27 Jan 2026

This article has been reviewed by: Lester Morse, Director of Rehabs UK

Xanax (alprazolam) is a benzodiazepine, a class of sedative medications prescribed for anxiety and panic disorder. While it offers rapid anxiety relief, often within an hour, many people underestimate the trade-off: the same neurological slowing that eases panic can also impair memory, learning, emotional regulation and, with long-term use, may increase the risk of brain shrinkage and dementia.

This article explains how Xanax works in the brain, why it can cause memory loss, the reality of “benzo brain”, and what research says about long-term risks. It also highlights how counselling and structured rehab, including support from Rehabs UK, play a crucial role in protecting long-term cognitive health.

Table of contents

  • How does Xanax work on the brain?
  • Short-term effects
  • Does Xanax cause memory loss?
  • Brain fog and “benzo brain”
  • Long-term risks: Shrinkage and Alzheimer’s
  • Can memory loss from Xanax be reversed?
  • Looking for Xanax addiction support? Talk to Rehabs UK
  • Bibliography
  • Related articles

How does Xanax work on the brain?

To understand what Xanax does to the brain, it helps to know a little about neurotransmitters. Xanax enhances the action of gamma-aminobutyric acid (GABA), the brain’s main inhibitory chemical messenger.

Think of GABA as the brain’s “brake pedal”. When anxiety hits, the brain’s electrical activity speeds up. Xanax pushes the brake harder, slowing things down.

How does this produce calm?

Xanax binds to GABA-A receptors and makes GABA more effective. This causes:

  • Reduced neural firing
  • Slower communication between brain regions
  • Relaxation of muscles
  • Less activity in the amygdala (the brain’s fear centre)

What part of the brain does Xanax affect?

Primarily the amygdala, hippocampus, prefrontal cortex, and the cerebellum—regions that govern fear, memory, decision-making, and coordination.

This slowing creates relaxation—but also brings side effects such as poor coordination, slowed reactions, emotional blunting, and drowsiness.

Does Xanax cross the blood–brain barrier?

Yes. Xanax is highly lipid-soluble, so it crosses the blood–brain barrier rapidly, one reason it works quickly but also has strong cognitive effects.

Short-term effects

Short-term effects relate to functional, not structural, changes, meaning the brain is temporarily impaired while the drug is active. For most people, Xanax affects the brain for 6–12 hours, but it can persist longer in chronic users, older adults, or those on higher doses.

Common short-term neurological effects:

  • Anterograde amnesia (inability to form new memories)
  • Reduced attention
  • Slowed processing speed
  • Impaired coordination
  • Drowsiness (the most common side-effect)
  • Emotional numbing or flatness

This explains why users may:

  • Forget conversations they just had
  • Not remember sending messages
  • Lose track of time
  • Experience “blackout-like” episodes, even at therapeutic doses

“Xanax is one of the most problematic addictions that we treat… It is really very highly addicting.” — Dr Dan Angres, Director of Rush Behavioral Health treatment network.

Does Xanax cause memory loss?

Yes—both short-term and, with long-term use, potentially lasting memory problems.

Why does Xanax cause memory loss?

Because it suppresses neural activity in the hippocampus, the brain area essential for forming new memories. Over time, chronic suppression can make this region less efficient.

Long-term effects may include:

  • Cognitive Domain
  • Impact of Long-Term Xanax Use
  • Verbal memory
  • Difficulty recalling words, conversations, names
  • Processing speed
  • Slower thinking, slower problem-solving
  • Attention and concentration
  • Reduced ability to focus
  • Executive function
  • Poorer planning and decision-making
  • Emotional memory
  • Blunted emotional responses

Research supports this: long-term benzodiazepine users show consistent cognitive deficits, sometimes lasting months after discontinuation.

“People were innocently put on this medication [Xanax] and in some instances it works out well. But there is a significant risk… Many people… have lost jobs, been on the verge of suicide… During withdrawal… heart rate may go up, they may have a seizure… in some instances it’s fatal.” — Dr Neil Capretto, Director of the Gateway Rehabilitation Center, Pennsylvania.

Do anti-anxiety medications affect memory?

