Xanax (Alprazolam) Withdrawal Symptoms - Xanax Withdrawal Timeline
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Xanax (Alprazolam) Withdrawal Symptoms – Xanax Withdrawal Timeline

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

March 18, 2019

Xanax withdrawal symptoms include insomnia, hallucinations, cramps, vomiting, tremors, and seizures. Acute withdrawal begins about four days after the last dose and may last several weeks. Seeking professional help is the best way to safely handle withdrawal symptoms.

When someone becomes physically or mentally dependent on Xanax, they experience withdrawal symptoms when they stop taking it or reduce their dosage. This is the body’s reaction to not having something it relies on in order to function. To maintain balance, the body and brain adjust to the effects of Xanax and need time to readjust when Xanax is no longer used.

Xanax (Alprazolam) Withdrawal Symptoms

Because Xanax can be both physically and mentally addictive, withdrawal symptoms can affect both the body and the brain. Some of the following symptoms are life-threatening, so an individual should always seek medical help when trying to stop or reduce Xanax use.

Physical Xanax (alprazolam) withdrawal symptoms include:

  • muscle cramps
  • headaches
  • vomiting
  • sweating
  • tremors
  • convulsions/seizures
  • hyperthermia
  • heart palpitations (fluttering)

Mental Xanax (alprazolam) withdrawal symptoms may be:

  • anxiety
  • irritability
  • panic attacks
  • insomnia
  • trouble with memory
  • dysphoria (dissatisfaction with life)
  • mood changes
  • suicidal thoughts
  • hallucinations

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Xanax Withdrawal Timeline

According to the U.S. Food and Drug Administration (FDA), Xanax has an average elimination half-life of 11 hours. That means that half of a Xanax (alprazolam) dose will be processed by and excreted from the body within 11 hours. This is relatively short compared to other benzodiazepines like Klonopin (clonazepam) and Valium (diazepam).

Early withdrawal begins while Xanax is still in someone’s system. This generally occurs around six to 12 hours after the last dose. During this phase of withdrawal, individuals will likely experience “rebound symptoms,” or effects that Xanax is supposed to treat. This can include panic attacks, anxiety, and insomnia.

Acute withdrawal may begin about four days after the last dose when all of the Xanax has been expelled from a person’s body. This phase is the most severe and may last a few days to several weeks. For many people, withdrawal peaks in two weeks.

However, some individuals who are dependent on benzodiazepines like Xanax develop post-acute withdrawal syndrome (PAWS) when they stop taking them. Symptoms of PAWS include depression, panic attacks, anxiety, and obsessive-compulsive tendencies. This condition can appear weeks after the normal withdrawal process and may last up to two years.

Factors That Affect Xanax Withdrawal Timeline

The Xanax withdrawal timeline is not the same for each individual. On average, it takes four days for the body to completely metabolize (break down and excrete) Xanax before acute withdrawal begins. This process can be affected by many things, such as a person’s age, height and weight, health, and genetics.

There are also several factors that affect how long the withdrawal process lasts, including time frame, dosage, and tapering.

Time Frame

The length of time that someone has been taking Xanax can play a significant role in how long it takes them to withdraw from it. Over time, excess benzodiazepines may be stored in the body’s fatty tissues.

This is more likely to happen if someone takes Xanax frequently, not allowing the drug to completely clear from their system. In this case, it will take longer for the body to be rid of Xanax, so acute withdrawal may be delayed.

Dosage

The size of a regular Xanax dose can cause the drug to build up in someone’s system too. Some individuals are only prescribed 0.25 mg of Xanax per day, while others may take up to 4 mg per day. People who abuse Xanax are likely to take much more than this. A larger amount of Xanax takes longer for the body to break down, and frequent large doses slow the process even more.

Tapering

Depending on how slowly someone tapers off Xanax, the withdrawal process may last longer, but should be less severe. However, if someone stops taking Xanax abruptly, withdrawal symptoms may be so severe that they cause additional harm to the body and extend the withdrawal timeline.

Xanax Tolerance And Abuse

Most individuals develop a tolerance to Xanax (alprazolam) quickly, making it ineffective as a long-term anxiety treatment. Some people increase their dosage to counteract tolerance, which can lead them to physical dependence and addiction. Doctors may transfer patients to a longer-acting benzodiazepine after a few weeks to reduce the chance of Xanax abuse.

Tapering Off Xanax

Doctors tend to taper people off Xanax (alprazolam) in order to avoid or decrease withdrawal symptoms. Tapering is the process of gradually reducing dosage until the body no longer needs Xanax to function normally.

The slower the tapering, the lower the likelihood of severe withdrawal symptoms. This can prevent death and serious complications from benzodiazepine withdrawal.

Tapering is the only way many people are able to stop taking Xanax. The drug has a short onset of action, which allows it to provide quick relief from withdrawal symptoms. Unfortunately, this immediate effect is why many people abuse Xanax and become dependent on it in the first place.

Since Xanax is a short-acting benzodiazepine, anxiety symptoms may resurface between doses, making it hard to reduce the frequency or size of the dose. Doctors may prescribe a long-acting benzodiazepine like Valium (diazepam) to take the place of Xanax. Valium stays in the system longer, so it is easier to slowly reduce dosage until the drug is no longer needed.

An individual may try to self-taper off Xanax, which is never recommended. It can be very difficult for a person to tell how much to reduce their dosage, and to monitor their own reaction to the reduction. If someone’s body has adjusted to a lower dose of Xanax and they decide to stop tapering and resume their original dose, it may be more than their body can handle.

Medically Assisted Detox For Xanax

It is difficult and dangerous for someone to detox from Xanax alone. Benzodiazepine withdrawal can be unpredictable and deadly. People who abuse Xanax may especially benefit from a medically assisted detox program, which stabilizes individuals and monitors their vital signs during withdrawal.

Medically assisted detox programs generally create a tapering schedule for Xanax and ensure that individuals are nourished, hydrated, and safe. Medical professionals may administer medications to reduce withdrawal symptoms. Counseling and therapies may also be offered to prevent relapse and set the foundation for an addiction treatment program.

Treatment for Xanax addiction should address all of the issues surrounding Xanax abuse, including other mental issues like anxiety and panic disorders. The goal of treatment is to help individuals break free from substance abuse and learn to regulate their thoughts and behavior so they can experience lasting recovery.

To learn more about Xanax withdrawal and treatment options, contact us today.

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