Xanax Withdrawal Symptoms, Timeline, and How to Get Help
Written by The Recovery Village
& Medically Reviewed by Dr. Kevin Wandler, MD
Medically Reviewed
Last updated: 12/01/2024
Key Takeaways
- Xanax, known generically as alprazolam, is used to manage anxiety and panic disorders but carries a risk of dependency and withdrawal.
- Physical dependence on Xanax can lead to tolerance and withdrawal symptoms like tremors and seizures, while psychological dependence involves a perceived need to cope with stress.
- Withdrawal symptoms typically begin within 6-12 hours after the last dose, peaking around the second day and can persist for weeks or months.
- Medical detoxification with a gradual tapering of the dosage is recommended to mitigate withdrawal symptoms and ensure safety.
- Effective treatment for Xanax addiction requires a comprehensive approach, including medical detoxification, therapy, counseling and sometimes medication.
- Therapy and counseling, particularly cognitive-behavioral therapy (CBT), are effective in addressing the psychological aspects of Xanax dependence.
- The withdrawal timeline is highly individualized, with factors such as dosage, duration of use and individual physiology affecting the duration and severity of symptoms.
- Medical professionals may use a pharmacological approach to manage withdrawal symptoms, including prescribing long-acting benzodiazepines or other supportive medications.
What Xanax is Mainly Used For
Xanax, generically known as alprazolam, is a medication primarily used to manage anxiety and panic disorders. It belongs to the class of drugs known as benzodiazepines, which act on the central nervous system to produce a calming effect.
The medicine is indicated for the short-term relief of symptoms of anxiety and for the treatment of panic disorders, with or without agoraphobia. It may also be prescribed for anxiety associated with depression and in the management of anxiety disorders. However, due to its potent effects and the potential for abuse, it is important to use Xanax under strict medical supervision.
How Xanax Works
Xanax works by enhancing the effects of a natural chemical in the body (GABA), helping to reduce nervous tension and anxiety. While it is one of the most commonly prescribed psychotropic medications in the U.S., it also carries the risk of dependency and withdrawal symptoms, especially when used for extended periods or misused.
Patients with a history of substance use disorder or those taking other medications that depress the central nervous system, such as opioids or alcohol, should exercise caution when using Xanax.
Physical and Psychological Facets of Xanax Addiction
Xanax dependence is a multifaceted condition characterized by both physical and psychological elements. Physically, the body adapts to the presence of Xanax, leading to tolerance and withdrawal symptoms when usage is reduced or stopped. Psychological dependence involves a perceived need for Xanax to cope with stress, anxiety, or other emotional states, even in the absence of physical withdrawal symptoms.
The development of dependence on Xanax is influenced by its impact on brain chemistry, specifically the potent calming effects it produces by enhancing the action of neurotransmitters that inhibit brain activity. The short duration of action and rapid relief of anxiety symptoms contribute to its potential for abuse. As tolerance builds, individuals may find themselves needing larger doses to achieve the same level of calm, leading to a cycle of increased use and dependency.
Physical Dependence and Tolerance
Physical dependence on Xanax develops as the body adapts to the presence of the drug, leading to tolerance and withdrawal symptoms when use is reduced or stopped. Tolerance occurs when the initial dose of Xanax becomes less effective over time, prompting the need for higher doses to achieve the same therapeutic effects.
Psychological Dependence
Psychological dependence on Xanax involves a complex interplay between brain chemistry and emotional well-being. This dependence is often characterized by intense cravings and a preoccupation with obtaining and using the drug, which can overshadow other aspects of an individual’s life. Research indicates that the brain’s reward system may become hijacked as Xanax use continues, leading to a cycle of misuse.
Xanax Withdrawal Symptoms
Xanax withdrawal is a challenging process that can manifest with a variety of symptoms, which are both physical and psychological in nature. The onset of withdrawal symptoms typically begins within 6-12 hours after the last dose, peaking around the second day and may persist for weeks or even months, depending on individual factors and the duration of use.
Given the complexity and potential danger of Xanax withdrawal, seeking professional medical help is imperative for a safe detox process. The Recovery Village offers comprehensive treatment plans tailored to individual needs, ensuring both safety and comfort during the withdrawal phase.
Physical Manifestations
Common physical withdrawal symptoms include insomnia, fever, digestive disturbances, weight loss and sensory hypersensitivity. These symptoms can begin as early as 6-12 hours after the last dose and may peak around the second day.
Additional symptoms often reported are sweating, tension headaches, muscle aches and cramps. More severe manifestations can include tremors, seizures and heart palpitations, emphasizing the need for medical supervision during detox. The intensity and duration of these symptoms can vary based on factors such as the duration of use, dosage and individual health conditions.
During the first few days post-cessation, individuals may experience flu-like symptoms such as muscle aches, sweating, nausea and loss of appetite. Other physical symptoms might include shaking, headaches, blurred vision, diarrhea and vomiting.
Psychological Symptoms
The psychological symptoms often begin within hours to a few days after the last dose and can persist for months, with some individuals experiencing Post-Acute Withdrawal Syndrome (PAWS) long after cessation. Common psychological symptoms include:
- Intense anxiety and panic attacks
- Depression and mood swings
- Concentration difficulties and memory issues
- Sleep disturbances such as insomnia
- Mood instability
- Hypersensitivity to sensory input
- Delusions or hallucinations in severe cases
- Suicidal ideation
The Xanax Withdrawal Process
Generally, withdrawal symptoms can begin to manifest within 6 to 12 hours after the last dose, with the first 24 to 72 hours being particularly intense. The acute symptoms typically peak around the second day, and it is during this time that medical intervention is often most critical.