Many can, but benzodiazepines—especially short-acting ones like Xanax—cause the most pronounced memory impairment.

Do benzodiazepines cause long-term memory loss?

Studies suggest prolonged use increases the risk of persistent cognitive impairment, particularly in older adults.

Brain fog and “benzo brain”

“Benzo brain” is the term many people use to describe the cognitive dullness associated with benzodiazepine dependence.

Common symptoms:

  • Mental cloudiness
  • Difficulty concentrating
  • Feeling detached or “spaced out”
  • Struggling with multitasking
  • Slower speech or difficulty finding words
  • Feeling emotionally flat

Many people describe it as:

“It felt like someone had wrapped my brain in cotton wool.” “I was there, but not really there.”

This subjective fog is a sign that the brain’s communication pathways are being dampened and not working at normal speed.

Does Xanax affect cognitive ability? Yes—both speed and accuracy of thinking are typically reduced.

Long-term risks: Shrinkage and Alzheimer’s

Long-term use of Xanax, especially daily use for months or years, has been linked to structural changes in the brain.

Brain shrinkage (brain volume loss)

A 2022 study in Neuropsychopharmacology found that chronic benzodiazepine use is associated with reduced grey matter volume, particularly in:

  • The hippocampus
  • The prefrontal cortex

These are regions essential for memory, mood regulation, and problem-solving.

Increased Alzheimer’s risk

Multiple studies, including BMJ (2014), found that long-term benzodiazepine use is associated with a 32%–84% increased risk of developing Alzheimer’s disease.

This does not prove causation, but the association is strong enough that most experts advise caution when prescribing long-term medications.

Xanax and dementia risk

Long-term benzodiazepine use is considered a modifiable risk factor for dementia, especially in older adults.

“Our results underline guidelines that say that you shouldn’t take benzodiazepines for a very long period of time… look into other therapies instead of just riding out the benzodiazepines.” — Ilse vom Hofe, co-senior author, neuroscience study on benzodiazepines and brain volume

Can memory loss from Xanax be reversed?

Yes—in many cases, cognitive function improves significantly after stopping Xanax, thanks to neuroplasticity, the brain’s ability to reorganise and repair.

What recovery looks like

  • Short-term memory often improves within 4–12 weeks
  • Verbal memory and processing speed may take 3–12 months
  • Older adults may recover more slowly
  • People tapering slowly tend to see better outcomes

Lester Morse, Director of Rehabs UK

“Counselling and structured rehab not only help with withdrawal but also give the brain space to start rebuilding.”

“Xanax… causes a reactive hyperactivity of the receptors that they block. The hyperactive receptors then require one or more doses… After the patient stops taking the Xanax, it takes the brain six to eighteen months to recover.” — Dr John Steinberg, Medical Director of Chemical Dependency Program at Greater Baltimore Medical Center.

Where counselling fits in

Counselling helps by:

  • Reducing relapse risk
  • Teaching anxiety-management strategies
  • Supporting memory, organisation and cognitive rehabilitation
  • Addressing emotional regulation issues caused by long-term use
  • Helping clients rebuild confidence and daily functioning

This is why a medical detox combined with long term support is the safest way to recover from Xanax dependence.

Looking for Xanax addiction support? Talk to our Treatment advisors here at Rehabs UK

Although Xanax changes how the brain functions, recovery is absolutely possible—especially with the right support.

Rehabs UK can help you access:

Bibliography

  • Barker, M. J., et al. “Cognitive effects of long-term benzodiazepine use.” Psychopharmacology (2004).
  • Billioti de Gage, S., et al. “Benzodiazepine use and risk of Alzheimer’s disease.” BMJ (2014).
  • Livingston, G., et al. “Dementia prevention, intervention, and care.” The Lancet (2020).
  • Lader, M. “Benzodiazepines revisited.” British Journal of Addiction (1991).
  • Zhang, X., et al. “Long-term benzodiazepine use and brain volume.” Neuropsychopharmacology (2022).

Related articles

How to spot the signs of Xanax addiction

Xanax Detox

The Silent Epidemic of Prescription Medication Addiction