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Xanax (Alprazolam) Withdrawal Symptoms & Treatment

Alprazolam withdrawal effects
Written by:

Umar Javed

Dr. MBBS

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Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.Read more
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.

Highlights

  • Xanax (alprazolam) has a high potential for addiction and poses a significant risk of withdrawal symptoms due to its effects on the brain.
  • Withdrawal from Xanax includes both physical symptoms (e.g., tremors, seizures) and psychological symptoms (e.g., anxiety, depression).
  • The withdrawal process typically peaks within the first month and can persist at a lower intensity for several months.
  • Treatment for Xanax withdrawal involves gradual tapering of the dose, medical detoxification, psychotherapy, and lifestyle changes.

Xanax (alprazolam) is commonly prescribed for anxiety disorders. At the same time, it is also one of the most commonly misused medications and poses a significant risk of withdrawal symptoms. This article sheds light on the addiction and withdrawal risks associated with Xanax and how to deal with these unwanted effects.

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What Is Xanax?

Xanax (alprazolam) is a prescription medication belonging to the benzodiazepine class. It works by modulating the activity of the primary inhibitory neurotransmitter, gamma-aminobutyric acid (GABA) in the central nervous system. Increased activity of GABA promotes calmness and relaxation. While it is FDA-approved for generalized anxiety and panic disorder, due to its effects, it is also sometimes used off-label for insomnia, depression, and premenstrual syndrome.

Xanax Addiction and Abuse

Xanax is considered to be the most widely prescribed psychotropic medication [1*] in the U.S. However, it can cause serious side effects and complications, hence it is placed under the DEA list of controlled substances [2*] . It is a Schedule IV medication, which indicates its potential for abuse and addiction. Therefore, it should only be used under the supervision of a qualified healthcare practitioner.

Studies [3*] show that benzodiazepines affect the reward system in the brain and increase dopamine levels. In some cases, such as prolonged use, this forms the pharmacological basis for developing Xanax dependence and can ultimately lead to addictive behavior. The risk of addiction is higher in individuals with personal or family history of alcohol or substance use disorder.

Xanax Withdrawal Symptoms & Signs

Prolonged use of Xanax at high doses can lead to benzodiazepine withdrawal syndrome [4*] . The symptoms of alprazolam withdrawal syndrome can be divided into two categories: physical and psychological.

Our medical team is here to supervise your medication management plan for anxiety treatment.

Physical Symptoms of Xanax Withdrawal

Using Xanax over an extended period poses the risk of developing physical dependence, so the body may not be able to function properly without taking the medication. An abrupt stop of treatment or a significant decrease in dosage may result in withdrawal symptoms.

Common physical symptoms associated with acute Xanax withdrawal are:

  • Tremors
  • Headaches
  • Nausea and vomiting
  • Muscle stiffness and pain
  • Dizziness or lightheadedness
  • Gastrointestinal disturbances, such as diarrhea or stomach cramps
  • Sweating
  • Increased heart rate
  • Blood pressure fluctuations
  • Insomnia or sleep disturbances
  • Changes in libido
  • Seizures
  • Sensory hypersensitivity

Psychological Symptoms of Xanax Withdrawal

As this medication directly impacts the brain, stopping it abruptly may affect psychological functioning. Common mental symptoms include:

  • Rebound anxiety
  • Increased stress levels
  • Panic attacks 
  • Irritability and mood swings
  • Depressive feelings
  • Cognitive issues, such as memory problems and difficulty concentrating
  • Confusion or disorientation
  • Hallucinations or delirium 
  • In severe cases, suicidal thoughts or self-harm

When the physical and psychological symptoms become severe, it can transform into Xanax withdrawal syndrome.

