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Symptoms
Symptoms Checklist

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Do you have sudden unexplained periods of intense fear or discomfort accompanied by some of the following: chest pain/discomfort, palpitations, pounding or rapidly beating heart; abdominal distress or nausea; sweating, trembling, or shaking; shortness of breath, choking, dizziness; feeling unsteady, light-headed or faint; feelings of unreality or detachment; fear of dying or going crazy?*

Print this form and carefully answer the following. Be honest with your answers. Schedule an appointment with your doctor (or an anxiety specialist) and show him/her the completed form.

Print Checklist

1. Have you experienced repeated, unexpected "attacks" in which you feel overwhelmed by fear for no apparent reason?

  Yes       No
2. During these attacks, did you feel like you were "going crazy" or going to die?

  Yes       No
3. Do you avoid being in a situation or a place where escape might be difficult? (for example, crossing a bridge or going to a specific restaurant)

  Yes       No
4. Do you feel as if you need someone to be with you while traveling?

  Yes       No
5. For at least 1 month following one of these unexpected "attacks," were you always worried that you would have another?

  Yes       No
6. Check all of the following that you experienced during these attacks:

     Racing heart
     Sweating
     Trembling
     Shortness of breath
     Fear of going crazy
     Fear of dying
     Numbness or tingling
     Chills or hot flushes
     A choking feeling/sensation
     Chest pain or discomfort
     Nausea or abdominal distress
     Feelings of unreality

7. Have your eating or sleeping habits changed recently?

  Yes       No

8. Do you feel sad or depressed?

  Yes       No
9. Do you feel like you've lost interest — in everything? Have you stopped doing your favorite things?

  Yes       No
10. If you drink or use drugs, have they gotten you into trouble with your personal life, work, or the law?

  Yes       No
Print Checklist

*These symptoms can be signs of another underlying condition; make sure to follow-up with your physician and get regular check ups.

Reference: Adapted from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association;2000:432.

How Common Are They? >>

Important Safety Information: XANAX XR should not be used if you are allergic to benzodiazepines, have a condition called acute narrow angle glaucoma, or are taking the anti-fungal medications ketoconazole or itraconazole. XANAX XR is not recommended for use in pregnancy. Therefore, let your doctor know if you are pregnant, if you are planning to become pregnant, or if you become pregnant while you are taking this medication. Let your doctor know if you are nursing.

The most common side effect is sedation, but this often decreases or goes away in most people after their bodies get used to the drug. Until you experience how XANAX XR affects you, do not drive a car or operate potentially dangerous machinery, etc. Other common side effects, which occur in fewer patients, include sleepiness, memory impairment, impaired speech, abnormal coordination and/or muscle action, and reduced sexual drive. Some patients may experience side effects associated with psychological and/or physical dependence on XANAX XR. Medications like XANAX XR, even when used as recommended, may produce psychological and/or physical dependence. This may make it very difficult to discontinue treatment with XANAX XR. Discontinuation symptoms, including the possibility of seizures, may occur following abrupt discontinuation from any dose, but the risk may be increased with extended use at doses greater than 4 mg/day. It is important that you get your doctor's advice on how to discontinue treatment safely and carefully. Gradually tapering your XANAX XR dose will help to decrease the possibility of discontinuation symptoms.

For more information, see important safety information.


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