Following the initial phase, patients may experience a second phase of withdrawal that lasts from 10 to 14 days. This period is characterized by continued but gradually lessening symptoms, often called the ‘acute withdrawal phase.’
PAWS may follow, with symptoms persisting or reemerging weeks after cessation. These symptoms can fluctuate in intensity and may include cognitive difficulties, mood swings and prolonged anxiety.
Initial Symptoms and Onset
The initial signs can include a range of discomforts, such as headaches, insomnia, anxiety, restlessness and intense cravings for Xanax. It is crucial to note that abrupt cessation of Xanax can lead to severe and potentially dangerous withdrawal symptoms. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides guidelines for safely managing withdrawal from substances like Xanax.
Common early withdrawal symptoms encompass both physical and psychological aspects. Additionally, individuals may experience memory issues and concentration difficulties. These early symptoms typically peak around the second day and are an indication of the body beginning to adjust to the absence of the medication.
Given the severity and potential complications associated with Xanax withdrawal, it is often recommended to undergo a medically supervised tapering process. This approach helps to mitigate the risks of severe withdrawal and ensures a safer transition towards recovery.
Middle Stage: Symptoms and Complications
The middle stage of Xanax withdrawal is a critical period characterized by the peak intensity of symptoms and potential complications. During this time, individuals may face psychological symptoms like depression and cravings, which can be distressing and challenging to manage. Typically, this acute phase begins around the second day after the last dose and can last for up to two weeks.
- Anxiety and panic attacks: Heightened anxiety is a hallmark of this stage, often leading to panic attacks.
- Physical symptoms: Tremors, muscle spasms and aches, as well as sleep disturbances, are common.
- Sensory hypersensitivity: Individuals may experience an increased sensitivity to light, sound, or touch.
- Medical complications: Serious health risks like seizures and heart complications necessitate medical oversight.
Late Stage: Toward Long-Term Recovery
The late stage of Xanax withdrawal is characterized by a significant reduction in the intensity of symptoms, marking the transition toward long-term recovery. Some individuals may experience protracted withdrawal symptoms that can persist for several months. These may include ongoing anxiety, depression and sleep disturbances.
For many, the late stage of withdrawal is a time when the body and mind gradually return to a state of equilibrium. Medical supervision remains important, as the risk of relapse is still present. Engaging in therapy and counseling can provide the necessary tools to manage any lingering psychological effects and reinforce coping strategies for stress and triggers.
How to Treat Xanax Withdrawal
Managing Xanax withdrawal requires a comprehensive approach due to the potential severity of symptoms and complications associated with benzodiazepine discontinuation. Medical detoxification is another critical component of Xanax withdrawal treatment.
Personalized therapy, including cognitive-behavioral therapy (CBT), can address underlying mental health issues and aid in recovery. Holistic treatments, such as yoga and meditation, may complement traditional therapies, supporting overall well-being.
Medical Detoxification
Medical detoxification is a critical initial step in the process of recovering from Xanax dependence. The primary goal of medical detox is to safely remove the drug from the body while effectively managing the acute physical and psychological withdrawal symptoms that can arise.
Under medical supervision, detox often involves a gradual tapering off of Xanax to minimize withdrawal severity. The World Health Organization (WHO) recommends a tapered discontinuation schedule, often substituting Xanax with a longer-acting benzodiazepine like Valium (diazepam) to stabilize the individual during the process.
Healthcare professionals monitor the patient’s vital signs and provide support to ensure safety throughout the detox process. Attempting to detox without medical assistance can be hazardous and potentially fatal due to the risk of severe withdrawal symptoms like grand mal seizures.
Therapy and Counseling
Studies have shown that incorporating supportive therapy with a gradual tapering strategy can significantly increase the chances of successful withdrawal. Effective therapeutic approaches may include CBT, which helps patients develop coping strategies for managing cravings and negative thought patterns and supportive therapy, which provides a comforting environment for individuals to process their experiences and emotions.
Additionally, therapy can help address any underlying mental health issues, such as anxiety or depression, which may have contributed to Xanax dependence in the first place. Given the potential severity of withdrawal symptoms, it is crucial that therapy and counseling are delivered by qualified mental health professionals within a structured treatment program.
Pharmacological Management
In some cases, doctors may prescribe certain medications off-label to manage specific symptoms or complications during the withdrawal phase. While there is no universally accepted standard medication for benzodiazepine withdrawal, potential pharmacological aids include:
- Long-acting benzodiazepines to reduce the intensity of withdrawal symptoms.
- Anticonvulsants for seizure prevention.
- Antidepressants to manage mood disturbances.
- Non-benzodiazepine sleep aids to address insomnia.
- Supplements like valerian and melatonin, which may offer some relief, although research on their efficacy is mixed.
Ready to Kick the Xanax Habit? We’re Help You Get Your Life Back On Track
If you’re seeking addiction treatment for yourself or a loved one, The Recovery Village Cherry Hill at Cooper is here to help. Our facility is conveniently located within the heart of New Jersey, under 20 minutes from Philadelphia. We have a full range of treatment options, including medical detox, inpatient care, partial hospitalization programming and intensive outpatient services. We offer a state-of-the-art inpatient facility and have specialized options for trauma, including EMDR and a specialty track for veterans and first responders.
If you or a loved one are ready to begin the journey toward a substance-free life, we’re standing by to take your call. Reach out to our Recovery Advocates to learn more about our treatment programs and find a plan that works well for your specific needs and situation.
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