Does Xanax Cause or Help Heart Palpitations?

In this article, we will take a close look at the potential effects of Xanax on heart palpitations. We will also explain the diagnosis and look at the treatment of heart palpitations to see whether Xanax can help with this symptom.
Jakub Gwiazdecki

Jakub Gwiazdecki

Fifth year medical student at the Medical Faculty of Comenius University in Bratislava.

A blue image with text saying "Does Xanax Help Heart Palpitations?"

Can Xanax Cause Heart Palpitations?

Does Xanax Help Heart Palpitation?

Xanax, also known as alprazolam, is primarily used to treat anxiety disorders and panic disorders. Xanax alleviates psychological symptoms of anxiety, and helps with restlessness, racing thoughts, and muscle tension. Patients with anxiety or panic often report experiencing heart palpitations [1, 2]. While Xanax can slow down the heart rate, it's important to note that Xanax is not a primary treatment for heart palpitations which come from other causes.

Xanax can slow down essential functions such as heart rate, breathing and temporarily lower blood pressure. Nevertheless, those changes come from the nerves, not from any receptors on the heart or lungs. That means, that Xanax does not directly target the mechanisms causing heart palpitations [1].

Moreover, the safety and effectiveness of Xanax for treating anxiety disorder for longer than 4 months or panic disorder for longer than 10 weeks is not known [2]. Long term use of Xanax should be omitted as it can cause dependency and addiction [1]. Benzodiazepine abuse, which includes Xanax, has even been linked to dementia or Parkinson's disease.

If someone suffers from panic or anxiety disorders with persistent heart palpitations, which continue in situations without psychological symptoms, Xanax should be stopped and a thorough investigation of the underlying causes should be performed.

What are heart palpitations?

Heart palpitations are sensations of rapid heart rate or irregular heartbeat. They are symptoms and are subjective to anyone. Nevertheless, heart palpitations are not to be ignored. Sometimes they can spread through the body and are felt in the chest, neck or throat [3, 4].

Because palpitations are subjective they can manifest in various ways. They may feel like the heart has skipped a beat, added an extra beat, or is racing, pounding, or fluttering [4]. In some cases, the heart may speed up without any obvious reason, "skip a beat," or slow down [5].

In cardiology, heart palpitations are associated with abnormal heart rhythms, called arrhythmias. They can arise due to structural changes in the heart as well as from noncardiac conditions. Those can be linked to stress and hormones. Conditions which can cause heart palpitations include hyperthyroidism (high levels of thyroid hormones), Cushing syndrome (high cortisol levels) or diabetes mellitus [3]. The higher-mentioned diseases and as well as cardiac problems are the reasons why heart palpitations should not be ignored [5].

Heart palpitations can also be experienced during periods.

What is the diagnosis of heart palpitations?

The diagnosis of heart palpitations typically begins with a detailed history and physical examination [6, 7]. A standard 12-lead electrocardiogram (ECG) is an essential initial diagnostic test [8]. However, due to the transitory nature of palpitations, additional monitoring methods may be required [9, 10].

Several tools are available for this purpose. A few common are 24-hour Holter monitoring, 30-day external continuous monitoring, and implantable loop recorders [11]. In unclear cases, an echocardiogram is performed to visualise the structure of the heart. Other diagnostic tests may include a stress test, chest X-ray, and ambulatory cardiac monitor test [12].

If the cardiological tests are negative other directions are tested. Hormonal levels of cortisol and thyroid hormones are taken, as well as a psychological or neurological examination is performed.

What is the treatment of heart palpitations?

The treatment for heart palpitations depends on the underlying cause. For many people, palpitations will resolve on their own without any treatment. However, if an underlying cause is identified, treatment of it is initialized to stop the palpitations [13, 14].

If anxiety or stress is causing the palpitations, techniques such as meditation, journaling or yoga may be beneficial. If the problem is serious, medication to ease symptoms of anxiety may be considered [13]. Also, psychotherapy should be considered to work on the ground of the disease. During the treatment lifestyle modifications, such as staying hydrated, eating well, and regular exercise, can also reduce the risk of heart palpitations [13].

In some cases, substances such as certain drugs, medications, or foods can lead to palpitations. If a particular substance is identified as causing palpitations, it may be recommended to remove it from the diet [13].

If the palpitations are the result of a specific condition or disease, a specialist will work with the patient to find an appropriate treatment. These treatment options may include medications, catheter ablation, or electrical cardioversion [13].

What is Xanax and what is it used for?

Xanax is also known by its generic name alprazolam. It is a medication used to manage conditions such as anxiety, depression, and panic attacks. It belongs to the class of benzodiazepines. They are potentially dangerous and can cause addiction. That is why Xanax is considered a controlled substance [15]. In addition to treating anxiety and panic disorders, Xanax is sometimes prescribed off-label for other conditions. These other diseases include insomnia, depression, and premenstrual syndrome (PMS) [1]. It can also be used to treat symptoms of the manic phase of bipolar disorder. It helps in the management of racing thoughts and speech, high energy, reduced need for sleep, difficulty concentrating, impulsiveness, and impatience [16].

Alprazolam works by interacting with the central nervous system and produces a calming effect, slowed breathing, and muscle relaxation. It is available in liquid or pill form, with the dosage varying depending on response. A common dosage is a 0.25 mg dose taken two or three times per day [1, 15].

Xanax is a potent drug and requires a prescription. It's important to take only the prescribed dosage and adhere to the usage time. Ignoring the prescription and long period of use can lead to potential addiction or in severe overdose death[15]. A high dose of alprazolam causes shallow breathing, significant respiratory depression and low blood pressure as well as slower brain activity. All this combined is a pathway to death and the result of the does. Due to this high risk, Xanax should only be used under the supervision of a health care provider.

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Jakub Gwiazdecki

Jakub Gwiazdecki

Jakub is in his fifth year as a medical student at Comenius University in Bratislava, Slovakia. He has special interested in cardiology and in patient-centered medicine. His love for heart health isn't just book-smarts; he wants to know how it works, what it means for our feelings, and how key it is for health and happiness. Jakub thinks real good health care comes from always putting the patient at the centre, treating each person as a whole.