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 occasionally prescribed for women with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) when anxiety is the main symptom and other treatments have not been effective. 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

Possible side effects of benzodiazepine medicines include:

  • Addiction. Physical addiction can be life-threatening, especially during rapid withdrawal.
  • Drowsiness.
  • Low blood pressure.
  • A general lack of interest (apathy).
  • Dizziness.
  • Forgetfulness.
  • Weight gain.

If you are taking alprazolam, use caution when driving or operating machinery. This medicine may cause drowsiness, which may make it harder to concentrate.

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

What To Think About

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 anti-anxiety 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.

The benefits and effectiveness of anti-anxiety medicines need to be compared with the side effects and costs of treatment. You can discuss this with your health professional.

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



  1. Kwan I, Onwude JL (2007). Premenstrual syndrome, search date November 2006. Online version of BMJ Clinical Evidence. Also available online:


By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Kirtly Jones, MD, MD - Obstetrics and Gynecology
Last Revised July 26, 2010

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.