Xanax Withdrawal Timeline

Withdrawal unfolds in stages, each with unique characteristics and challenges. Understanding the Xanax withdrawal time frame can help individuals and their healthcare providers better navigate the process. Here’s an overview of the three primary stages:

  1. Stage 1: 1-2 days after taking the last dose. At this point, individuals may start to experience the first signs of Xanax withdrawal, such as dizziness, headaches, and nausea. These early symptoms can be relatively mild but still uncomfortable. Anxiety and restlessness may also intensify during this period.
  2. Stage 2: 14-28 days, the rebound effect. During the first two weeks to a month after the last dose, severe withdrawal symptoms, both physical and psychological, tend to peak. Anxiety and panic attacks can be particularly intense, and individuals may experience depression, mood swings, and cognitive difficulties. Physical symptoms like tremors and gastrointestinal problems may persist or worsen.
  3. Stage 3: several months. This Xanax withdrawal period involves a gradual return to normalcy. Symptoms gradually subside, and individuals often experience a mild Xanax withdrawal as well as a stabilizing emotional state. However, some residual symptoms, such as mild anxiety and insomnia, may persist for an extended period.

Risk Factors

Several factors can influence the severity and duration of withdrawal, including:

  1. Age: As a person ages, their metabolism slows down. This can prolong the elimination half-life of different medications. For example, the efficacy of the liver microsomal oxidase enzyme system decreases with age, which can result in prolonged Xanax withdrawal in elderly patients.
  2. Duration of Use and Dosage: The dosage and duration of treatment are directly proportional to the risk of experiencing more serious withdrawal symptoms. The risk of severe Xanax withdrawal after short-term use (2-3 months) at low doses is considerably lower. 
  3. Individual Differences: Each person’s body and brain chemistry are unique, which means that some individuals may be more sensitive to discontinuing alprazolam than others.
  4. Abrupt Discontinuation: Suddenly stopping alprazolam without tapering the dosage can lead to more severe withdrawal symptoms. A gradual reduction in dosage is often recommended to mitigate these effects.
  5. Co-occurring Conditions: Individuals with co-occurring mental health disorders may experience more pronounced psychological symptoms during discontinuation.
  6. Medical History: Individuals with a history of substance abuse or withdrawal from other medications may be at a higher risk.
Obtain an individualized treatment plan based on your symptoms and a detailed overview of your health history.

How Long Do Xanax Effects Last in the Body and Brain?

Xanax has a half-life of 8-16 hours, meaning it is metabolized and eliminated from the body relatively quickly. Its effects typically peak within 1-2 hours and can last anywhere from 4 to 6 hours. However, the influence of the extended-release formulation (Xanax XR) on the brain can be longer.

The long-term effects on the brain can be more concerning. Extended use can lead to structural and chemical changes in the brain, which may result in a greater likelihood of dependence and more severe withdrawal. Hence, the treatment process should be supervised.

How Much Xanax Causes Withdrawal?

The maximum daily dosage of Xanax for anxiety and panic disorder is 4 mg and 10 mg, respectively. However, the dosage causing withdrawal varies from person to person and depends on individual tolerance and duration of use. Exceeding the recommended dose without consulting a healthcare professional increases the likelihood and severity of adverse reactions when discontinuing the medication even if the dosage is far from maximum.

Treatment Options for Xanax Withdrawal

Xanax withdrawal can feel like a difficult and uncomfortable experience, but it is manageable with the right support and treatment. There are several approaches to help individuals safely detox from Xanax:

  • Tapering: Gradual reduction of dosage, under the guidance of a medical professional, can help ease the symptoms of detoxing from Xanax. Tapering minimizes the shock to the body and brain, making the process more manageable.
  • Medical Detoxification: Medical detox is often the safest option to treat Xanax withdrawal. This process involves a healthcare provider supervising the tapering of dosage while monitoring and addressing any severe withdrawal symptoms. It can be done in an inpatient or outpatient setting, depending on the severity of the addiction.

Medications Used to Ease Xanax Withdrawal

  • Benzodiazepines: Healthcare professionals may transition individuals to longer-acting benzodiazepines like diazepam (Valium). This controlled substitution [5*] allows for a more gradual reduction of the medication concentration in the body and can help minimize the intensity of withdrawal symptoms.
  • Antidepressants: In cases where individuals experience significant anxiety and mood disturbances during alprazolam withdrawal, antidepressants may be prescribed. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used. While they may not provide immediate relief, they can be valuable in the long-term management of withdrawal symptoms.
  • Anti-seizure Medications: In severe cases, where seizures occur, physicians may administer anti-seizure medications to prevent or manage these episodes. Commonly used anti-seizure options include sodium valproate and carbamazepine.
  • Beta-blockers: Beta-blockers, such as propranolol, are sometimes prescribed to manage physical symptoms like tremors, increased heart rate, and sweating. They can also help alleviate the physiological manifestations [6*] of withdrawal.

