Alprazolam (Xanax) Withdrawal Symptoms & Timeline
Xanax withdrawal symptoms include changes in behavior, sleeping problems, a loss of appetite, rebound anxiety, psychosis, and other symptoms.
Xanax is prescribed to treat anxiety disorders and panic disorders. Stopping Xanax may cause these disorders to come back, along with new symptoms. Withdrawal is more likely if you were taking Xanax in high doses for more than six weeks at a time.
You may experience some or all Xanax withdrawal symptoms while going through a detox program. Proper care from health professionals during a Xanax detox program can make withdrawal more manageable than quitting “cold turkey.”
Symptoms Of Xanax Withdrawal
There are a wide-range of withdrawal symptoms you may experience after stopping Xanax use, including:
- changes in perception
- weight loss
- blurry vision
- loss of appetite/weight loss
- increased heart rate
- increased blood pressure
- sleeping problems
- violent behavior (or thoughts of violent behavior)
- mental health issues
- rebound anxiety (worsened anxiety compared to before starting Xanax)
Xanax withdrawal can occur after the body develops a physical dependence to the drug. Xanax is not recommended for use for more than six weeks. However, it is common for Xanax prescriptions to last longer, increasing the risk of dependency and withdrawal.
Xanax Withdrawal Timeline
How Xanax affects the central nervous system is still being studied, but some experts believe the effects of benzodiazepines on the GABA receptors and neurotransmitters may lead to dependency and withdrawal.
Withdrawal symptoms tend to start around one day after the last dose of Xanax, and likely progress from mild to severe as time goes on. Acute withdrawal symptoms can last for up to one month.
Anxiety may return after stopping Xanax, along with sleeping problems. Some physical symptoms, such as weakness, tremors, muscle pains, and sweating, may arrive several days after.
Around 2 weeks after the last dose, Xanax withdrawal symptoms tend to peak. Severe benzodiazepine withdrawal may include hallucinations, delirium, and seizures. By this point, other withdrawal symptoms like convulsions and altered perceptions may have set in as well.
Acute withdrawal symptoms tend to last for around a month after the last dose, but other symptoms may remain for longer.
Some severe symptoms of Xanax withdrawal, like violent behavior or psychosis, have not been observed in other brand name benzodiazepines like Valium or Klonopin.
Day 28+: Post-Acute Withdrawal Syndrome (PAWS)
If a patient has gotten past acute withdrawal symptoms, they may still experience withdrawal symptoms for months after their treatment program is complete.
Long-term withdrawal symptoms are also known as protracted withdrawal syndrome or post-acute withdrawal syndrome.
Protracted withdrawal may not be as intense as acute withdrawal, but symptoms may come and go in “waves.” Anxiety, insomnia, muscle pain, and numbness are common symptoms of post-acute withdrawal syndrome.
Some withdrawal symptoms may take up to a year to subside.
Managing Xanax Withdrawal
Serious cases of Xanax withdrawal may require management from medical professionals. You may also be recommended for a medical detox (a cleanse under medical supervision) if you have been on Xanax for a long period of time, due to the possibility of withdrawal.
Benzodiazepine withdrawal symptoms can be managed with tapering. Tapering off Xanax means gradually reducing the dose over time, instead of stopping Xanax use all at once (“cold turkey”).
Xanax manufacturers recommend a tapering schedule of no more than 0.5 mg every 3 days. High dose Xanax prescriptions tend to reach a maximum of 4 mg/day. By this tapering schedule, a patient on high doses of Xanax can completely taper after about 6 months.
Tapering schedules vary from patient to patient. Manufacturers of Xanax, as well as health professionals, recommend tapering to avoid severe withdrawal symptoms. However, tapering may not eliminate the risk of withdrawal completely.
Medications may be used in treating benzodiazepine withdrawal syndrome. Carbamazepine and gabapentin have seen some success in case studies that treated benzodiazepine withdrawal.
Despite the reported effectiveness of these medications, more research may be needed to determine their interactions with Xanax and potentially approve them for medical use.
Treating Xanax Abuse
Xanax is a common prescription drug that is also a popular target for substance abuse in the United States. When Xanax is a subject of drug abuse, the risk of severe side effects and withdrawal may increase.
Long-term benzodiazepine treatment may also include options like cognitive behavioral therapy (CBT). To learn if Northeast Addictions Treatment Center is a good fit for yourself or a loved one, please contact us today.
- Benzo.org.uk — Protracted Withdrawal Symptoms from Benzodiazepines, Professor C.H. Ashton, 2004
- National Institute on Drug Abuse — Prescriptions CNS Depressants DrugFacts
- National Library of Medicine: PubMed — A Review of Alprazolam Use, Misuse, and Withdrawal
- U.S. Food and Drug Administration — XANAX® alprazolam tablets, USP - CIV
Northeast Addition Editorial Team
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