Every year, physicians in the U.S. write millions of prescriptions for Xanax and Lexapro. But is it safe to use both of these meds at the same time? Can you take Xanax with Lexapro, or would doing so be harmful to your health?
At Valor Behavioral Health, we offer on-site psychiatric services. This allows our clients to make informed decisions about which medications to take. If you’re interested in learning more about medication management in Atlanta, contact us today.
Xanax and Lexapro: The Basics
Before we discuss whether or not you can take Xanax with Lexapro, let’s review a few facts about each medication.
Ingredients
Xanax contains alprazolam, which is a benzodiazepine.
It was first synthesized in 1971, and was approved by the U.S. Food and Drug Administration (FDA) in 1981:
- Benzodiazepines, or benzos, are a class of central nervous system (CNS) depressants.
- Benzos slow the delivery of messages between the brain and other body parts, which has a calming effect on the body and mind.
- Unfortunately, benzos also pose a risk of both abuse and addiction. In the U.S., Xanax and other benzos are Schedule IV controlled substances.
Lexapro contains escitalopram, which is a selective serotonin reuptake inhibitor (SSRI).
It first earned FDA approval in 2002:
- Lexapro and other SSRIs boost the level of serotonin, a neurotransmitter that is involved with functions including mood, learning, memory, body temperature, and sexual desire.
- SSRIs increase serotonin levels by disrupting the process through which the hormone is reabsorbed after carrying its message from one nerve cell to another.
- Disrupted reabsorption leads to a serotonin buildup in the synapses, which amplifies the hormone’s effects.
Approved & off-label uses
When the FDA approves a medication, part of that process involves identifying specific conditions the med is approved to treat. This doesn’t mean that other uses are banned or inherently dangerous. It simply means that the FDA did not assess the safety and effectiveness of those other uses.
Once a drug has been approved by the FDA, doctors are allowed to prescribe it on an “off-label” basis. This means for non-approved purposes if they have a legitimate medical reason for doing so.
Xanax and Lexapro have both been approved by the FDA to treat two conditions:
- Xanax is approved for generalized anxiety disorder (GAD) and panic disorder with or without agoraphobia
- Lexapro is approved for GAD and major depressive disorder (MDD)
Physicians also prescribe both medications on an off-label basis to treat a variety of additional disorders:
- Common off-label uses of Xanax include treating depression, social anxiety disorder (social phobia), premenstrual dysphoric disorder (PMDD), and insomnia.
- Lexapro’s off-label uses include treating social anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), and PMDD.
Frequency of use
As noted at the top of today’s post, Xanax and Lexapro are extremely popular prescription medications.
According to the online medical resource ClinCalc:
- U.S. pharmacies filled more than 37 million prescriptions for Lexapro or generic escitalopram in 2023, making it the 14th most frequently prescribed drug that year.
- From 2014-2023, the annual number of Lexapro/escitalopram prescriptions increased by 89%, rising from about 19.6 million to over 37 million.
- Physicians wrote almost 15.9 million prescriptions for Xanax and generic alprazolam in 2023, which earned it 37th place on the most frequently prescribed drugs list.
- From 2014-2023, the yearly total of prescriptions for Xanax or alprazolam decreased by about 45%, falling from about 28.9 million to below 15.9 million.
Can You Take Xanax With Lexapro?
So, now that we’ve covered some important basic facts about these drugs, let’s turn our attention back to the question in today’s headline: Can you take Xanax with Lexapro?
Though this looks like a simple yes-or-no question, the answer isn’t quite as straightforward.
In some cases, it can be both safe and beneficial to take Xanax and Lexapro at the same time. In other circumstances, it might be a bad idea to combine the two medications.
Factors that can influence whether you should or shouldn’t take them simultaneously include potential side effects, how long you take them together, and your age and health.
Side effects
Xanax and Lexapro don’t seem to interact with each other in dangerous ways, nor do either of them interfere with the other’s efficacy. However, they both can cause certain similar adverse effects, which may be magnified to a concerning level if you have them both in your system at the same time.
Side effects include:
- Common side effects of Xanax include dizziness or lightheadedness, drowsiness, forgetfulness, impaired balance and coordination, and muscle weakness.
- Lexapro’s more common side effects include fatigue and drowsiness, headache, nausea, restlessness, and insomnia.
Among these effects, extreme drowsiness and fatigue are perhaps greatest risk among people who take Xanax and Lexapro simultaneously. Especially when combined with impaired coordination and lack of sleep, these intensified effects can put a person in danger of slips, falls, automobile accidents, and similar concerns.
The problem may be particularly pronounced if you have just begun to take Lexapro, as the side effects mentioned above are typically most pronounced during the first few weeks as your body adapts to the drug.
Duration of use
Lexapro is designed for long-term use. As with other SSRIs, it usually takes four to six weeks for a person to begin to feel a noticeable improvement, after which they may remain on the medication for several years.
Xanax’s effects usually kick in within about 30 minutes and peak within an hour or two. Patients use this med when they are in the midst of a panic attack or experiencing particularly acute anxiety.
Using Xanax on a regular basis over an extended period can increase their risk of developing an addiction to the drug. The FDA recommends limiting Xanax use to no more than 10 weeks for panic disorder or a maximum of four months for GAD.
If you are in the early stages of using Lexapro, taking Xanax at the same time can increase your risk of more severe side effects.
Conversely, if you use Xanax and Lexapro for more than a few months, you may be in danger of becoming dependent. This means you could develop powerful cravings for Xanax and experience withdrawal symptoms when you try to stop using it.
Patient age and health
Physicians usually exercise greater caution when prescribing Xanax and Lexapro to older adults. They are more susceptible to effects such as drowsiness, fatigue, balance/coordination problems, and delayed cognition.
Taking these drugs can also pose an unacceptable risk to patients with health concerns such as:
- Liver disease
- Heart problems
- Pain treated with opioids
- History of addiction
The best way to determine if you can take Xanax and Lexapro together is to talk to your doctor. A qualified healthcare provider who is familiar with your medical and mental health history can help you make an informed decision.
Find Treatment for Anxiety and Depression in Atlanta
Xanax and Lexapro are by no means the only options for treating anxiety, depression, or related mental health concerns. If you would like to explore other ways to manage your symptoms, Valor Behavioral Health is here for you.
Our outpatient mental health treatment center in Atlanta, GA, is a trusted source of personalized care for adults and adolescents. Treatment options include a partial hospitalization program (PHP), intensive outpatient program (IOP), evening IOP, virtual (online) IOP, and adolescent program.
To learn more about how we can help you or a loved one, please visit our Admissions page or call us today.
