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Xanax Withdrawal and Detox

Posted in Xanax Addiction Treatment on November 1, 2016
Last modified on December 2nd, 2018

While the severity and duration of withdrawal symptoms appear to be related to dosage and length of use, people taking Xanax for brief periods at recommended doses (e.g. 0.75 to four mg/day) have reported withdrawal symptoms including seizures. The physical withdrawal symptoms of Xanax are similar to those of sedative-hypnotics and alcohol.1,2

Alprazolam (the active ingredient in Xanax) is 10 times more potent than the benzodiazepine drugs diazepam and clonazepam. Moreover, alprazolam is eliminated from the body faster than longer-acting benzodiazepines. Even Xanax XR (the extended version) may cause stronger withdrawal symptoms than some immediate release benzodiazepines. As such, Xanax withdrawal symptoms may be worse than other drugs in this class.3

Withdrawal symptoms may start within a few hours of stopping Xanax and usually last about one week. In rare cases, less severe withdrawal symptoms may continue as long as two years after cessation, a phenomenon known as post-acute withdrawal syndrome (PAWS) or protracted withdrawal.3

Physical Withdrawal Symptoms

  • Insomnia
  • Abdominal pain
  • Vomiting
  • Headache
  • Sweating
  • Muscle cramps
  • Tremors
  • Seizures
  • Uncontrollable shaking
  • Blurred vision
  • Sensitivity to noise and light
  • Numb fingers
  • Loss of appetite
  • Heart palpitations

Behavioral Withdrawal Symptoms

When Xanax is prescribed for panic disorder, generalized anxiety disorder or insomnia, stopping the drug often causes rebound. Rebound manifests as intensified symptoms of the pre-existing disorder, causing a person to temporarily experience increased anxiety, panic attacks or insomnia. Rebound symptoms typically disappear a few days to several weeks after withdrawal, however, it’s important that the underlying issue that led to Xanax use is addressed with specialized treatment.3

  • Anxiety
  • Paranoia
  • Mild dysphoria
  • Aggression
  • Depression

Withdrawal Factors

While there are similarities in Xanax withdrawal, the process differs for every individual. The following factors influence how a person experiences withdrawal.3

  • Dosage
  • Frequency of use/abuse
  • Duration of use/abuse
  • Method of ingestion
  • Age at first use
  • Co-occurring drug or alcohol use
  • Overall mental and physical health
  • Underlying medical conditions
  • Genetic predisposition (family history of addiction)
  • Stress levels
  • Prior addiction
  • Environmental factors

Medical Detox

Medically supervised Xanax detox involves gradually lowering the dose to help lessen withdrawal symptoms. This generally involves several types of interventions such as gradual reduction with long or short half-life benzodiazepines, switching to non-benzodiazepine anxiolytics or prescribing adjunctive medications including antidepressants or anticonvulsants.4 After detox, drug rehab involves working on psychological issues that led to addiction to help ensure long-term recovery from Xanax addiction.

  1. Alprazolam Dependence – Signs of Alprazolam Use Vs. Abuse, Tolerance. Dependency.net website http://www.dependency.net/learn/alprazolam/ Accessed October 12, 2016.
  2. Xanax Effects and Withdrawal Symptoms. Drug Rehab Treatment Help website. http://drugrehabtreatmenthelp.com/drugs/xanax/ Published 2010. Accessed October 12, 2016.
  3. Xanax addiction and withdrawal symptoms. Drug Details website. http://drugsdetails.com/xanax-addiction-and-withdrawal-symptoms/ Published September 21, 2016. Accessed October 12, 2016.
  4. Liebrenz M, Schneider M, Buadze A, Gehring M-T, Dube A, Caflisch C. Attitudes towards a maintenance (-agonist) treatment approach in high-dose benzodiazepine-dependent patients: a qualitative study. Harm Reduct J. 2016;13:1. doi:10.1186/s12954-015-0090-x.
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