Xanax Withdrawal Symptoms, Timeline & Treatment

Xanax Withdrawal Symptoms, Timeline & Treatment Addiction Coping and Recovery Overcoming Addiction Print How Long Does Withdrawal From Xanax Last? By Corinne O’Keefe Osborn linkedin Corinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology. Learn about our editorial policy Corinne O’Keefe Osborn Medically reviewed by Medically reviewed by Steven Gans, MD on May 07, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on August 07, 2019 More in Addiction Coping and Recovery Overcoming Addiction Methods and Support Personal Stories Alcohol Use Addictive Behaviors Drug Use Nicotine Use In This Article Table of Contents Expand Overview Signs & Symptoms Coping & Relief Warnings Long-Term Treatment Resources View All Back To Top Xanax (alprazolam) is a common anti-anxiety medication. Doctors prescribe it for patients struggling with insomnia and mental health issues such as excessive worry, panic attacks, and PTSD. Xanax does a lot of good for people in acute distress, but it is not intended for long-term use. The long-term use of benzodiazepines like Xanax can potentially create problems with dependence and withdrawal.  Verywell / JR Bee Overview Xanax withdrawal is not as easy as some people think. Depending on your dose and how often you are using Xanax, your withdrawal experience can be anywhere from uncomfortable to really really unpleasant. It can also be medically serious. If you have been taking Xanax several times a day, then quitting is going to take time, patience, and determination. The only safe way to quit is to slowly taper down your dose. Quitting cold turkey can cause extreme and dangerous withdrawal symptoms, including delirium and grand mal seizures. That is not a risk you want to take. If you have been taking your Xanax prescription exactly as your doctor prescribed, it can come as a surprise that you are facing a withdrawal experience. Xanax doesn’t discriminate. Anyone taking enough of it for more than a few weeks will develop a physical dependence. Once you have become physiologically dependent on a drug, you will experience withdrawal symptoms when you stop or reduce your dose. While you taper down your dose, you may feel surges of anxiety and agitation. People experience varying degrees of physical and mental discomfort. For example, you may feel unusual sensations, like you’re crawling out of your skin, along with feelings of restlessness and irritation. In 2011, doctors wrote nearly 50 million prescriptions for alprazolam (Xanax). Reckless prescribing practices have contributed to thousands of cases of dependence and abuse. Research shows that as of 2016, an estimated half a million people in the U.S. were misusing sedatives like Xanax. Signs Symptoms The signs and symptoms of Xanax withdrawal vary a bit from person to person. Research indicates that roughly 40 percent of people taking it for more than six months will experience moderate to severe withdrawal symptoms. The remaining 60 percent can expect milder symptoms. Most people quitting Xanax will experience a brief increase in their anxiety levels. Depending on the severity of your symptoms, you may experience a level of anxiety worse than your pre-treatment level. It is common to feel nervous, jumpy, and on-edge during your taper. Many people experience irritability and agitation, which can cause problems at home, work, or school. You might be easily annoyed or short-tempered with family or friends. You may feel experience moodiness or depression.   Insomnia is another common symptom of Xanax withdrawal. Insomnia can be both mentally and physically taxing and can contribute to feelings of anxiety and agitation. Symptoms may come and go during your Xanax taper. At various points, you may experience physical symptoms such as headaches, muscle aches, or hand tremors. Possible Symptoms of Withdrawal Physical Insomnia Tremors Muscle spasms Headaches Sweating Racing pulse Hyperventilation Seizures Psychological Anxiety Depression Restlessness Difficulty concentrating Delirium Hallucinations Feelings of unreality Panic attacks The symptoms of Xanax withdrawal typically appear within 8 to 12 hours of your last dose. If you fail to taper your dose, your withdrawal symptoms will grow increasingly intense. Some studies describe that withdrawal is at its worst on the second day, and improves by the fourth or fifth day. However, other reposts, including the World Health Organization (WHO), have found that acute symptoms can last significantly longer. Unfortunately, that is not the end of it for some people. Estimates suggest that about 10 to 25 percent of long-term benzodiazepine users experience what’s known as protracted withdrawal. Protracted withdrawal is a prolonged withdrawal experience marked by waves of mild psychological symptoms that come and go over the course of several months.   