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Xanax Withdrawal Symptoms, Timeline, and Treatment

Last Medical Review On: July 27, 2024
Updated On: June 15, 2024
5 min read
Written by:

Amanda Stevens, B.S.

Medical Review by:

Dr. Po-Chang Hsu, M.D., M.S.

Xanax, a benzodiazepine prescribed to treat anxiety disorders and panic attacks, also presents a risk for abuse and dependence due to its calming and sedative effects—which are sometimes misused for recreational purposes.[1]

Similar to other benzodiazepines, Xanax withdrawal symptoms can present substantial difficulties for those who have become dependent on the medication. Abrupt cessation or reduction in dosage may trigger a variety of uncomfortable symptoms, including severe complications.

Xanax Withdrawal
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    How Does Xanax Work?

    Xanax, also known as alprazolam, affects the central nervous system by inducing a calming influence.[2] The medication achieves this by enhancing the activity of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. GABA diminishes the activity of nerve cells, ultimately resulting in a calming effect. By augmenting GABA activity, Xanax can help alleviate symptoms of anxiety, such as excessive worry, tension, and restlessness.

    Moreover, Xanax possesses sedative properties, which can help manage symptoms of panic disorders and, in some cases, insomnia. The medication can induce relaxation and drowsiness by slowing the brain’s activity.

    What is Xanax Withdrawal Like?

    Withdrawal from Xanax, especially after prolonged use, can present a range of uncomfortable symptoms.[3] Individuals may experience a resurgence of anxiety and insomnia, as the medication’s absence can lead to rebound anxiety and difficulty sleeping. Furthermore, irritability, restlessness, and emotional volatility are common during Xanax withdrawal, making the process mentally taxing. Physical discomfort in the form of muscle aches, pains, tremors, and shakiness can also accompany withdrawal.

    Moreover, excessive sweating and an increased heart rate may manifest during withdrawal. In severe cases, abrupt cessation of Xanax can even lead to seizures, particularly among individuals who have been taking high doses or using the medication for an extended period.

    Given these potential challenges, it’s crucial for individuals looking to discontinue Xanax to seek the guidance of a healthcare professional. Gradually tapering off the medication under medical supervision can help manage and minimize withdrawal symptoms, ensuring a safer and more manageable process.

    Xanax Withdrawal Symptoms

    Withdrawal from Xanax, particularly after prolonged use, can elicit a range of challenging symptoms, including:[4]

    • Rebound anxiety and insomnia: Discontinuation of Xanax may result in a resurgence of anxiety and difficulty sleeping, known as rebound anxiety and insomnia.
    • Irritability and agitation: Individuals undergoing Xanax withdrawal may experience heightened irritability, restlessness, and emotional volatility as their body adjusts to the absence of the medication.
    • Muscle aches and pains: Physical discomfort in the form of muscle aches and pains is a common symptom during Xanax withdrawal, contributing to overall unease.
    • Tremors: Withdrawal from Xanax can be accompanied by tremors and shakiness, which can be distressing for individuals undergoing the process.
    • Sweating and increased heart rate: Some individuals may experience excessive sweating and an elevated heart rate as their body adapts to the absence of Xanax.
    • Seizures: Abrupt cessation of Xanax can lead to seizures, particularly among individuals who have been taking high doses or using the medication for an extended period.

    Xanax Withdrawal Timeline

    The withdrawal timeline for Xanax can vary from person to person, but it generally follows a pattern that consists of several phases, each characterized by specific withdrawal symptoms:[5]

    • Early Withdrawal (8 to 12 hours): During the first 8 to 12 hours after discontinuation, individuals may experience the first symptoms of withdrawal from Xanax.
    • Peak Physical Symptoms (days 2-5): Many people experience their worst physical withdrawal symptoms between days 2 and 5.
    • Peak Mental and Cognitive Symptoms (days 3-6): Physical Xanax withdrawal symptoms generally lessen in severity around day 4. However, mental and cognitive symptoms may be their worst around this time. Cognitive and mental withdrawal symptoms are often worse from days 3 to 6 following your last dose.
    • Post-Acute Withdrawal (weeks to months): Some individuals may experience lingering symptoms, known as post-acute withdrawal symptoms (PAWS), which can persist for weeks or months. These symptoms may include intermittent anxiety, mood swings, and sleep disturbances.

