Xanax Withdrawal: Symptoms, Timeline, & Detox

Xanax withdrawal symptoms may include anxiety, panic attacks, tremors, sleep problems, muscle spasms, sweating, and even dangerous symptoms like psychosis and seizures. [1], [2]

Dependence on Xanax and other benzodiazepines can develop relatively quickly. Some people may become dependent on Xanax in as little as 3 to 6 weeks. [1] And if you misuse Xanax in order to get high, dependence could develop even faster and become more severe—leading to more severe and potentially life-threatening withdrawal.

How Long Does Xanax Withdrawal Take? 

Xanax withdrawal generally occurs in two forms: acute and protracted. [3]

Acute Withdrawal

Acute withdrawal symptoms are symptoms that occur shortly after taking Xanax for the last time and this can last anywhere between 5 and 28 days, depending on many factors. [1]

However, a withdrawal timeline largely depends on the half-life of a drug. Xanax has a half-life of about 8 to 16 hours, meaning it exits the body relatively quickly compared to other benzodiazepines. This means acute withdrawal symptoms may begin within a few hours of taking Xanax if a person who is physically dependent on this drug does not take another dose. [4] 

As such, your Xanax withdrawal may likely follow a predictable timeline for shorter-acting benzos and fall on the shorter end of that 5 to 28-day window. [2]

Day	Symptoms	Intensity	Risk of Complications
1	Rapid pulse, vomiting, insomnia, anxiety, mood swings, cravings, sweating, seizure	Symptoms emerge	High
2-3	Rapid pulse, vomiting, insomnia, mood swings, anxiety, cravings, sweating, seizure	Symptoms peak	High
4-5	Rapid pulse, sleep problems, irritability, cravings	Symptoms begin to improve	Moderate
7	Physical symptoms may subside and some emotional and mood symptoms may linger	Acute symptoms may resolve	Moderate/low
Weeks 2-4	Post-acute symptoms, such as anxiety, panic, depression, irritability	Fluctuating	Low

Protracted Withdrawal

With protracted withdrawal, symptoms continue long after the cessation of the initial acute symptoms, for weeks, months, or even up to a year. [1], [3]

As many as 25% of people who use benzodiazepines like Xanax long-term develop protracted or post-acute withdrawal symptoms, which may fluctuate in severity. [1] These symptoms may include: [3]

• Panic attacks
• Schizophrenia-like symptoms
• Obsessive-compulsive-related symptoms
• Generalized anxiety
• Agitated depression

It may be challenging to tell if you are experiencing protracted withdrawal symptoms or something known as “symptom reemergence” or “symptom rebound.” Symptom reemergence occurs when the symptoms you were experiencing when you were prescribed Xanax—such as anxiety or insomnia—return at the same severity as before you started taking the benzo. And these symptoms don’t go away due to an underlying condition that needs treatment. [3]

On the other hand, symptom rebound involves the return of acute withdrawal symptoms, restlessness, insomnia, and anxiety, which are often intensified but will eventually dissipate. [3] Specifically, patients may experience “rebound anxiety” for weeks after their last dose of Xanax. Rebound anxiety is the presence of anxiety that may be worse than the initial anxiety for which a person began taking Xanax. [5] 

Acute Xanax withdrawal can last between 5 and 28 days , but protracted withdrawal symptoms can persist for months or even a year.

What Can Affect Xanax Withdrawal?

While there is a general timeline you can expect, a variety of factors can influence how long Xanax withdrawal lasts as well as the severity of withdrawal symptoms. Factors include the following: 

• Dosage: If you are taking a higher dose of Xanax, acute withdrawal symptoms may be more severe.
• Mixing Xanax with alcohol or other drugs: Mixing Xanax with other substances may cause more severe withdrawal symptoms. It will also increase the likelihood of overdose.
• How long Xanax has been used: People who have been using Xanax for longer periods may experience more serious withdrawal symptoms, given that their bodies may be more dependent on the drug.
• The person’s mental health: People who were more anxious before taking Xanax, who have other substance misuse issues, or who have other co-occurring mental health disorders may have more severe symptoms compared to those with lower initial levels of anxiety or without co-occurring conditions.
• The person’s physical health: Comorbid medical conditions could exacerbate Xanax withdrawal and make it more distressing and dangerous.
• Whether the person misused Xanax: Misusing Xanax to get high may involve taking a higher dose than prescribed, taking it without a prescription, or using it in a way other than directed, such as by crushing and snorting it or injecting it. This greatly increases the risk of severe dependence and withdrawal.
• The person’s individual physiology: Everyone’s body is different, and as such, everyone’s experience with Xanax, including effects, effectiveness, metabolism, and withdrawal, is going to be different.

