Chronic Xanax (alprazolam) use or misuse can lead to physical dependence, which means if you suddenly stop taking this benzodiazepine, you’ll experience withdrawal symptoms. They generally last 5 to 7 days, but some symptoms may persist for a month or longer.
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Xanax withdrawal symptoms may include anxiety, panic attacks, tremors, sleep problems, muscle spasms, sweating, and even dangerous symptoms like psychosis and seizures. [1], [2]
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I may have a problem I am concerned for a loved oneDependence on Xanax and other benzodiazepines can develop relatively quickly. Some people may become dependent on Xanax in as little as three to six 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. However, professional Xanax detox treatment can help keep you safe and comfortable while you detox from this benzo.
Early Xanax withdrawal symptoms can be subtle and easy to ignore. Researchers say many people experience symptoms like poor sleep or mild agitation in the first few days after they quit Xanax abruptly. If people don’t get help, these symptoms can intensify.[13]
Never stop taking Xanax abruptly. Always ask a doctor for help. If you try to quit alone and you feel unusual or sick, call your doctor immediately and ask for help.
Xanax withdrawal syndrome generally occurs in two forms: acute (or short term) and protracted (or long term). [3]
Xanax withdrawal begins shortly after taking Xanax for the last time. This can last anywhere between five 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 |
Long-term withdrawal (often called protracted withdrawal) involves symptoms that continue for weeks, months, or even up to a year. [1], [3]
Of people who use benzodiazepines like Xanax long-term may develop protracted withdrawal symptoms.
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 Xanax 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 symptoms can last between 5 and 28 days , but protracted withdrawal symptoms can persist for months or even a year.
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:
The duration of use
Benzodiazepines are sedating drugs, and they work directly on brain cells. If you’ve used them for long periods, your brain cells may be accustomed to a slow and steady pace. When you quit, they are more likely to experience a rebound of electrical activity, leading to seizures and tremors.
The drug you took
Xanax is a short-acting benzodiazepine, meaning it works and wears off fast. If you mixed Xanax with long-acting benzodiazepines (like Klonopin), your Xanax withdrawal process could last longer.
Daily dose
If you took a lot of Xanax every day, your taper process will take longer. Doctors typically reduce doses by small amounts, so bigger doses will take more time to taper.
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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]
Xanax Withdrawal Symptoms
In severe cases, Xanax withdrawal can cause dangerous and worrying 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.
Xanax is one of the most potent benzodiazepines prescribed to patients. Because of this, Xanax withdrawal should be carefully monitored and supervised by medical professionals in a professional Xanax detox setting. 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.
The most common way to treat Xanax withdrawal is by gradually decreasing the dose a patient is prescribed. This is known as Xanax tapering.
Since Xanax withdrawal can be dangerous or even life-threatening, you can’t do it alone. Instead, you’ll need help from a doctor or addiction treatment professional to move through this process in a safe, supervised manner.
Typically, a taper process begins with a conversation. You talk about how much Xanax you’re taking daily, and your doctor helps to create a tapering schedule. A common version looks like this:[11]
| Week 1 | You take your normal dose. |
| Week 2 | Your dose decreases by 25%. |
| Week 3 | You take the same decreased dose. |
| Week 4 | Your dose decreases by 25%. |
| Weeks 5-8 | You take the same decreased dose. |
| Week 9 | Your dose decreases by 25%. |
During your taper, your doctor will watch your symptoms carefully. If you develop worrisome symptoms (like tremors or intense anxiety), your taper might be moving too quickly.
At the end of the taper process, you’re not taking Xanax at all. The slow, steady withdrawal rate ensures that your brain adjusts to sobriety as carefully as possible.
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]
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.
Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More
Evidence Based
13 sources cited
Evidence Based
13 sources cited
