Last Updated on July 29, 2021 by
Last Updated on July 29, 2021 by
These are not all the withdrawal symptoms that may be experienced while coming off Xanax.
Special Note: Never stop using benzodiazepine drugs suddenly. Withdrawals can be eased by gradually tapering down instead of stopping all at once, especially for rapidly acting benzodiazepines such as Xanas.6,7-10
Benzodiazepines like Xanax are not a typical drug withdrawal. The strategy for eliminating this drug needs to be compassionate and tailored to individual needs.
Xanax (alprazolam) is a tranquilizer in the benzodiazepine drug class, FDA-approved to be used as a sedative to treat anxiety and panic disorders.1 It comes in immediate or delayed-release versions. Benzodiazepines are often prescribed longer than is recommended by health authorities, putting consumers at risk of dependence and addiction. According to the Heather Ashton guidelines, benzodiazepines should be taken for a few days to a few weeks and regarding cessation, Xanax withdrawal need not be traumatic if done correctly and with individual care.2
Information is provided below, on the most frequently requested topics concerning Xanax and Xanax withdrawal. Always do your best to research before starting or stopping Xanax or other medications.
Xanax is a central nervous system suppressant and is primarily prescribed to treat anxiety or panic disorders. Because of the drug’s dampening effects on alertness and cognitive function, driving or operating machinery is not advisable when under the influence of Xanax.
Xanax is a brand or trade name for the generic drug, alprazolam. Other brand names in the US include Gabazolamine-05 and Niravam.
Xanax has developed a presence as a street drug that can be purchased for as little as $5 a pill. Its popularity is possibly due to its sedative effects and pleasurable sensation of mild euphoria. According to the Connecticut Department of Consumer Protection, numerous street names have evolved, including bricks, footballs, bars, zanbars, and others.3
Quitting Xanax or any benzodiazepine drug can be deadly if done abruptly, i.e., all at once. A gradual taper is the FDA-recommended approach to avoid these severe and sometimes deadly withdrawal symptoms. There are several factors that will affect the timeline of your withdrawal including how long you used Xanax, general health, age, and even some genetic factors that may affect the rate of clearing from the body. Xanax has an extremely short half-life, which makes a smooth withdrawal near to impossible. A recommended strategy to discuss with your prescribing caregiver is to transition over to a longer-acting benzodiazepine such as diazepam ( Valium ) for a less problematic withdrawal schedule. You can read more about cross-tapering methods on our services overview. Always seek professional guidance or inpatient care for your best outcome.2,6-10
The FDA defines “side effect” as any undesirable adverse effect of, or unexpected reaction to a drug.4
Xanax can cause mild as well as more serious side effects. According to statistics compiled by the US Gov., alprazolam causes a wide range of adverse effects, from mild to severe, and even life-threatening in some cases.5 The list is long, and we have grouped these adverse effects into categories for clarity.
Nervous System disorders: Akathisia, insomnia, abnormal involuntary movements, twitching, impaired coordination, muscle tone disorders, weakness, lightheadedness, dizziness, menstrual difficulties, infrequent or stopped menstrual periods, infertility, blurry vision.
Gastrointestinal disorders: Nausea, vomiting, diarrhea, constipation, dry mouth, increased salivation.
Cardiovascular disorders: tachycardia, hypotension
Dermatological, skin, & subcutaneous tissue disorders: Stevens-Johnson syndrome, rash, sweating, photosensitivity.
Psychiatric disorders: emotional blunting,6 mania, hypomania, anxiety, irritability, memory impairment, derealization, depression, confusion, decreased/increased libido, disinhibition, dysarthria (difficulty in articulating speech), fatigue, sexual dysfunction, infertility.
Metabolism disorders: Weight loss, weight gain, increased/decreased appetite.
Pregnancy: Use in pregnancy is associated with depressed respiration and withdrawal symptoms post-birth in the infant. Infant Xanax withdrawals include irritability, restlessness, tremors, hyperreflexia (overactive reflex response), inconsolable crying, and feeding difficulties.
