Xanax Withdrawal Symptoms and Timeline

Xanax Withdrawal Symptoms and Timeline

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Table of Contents

What is Xanax?

Once thought to be a safer alternative to traditional sedatives and tranquilizers, researchers now know that Xanax carries a risk for abuse and addiction. Learn about Xanax withdrawal symptoms and what you can do to reclaim your life.

Drug Class

Xanax is the brand name of the prescription medication alprazolam. It belongs to a class of drugs called benzodiazepines that are prescribed to treat generalized anxiety disorder and panic disorders. Other medications in this class include diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), and flurazepam (Dalmane). Xanax is also the most commonly prescribed psychiatric medication in the United States. In 2013, 48 million prescriptions were issued.1

Some of its main traits include:

Fast onset of action

Shorter half-life than Valium and Librium

Xanax is classified as a Schedule IV drug by the DEA. The consensus is that, although the drug has an accepted medical use, it carries a low but real potential for abuse and dependence.

What Is It Used For?

Xanax is a prescription sedative generally prescribed for the treatment of anxiety, insomnia, and panic disorders. It works by depressing the function of the central nervous system (CNS). Specifically, it binds to GABA receptors in the brain, slowing down brain activity and reducing anxiety, fear, and stress. Xanax produces rapid symptom relief within a week of beginning treatment. Doctors can prescribe it as short-term relief from symptoms or as part of a long-term management plan for anxiety and panic disorders.

Xanax Addiction

How Xanax Addiction Develops

Although Xanax has lower misuse potential than traditional tranquilizers and sedatives, it still carries a risk for abuse and addiction. Non-medical use or taking larger doses than recommended are the main factors for developing a Xanax addiction.

By activating GABA receptors, Xanax reduces feelings of anxiety and panic. However, some of the accompanying feelings include a sense of euphoria, especially when taken in large doses. This euphoric high is one of the primary reasons why so many people abuse the drug.

Anyone can develop an addiction to Xanax. The benzodiazepine drug can result in tolerance, addiction, and dependence if taken in large doses or used for a prolonged period. Addiction can happen with or without physical dependence. However, physical dependence is a common feature of addiction.

People with a history of substance use disorder have a higher risk of addiction. Other factors that contribute to addiction include the patient’s environment and life experiences. Prolonged and heavy Xanax use can alter a person’s brain chemistry, changing how their brain experiences pleasure. This makes it hard for the person to stop using the drug.2

Common Signs of Xanax Addiction

When a patient overdoses on Xanax, they may experience negative side effects such as confusion and drowsiness. However, taking Xanax alone rarely leads to life-threatening side effects. Life-threatening effects appear when the drug is combined with other substances such as cocaine or alcohol. The combination can turn out to be deadly if taken in large doses.2

When a patient overdoses on Xanax, they may experience negative side effects such as confusion and drowsiness. However, taking Xanax alone rarely leads to life-threatening side effects. Life-threatening effects appear when the drug is combined with other substances such as cocaine or alcohol. The combination can turn out to be deadly if taken in large doses.2

Xanax Withdrawal Symptoms

When Xanax first appeared on the market in 1981, it was believed that it does not pose a risk for abuse. However, later research showed that it produces severe withdrawal symptoms in patients who stop taking the drug abruptly. Even patients who follow their doctor’s recommendations can experience withdrawal.

The withdrawal syndrome associated with the discontinuation of Xanax is more severe than other benzodiazepine withdrawal syndromes. The withdrawal syndrome of Xanax involves more complicated and unique rebound anxiety compared to other benzodiazepines.

