Xanax Tapering/Weaning Schedule
Medically reviewed byDr. Richard Foster, LICDC-CS
March 20, 2019
A Xanax tapering/weaning schedule eases the withdrawal process, lowering the risk of death and other complications. Tapering off Xanax is the only way some people are able to stop taking it.
Xanax (alprazolam) is an anti-anxiety medication that causes physical dependence in many people. Some individuals become tolerant to its effects within weeks, even if they take it as prescribed. If they increase their dosage to counteract tolerance, they increase the risk of their body becoming dependent on Xanax to function properly.
Once someone is dependent on Xanax, they experience withdrawal symptoms if they try to reduce dosage or stop taking the drug. These symptoms may be mild to moderate, but often benzodiazepine withdrawal is severe and can be life-threatening.
Tapering is the process of gradually reducing Xanax dosage until the body no longer needs it. This process can be adjusted to an individual’s needs; it is not the same for everyone. Tapering decreases the severity and frequency of withdrawal symptoms so that a person can stop taking Xanax safely and successfully.
Xanax Tapering/Weaning Schedule
The Xanax (alprazolam) drug label recommends reducing dosage no more than 0.5 mg every three days. For some people, this tapering schedule may be too drastic. An individual should consult with their doctor to determine the right schedule for them.
The maximum daily dose of Xanax for people struggling with anxiety disorder is 4 mg. For panic disorders, individuals may be prescribed up to 10 mg daily. According to the U.S. Food and Drug Administration (FDA), individuals who are used to taking 4 mg or more of Xanax per day have more trouble “tapering to zero doses” than those who take less than 4 mg per day.
Withdrawal symptoms may be more severe if a person has abused Xanax, taking high doses and using the drug more often than prescribed. In the case of Xanax abuse, individuals may need to taper off the drug more slowly.
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A person who tapers from a high dose of Xanax may be able to reduce their dosage in larger increments than a person who starts at a low dose. This is because the percentage of change can have a significant impact.
For example, if someone is taking 6 mg of Xanax, decreasing their dosage by 0.5 mg is an eight percent reduction. If they are taking 2 mg and decrease by 0.5 mg, it is a much larger reduction at 25 percent. Reducing dosage too quickly and drastically can cause the withdrawal symptoms that tapering is meant to avoid.
Substitution Taper Or Direct Taper For Xanax
Since Xanax (alprazolam) is a short-acting drug, its effects wear off quickly and it can cause mild withdrawal symptoms between doses. This makes it hard to wean off of and prompts many people to increase their dosage to avoid rebound anxiety. A direct taper off Xanax requires very gradual reduction if it is to be successful.
A longer-acting benzodiazepine like Valium (diazepam) may be used in a substitution taper for Xanax. Valium stays in a person’s system longer and has a lower risk of rebound anxiety and withdrawal symptoms between doses. This allows the tapering process to be less gradual while still reducing withdrawal symptoms.
Why Taper Off Xanax (Alprazolam)?
Xanax withdrawal keeps some people from trying to stop using or abusing it. Even if Xanax no longer makes them feel good, withdrawal symptoms may feel worse. Since benzodiazepine withdrawal can be fatal, it is best that a person tapers off of Xanax to avoid this risk.
Severe withdrawal symptoms from Xanax (alprazolam) may include:
- suicidal thoughts
With prolonged Xanax use, the body and mind adjust to the drug’s effects. They depend on Xanax to regulate brain activity and relax the central nervous system. They become less effective at doing these things naturally. When someone stops taking Xanax, the body and mind need time to adjust, which is why withdrawal symptoms occur.
If a person abruptly stops taking Xanax, withdrawal symptoms may be so bad that they cause other problems. This puts stress on the mind and body so they are unable to resume normal functioning. Tapering is a safer way to go through the withdrawal process that gives a person the time they need to adjust.
Can You Self-Taper Off Xanax?
Self-tapering off Xanax (alprazolam) can be dangerous. It is difficult for someone to regulate how much they should reduce their own dosage, and whether the weaning schedule they are following is working for them. Medical professionals are trained to help people taper off drugs like Xanax and they likely have a better understanding of the process.
Many people benefit from switching to a longer-acting benzodiazepine before tapering, which requires an additional prescription from a doctor. Skipping this step in order to self-taper can make withdrawals unnecessarily complicated.
If someone is determined to get to a zero dose by a certain date, they may push themselves too hard, causing severe withdrawals or even relapse. Or they may reduce their dosage too slowly, which could extend the process and keep them dependent on Xanax longer than need be.
Some individuals who try to self-taper give up because they do not like how it affects them. They may return to their original dose because they know it worked. However, if they have been tapering for a while, their body will have adjusted to the lower dose, and resuming a high dose could be deadly.
Medical Detox For Xanax Dependence
Medical detox programs may take place within an addiction treatment center, hospital, or specialized facility. Within these programs, medical professionals stabilize and monitor individuals during withdrawal to ensure their safety. This can take place in an inpatient setting with around-the-clock care for those struggling with severe Xanax dependence and addiction.
A tapering schedule is generally used for benzodiazepine withdrawal within a medical detox program. Some of these programs go above and beyond setting a tapering timeline by including nutrition, hydration, and care for mental wellbeing in addition to physical health. Some offer counseling and behavioral therapy, which are foundational treatments for addiction.
Treatment For Xanax (Alprazolam) Addiction
After detox, an individual may choose to continue recovery with an addiction treatment program. These may also be inpatient or outpatient, though many people find that the therapeutic community of inpatient treatment is vital to breaking free of substance use.
Xanax (alprazolam) addiction treatment programs often employ a wide range of evidence-based therapies such as meditation, art, music, motivational interviewing, and dialectical behavior therapy. Dual diagnosis treatment may also benefit those suffering from anxiety disorders by helping them deal with these issues in a healthier, more natural way.