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Xanax Withdrawal

Xanax, a brand-name formulation of alprazolam, is a benzodiazepine medication used to treat specific anxiety disorders, including panic disorders.1 Xanax is the most prescribed benzodiazepine medication in the U.S. and is one of the most commonly misused medications for non-medical use.2, 3

Although Xanax is used for medical purposes, people often misuse it for its anxiolytic (anxiety-reducing), disinhibition, and euphoric effects; in other words, for recreational use.2 The medication can be misused in several ways, such as taking more Xanax than prescribed or taking someone else’s prescription.4

Even when taken as prescribed, Xanax has the potential for misuse, dependence, and in some cases, addiction.1 Ongoing misuse may increase the risk of developing a physiological dependence on Xanax, which can manifest as withdrawal symptoms when a person abruptly reduces or stops using the medication.1 Certain Xanax withdrawal symptoms, like seizures, can be potentially life-threatening.1

If you or someone you know uses or uses Xanax, you can benefit from learning more about alprazolam withdrawal. This article will help you understand:

  • The symptoms of Xanax withdrawal.
  • The Xanax withdrawal timeline.
  • Factors that can influence Xanax withdrawal.
  • Xanax withdrawal treatment.
  • Getting help for Xanax misuse and addiction.

What Happens During Xanax Withdrawal?

Benzodiazepines like Xanax produce euphoric and sedative effects which can perpetuate a cycle of misuse and lead to dependence.5 Dependence is a physiological adaptation of the body that develops due to repeated exposure to a drug.1 The body becomes so used to the drug being present in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge. With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.1, 5

Xanax Withdrawal Symptoms

The symptoms of benzodiazepine withdrawal can vary from mild (e.g., anxiety, fatigue, irritability) to severe (e.g., hallucinations, seizures).1

Common withdrawal symptoms associated with benzodiazepines like Xanax include:1, 6

  • Autonomic hyperactivity (e.g., increased blood pressure, body temperature, or heart rate).
  • Sweating.
  • Tremors.
  • Insomnia.
  • Nausea and/or vomiting.
  • Transient auditory, tactile, or visual hallucinations.
  • Psychomotor agitation (e.g., restlessness or uncontrollable movements).
  • Anxiety.
  • Seizures.

Research suggests that Xanax withdrawal may be more severe than other benzodiazepine withdrawal syndromes.7 Alprazolam withdrawal has also been described as having more complicated rebound anxiety compared to withdrawal from other benzodiazepines.7

Different factors can influence the symptoms and severity of symptoms a person experiences during benzodiazepine withdrawal.6, 8 These factors include the benzodiazepine’s half-life, the dosage and duration of use, and additional substances consumed (e.g., alcohol, opioids, sedatives).6, 8 Ultimately, the course of benzodiazepine withdrawal can be difficult to predict, which is why a person should not attempt to reduce or stop taking Xanax without speaking to a doctor or other medical professional first.1, 8

How Long Does Xanax Withdrawal Last?

The alprazolam withdrawal timeline can vary.6 In general, withdrawal from shorter-acting benzodiazepines like Xanax can begin within hours to 1-2 days after the last dose.6, 9 Alprazolam withdrawal symptoms generally tend to peak in intensity on the second day and improve by the fourth or fifth day, but symptoms may last 2-4 weeks or longer.6, 9

Some people may develop a protracted withdrawal syndrome, which can occur after the initial withdrawal period.6 Symptoms of protracted withdrawal associated with benzodiazepines like Xanax can include anxiety, depression, insomnia, tremor, and tinnitus, among others, and can last for weeks to more than 12 months.1, 6

Factors That Influence Xanax Withdrawal

As mentioned, different factors can influence the symptoms and severity of symptoms a person experiences during benzodiazepine withdrawal, including:6, 8, 10

  • How much Xanax you take and for how long. The risk of dependence and withdrawal may increase in people who use high daily doses for longer durations.
  • Reducing how much Xanax you take. It’s not recommended to adjust your dose without talking to your doctor or other medical professionals first.
  • Using Xanax with other substances such as alcohol, opioids, or other benzodiazepines. Polysubstance use can have several adverse health consequences including a life-threatening overdose and can increase the risk of complicated or severe withdrawal.

Xanax Withdrawal Treatment

Undergoing withdrawal from Xanax and other benzodiazepines is not recommended without medical supervision, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).8 Medical supervision and pharmacological management may be needed to help keep a patient as comfortable and safe as possible during withdrawal and address any potential symptoms or complications that arise.8

In some cases, a patient may be switched to a longer-acting benzodiazepine (e.g., clonazepam) as a substitute for Xanax.8 Some patients may receive the long-acting barbiturate phenobarbital, which may be preferable to other sedatives for the treatment of acute sedative withdrawal.11 Because people who misuse benzodiazepines commonly misuse other substances, a patient’s treatment may be adjusted as necessary if they develop a more complicated polysubstance withdrawal syndrome.8

Detox can take place in inpatient or outpatient settings. Per SAMHSA, hospitalization or another form of inpatient detox may be recommended for people undergoing benzodiazepine withdrawal, especially if they have used high doses of Xanax for an extended period.8 Outpatient detox may be appropriate for people who have used therapeutic doses of benzodiazepines, who are not dependent on other substances, and who have reliable support systems to help them monitor and supervise their progress.8

Getting Help After Xanax Detox

While medical detox is an important first step in recovery, it is not a substitute for more comprehensive rehabilitation.12 Following detox with ongoing Xanax addiction treatment can help address the behavioral components of addiction.12

Treatment for benzodiazepine addiction varies, but may include a combination of:13

  • Behavioral therapy (e.g., cognitive-behavioral therapy).
  • Individual counseling.
  • Support groups.
  • Evaluation and treatment for co-occurring mental health issues (e.g., anxiety, depression).

Because there are no FDA-approved medications available for addiction to prescription sedatives like Xanax, a patient’s treatment plan may focus on behavioral counseling and therapy.14 If necessary, treatment can also address additional substance misuse and addiction (e.g., co-occurring disorders). This can be beneficial as the misuse of benzodiazepines often involves the misuse of alcohol, opioids, or other illicit drugs.1, 13

If you or someone you care about may be struggling with addiction, American Addiction Centers (AAC) can help. AAC is a leading provider of evidence-based addiction treatment throughout the U.S. You can contact AAC 24 hours a day at for more information, resources, and support.

 

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