Stopping Xanax may cause seizures and hallucinations. Here's how to taper off and avoid severe withdrawal
- Taking Xanax for three weeks or longer may lead to withdrawal symptoms when you stop taking it.
- Withdrawal may cause mood changes, nightmares, muscle spasms, increased anxiety, and seizures.
Benzodiazepines like Xanax, Valium, and Klonopin are the most commonly prescribed psychiatric drugs in the United States. These sedatives help reduce stress and relax your muscles, so they're often prescribed to treat panic attacks and generalized anxiety disorder in the short term.
You might feel ready to stop taking Xanax if your anxiety lessens or you've noticed an increasing desire to take larger doses, or take Xanax more often. But if you've become dependent, stopping Xanax will lead to withdrawal, which can cause intense symptoms that may start within a day of your last dose.
Withdrawal symptoms most commonly include extreme anxiety, insomnia, restlessness, irritability, and potentially seizures, says Ben Brafman, Certified Addiction Professional and Clinical Director at the Sylvia Brafman Mental Health Center.
Here's what to expect during Xanax withdrawal and what you can do to reduce uncomfortable symptoms when you stop taking it.
Important: Withdrawal can be dangerous, even life-threatening, if not managed by a medical professional. So you should never stop taking Xanax on your own, says Dr. David Seitz, Medical Director at Ascendant Drug and Alcohol Detox Center.
Signs and symptoms of Xanax withdrawal
Withdrawal happens because your nervous system quickly gets used to benzodiazepines like Xanax, so you may have trouble functioning without the drug after a few days of use.
Important: Taking higher doses, or taking Xanax more frequently, can increase your likelihood of experiencing withdrawal symptoms — but you will experience withdrawal if you've become mentally or physically dependent on the medication.
While the withdrawal timeline for Xanax can vary for everyone, symptoms typically last anywhere from a few weeks to several months.
There are three phases of Xanax withdrawal:
- Early withdrawal may begin within 24 hours to several days after your last dose. Anxiety, insomnia, and any other health concerns you used Xanax to treat may "rebound," or return.
- Acute withdrawal lasts from about 5 days to a month. This phase may also include new symptoms, like muscle spasms, nausea and vomiting, mood fluctuations, seizures, and hallucinations. Your doctor may prescribe medication to lower your risk of these side effects. For instance, anticonvulsants can help prevent seizures.
- Protracted withdrawal, commonly called post-acute withdrawal, refers to withdrawal symptoms like anxiety or insomnia that persist for months or years. Less than 15% of people experience protracted withdrawal.
Some of the other symptoms you could experience during withdrawal include:
- Rapid heart rate
- Excessive sweating
- Trouble focusing
- Loss of interest in activities you once enjoyed
- Feeling sad, empty or having thoughts of suicide
Important: If you're having thoughts of suicide, help is available right now. You can get free, confidential support from compassionate crisis counselors by calling 988 to reach the Suicide and Crisis Lifeline or texting "HOME" to 741741 to reach the Crisis Text Line.
Can you prevent withdrawal?
If you've developed a tolerance or dependence on Xanax, there's no way to prevent withdrawal altogether.
That said, the severity of your withdrawal symptoms may depend on several factors, says Dr. Harold Hong, board-certified psychiatrist and Medical Director at New Waters Recovery. These factors include:
- How long you've taken Xanax
- Your current dosage
- Any underlying medical conditions
Other factors that may increase your risk of severe withdrawal symptoms include:
- Substance use disorder (SUD): Previous dependence and tolerance related to a different substance can make withdrawal more challenging, especially if you don't want to experience withdrawal symptoms again.
- Age: Chronic Xanax use (daily use for at least two weeks) is dangerous for adults over age 60 as it can increase the risk of falls and dementia.
- Dose: Taking more than 4 mg of Xanax per day. A typical adult dosage is 0.25 mg to 4 mg per day.
- Frequency: Taking Xanax daily for at least 12 weeks, which may be the prescribed length of your treatment.
Stopping Xanax "cold turkey" is a bad idea because it increases your likelihood of serious symptoms like seizures and thoughts of hurting yourself. Your best option involves asking your doctor about a tapering plan that's right for you.
Important: Benzodiazepine withdrawal can be lethal. You should never stop taking Xanax, or any benzodiazepine, without guidance from your prescribing doctor or another medical professional.
Tapering involves gradually reducing your dose over the course of several weeks or months until there's no Xanax left in your system. Developing a treatment plan before you stop taking Xanax may help minimize the severity of any symptoms you may experience.
How to treat it
If you're already experiencing Xanax withdrawal symptoms, your prescribing doctor can help you keep reducing your intake safely by tracking your symptoms and recommending treatments for uncomfortable withdrawal symptoms.
They might reduce your dose by 25% on week two, for instance, then again on week four if you only experience mild symptoms. If you have more serious symptoms of withdrawal, they may recommend taking the same dose for another week and discuss medication to reduce those symptoms.
Your doctor may prescribe:
- Anticonvulsant medications to reduce your risk of seizures.
- Other benzodiazepines, at a low dose, to ease irritability, anxiety, or restlessness.
- Sedatives like Temazepam and Promethazine for insomnia.
- Anti-nausea medication for vomiting or upset stomach.
- Acetaminophen (Tylenol) and ibuprofen (Advil and Aleve) for headaches or overall pain.
Other types of treatment include:
- Supervised detox, which involves medically supervised withdrawal and sometimes the help of prescription medication to reduce withdrawal symptoms.
- Outpatient care, where you'll visit a treatment center once a week or more while living at home.
- Hospital inpatient care, where you check into the hospital for days or weeks while getting 24/7 treatment.
- Residential, or live-in, care lasting from a month to a year.
- Transitional housing where you can live while transitioning from intensive treatment to living independently.
- Therapy and support groups to help with cognitive effects like mood fluctuations and agitation.
- Telemedicine, where you'll receive medical support over the phone or online.
Note: Your health insurance may cover additional treatment costs, like time at a rehabilitation center where healthcare professionals can monitor your symptoms 24/7. A good first step may involve calling your provider to ask about coverage.
You can also access free resources, like the government-funded SAMHSA National Helpline. This is a confidential resource available 24/7 that offers free treatment referrals and information to people living with substance use disorders.
You should never try to quit taking Xanax, or any other benzodiazepine, alone.
While withdrawal isn't always easy, support from a trusted clinician can minimize symptoms as your body readjusts to functioning without Xanax.
"A medical professional can help you taper off the drug safely and make sure that you're as comfortable as possible during the process," Seitz says.
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