In one study of 126 patients who were treated for panic disorder with Xanax, 27% developed rebound anxiety that was more severe than their pretreatment anxiety. Approximately 33% had new somatic symptoms.3

In another study with eight patients receiving Xanax treatment for combat-induced post-traumatic stress disorder, all eight patients developed worsening anxiety, sleep disturbance, and nightmares. Other symptoms included irritability, hyper-alertness, rage reactions, and homicidal ideation.4

A third study concluded that Xanax withdrawal can lead to more severe sleep disturbances than diazepam withdrawal. There are several case reports of delirium and psychosis caused by alprazolam withdrawal.5

Physical Symptoms of Xanax

Anxiety

Sleep problems

Nightmares

Irritability

Hyper-alertness

Homicidal ideation

Headaches

Muscle pain

Diarrhea

Sensitivity to light and sound

Sweating

Loss of appetite

Panic

Behavioral Symptoms of Xanax

When a patient stops taking Xanax abruptly, their brain needs time to return to its normal functioning. As a result, a range of behavioral symptoms may appear.

Anxiety

Depression

Thoughts of suicide

Mood swings

Hallucinations

Short-term memory loss

Trouble concentrating

Unable to control emotions

Paranoia

Xanax Withdrawal Timeline

The Xanax withdrawal symptoms begin within 24-hours and can last from a few days to a few months. There are three phases for Xanax withdrawal, each with an estimated timeline.

Severity of Symptoms

The early withdrawal symptoms are called rebound symptoms. They appear soon after a patient stops taking the drug. During this early stage, the symptoms of the initial condition that the drug was trying to treat may start to return. For example, symptoms of anxiety and insomnia may return or get worse.

Acute withdrawal is the second phase of the Xanax withdrawal timeline. These symptoms appear within a few days after last use and generally last 5 to 28 days, or even a few months. The severity of the symptoms depends on the duration of taking Xanax, the dosage, and if other drugs were taken simultaneously. A patient will experience most of the Xanax withdrawal symptoms during this face. According to patients, acute withdrawal is also the most challenging phase to overcome.

The third phase is called protracted withdrawal, during which some lingering side effects may appear. These symptoms may occur without warning and negatively affect a person’s quality of life. Also called post-acute withdrawal symptoms, they include:

Anxiety

Insomnia

Depression

Mood swings

Low sex drive

Poor concentration

Dangerous Symptoms

Patients who take the drug in smaller amounts and shorter period may experience milder Xanax withdrawal symptoms. However, 40% of people who take benzodiazepines for longer than 6 months experience moderate to severe withdrawal symptoms.

One of the most severe symptoms is grand mal seizures. They usually happen in patients who have been taking Xanax for an extended period and at high doses. These seizures have also been reported at therapeutic doses. The severity of the grand mal seizures ranges from a single episode to coma and death.6

Other dangerous symptoms include sensory distortions, seizures, depression, paranoia, and delirium.7

How to Help Ease Symptoms of Xanax Withdrawal

Medication-Assisted Treatment

Detoxing from Xanax cold-turkey and without any medical supervision can have life-threatening consequences. Rather than going cold-turkey, the recommended method is medication-assisted treatment. Although medication-assisted treatment may take longer, it is significantly safer.

Xanax dose tapering can be done faster in patients who have been taking high doses of the drug. The dosage can be reduced more slowly in therapeutic dosage users.

A longer-acting benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium), or chlordiazepoxide (Librium), may be substituted for Xanax. By administrating a small amount of benzodiazepines in the bloodstream, drug cravings and withdrawal symptoms may be controlled until the drug is fully removed from the system. Other medications like beta-blockers and antidepressants may be used to help manage the symptoms of Xanax withdrawal.

Therapy

According to research, gradual dose reduction combined with psychological treatment was superior to gradual dose reduction alone. Adding cognitive-behavioral therapy during tapering was more effective than just tapering the dose. Motivational interviewing is another type of therapy that can improve a patient’s chance of obtaining long-term sobriety.8

Resources

  1. https://www.drugs.com/xanax.html
  2. https://www.healthline.com/health/addiction/xanax-addiction#dependence-vs.-addiction
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/
  6. https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.12023
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/

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