Xanax and Lexapro have helped millions of people achieve improved mental health and better overall quality of life. But in certain circumstances, taking both meds at the same time could expose a person to considerable harm
What Are Xanax and Lexapro?
Xanax and Lexapro are the brand names of two prescription medications that are commonly used to treat mental health concerns.
Xanax was first approved by the U.S. Food and Drug Administration (FDA) in 1981. The brand is currently owned by Viatris, Inc. Lexapro, which earned initial FDA approval in 2002, is currently owned by AbbVie, Inc.
Few psychiatric meds are prescribed more often than Lexapro and Xanax. For example, in 2020:
- U.S. pharmacies filled 30.6 million prescriptions for Lexapro and its generic equivalent, making it the second-most frequently prescribed psychiatric med that year.
- Xanax and its generic version earned ninth place on the list, with 16.78 million prescriptions.
Active Ingredients
The primary active ingredients in these medications are alprazolam (Xanax) and escitalopram (Lexapro). Alprazolam is a benzodiazepine (benzo), while escitalopram is a selective serotonin reuptake inhibitor (SSRI):
- Benzos are a category of drugs that slow the delivery of messages throughout the central nervous system (CNS). This can have a calming, sedating effect on the body and mind. Other frequently prescribed benzos include clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan).
- SSRIs artificially increase levels of serotonin, a naturally produced neurotransmitter that is associated with functions such as mood, memory, learning, and reward. Other popular SSRIs include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
Common Uses
The FDA has approved Xanax to treat anxiety disorders and panic disorders. Some doctors also prescribe it on an off-label basis to treat people who have insomnia, depression, and premenstrual syndrome.
Lorazepam’s FDA-approved uses are treating major depressive disorder (MDD) and generalized anxiety disorder (GAD). This medication’s off-label uses include treating:
- Social anxiety disorder (social phobia)
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Posttraumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder (PDD)
Side Effects
As is also the case with virtually every other prescription medication, Xanax and Lexapro can both cause adverse effects.
In the case of Xanax, common side effects include:
- Drowsiness
- Dizziness or lightheadedness
- Low blood pressure
- Slurred speech
- Increased sex drive
- Weight gain or loss
Typical side effects of Lexapro include:
- Insomnia
- Increased perspiration
- Diminished sex drive
- Difficulty achieving orgasm
- Fatigue
- Suicidal ideation
Dangers of Mixing Xanax and Lexapro
It’s not uncommon for a person to have two mental health disorders at the same time, such as anxiety and co-occurring depression or PTSD and co-occurring panic disorder. In cases like these, a doctor may prescribe both Xanax and Lexapro – but combining these two medications could be problematic, especially if the patient misuses either of them.
Four potential dangers of mixing Lexapro and Xanax are:
- Oversedation: Both of these medications can have a calming, sedating effect. Taking both at the same time could intensify this effect, which can lead to excessive drowsiness, diminished attentiveness, and delayed responsiveness. If a person experiences these difficulties while driving, operating machinery, or engaged in certain other activities, they could put themselves and others in danger.
- Serotonin syndrome: Low serotonin can contribute to depression, which is why Lexapro can be beneficial to some people who have depressive disorders. Though Xanax doesn’t directly affect serotonin, it can exert an indirect influence. If a person’s serotonin levels get too high, they risk developing a rare but potentially fatal condition called serotonin syndrome.
- Respiratory impairments: The sedating effects of both Lexapro and Xanax can slow a person’s breathing. If someone who has already been experiencing certain respiratory problems takes both meds, the combination could be particularly harmful. The risk of serious respiratory concerns can increase significantly if the individual is also using alcohol or other substances while taking Xanax and Lexapro.
- Liver damage: Though rare, the long-term use of either Xanax or Lexapro can cause damage to the liver. Combining the drugs could increase the likelihood of this occurring. Given the liver’s essential role in filtering toxins from the bloodstream, any harm that is inflicted on this organ can have a profound impact on a person’s overall health.
The risk of health damage from the simultaneous use of Lexapro and Xanax is greatest among people who misuse either (or both) of these meds, or who use them in combination with alcohol, opioids, or other recreational substances.
However, even a small risk of damage from physician-approved use of both drugs should not be ignored. To keep yourself as safe as possible, be sure that your doctor is aware of all medications and supplements that you are taking, ask them about warning signs to watch out for, and never deviate from your dosage regimen without consulting with them first.
Risk of Addiction to Xanax and Lexapro
As a benzodiazepine, Xanax has been linked with both abuse and addiction.
The U.S. Drug Enforcement Agency (DEA) has classified alprazolam as a Schedule IV controlled substance. This classification is reserved for substances that pose “a low potential for abuse and low risk of dependence.”
It is important to note that low risk is not the same as no risk. While those who misuse Xanax for recreational purposes or in an attempt to self-medicate have a greater risk of addiction, even people who take this it as prescribed by their doctor can become dependent on it.
Researchers have not associated Lexapro with either abuse or addiction, though people who use the drug for an extended period may experience some withdrawal symptoms if they abruptly stop using it.
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