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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 10061
Experience:  14 years experience in the field of Family Practice
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Hi, I suffered a debilitating panic attack yesterday and so

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Hi, I suffered a debilitating panic attack yesterday and so I went to a doctor. THe doctor at the urgent care center gave me .25 of Xanax. At the moment it brought relief. Today, I took .125 of Xanax in the afternoon because I was feeling anxious. It helped a little, but I decided to take the other half 4 hours later. About 20 minutes afterwards I started feeling kind of shaky and as of right now I'm shaking a lot. I feel jittery, like shivering. I don't know if this is because I was anxious about taking the second half or what. SHouldn't the Xanax have prevented this? I'm really scared. Will this go away? Should I go to an ER?

Anthony Bray, MD : Hello!
Anthony Bray, MD : the Xanax is helpful for panic attacks -- your dose is relatively low and this is appropriate to start ...

I know, but after this latest half dose, I am shaking uncontrollably.

Anthony Bray, MD : I would advise you to plan to get in to consult a psychiatrist to consult with regard to your anxiety and panic attacks!!

yes, but do you think shaking is a normal side effect?


I already have an apointment with a psychiatrist for next week, but I'm worried about this right now.

Anthony Bray, MD : the shaking would NOT be caused by Xanax -- it would fit as a symptom of anxiety though...

so you think my anxiety is overriding the effect of the xanax?


Do you think I should go to the ER?

Anthony Bray, MD : No shaking is not a side effect of the dose if Xanax that you took... Not at all!!
Anthony Bray, MD : Has there been something that has heightened your anxiety?? That is what it sounds like here....

but how is it possible that i am so anxious all of a suddent after taking xanax... isn't the whole point of it to calm me down?


I felt nauseous as soon as I took it so maybe i became anxious because of that?


that nausea has since gone away

Anthony Bray, MD : Yes that is the point but your dose was very low ... 0.25 mg is low dose and then you last tool half if that right??

yeah, i took half of that five hours ago and the other half about 1 hour ago


maybe i'm worried about addiction. i don't want to become dependent on xanax

Anthony Bray, MD : you should probably not need to go to ER for panic attack but at times people do... Panic attacks are scary and miserable but not truly dangerous to you....

so you definitely don't think the shaking was caused by the xanax

Anthony Bray, MD : Well often we use an SSRI antidepressant as the mainline panic attack prevention --- often in combination with a benzodiazepine such as Xanax ... Lower dose is lower risk for abuse or addictive tendencies ....

also, how long do you think it takes to become addicted to xanax?

Anthony Bray, MD : No -- absolutely not -- not a side effect of Xanax--- absolutely a symptom of anxiety though...
Anthony Bray, MD : I think you are at heightened level of anxiety for some reason ....

also, do you have any suggestions for calming my current anxiety since you don't think it's related to the xanax?


i don't want to take more xanax

Anthony Bray, MD : Most people are not addicted to this even with long term use.... Personal traits influence addictive potential ... If you have addictive tendency such as smoking or alcohol then you would be at increased risk ...
Anthony Bray, MD : so addiction risk is present but combination of personal traits plus dose and length if time are factors with this potential ....
Anthony Bray, MD : Well over the counter you could try Bebedryl as this over the counter anti- histamine hassle mild sedating effect 25 mg every 6 hours as needed... Better to see your doctor ... Paxil may help for example ... This is not addictive at all ...

final question, i seem to experience a little bit of depression as the xanax wear off... is this something that happens with xanax?

Anthony Bray, MD : Buspar is helpful for generalized anxiety but less helpful for panic attacks specifically....
Anthony Bray, MD : Depression may occur with this class ( Xanax or others of the benzodiazepine class) this is a known potential side effect ... The antidepressant class obviously better in this regard !!

thanks, XXXXX XXXXX meant immediately right now. any techniques that you know of that might help me stop this shaking after taking the xanax

Anthony Bray, MD : Paxil, Lexapro or Zoloft would be antidepressants as options for treatment of anxiety and panic attacks ... I think one of these would be helpful for you!

so you're positive my current shaking is not related to xanax and is an anxious reaction


i'm still confused about this! isn't the xanax supposed to stop the anxiety!!

Anthony Bray, MD : Well you could take another dose of Xanax and go to sleep... As that dose wears off you would not be anxious ( sleep would take care of any tendancy to feel anxiety as that dose wore off....)
Anthony Bray, MD : Yes I do not think Xanax would make you shaky at all!!
Anthony Bray, MD : i think you have fear --- perhaps even fear if taking medicine in general !! It is not a direct of effect of the Xanax though!!

ok. thanks for your imput.


i guess i don't have other questions.

Anthony Bray, MD : You are very welcome!
Anthony Bray, MD : I encourage you to discuss this further with your doctor!! I think a psychiatrist would be best to help you with the anxiety and panic attacks! I think you would do best with an SSRI antidepressant to treat -- Lexapro / Zoloft/ Paxil --- these would avoid your concerns with the benzodiazepine class!!
Anthony Bray, MD : i hope this is helpful for you!
Anthony Bray, MD : let me know if you have further questions, I will be happy to get back with you!
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 10061
Experience: 14 years experience in the field of Family Practice
Anthony Bray, MD and 5 other Medical Specialists are ready to help you

This is Dr. Anthony Bray from We spoke the other day with regard to your concerns with regard to panic attacks. Thank you for your positive feedback! I welcome you to return to our site in the future if you have further questions!

I welcome you to ask me further questions if you have medical or health related questions or concern. You may reach me specifically via my profile page on the site at

Just type question in the box on this page and it will come to me. Thank you again for your questions. I hope that you get excellent care regarding your anxiety! Take care and best regards!

Anthony Bray MD

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