Alprazolam for PMS-Related Anxiety

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Alprazolam for PMS-Related Anxiety


Generic NameBrand Name

How It Works

Alprazolam is a high-potency benzodiazepine that depresses the central nervous system, causing a mood-elevating and sedative effect and relieving feelings of anxiety. This medicine can be addictive.

Why It Is Used

Alprazolam is sometimes prescribed for women who have premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) when anxiety is the main symptom and other treatments have not worked. It is only recommended for a few days' use (no longer than the premenstrual part of the cycle), because it loses effectiveness over time and may become addictive if used continuously.

How Well It Works

Alprazolam is considered to be somewhat effective for PMS-related anxiety and irritability.1 But it can dull the mind and become addictive.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • Hives.
  • Confusion.
  • Slurred speech.
  • Thoughts of suicide.

Common side effects of this medicine include:

  • Drowsiness.
  • Dizziness.
  • Memory loss.
  • Tolerance (your body keeps needing more of the medicine to get the same effect).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

If you are taking alprazolam, use caution if you drive or operate machinery. This medicine may cause drowsiness, which makes it harder for you to concentrate.

For some women, anxiety is linked to other PMS symptoms. Physical symptoms like weight gain or emotional symptoms like feeling out of control may cause anxiety. Reducing these symptoms often relieves anxiety without the need for antianxiety medicines.

If used continuously, alprazolam can become addictive after a few weeks and often must be tapered gradually to avoid symptoms of withdrawal, which can be life-threatening.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Women who use this medicine during pregnancy may have a slightly higher chance of having a baby with birth defects. If you are planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.



  1. Kwan I, Onwude JL (2009). Premenstrual syndrome, search date July 2009. Online version of BMJ Clinical Evidence:


ByHealthwise Staff
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Specialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology
Last RevisedJune 8, 2012

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