Xanax (Alprazolam) is a medication that is prescribed to treat intense anxiety and panic disorders. It is currently among the most prescribed drugs in the United States, and has been for years. The reason that many people turn to Xanax and that doctors give out prescriptions for this medication is simple: because it works. There is really not a more effective medication on the market for sheer anxiety and panic than this one.
The major drawbacks associated with this medication can cause some people to stop taking it. In most cases, it is recommended to avoid using this medication unless you are 100% sure that you’ll need it. Consistent long term usage of Xanax (and other benzodiazepines) is linked to developing dementia as well as other permanent cognitive deficits. These facts are not meant to scare people, rather point out that Xanax is typically not safe for the long term.
For this reason, many people have turned to other medications and/or just decided to quit using Xanax. When you decide to quit Xanax, it is important to work closely with your doctor and/or under the supervision of a professional. Withdrawal symptoms can be serious and extreme compared to most other medications. In fact, for certain individuals, this is the single hardest drug that they’ll ever withdraw from.
Factors that influence Xanax withdrawal
Not everyone will experience the same degree of withdrawal symptoms when coming off of Xanax. For some people it will be a relatively moderate withdrawal, while for others it will be total hell. Various factors that play a role in influencing withdrawal include: time span, dosage, your physiology, and how you quit.
1. Time Span
How long have you been on Xanax? Were you just using it on an “as needed” basis? Or were you taking it for months? Some people have been on this medication for years, taking it every single day. Individuals that have been on it consistently for long periods of time are going to have the most difficulty when it comes to withdrawal.
2. Dosage (.25 mg, .5 mg, 1 mg, 4 mg)
Typically in cases of treating generalized anxiety or social anxiety, a person only will need about 0.25 mg to 0.5 mg to alleviate symptoms. Even for panic attacks, the maximum recommended dose is only 0.5 mg. Since the immediate release version of the medication may need to be taken multiple times per day, it is not recommended to exceed 4 mg daily. Most professionals will not prescribe more than 4 mg to be taken on a daily basis.
Your personal physiology will play a role in determining how quickly you recover from the withdrawal symptoms. Some people heal faster than others so just realize that your withdrawal experience is unique to you. Not everyone has the same degree of social support or the same opportunities. The way that your nervous system reacts to the withdrawal will be dependent upon your individual situation.
4. Cold turkey vs. tapering
It is actually dangerous in many cases to quit taking Xanax “cold turkey.” Therefore it is not medically advised to just stop taking this medication without having slowly tapered down the dose over an extended period of time. Work with your doctor or another professional if you need help with this process. The person who prescribed you this medication should be well aware that you need to “taper” and should never quit “cold turkey” unless you are already on the lowest possible dose.
Xanax Withdrawal Symptoms List
Below are some symptoms that you may experience when you stop taking Xanax. Realize that this medication is considered one of the most difficult to quit. People can build up a quick tolerance to the drug and since it works so quickly and effectively, many people become addicted. During your withdrawal, it is important to realize that many of the symptoms you will experience are a result of your brain readjusting to processes without the drug.
- Anxiety: When you stop taking Xanax, your brain no longer has the drug to bind to GABA receptors. Therefore instead of the calm feeling you experience while on Xanax, you may experience very severe anxiety. It may be so severe that you have a difficult time functioning and/or coping. Just know that the severity will subside as time passes throughout your withdrawal.
- Concentration difficulties: Many people report difficulties with concentration while taking this drug, but also during withdrawal. Research has shown that people exhibit cognitive deficits for weeks after taking this drug. If it seems as though you are not able to think clearly, it is likely a result of the withdrawal process.
- Convulsions: This is a condition in which the muscles rapidly contract and relax rapidly and repeatedly. These are especially common if you try to quit taking Xanax in “cold turkey” fashion. It is basically uncontrollable shaking of your body because you have become accustomed to the drug for functioning. These will subside as long as you do an extremely gradual taper.
- Depression: It is extremely common to experience increasing depression when coming off of Xanax. For some people the calmness associated with this medication actually helps with depressive symptoms. The combination of all of the withdrawal symptoms can lead to feelings of deep depression and sorrow.
- Hallucinations: It is thought that when you stop taking Xanax, especially if you do not slowly taper, that neurons become overexcited. The overexcitement is thought to contribute to some individuals experiencing hallucinations. Although this isn’t a common withdrawal effect, some people do experience them as a result of quitting Xanax.
- Headaches: People have reported minor headaches, to major migraine-esque headaches when coming off of Xanax. These can make life very difficult to deal with especially if they are ongoing. It is recommended to make sure you are drinking adequate water and taking over-the-counter headache relief if necessary.
- Insomnia: Perhaps the most common symptom that people experience when withdrawing from Xanax is insomnia. You may not be able to fall asleep at night and instead your mind seems to be controlled by anxiety and stressful thinking. Even when your physical body is exhausted, your mind runs an uncontrollable course that keeps you awake.
- Irritability: Many people report feeling irritable when they come off of benzodiazepines. Some people experience aggression in combination with feeling highly irritable. Recognize that little things may really irritate you during withdrawal.
- Memory problems: Long term use of this drug has been linked to developing dementia. It is not a surprise that Xanax is linked to memory problems during withdrawal. Most people should experience their memory return to normal within a few months into withdrawal.
- Mood swings: Many people have experienced mood swings during withdrawal from benzodiazepines. These mood swings make actions unpredictable and can make recovery difficult because one minute you may feel good and the next very depressed.
