Xanax (Alprazolam) & Erectile Dysfunction

Erectile dysfunction causes men to either not have erections or be unable to sustain one long enough to have sex.

Many different kinds of medications can induce erectile dysfunction — and Xanax is one of them.

Xanax, or alprazolam, is available under many brand names, but the effects — good and bad — are the same.

We’ll go into more depth regarding these medications in this article.

What is Xanax (Alprazolam)?

Xanax is the brand name of the drug alprazolam, a commonly used anxiolytic. It belongs to the class called triazolobenzodiazepines.

Xanax works by slowing down the activity of your central nervous system (CNS), which produces a sedative effect and is mainly used for treating anxiety, panic disorders, and nausea induced by chemotherapy.

It has been used since 1981, when the Upjohn Company first put it on the market. It was later bought by Pfizer Pharmaceuticals, which still makes it today.

Xanax & Erectile Dysfunction

Poor blood supply to the penis is one of the most frequent causes of erectile dysfunction (ED), but drugs like Xanax can also impact on the sex drive and result in ED.

Most commonly, Xanax treats generalized anxiety disorder and panic disorder. It can also treat alcohol withdrawal, some sleep disorders, and anxiety brought on by depression due to its ability to slow down the central nervous system.

Xanax also impacts neurotransmitter molecules, which are used to communicate between brain cells — all nerve impulses are impacted by CNS inhibition.

The exact reason why Xanax can cause ED has not been determined. However, it is speculated that an enhanced gamma-aminobutyric acid (GABAA) receptor function causes this [1]. GABAA is an amino acid that works as a primary inhibitory neurotransmitter for the central nervous system (CNS).

Preventing nerve transmission lowers neuronal excitability — the same action that could be responsible for reducing erection and decreasing libido.

Xanax can decrease your libido or sex drive because it depresses your CNS; it’s tough to get an erection if your libido is low.

Xanax isn’t the only thing that causes sexual problems. Anxiety or depression can also be responsible for ED and a lower sex drive. A large number of cases of erectile dysfunction have been found in users with anxiety disorders [2]. ED could be a result of anxiety and depression, regardless of whether you take Xanax or not.

Because of this complicated link, it’s crucial to work with your doctor to identify the precise cause of ED. Finding out which condition came first is helpful.

You might want to give it some time if you had ED before taking Xanax and are using it to address anxiety or depression. Xanax may help with ED if depression or anxiety is the root of the problem.

However, if you didn’t have ED before using Xanax, the medication might or might not be the reason. Several systems are necessary for obtaining and maintaining an erection — your CNS, circulatory system, and hormonal system all have a significant impact. ED is often a symptom of underlying health issues.

Because erections are so complicated, it’s crucial to get a correct diagnosis so you can get treatment tailored to your needs. Consulting your physician is the first course of action.

Other Causes of Erectile Dysfunction

There are many other causes of erectile dysfunction, so we’ll look at the most common ones here.

Other Medications

Many other medications besides Xanax can cause ED [3]. This includes:

Antidepressants
Antihistamines
Antihypertensives
Diuretics
Chemotherapy
Opiates

Health Conditions

As we mentioned, ED is often a symptom of more serious health issues [4]. This makes it crucial to find out the exact cause.

Heart disease
High blood pressure
Obesity
Diabetes
Metabolic disorders
Mental illnesses
Performance anxiety

Age

As you grow older, the vessels that help in penile erection may be compromised, causing ED. However, erectile dysfunction or other sexual problems don’t have to be a part of getting older, so make sure to talk to your doctor [5].

Treatment Options for ED Caused by Xanax

Your physician can help you determine whether using Xanax is the cause of your ED or if there are other factors involved. Once your doctor knows what’s causing your ED, he or she can come up with a plan for treatment.

The treatment strategy may involve the following:

1. Watch & Wait

If Xanax is the source of your ED, the symptoms might subside as your body gets used to the new medicine. Your doctor could advise waiting a little while to see if the ED resolves itself.

