Xanax long-term use can lead to tolerance, dependence, and difficult withdrawal (including rebound anxiety and insomnia). Cognitive effects may include memory problems, slowed thinking, and reduced attention. Mood changes, depression, and emotional blunting can occur. There’s increased risk of falls, accidents, and impaired coordination. Prolonged use may worsen anxiety over time. Combining with alcohol or opioids raises overdose risk. Medical supervision is essential when tapering.