Protracted Xanax withdrawal can last up to one year. Coping Relief The best way to avoid a difficult withdrawal is to slowly taper down your dose of Xanax. Tapering means taking progressively smaller doses over the course of several weeks. While you could try and taper on your own, it is better to work with your prescribing doctor. Xanax is a short-acting drug, which means your body metabolizes it very quickly. Tapering Xanax is challenging because the amount of drug in your system is going up and down. To help you avoid these peaks and valleys, doctors often switch you from Xanax to a long-acting benzodiazepine such as diazepam. Switching from short-acting Xanax to its longer-acting cousin diazepam will make it easier for you to quit. Once you are stabilized on a dose of diazepam, your doctor will help you slowly taper down a little bit at a time. This gives your body and mind the time to adjust to life without Xanax. If you have breakthrough withdrawal symptoms when your dose is reduced, your doctor can pause or stretch out your taper. It’s up to you and your doctor to figure out the best tapering schedule for your individual needs. Tips For Alleviating Symptoms of Breakthrough Withdrawal Herbal sleep aids (valerian root, chamomile)Cognitive behavioral therapyMeditationMindfulness practiceExerciseMelatonin Should You Take Benzodiazepines to Treat Anxiety? Warnings Grand mal seizures may occur in some individuals undergoing untreated withdrawal from these substances. Unlike many other withdrawal syndromes, benzodiazepine withdrawal can be complicated and, occasionally, life-threatening. If you have been diagnosed with a serious mental illness in the past, such as a panic disorder, PTSD, bipolar disorder, or borderline personality disorder, then great care should be taken when coming off of Xanax. In such cases, your doctor’s help will be invaluable. It can be difficult to predict which dormant symptoms, if any, may return when Xanax is removed from the equation. People with a history of complicated withdrawal syndromes and people with underlying health issues should also work closely with their doctor. Xanax withdrawal does carry a risk of seizures. Elderly people and people with cognitive decline should also work closely with a doctor as there are unique risks. If you plan to or have become pregnant, you will need to discuss your options with your prescribing doctor and OB/GYN about the risks and benefits of continuing versus tapering benzodiazepines. Some women continue taking benzodiazepines throughout their pregnancy while others follow a dose tapering schedule. If you have acquired your Xanax illicitly, you can still work with a doctor to taper down your dose. Start by visiting a primary care doctor or urgent care center and tell them that you are in or are planning to be in benzodiazepine withdrawal. If you don’t have insurance, visit a community health center. If you are concerned about the risks involved in Xanax tapering for any reason, discuss these concerns with a doctor. You may be better suited for inpatient detoxification. While inpatient treatment is typically more expensive, it is covered by many insurance plans. Long-Term Treatment When it comes to the long term management of getting off benzodiazepines, there are two directions you can go. Research shows that most stable, healthy adults will achieve long-term abstinence after completing a taper. The key to achieving this goal is to follow the tapering schedule to the very end. By the end of your taper, you might be cutting pills into halves or quarters. Some individuals may be better suited for a harm reduction approach, in which the taper leads to a maintenance dose rather than abstinence. Resources If you are ready to quit Xanax, you will need to meet with your prescribing doctor. If you don’t have a regular doctor, start by making an appointment with a primary care doctor, psychiatrist, or local health clinic. You can find a doctor by searching your insurance company’s list of covered providers. Alternatively, you can find a free community health clinic with this searchable database from the U.S. Department of Health and Human Services. To find a doctor who specializes in addiction treatment, use this searchable directory from the Substance Abuse and Mental Health Services Administration (SAMHSA). You can also call SAMHSA’s national helpline at 1-800-662-HELP (4357).   A Word From Verywell Quitting Xanax takes time, patience, and determination. If you’ve been using it for longer than a few months, quitting can be hard. There will be days where you want to give up and give in. But with a lot of grit and a little support, you can power through. Trust us, when this is all behind you and you are stepping out of the fog, you won’t regret it. What to Know About Psychotherapy