Questions about anxiety and Xanax

My doctor prescribed Xanax (1mg) because he thinks that my symptoms are consistent with anxiety. I have been suffering from a multitude of symptoms since last October.  Since January I have been experiencing shortness of breath and a tight or fullness in my chest. Sometimes I get a warm feeling.  My symptoms improve significantly with the xanax although not 100%.  I have a few questions...

1) Since my symptoms do seem to improve significantly with the xanax, is it safe to assume that my symptoms are caused by my anxiety?

2) Is it safe to take Xanax on a long term basis?  Does it cause any kind of physical damage like liver damage?

3) I only take the xanax when I feel like my symptoms are bad in the morning.  I sleep very well when I take the xanax but I have problems falling to sleep when I don't take it.  Before I started taking I never had problems falling asleep.  Could I become dependent on this drug to make me fall asleep?  I don't want this to happen.  I would rather overcome my anxiety holistically.  Any suggestions?

[Roger Gould, M.D.]

Xanax is a very useful and powerful medication but it's also something that can become addictive and is very hard to get off, so be very careful.  Ask your doctor about klonopin which is longer lasting, less addictive and serves the same purpose.

[brandon72223]

I would like to warn you.   I was in your same position.   Xanax will stop a panic attack in about 5 min.  However it is addictive and with alachol dangerous.  

In a matter of 3 weeks I got two d.w.i.'s and wrecked 3 cars while taking xanax and drinking.   I blacked out on xanax.  I am blessed with means so I was able to beat the dwi's but it cost me an arm and leg.   I got on Lexapro and it cured the attacks with no side affects.   Please be careful with Xanax.  

[flicka250]

I have prescribed xanax and ativan for many people with good results but it's always wise to be careful. Xanax can be very effective in the moment with panic attacks and can also help with sleep if the problem falling asleep is related to anxiety. Talk to your doctor about your dose to see if you could try a smaller dose more often or as suggested above, move to something in the same class but longer lasting, like Ativan or Klonopin. As the post above demonstrates, you don't want to drink alcohol when taking any of these meds.

Aside from that, I suggest that in addition to medication you talk to someone in counseling who can help you identify sources of anxiety and assist you in developing alternative coping mechanisms. This is really the foundation of treating anxiety. Xanax or similar meds can be very helpful in getting you to point where you can work through some of this stuff without the distraction of acute anxiety. There are also longer term medications if necessary, like a different SSRI, or buspar.

Education is also key. Believe it or not, "Anxiety for Dummies" is a great resource! Skip the section on benzodiazepenes, though, because it is a bit dramatic and overstated with a definite antimedication bias. "Dummies" also has a great anxiety and depression workbook. I also suggest "Cognitive behavioral therapy for Dummies"

Good luck!