There are several safety warnings on Xanax packaging. These are:
Below are some of the most frequently asked topics about Xanax, including safety, health risks, mechanism of action in the brain, and other important subjects of interest. It is recommended that a person learn as much as possible about a drug before starting or stopping a prescription.
At Alternative to Meds Center, we specialize in safe Xanax withdrawal treatments. Another pillar of treatment of equal or even greater importance is to provide the testing and therapies that can relieve symptoms for which prescription drugs may have been prescribed in the first place.
The FDA recommends that for day-to-day stress or tension, such as workplace stress, or family discord, or other challenges, that benzodiazepines should not casually be prescribed in these cases.2
However, it is known that as of The Top 300 Drug Stats Report for 2021, Xanax (alprazolam generic) ranked at #37 of the top 300 most prescribed drugs in the US. More Xanax prescriptions were written than for Oxycodone, hydromorphone (Dilaudid) and Penicillin combined.21 Deaths due to benzodiazepines rose from 1000 per year in 1999 to roughly 9,000 per year in 2019. Also of concern, one-third of benzodiazepine prescriptions were accompanied by prescriptions for opioid medications, a potentially lethal combination. Tragically, 85% of benzodiazepine overdose deaths involved opioids. And despite recommendations for short-term use only, the CDC reports that many of these prescriptions have gone on long-term.21,22&
Addiction can occur whether one was pleasure-seeking or just seeking relief. These factors make a perfect storm for drug injuries in greater numbers.
A particularly popular aspect of the Alternative to Meds program is investigative lab testing to detect accumulated toxins and facilitate their removal from the body. It is true that some symptoms like anxiety and insomnia could be related to neurotoxicity, especially troublesome in our industrialized world. Pollutants, including pesticides, food additives, and heavy metals, do have the capacity to damage and interfere with normal healthy hormones, reproductive systems, neurochemistry, and innumerable parts of the complex body. These substances have been overlooked in mainstream mental health treatment.23 Alternative to Meds Center has observed that clearing these toxins from the body is a positive and in many cases necessary step toward restoring natural mental health improvements and long-term success.
Safe tapering is another specialty that can help those who have found limited or no success in drug-based treatments and who wish to discontinue them.
We invite you to contact us at Alternative to Meds Center for further information on safe and comfortable Xanax withdrawal, especially if you are struggling with Xanax addiction or dependence, and wish to find holistic answers or alternative mental health treatment.
1. FDA drug label Xanax (alprazolam tablets) [online] Revised 2016 [cited 2021 July 28]
2. Ashton H. The diagnosis and management of benzodiazepine dependence. Curr Opin Psychiatry. 2005 May;18(3):249-55. doi: 10.1097/01.yco.0000165594.60434.84. PMID:16639148. [cited 2021 July 28]
3. Connecticut Gvt. Department of Consumer Protection Information “Aprazolam” [online] [cited 2021 July 28]
4. FDA information, “Finding and Learning About Side Effects (adverse reactions).” 2018 July 19] [online] [cited 2021 July 28]
5. DailyMed prescription drug information, “Alprazolam” [online] Mar 21, 2021 [cited 2021 July 28]