Xanax Withdrawal Symptoms

Many of the symptoms of Xanax withdrawal are related to anxiety itself, as the medication is primarily used as a treatment for anxiety. Some of these symptoms are listed below: [1], [2]

• Anxiety
• Panic attacks
• Rapid pulse
• Irritability
• Problems sleeping
• Hyperventilating
• Hand tremors
• Spasms, pain, or stiffness of the muscles
• Losing weight
• Excessive sweating
• Trouble concentrating
• Mood swings

Other, non-anxiety-related symptoms generally have to do with a difference in perception compared to others. This can include auditory issues, such as hyperacusis, where normal sounds seem incredibly loud, or the feeling of viewing oneself from the outside looking in (dissociation). [1]

Dangerous Withdrawal Symptoms

In severe cases, Xanax withdrawal can cause dangerous and potentially life-threatening symptoms. These symptoms include grand mal seizures and psychosis, which manifests in the form of hallucinations or profound confusion as well as problems with memory.

Severe benzodiazepine withdrawal tends to be associated with: [1], [2]

• Taking high doses 
• Using more than one benzodiazepine
• Using shorter half-life benzodiazepines (like Xanax)
• Rapid tapering schedule
• High pretreatment depression, anxiety, and psychological distress
• Diagnosis of panic disorder
• History of drug and alcohol misuse

If you or someone you know is experiencing severe Xanax withdrawal, call 911 immediately or go to your nearest emergency room. Doctors can provide treatment and medical monitoring to ease symptoms and prevent life-threatening complications.

Treatment Options for Alprazolam Withdrawal

Xanax is one of the most potent benzodiazepines prescribed to patients. Because of this, the treatment of Xanax withdrawal should be carefully monitored and supervised by medical professionals. No one should attempt to suddenly stop taking Xanax or any benzodiazepine on their own after a period of sustained use.

Even under the supervision of medical professionals and following the recommended withdrawal procedures provided by the manufacturer itself, Xanax withdrawal symptoms are often more severe than the withdrawal symptoms associated with other benzodiazepines.

Tapered Withdrawal 

The most common way to treat Xanax withdrawal is by gradually decreasing the dose a patient is prescribed. This is known as Xanax tapering, and a doctor will create this schedule based on your current dose, your symptoms, how you respond to a lower dose, and your seizure risk. [6]

In some cases, the patient will be switched to a longer-acting benzodiazepine, such as clonazepam (Klonopin), and then gradually tapered off that medication. [4]

Medications to Help Withdrawal

While other benzodiazepines are commonly used to treat Xanax withdrawal, more research must be done to determine the specific drugs that present the best treatment.

Clonazepam is a benzodiazepine that is sometimes used to treat Xanax withdrawal because it has a much longer half-life of 17 to 60 hours. Withdrawal symptoms take longer to set in, and it’s easier to taper off this medication than Xanax. [4]

Medications that are used to prevent seizures, such as valproate, are sometimes recommended for Xanax withdrawal. Some evidence has shown gabapentin to be beneficial in managing Xanax withdrawal symptoms as well, reducing discomfort and decreasing cravings. While there are some promising results in the use of these medications, more research must be completed before they become available for widespread use. [4]

Another medication that has seen some success in the testing phase for treating Xanax withdrawal is flumazenil. Flumazenil is generally used to treat patients who have overdosed on benzodiazepines, but it has shown promise in treating Xanax withdrawal as well. While more research is needed before the drug is approved to treat withdrawal, flumazenil may reduce both acute and protracted withdrawal symptoms. [10]

The Need for Medical Supervision

No matter which withdrawal approach is recommended, people should always be under medical supervision when withdrawing from Xanax or any benzodiazepine. The best settings for Xanax withdrawal management and medical detox include:

• Acute hospital setting
• Inpatient psychiatric hospital
• Free-standing detox clinic
• Inpatient addiction treatment program offering detox services

In addition to medical support, you can also get emotional and psychological support, which increases the likelihood that you’ll safely and successfully make it through the Xanax withdrawal process and transition into long-term care and therapy.