Non-pharmacological Help for Xanax Withdrawal

In addition to medications, there are various Xanax withdrawal tips and strategies that can help individuals cope with symptoms:

  • Psychotherapy: Cognitive-behavioral therapy (CBT) can make Xanax withdrawal easier as individuals learn coping strategies to manage anxiety and address mood disturbances. Therapy sessions provide a safe space to discuss the emotional challenges of going through withdrawal.
  • Lifestyle Changes: A healthy lifestyle can significantly impact the response to the discontinuation process. Regular exercise, a balanced diet, adequate hydration, and sufficient sleep can help the body recover and mitigate some of the physical and psychological symptoms. Avoiding caffeine and alcohol can also be beneficial.
  • Relaxation Techniques: Mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can be helpful in reducing anxiety. These techniques can be used to alleviate psychological symptoms and manage stress.
  • Social Support: Friends and family can provide emotional support and encouragement throughout the process. In some cases, support groups or counseling may be beneficial to connect with others facing similar challenges.

That being discussed, there is no specific fastest and best way to detox from Xanax. Seeking professional guidance is paramount. Your healthcare provider may recommend specific medications as well as non-medication strategies to handle and overcome the symptoms.

In Conclusion

Xanax withdrawal can be challenging, but with appropriate management, it is possible to successfully navigate its stages and acute symptoms, ultimately finding relief and recovery.

Contact medical providers at MEDvidi if you want to learn more about evidence-based ways to treat anxiety disorders and receive a personalized plan.

Frequently Asked Questions

The typical duration for taking Xanax is relatively short-term, generally not exceeding 2 to 4 weeks. Taking this medication daily for an extended period can lead to tolerance, dependence, and the risk of experiencing withdrawal symptoms when discontinuing it. It is essential to follow a healthcare provider’s instructions and consider alternative treatments if long-term anxiety management is necessary.
If Xanax seems less effective over time, it might be due to the development of tolerance. As your body adapts to the medication, the same dose may no longer produce the desired calming effect. Additionally, anxiety or a panic disorder can evolve, leading to increased severity or new symptoms that alprazolam might not adequately address. Consult your healthcare provider to assess your current condition and explore alternative treatment options.
Alprazolam primarily affects the gamma-aminobutyric acid (GABA) receptors in the brain, enhancing GABA’s calming influence. Unlike certain antidepressant medications (SSRIs and SNRIs), Xanax does not directly affect serotonin levels. However, its sedative effects can indirectly influence mood and anxiety, which may involve serotonin pathways to some extent.

If you wish to stop the alprazolam withdrawal effects, it is essential to follow a tapering plan prescribed by a healthcare professional. Abruptly discontinuing Xanax can lead to severe withdrawal symptoms.

The healthcare provider will create an individual and comprehensive alprazolam withdrawal protocol for you based on a gradual decrease in dosage over time. This approach typically helps to minimize the intensity of withdrawal effects.

The duration of alprazolam use varies depending on the individual’s condition and response to treatment. It is generally intended for short-term use, often not exceeding four weeks, to manage acute anxiety or panic symptoms. For some patients, longer-term use may be necessary, but this should be under close medical supervision.

Sources

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6 sources
  1. A Review of Alprazolam Use, Misuse, and Withdrawal
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  2. DEA list of controlled substances
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  3. Neural bases for addictive properties of benzodiazepines
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  4. The benzodiazepine withdrawal syndrome
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  5. Management of benzodiazepine misuse and dependence
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  6. Benzodiazepines: Uses, Dangers, and Clinical Considerations
    Source link
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Written by:

Umar Javed

Dr. MBBS
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