Xanax® Withdrawal Symptoms

• Xanax® (Alprazolam) is a benzodiazepine primarily used for treating anxiety and panic disorders
• Depending on the amount of drug that is taken and for how long, Xanax® can become an addictive substance.
• If a chemical dependence has manifested in the body, users of Xanax® can experience certain withdrawal symptoms when discontinuing its use including headaches, muscle pains, irritability, sweating, nausea, and depression.
• More serious withdrawal symptoms can include increased insomnia, hallucinations, and seizures.

Xanax® is a widely prescribed medication for anxiety and panic disorders that has been in circulation since the 1970s. While it can be highly effective in managing specific stress disorders, Xanax® does come with it a potential for addiction.

When this happens, there is a possibility of experiencing certain withdrawal symptoms when discontinuing the medication. The withdrawal process from Xanax® can be challenging and potentially dangerous, particularly if not managed under medical supervision.

What is Xanax®?

Xanax®, or Alprazolam[1], is a benzodiazepine that acts as a central nervous system (CNS) depressant. Xanax® works by enhancing the effect of the neurotransmitter GABA (gamma-aminobutyric acid) in the brain, which, in effect, decreases overall brain activity levels. GABA is responsible for inhibiting nerve activity and promoting relaxation. By increasing GABA’s effectiveness, Xanax® helps reduce feelings of anxiety, fear, and restlessness, relieving those who struggle with these conditions.

What Causes Xanax® Withdrawal?

Xanax® withdrawal arises when an individual who has formed physical dependence on the medication either lowers their dose or discontinues use. Dependence results from the body getting acclimated to the presence of Xanax®, leading to internal adjustments that accommodate the drug’s impacts.

In due course, the brain comes to rely on Xanax® to achieve a sense of composure and relaxation and maintain normal function. However, upon removing or reducing the drug, the body experiences withdrawal symptoms as it struggles to manage its loss.

Several factors contribute to the development of Xanax® dependence[2] and, subsequently, withdrawal. These factors include:

• Dosage: The body can become dependent on Xanax® when higher doses are taken due to the drug’s stronger effects.
• Duration of Use: Using Xanax® for a long time increases the chances of becoming dependent as your body gets accustomed to the drug’s effects.
• Frequency of Use: Frequent use of Xanax® can increase the likelihood of developing dependence on the medication since the body is regularly exposed to it.
• Individual Factors: A person’s unique physiology, genetics, and mental health history can influence the likelihood and severity of withdrawal symptoms.

Individuals may still develop a dependence on Xanax® despite taking it under a physician’s prescription. Consequently, strictly observing your healthcare professional’s directives concerning drug amount and length of use while disclosing any apprehensions or unwanted reactions is paramount.

Xanax® Withdrawal Signs and Symptoms

Withdrawal from Xanax®[3] can be an uncomfortable and distressing experience. Familiarizing yourself with the symptoms can assist you in anticipating what to expect and seeking needed care and support.

The severity and duration of withdrawal symptoms, including physical and psychological disturbances, depend on dosage, time, frequency, and individual physiology. Below are some common signs and symptoms associated with Xanax® withdrawal.

Physical Symptoms

• Tremors: Shaking or trembling of the hands and other body parts.
• Muscle Pain and Stiffness: Discomfort, aches, or muscle cramps.
• Headaches: Persistent or recurring headaches ranging from mild to severe.
• Nausea and Vomiting: Upset stomach, loss of appetite, and episodes of vomiting.
• Sweating: Excessive perspiration, often accompanied by chills or hot flashes.
• Seizures: In severe cases, uncontrolled muscle spasms and convulsions may occur, which can be life-threatening and require immediate medical attention.

Psychological Symptoms

• Anxiety: Heightened feelings of worry, fear, or restlessness that may be more intense than before starting Xanax®.
• Irritability: Increased sensitivity, agitation, or frustration in response to everyday situations.
• Depression: Sadness, hopelessness, or loss of interest in activities once enjoyed.
• Insomnia: Difficulty falling asleep, staying asleep, or experiencing restful sleep.
• Mood Swings: Rapid and unpredictable changes in mood or emotional state.
• Difficulty Concentrating: Trouble focusing on tasks or maintaining attention.
• Hallucinations: In rare cases, individuals may experience visual or auditory hallucinations during withdrawal.