- Muscle pain: You may experience an extensive amount of pain in your muscles or throughout the body. This could be a result of muscle tension and could also just be aches and pains of withdrawal.
- Nausea: You may feel nauseated for awhile and/or experience flu-like symptoms especially during the first few weeks of withdrawal.
- Nightmares: It is common to experience nightmares and other sorts of crazy dreams when coming off of Xanax.
- Palpitations: You may experience heart palpitations especially during the acute phase of withdrawal. These are sensations that your heart is beating rapidly, irregularly, or abnormally. These may drive you crazy because they can lead to further anxiety. They will eventually subside if you can relax.
- Panic attacks: Since this medication is used to treat panic, you are likely going to experience panic when coming off of it. The panic may be significantly worse than before you started taking Xanax. This is something that you will have to learn how to cope with. It will eventually go away and/or reduce in intensity, but during the initial withdrawal period it may be extreme.
- Perceptual changes: Changes in perception have been documented during withdrawal.
- Psychosis: Many people experience psychotic episodes as a result of withdrawing from Xanax. If you end up experiencing psychosis as a result of your withdrawal from Xanax, it could be due to the fact that you withdrew too fast. Psychosis as the result of withdrawal does not typically respond to an antipsychotic medication.
- Seizures: One of the huge dangers associated with not tapering off of Xanax is that of experiencing seizures. In cases of benzodiazepine dependency, seizures are a common withdrawal symptom if you cut bait with the medication cold turkey. This is not safe, so make sure you are slowly tapering off or “titrating” down to a lower dose over a period of time.
- Sleep disturbances: You may notice changes in your sleep patterns. It may be difficult to get a full night’s sleep and/or you may experience significant interruptions in your ability to stay asleep. These disturbances can make life even more stressful while trying to come off of Xanax.
- Suicidal thinking: The excessive anxiety may provoke thoughts of suicide and contribute to a person feeling trapped. During withdrawal, it may feel as if you are prisoner to the excessive nervousness, anxiety, and stress that you are experiencing. This will eventually get better, but in the meantime, make sure you have a coping strategy in case you start to feel suicidal.
- Sweating: Most people report extensive “night sweats” when coming off of Xanax. You may sweat excessively throughout the day, but most people report that their sweats throughout the night are significantly worse.
- Tingling sensations: You may feel tingling sensations across your body when you first come off of this medication. These sensations are not easy to deal with and may drive you crazy. Just recognize that this is a well-documented symptom of withdrawal that should be understood.
- Tremors: This is uncontrollable shaking usually in your hands and/or arms. The muscles contract and relax, sometimes in rhythmic frequencies. If these do not go away, you may need to conduct a slower taper.
- Vomiting: Some individuals end up puking as a result of the intense nausea that they experience. Although this isn’t a very common symptom, it has been reported.
Note: Following your last dose, Xanax stays in your system (along with its metabolites) for between 2 and 4 days. Some believe that discontinuation symptoms become most noticeable after it has been fully cleared from the body.
Xanax Withdrawal Timeline: How long does it last?
There is no specific timeline for withdrawal from Xanax. It may take one person a few weeks to overcome the withdrawal symptoms, while recovery for another person may take months or years. It is important to recognize that your experience with any medication is unique and cannot be generalized to everyone. Most researchers have found that people coming off of Xanax go through an “acute phase” (shorter term) which is sometimes followed by a “protracted phase” (longer term).
On average, withdrawal from Xanax lasts 2 months or more. A good rule of thumb I like to go by is the 90 day rule for any psychiatric medication. In most cases, withdrawal symptoms subside by the third month of not taking the medication. This is assuming that you gradually tapered off of the medication – not quit cold turkey. If you quit cold turkey, the withdrawal effects may linger for longer than just a few months.
There is evidence of a protracted or extended withdrawal phase in which people experience effects for months if not years after their last dose. It is suggested that up to 15% of individuals who have taken Xanax could exhibit symptoms for an extended period of time. These symptoms typically include things like: insomnia, tinnitus, cognitive deficits, anxiety, jerks, muscle weakness, tremors, muscle pain, and tingling sensations. People may experience brain damage if they were taking high doses of Xanax over an extended period of time.
Most people will fully recover from their Xanax withdrawal, but it may take months or years. There is no telling when the person is going to return back to a completely normal state of functioning. If you are dealing with Xanax withdrawal, take the time to focus on engaging in healthy activities. Do things that are good for your mind and body such as: getting natural sunlight, socializing with others, staying busy (e.g. at a job), exercising, and eating healthy.
My personal experience coming off of Xanax
I had taken Xanax immediate release as well as the XR (extended release) version. I was on the immediate release version for about a year, and I took the XR version for about a year and a half. They worked wonders for my anxiety and honestly I don’t know that I would have been able to make it through a year of my high school without them. I was plagued by severe social anxiety as well as general anxiety. This drug did what it was intended to do – reduce my anxiety.
Coming off of it was no fun, but I was lucky that I wasn’t put on a super high dose. The withdrawal experience was nothing short of a nightmare for me being a teenager at the time, but it was still easier than Paxil. My withdrawal symptoms lasted for 6 to 8 months, so I am well aware that the process takes awhile. My doctor didn’t even tell me to taper off of the medication, so that probably made things worse than necessary. Always make sure that you taper off of these drugs so that you can avoid dangerous effects of quitting cold turkey.
If you have been withdrawing from Xanax and would like to share your personal experience, many people would appreciate it. Sharing your experience helps people realize that they are not alone in this struggle and that full recovery is possible. I am living proof that you can make it out from Xanax withdrawal.