    Post Acute Withdrawal Syndrome (PAWS) for Xanax

    PAWS from Xanax can lead to persistent symptoms that endure beyond the acute withdrawal phase.[6] These lingering symptoms, which can last for months or even years, may include intermittent anxiety, mood swings, sleep disturbances, and cognitive challenges.

    During PAWS, individuals may experience recurring episodes of anxiety, fluctuations in mood, disrupted sleep patterns, and difficulties with concentration and memory. Effective management of PAWS often involves ongoing support, which may encompass therapy, lifestyle adjustments, and, in some cases, pharmacological interventions.

    Seeking professional assistance from healthcare providers or mental health professionals is essential for individuals experiencing PAWS to receive tailored support and effective management of these lingering withdrawal symptoms.

    Types of Drug Withdrawal Treatment

    Alpas offers a rehab program for Xanax addiction that delivers comprehensive care throughout the healing journey, providing services customized to address individual needs in treating Xanax and other substance use-related withdrawal:

    • Medical Detox: Detoxification involves allowing the body to rid itself of a drug while managing withdrawal symptoms. It is the initial phase of substance abuse treatment that focuses on the physical aspects of addiction. The goal of detox is to safely manage withdrawal symptoms when someone stops using drugs or alcohol. This process can occur in various settings, from inpatient facilities to outpatient clinics. It may involve medical supervision and support to ensure the individual’s safety and comfort during withdrawal.
    • Medically-Managed Care: Medically managed care refers to the provision of healthcare services, particularly for complex or chronic conditions, under the supervision of medical professionals. This approach involves coordination and oversight by healthcare providers, often utilizing evidence-based medical interventions, to ensure the delivery of comprehensive and integrated care. Medically managed care aims to optimize patient outcomes by emphasizing medical expertise, evidence-based practices, and coordinated treatment plans tailored to individual patient needs. This approach is commonly employed in the management of chronic illnesses, mental health conditions, substance use disorders, and other complex medical situations.
    • Inpatient Treatment: Inpatient treatment, or residential treatment, involves individuals receiving care and treatment within a specialized facility full-time. This type of treatment is commonly utilized for various conditions, including mental health disorders, substance abuse, and other medical issues requiring intensive intervention and support. In an inpatient setting, individuals reside within the facility for treatment, allowing for round-the-clock care, structured therapy sessions, medical supervision, and a supportive environment conducive to recovery. This intensive level of care is especially beneficial for those requiring a high level of support and monitoring to address their specific health needs.

    How Xanax Withdrawal Treatment Works

    Xanax withdrawal treatment involves a thorough assessment by healthcare professionals to determine the best care for you based on your medical history and the severity of your Xanax dependence. If needed, medical detoxification may be used to safely manage withdrawal symptoms, often involving medication to ease the process.

    After detox, you may move on to more intensive care, such as residential or inpatient treatment programs, where you’ll receive therapy, counseling, and support to address the psychological, social, and behavioral aspects of Xanax dependence. As you progress in your recovery, you may transition to lower levels of care, like outpatient treatment or support groups, to continue your journey to sobriety.

    This step-by-step approach ensures that individuals receive appropriate care at each stage of their recovery, increasing the likelihood of long-term success in overcoming Xanax dependence.[7]

    Medications Used for Xanax Withdrawal

    When managing Xanax withdrawal, healthcare professionals may utilize certain medications to help alleviate withdrawal symptoms and facilitate a safe transition from Xanax dependence.

    Some commonly used medications during Xanax withdrawal treatment include:[8]

    • Anticonvulsants: Certain anticonvulsant medications, like gabapentin or carbamazepine, may be prescribed to help control seizures and reduce the severity of withdrawal symptoms.
    • Antidepressants: In some cases, antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) may be used to manage mood-related symptoms associated with Xanax withdrawal.
    • Beta-blockers: These medications might help manage physical symptoms such as rapid heartbeat, tremors, and sweating during withdrawal.

