Alprazolam Withdrawal

Alprazolam Withdrawal

Alprazolam (Xanax) is a benzodiazepine drug that is prescribed for the treatment of anxiety disorders and panic attacks. 1 Benzodiazepines such as alprazolam increase the effects of GABA, an inhibitory neurotransmitter. 2 In this manner, the drug slows down activity in the central nervous system and produces a calming effect.

Long-term use of alprazolam can lead to dependence. The brain adapts to the presence of alprazolam, and its GABA modulating effects become less pronounced over time (tolerance). The user may then require larger and larger doses to try to experience the drug’s full effects. When the person stops using or reduces their dose, the brain “rebounds” and goes into an overexcited state, leading to withdrawal symptoms. 3,4

Medical treatment is available to manage many of the unpleasant effects of alprazolam withdrawal. Medications can be used to ease troublesome symptoms and help the person safely and comfortably detox from the drug. Physicians can also prescribe a tapering schedule to help users slowly reduce their dose, further minimizing withdrawal symptoms.

Alprazolam Withdrawal Symptoms

Xanax withdrawal symptoms can develop within 24 hours of the last dose and peak within 1 to 5 days. Higher doses and longer use increase the likelihood and severity of the symptoms. 4

Symptoms include:

  • Rapid heart rate.
  • High blood pressure.
  • Anxiety.
  • Insomnia.
  • Irritability.
  • Tremor.
  • Nausea.
  • Seizures.4

Other factors that can increase the severity of withdrawal symptoms include having a psychiatric disorder, abusing alprazolam with alcohol, and having a family history of alcoholism. Elderly and female patients are also at increased risk of experiencing more severe withdrawal. 4

Learn more about alprazolam withdrawal symptoms.

Withdrawing from Alprazolam: Options for Help

Detoxification, or detox, refers to the process of eliminating substances such as alprazolam from the body. Detoxification may take place at detox centers, residential rehabilitation centers, and outpatient detox programs.

  • Detox centers and inpatient programs provide 24/7 medical monitoring and support. Healthcare providers can treat physical or psychological symptoms and help the person avoid serious complications. A common detox method is to slowly lower the dose of alprazolam (tapering). Physicians can also prescribe longer-acting benzodiazepines such as clonazepam (Klonopin) or diazepam (Valium) to reduce or eliminate symptoms and then taper these slowly.
  • Outpatient detoxification is an option for milder alprazolam withdrawal. Physicians can administer slower-acting substitute medications or taper alprazolam on an outpatient basis. Outpatient detox allows people to continue their day-to-day activities while they receive withdrawal treatment.

Treatment for Alprazolam after Detox

Alprazolam withdrawal treatment is the first step in the addiction rehabilitation process. Once the person has completed detox, counseling and therapy are often necessary to identify and address the factors that led to alprazolam abuse.

  • Inpatient rehab programs can include cognitive behavioral therapy, individual and group therapy, family therapy, and alternative treatments such as art and music therapy, meditation, and exercise. Inpatient rehab can range from 28-90 days, and the person lives at the treatment center while they complete the program.
  • Outpatient rehab programs can serve as a primary treatment for addiction or offer continued support for people who have completed inpatient rehab. These programs offer many of the same types of therapy as inpatient programs, but the person does not live at the treatment center.
  • Peer support groups, such as those based on the 12-step method, can also serve as a primary treatment or offer ongoing support. People who are recovering from alprazolam addiction can participate in these peer support groups for as long as they feel the need to do so. Pills Anonymous is one such group focused on prescription drug abuse.
Alprazolam Information at a Glance
Medication Name, Costs Class of Medicine
Generic Name: Alprazolam
Brand Name: Xanax, Xanax XR, Niravam 3
Cost/Price: $0.08-$8/tablet 1
Used to Treat Addiction? No
Function or Use at Low Dose: Treat anxiety disorder and panic disorder 1,2
Duration of Action: Several hours
Form, Intake, and Dosage Interactions and Complications
Drug Forms: Pill, capsule
Administration Routes: Orally administered
Dosage: For anxiety: 0.25 mg-0.5 mg, 3 times a day, which may be increased to a maximum daily dose of 4 mg; 0.5 mg-1 mg once a day (XR) 2
Overdose symptoms: confusion, coma, impaired coordination, sleepiness, and slowed reaction time 1
Alcohol Interaction: Can cause overdose and death 2
Prescription or illicit opioid interaction: Slowed or stopped breathing and possible death 3
Contraindications: Glaucoma, concurrent use of ketoconazole, itraconazole 2
Effects and Adverse Reactions Substance Abuse
Short-Term: Drowsiness, light-headedness, headache, insomnia, diarrhea, dry mouth, constipation 2
Long-Term: Depression, confusion, palpitations, addiction 2
Risk of Substance Abuse: High
Signs of Abuse: Anxiety, confusion, depression, mood swings 2
Physiological Problem Signs and Symptoms Dependence and Addiction Issues
Withdrawal Syndrome Onset: 6-8 hours after last dose 5
Withdrawal Symptoms: Muscle cramps, vomiting, insomnia, sweating, tremors, agitation, convulsions 2
Tolerance: Users may develop tolerance
Psychological Dependence: High
Legal Schedules and Ratings
Controlled Substances Act Rating: Schedule IV 2,4

 

Frequently asked questions

  • The amount of time someone will experience withdrawal symptoms varies depending on the duration of use and how much alprazolam the person was using. However, the average withdrawal symptom timeline is 4-5 days. 4,5

  • Detoxing from alprazolam on your own or using alternative or home remedies is not recommended. Alprazolam withdrawal can be dangerous and even life-threatening. The best chance for lasting success is to attend a rehab facility or detox program.

  • Alprazolam can remain in a person’s system for 4-5 days or longer. Some withdrawal symptoms, such as seizures, can be dangerous and may need to be closely monitored throughout detoxification.

 

[1]. Food and Drug Administration. (2011). Xanax.

[2]. McGill University. Anxiety Neurotransmitters.

[3]. Longo, L.P. (2000). Addiction: Part I. Benzodiazepines-Side Effects, Abuse Risk and AlternativesAmerican Family Physician, 61(7), 2121-2128.

[4]. Herron, A. and Brennan, T.K. (2015). The ASAM Essentials of Addiction Medicine: Second Edition. Wolters Kluwer.

[5]. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Alprazolam Information at a Glance: Sources

[1]. Drug Bank. (2016). Alprazolam.

[2]. Food and Drug Administration. (2011). Xanax.

[3]. National Library of Medicine: Medline. (2016). Alprazolam.

[4]. Drug Enforcement Administration. Drug Schedules.

[5]. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.