2. Dosage Reduction

If your doctor determines that Xanax is the issue, they may change your dose or prescribe you another medication altogether. Make sure you strictly follow your doctor’s recommendations.

3. Use An ED Medication

Your doctor may prescribe a medication to treat ED. Most of these are phosphodiesterase-5 (PDE-5) inhibitors and include Viagra and Cialis.

What’s the Dose of Xanax

Xanax is available in doses of 0.25 mg and 2 mg and comes in packs of ten-pill packs.

How Long Does It Take for Xanax To Kick In?

It takes about 5 minutes to an hour for Xanax to start working.

How Long Does Xanax Last?

Xanax has a half-life ranging from 6 to 27 hours, depending on the user.

How Much Does Xanax Cost?

Xanax costs about $3 per 0.25 mg.

Who Should Take Xanax?

Xanax is for those with generalized anxiety disorders, phobias, and anxiety.

Is Xanax Safe?

Xanax is safe for most users. However, it may cause more side effects in adults who are 65 years and older. This is because the sedation may last longer in older people, causing more side effects.

Common Side Effects of Xanax

Akathisia
Blurred vision
Cognitive disorder
Confusion
Constipation
Decreased appetite
Decreased or increased libido
Decreased salivation
Depression
Diarrhoea
Difficult micturition
Dizziness
Drowsiness
Dry mouth
Dysarthria
Fatigue
Headache
Hypotension
Impaired coordination
Incontinence
Increase in appetite
Increased salivation
Insomnia
Irritability
Lightheadedness
Memory impairment
Menstrual disorder
Nasal congestion
Nausea
Nervousness
Syncope
Tachycardia
Talkativeness
Tremor
Vomiting
Weight change

Potential Drug Interactions With Xanax

CYP3A Inhibitors

CYP3A4 enzymes break down Xanax, so taking it with drugs that slow down CYP3A4 (inhibitors) makes Xanax build-up, increasing the risks.

Common CYP3A inhibitors include:

Cobicistat
Clarithromycin
Erythromycin
Diltiazem
Iraconazole
Ketoconazole
Ritonavir
Verapamil
Goldenseal
Grapefruit

CYP3A4 Inducers

Taking Xanax alongside CYP3A4 inducers can cause Xanax to be metabolized too quickly, decreasing its effects.

Common CYP3A4 inducers include:

Phenobarbital
Phenytoin
Rifampicin
St. John’s Wort
Glucocorticoids

Alcohol

Xanax and alcohol reduce neuronal activity in the brain and nervous system. Combining them may cause extreme sedation, slowed respiration, headaches, and vomiting.

Opioids

Concurrent use of opioids and benzodiazepines like Xanax can result in drowsiness, respiratory depression, coma, and death. Some common opioids include codeine, fentanyl, and morphine.

Antacids

Antacids may decrease the effects of Xanax, making it less effective. These include Alka-Seltzer and Gelusil.

Who Should Avoid Using Xanax

Some people should not use Xanax. It’s crucial that your doctor be aware of all your health conditions as well as the medications, supplements, and vitamins you use.

Your doctor might put you on a different medication if you have the following conditions:

A history of Xanax hypersensitivity
A history of seizures
Lung disease
Kidney disease
Liver disease
Need surgery, including dental
Are over 65

How Does Xanax Work

Xanax (alprazolam) is categorized as a high-potency triazolobenzodiazepine, a benzodiazepine with an attached triazole ring.

GABA receptors are the most common inhibitory receptors in the brain. This causes both beneficial and harmful effects. Alprazolam works by binding to and changing the activity of the GABAA benzodiazepine receptor site.

Alprazolam’s inhibitory or calming effects on the neurological system are mediated by the GABA chemical and receptor systems. Alprazolam increases GABA’s effects when it binds to the GABAA receptor. When GABA binds to the GABAA receptor, the channel opens, increasing the cell’s resistance to depolarization and inhibiting synaptic transmission to reduce anxiety.