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    What’s the Best Way to Find Xanax Withdrawal Treatment?

    Finding Xanax withdrawal treatment starts with seeking guidance from a healthcare provider or addiction specialist. They can assess your needs and recommend the most appropriate level of care. Research reputable treatment facilities that specialize in managing Xanax withdrawal, considering factors such as location and treatment options. Consult with these facilities to understand their approach to treatment and verify insurance coverage if applicable.

    Engage with support groups and utilize online resources to gather insights from others who have undergone Xanax withdrawal treatment. Involving supportive friends or family members can also provide emotional support. Ultimately, following the recommendations of healthcare professionals will ensure a safe and effective approach to addressing Xanax withdrawal and beginning the journey to recovery.

    Various resources are available to assist in finding treatment referrals as well, including:

    Cost of Drug Withdrawal Treatment

    The expense of drug withdrawal treatment is important to consider, but it shouldn’t hinder your access to care. Various options, such as insurance coverage and sliding scale fees, can assist. Furthermore, numerous treatment centers provide financial aid or flexible payment plans to support individuals facing financial challenges.

    While the cost of drug withdrawal treatment can differ based on the facility and level of care required, prioritizing access to care is essential for long-term recovery.

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    Frequently Asked Questions about Xanax Withdrawal Treatment

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    How long does Xanax withdrawal treatment last?

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    The duration of Xanax withdrawal treatment varies depending on individual factors such as the level of dependence, overall health, and the presence of co-occurring conditions. Treatment may range from a few weeks to several months.

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    Can Xanax withdrawal treatment be done on an outpatient basis?

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    In some cases, mild to moderate Xanax withdrawal can be managed on an outpatient basis with close medical supervision. However, severe withdrawal symptoms or co-occurring conditions may require inpatient treatment for comprehensive care.

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    What lifestyle changes can help during Xanax withdrawal treatment?

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    Adopting a healthy lifestyle, including regular exercise, a balanced diet, and stress-reducing activities, can complement Xanax withdrawal treatment. Avoiding triggers and establishing a stable routine can also support the recovery process.

    Sources
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    [01]

    [1] MedlinePlus. (2021, May 15). Alprazolam: MedlinePlus Drug Information. Medlineplus.gov. https://medlineplus.gov/druginfo/meds/a684001.html on April 10, 2024

    [2] Xanax (Alprazolam): Interactions & Side Effects. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/drugs/19498-alprazolam-tablets on April 10, 2024

    [3] PETURSSON, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(11), 1455–1459. https://doi.org/10.1111/j.1360-0443.1994.tb03743.x on April 10, 2024

    [4] Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2017). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine, 12(1), 4–10. https://doi.org/10.1097/adm.0000000000000350 on April 10, 2024

    [5] Srakocic, S. (2023, January 20). Your guide to xanax withdrawal symptoms and treatment options. Healthline. https://www.healthline.com/health/xanax-withdrawal-symptoms#duration on July 24, 2024

    [6] Lantz, M., Levya, R., Hartman, J., DiGenova, P., & Swift, A. (2021). The Withdrawal After the Withdrawal: Managing Benzodiazepine Reduction and Post-Acute Withdrawal in Older Adults. The American Journal of Geriatric Psychiatry, 29(4), S100–S101. https://doi.org/10.1016/j.jagp.2021.01.096 on April 10, 2024

    [7] Brett, J., & Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152–155. https://doi.org/10.18773/austprescr.2015.055 on April 10, 2024

    [8] Hood, S. D., Norman, A., Hince, D. A., Melichar, J. K., & Hulse, G. K. (2014). Benzodiazepine dependence and its treatment with low dose flumazenil. British Journal of Clinical Pharmacology, 77(2), 285–294. https://doi.org/10.1111/bcp.12023 on April 10, 2024

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