Xanax® Withdrawal Timeline

The procedure of discontinuing Xanax® usage usually adheres to a general timetable. However, it is essential to note that each individual’s experience may be unique due to individual factors. Familiarizing oneself with the typical stages of Xanax® withdrawal can help to predict and better
manage the symptoms.

Presented below is an outline of the Xanax® withdrawal timeline:

Early Withdrawal (10-12 hours after the last dose)

In the beginning stage, some people may have mild symptoms such as feeling more anxious, restless, irritable, and having trouble sleeping. They may also notice their heart rate and sweating increase.

Acute Withdrawal (1-4 days)

As one enters the acute withdrawal phase during their period of detoxification, they will face a culmination of withdrawal symptoms. Typically, these present themselves with heightened episodes of anxiety, leading to amplified states of panic attacks and potentially insomnia.

On a physical level, people often experience various effects throughout the body, including trembling limbs and muscles, nausea, and headaches. Severe withdrawal symptoms, including seizures and hallucinations, may occur independently of physical tiredness and require immediate medical intervention.

Subacute Withdrawal (5-14 days)

As the acute phase subsides, individuals will generally notice a gradual decline in the severity of their symptoms. However, lingering anxiety, sleep disturbances, mood swings, and difficulty concentrating may persist during this period.

Post-Acute Withdrawal Syndrome (PAWS) (15 days to several months)

Post-acute withdrawal syndrome (PAWS) may cause prolonged symptoms like depression, anxiety, irritability, and cognitive difficulties, with fluctuations in severity over time.

These symptoms can sometimes last for weeks, months, or even years. The severity of PAWS symptoms can fluctuate over time, with moments of improvement interspersed with episodes of heightened severity.

How to Treat Xanax® Withdrawal Safely

Managing Xanax® withdrawal safely is crucial to minimize potential complications and ensure a smooth transition to a medication-free state. It is always best to consult with a healthcare professional before attempting to stop or reduce your Xanax® use.

Here are some strategies to help treat Xanax® withdrawal safely:

Tapering

Abruptly stopping Xanax® can lead to severe withdrawal symptoms and increase the risk of complications. A healthcare professional will likely recommend a gradual tapering schedule, slowly reducing the dosage. This allows the body to adjust to lower levels of the medication, minimizing the intensity of withdrawal symptoms.

Medical Supervision

Regular check-ins with a healthcare provider throughout the withdrawal process can help identify potential issues or complications early on. If needed, they can adjust your tapering schedule based on your progress and experiences.

Medication Management

Sometimes, healthcare professionals prescribe additional medications to help manage specific withdrawal symptoms. For example, they may recommend antidepressants, anti-anxiety medications to alleviate anxiety or depression, or sleep aids to address insomnia. Following your healthcare provider’s guidance regarding using these medications is essential.

Support System

During the withdrawal process, a reliable support system is crucial. It can encompass people like friends, family members, or support groups who have a grasp of your situation and can uplift you with encouragement and aid whenever required. Mental health professionals such as therapists or counselors can provide valuable perspectives and coping mechanisms to help you tackle withdrawal challenges.

Healthy Lifestyle

Ensuring a healthy lifestyle is imperative to enhance both physical and mental well-being while undergoing the withdrawal process. A balanced diet, frequent exercise, healthy sleeping habits, and stress-reducing activities such as meditation or yoga can significantly contribute to a smoother withdrawal journey.

Patience and Self-Compassion

It is essential to bear in mind that the withdrawal process can pose significant difficulty, and fluctuations in mood may be expected. Exercising self-patience and practicing self-compassion as you traverse this journey is imperative. It may also be helpful to recognize that setbacks are a natural part of the journey, and progress may not always follow a steady course.

Sources

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[1] George, T. T., & Tripp, J. (2023). Alprazolam. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK538165/

[2] MedlinePlus. (2021, May 15). Alprazolam: MedlinePlus Drug Information. https://medlineplus.gov/druginfo/meds/a684001.html

[3] Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine, 12(1), 4–10. https://doi.org/10.1097/ADM.0000000000000350