6. Ashton H, “Benzodiazepines – How they Work and How to Withdraw” aka “The Ashton Manual” revised Aug 2002 [online] [cited 2021 July 28]
7. Garzone PD, Kroboth PD. Pharmacokinetics of the newer benzodiazepines. Clin Pharmacokinet. 1989 Jun;16(6):337-64. doi: 10.2165/00003088-198916060-00002. PMID: 2567646. [cited 2021 July 28]
8. Browne JL, Hauge KJ. A review of alprazolam withdrawal. Drug Intell Clin Pharm. 1986 Nov;20(11):837-41. doi: 10.1177/106002808602001102. PMID: 3536383. [cited 2021 July 28]
9. Bosshart H. Withdrawal-induced delirium associated with a benzodiazepine switch: a case report. J Med Case Rep. 2011 May 26;5:207. doi: 10.1186/1752-1947-5-207. PMID: 21615891; PMCID: PMC3117827. [cited 2021 July 28]
10. Busto U, Sellers EM, Naranjo CA, Cappell H, Sanchez-Craig M, Sykora K. Withdrawal reaction after long-term therapeutic use of benzodiazepines. N Engl J Med. 1986 Oct 2;315(14):854-9. doi: 10.1056/NEJM198610023151403. PMID: 3092053. [cited 2021 July 28]
11. O’brien CP. Benzodiazepine use, abuse, and dependence. J Clin Psychiatry. 2005;66 Suppl 2:28-33. PMID: 15762817. [cited 2021 July 28]
12. Kang M, Galuska MA, Ghassemzadeh S. Benzodiazepine Toxicity. [Updated 2021 Jul 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482238/ [cited 2021 July 28]
13. Ananth J. Benzodiazepines: selective use to avoid addiction. Postgrad Med. 1982 Oct;72(4):271-6. doi: 10.1080/00325481.1982.11716231. PMID: 6126869. [cited 2021 July 28]
14. Schmitz A. Benzodiazepine use, misuse, and abuse: A review. Ment Health Clin. 2016;6(3):120-126. Published 2016 May 6. doi:10.9740/mhc.2016.05.120 [cited 2021 July 28]
15. Temte V, Kjeldstadli K, Bruun LD, Birdal M, Bachs L, Karinen R, Middelkoop G, Øiestad E, Høiseth G. An Experimental Study of Diazepam and Alprazolam Kinetics in Urine and Oral Fluid Following Single Oral Doses. J Anal Toxicol. 2019 Mar 1;43(2):104-111. doi: 10.1093/jat/bky062. PMID: 30517712. [cited 2021 July 28]
16. Santo L, Rui P, Ashman J, “Physician Office Visits at which Benzodiazepines were Prescribed: Findings from 2014-2016 National Ambulatory Medical Care Survey” CDC national Health Statistics Reports #137 January 17,2020 [cited 2021 July 28]
17. Otte C. Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci. 2011;13(4):413-421. doi:10.31887/DCNS.2011.13.4/cotte [cited 2021 July 28]
18. DeRubeis RJ, Siegle GJ, Hollon SD. Cognitive therapy versus medication for depression: treatment outcomes and neural mechanisms. Nat Rev Neurosci. 2008;9(10):788-796. doi:10.1038/nrn2345 [cited 2021 July 28]
19. Otto MW, McHugh RK, Simon NM, Farach FJ, Worthington JJ, Pollack MH. Efficacy of CBT for benzodiazepine discontinuation in patients with panic disorder: Further evaluation. Behav Res Ther. 2010 Aug;48(8):720-7. doi: 10.1016/j.brat.2010.04.002. Epub 2010 Apr 28. PMID: 20546699; PMCID: PMC5962448. [cited 2021 July 28]
20. He Q, Chen X, Wu T, Li L, Fei X. Risk of Dementia in Long-Term Benzodiazepine Users: Evidence from a Meta-Analysis of Observational Studies. J Clin Neurol. 2019;15(1):9-19. doi:10.3988/jcn.2019.15.1.9 [cited 2021 July 28]
21. Statistical Report “The Top 300 of 2021” published by clincalc database [online] [cited 2021 July 28]
22. CDC statistics report, “Overdose Death Rates, figure 8” [online] [cited 2021 July 28]
23. Genuis SJ. Toxic causes of mental illness are overlooked. Neurotoxicology. 2008 Nov;29(6):1147-9. doi: 10.1016/j.neuro.2008.06.005. Epub 2008 Jun 24. PMID: 18621076. [cited 2021 July 28]
Originally Published Sep 13, 2018 by Diane Ridaeus
Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.