Medical Research Involving Xanax

Alprazolam is very useful in decreasing anxiety and panic disorders [6]. While the research on alprazolam is abundant, the research done on the brand Xanax is almost nonexistent.

This is because once patents expire, generic versions of the drug can be created using the original recipes, so there’s no reason to conduct further research.

Best Xanax Alternatives

Many medications can be used as an alternative to treat anxiety — some are natural supplements, while others are prescriptions.

Pharmaceutical Xanax Alternatives

Xanax is one of many benzodiazepines. Other drugs in this class include:

Librium
Klonopin
Tranxene
Valium
Prosom
Dalmane
Ativan

Some other drug classes can also help with anxiety, including the following:

Barbiturates (Amytal Sodium, Butisol Sodium, Mebaral, Nembutal Sodium, Luminal, and Seconal)
Beta-blockers (Inderal and Innopran)
Azapirones (Lullan)

Natural Xanax Alternatives

Some herbs can decrease anxiety and can be a great option to try if you’re hesitant to try prescription drugs — benzodiazepines, in particular, are very addictive, and many people try other methods first.

Ashwagandha (Withania somnifera): Ashwagandha is an adaptogen that can help the body deal with stress better. The plant’s roots or leaves are used to create extracts or powders that might treat a variety of conditions, including anxiety and infertility [7].

Chamomile (Matricaria recutita) — Chamomile can help reduce anxiety with long-term use [8].

Lavender (Lavandula angustifolia) — Lavender has calming effects that can help decrease anxiety and depression [9].

Where to Buy Xanax

Xanax is available only with a prescription and can be purchased in a pharmacy or online. The latter is the better choice because it is simpler and more covert.

While Xanax can cause erectile dysfunction, there are ways to treat it. It’s imperative that you contact and discuss this matter with your physician first due to the possible complications.

References

Zoroufchi, B. H., Doustmohammadi, H., Mokhtari, T., & Abdollahpour, A. (2021). Benzodiazepines related sexual dysfunctions: A critical review on pharmacology and mechanism of action. Revista internacional de andrologia, 19(1), 62-68.
Velurajah, R., Brunckhorst, O., Waqar, M., McMullen, I., & Ahmed, K. (2022). Erectile dysfunction in patients with anxiety disorders: a systematic review. International journal of impotence research, 34(2), 177-186.
Kaplan-Marans, E., Sandozi, A., Martinez, M., Lee, J., Schulman, A., & Khurgin, J. (2022). Medications most Commonly Associated with Erectile Dysfunction: Evaluation of the Food and Drug Administration National Pharmacovigilance Database. Sexual Medicine, 10(5), 100543.
McMahon, C. G. (2019). Current diagnosis and management of erectile dysfunction. Medical Journal of Australia, 210(10), 469-476.
Pellegrino, F., Sjoberg, D. D., Tin, A. L., Benfante, N. E., Briganti, A., Montorsi, F., … & Vickers, A. J. (2022). Relationship between age, comorbidity, and the prevalence of erectile dysfunction. European Urology Focus.
Chouinard, G., Annable, L., Fontaine, R., & Solyom, L. (1982). Alprazolam in the treatment of generalised anxiety and panic disorders: a double-blind placebo-controlled study. Psychopharmacology, 77(3), 229-233.
Salve, J., Pate, S., Debnath, K., & Langade, D. (2019). Adaptogenic and anxiolytic effects of the ashwagandha root extract in healthy adults: a double-blind, randomised, placebo-controlled clinical study. Cureus, 11(12).
Mao, J. J., Xie, S. X., Keefe, J. R., Soeller, I., Li, Q. S., & Amsterdam, J. D. (2016). Long-term chamomile (Matricaria chamomilla L.) treatment for a generalised anxiety disorder: A randomised clinical trial. Phytomedicine, 23(14), 1735-1742.
Kim, M., Nam, E. S., Lee, Y., & Kang, H. J. (2021). Effects of Lavender on Anxiety, Depression, and Physiological Parameters: Systematic Review and Meta-Analysis. Asian Nursing Research.