
| Tricyclics | Amitriptyline (Trepiline) | Depression; nerve pain at lower amounts |
| Anticonvulsants | Pregabalin (Nurika) | Nerve pain, epilepsy, some anxiety |
The benzodiazepines sit apart from the rest of this table: they are the only group giving relief within an hour, and the only group producing dependence. See the mental health and neurology medicines hub.
What to check before using Xanax
Do not drink alcohol. Both depress the central nervous system, and the combination can suppress breathing dangerously.
Do not drive until you know how it affects you.
Never take alprazolam that was not prescribed for you. Alprazolam is among the most commonly counterfeited medicines internationally, and tablets sold outside pharmacies have repeatedly been found to contain synthetic opioids instead. Tablets bought online or from an informal source cannot be assumed to contain what the marking claims.
Tell your prescriber or pharmacist if:
- You take opioids — tramadol, codeine, morphine. Benzodiazepines combined with opioids are a leading cause of fatal respiratory depression.
- You have breathing problems — sleep apnoea, COPD, severe asthma.
- You have a history of dependence on alcohol, benzodiazepines or other substances.
- You have liver or kidney disease.
- You are pregnant, planning pregnancy or breastfeeding.
- You are older. Confusion, falls and fractures are markedly more common.
- You have depression, which benzodiazepines can deepen.
- You take ketoconazole, itraconazole, an HIV protease inhibitor, or clarithromycin, which raise alprazolam levels substantially, or an oral contraceptive.
- You take other sedating medicines.
Avoid grapefruit juice, which raises alprazolam levels.
Follow the dispensing label exactly. This page does not set doses.
Possible cautions and when to ask a pharmacist or doctor
Do not stop abruptly after regular use. Alprazolam withdrawal is well recognised and can be severe — rebound anxiety and panic worse than the original, insomnia, tremor, sweating, and after prolonged use, seizures. Coming off it is done gradually under medical supervision, and prescribers often switch to a longer-acting benzodiazepine first to smooth the taper. Do not attempt this alone.
Watch for dependence. Needing it more often, taking more than prescribed, watching the clock between doses, or anxiety about the supply running out are all worth raising. This is common with alprazolam specifically, it is not a failure of willpower, and it is treatable.
Rebound anxiety between doses can be mistaken for worsening illness. If anxiety spikes as each dose wears off, tell your prescriber — that pattern points to the medicine rather than the condition.
Expect drowsiness, unsteadiness and slowed reactions. Memory gaps and poor concentration also occur.
Paradoxical reactions — agitation or aggression instead of calm — happen occasionally, more often in older adults.
Seek urgent medical attention for slow, shallow or difficult breathing, extreme drowsiness or difficulty waking someone, confusion, a fall with injury, or worsening depression or thoughts of self-harm. Contact your prescriber if it is not working as it did, or if you find yourself needing more.
Related medicine guides
Frequently asked questions
What is Xanax used for? Short-term relief of anxiety and panic disorder. It contains alprazolam, a benzodiazepine.
Can I get Xanax in South Africa? Alprazolam is available here, but generally under other names — Alzam, Xanor, Biozane and Panix. All are Schedule 5 prescription medicines.
Is it the same as Alzam or Xanor? Yes, the active ingredient is the same. The brand differs.
How is it different from diazepam? Alprazolam is shorter-acting, which makes it effective for panic attacks but also produces sharper rebound between doses and a harder taper.
Can I stop taking it suddenly? Not after regular use. Withdrawal can include seizures and severe rebound panic. Ask your doctor about a supervised taper.
Is it a treatment for anxiety disorder? No. It relieves anxiety while it is in the system. Treating the disorder means therapy — cognitive behavioural therapy in particular — and, where medication is used, an antidepressant.