Xanax Withdrawal: Symptoms, Timeline and Detox

Withdrawal and detox from Xanax can be dangerous. People who plan to stop their Xanax use should know what withdrawal symptoms they may experience.

What Causes Xanax Withdrawal?

Xanax works by binding to specific receptors that allow brain cells to communicate with each other and pass on electrical charges, known as gamma-Aminobutyric acid (GABA) receptors. By doing so, Xanax reduces the excitability of the brain, producing a calming effect. That is why Xanax helps reduce or prevent anxiety or seizures.

When people take Xanax for even short periods, the brain tries to compensate for the calming effects of Xanax by activating fewer GABA receptors and less GABA. As a result, when people suddenly stop taking Xanax or reduce the dose too quickly, the brain rebounds and becomes hyperexcitable.

This sudden hyperexcitability produces Xanax withdrawal symptoms, including anxiety. For people who had anxiety problems before taking Xanax, this rebound anxiety can be worse. The rebound hyperexcitability of the brain can cause jitteriness, muscle tension, stiffness and seizures. Many other symptoms can occur during Xanax withdrawal.

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Withdrawal and detox from Xanax can be dangerous. People who plan to stop their Xanax use should know what withdrawal symptoms they may experience.

Xanax (generic: alprazolam) is a benzodiazepine that is often prescribed to treat anxiety and panic disorders. Xanax is known for its high addiction risk and strong withdrawal symptoms. However, it is still widely prescribed. In 2021, there were about 34.6 million Xanax prescriptions. This makes it the most-prescribed benzodiazepine today.

Physical dependence on Xanax can develop in as little as 2 weeks of daily use. By 2–4 weeks of regular use, most patients will have developed at least a mild dependence on the drug. Once the brain and body have come to depend on Xanax, withdrawal effects begin. This often happens even after missing a single dose. 

The symptoms and severity of withdrawal will vary based on dosing and duration of use. Still, Xanax withdrawal can include severe complications that are difficult to manage. Seeking professional help for Xanax withdrawal is always advised. 

Xanax Withdrawal Symptoms

Acute (immediate) Xanax withdrawal symptoms are grouped into what is known as benzodiazepine withdrawal syndrome. This condition includes many physical and psychological symptoms. People are at risk for Xanax withdrawal syndrome, even with a low dose or with a short duration of use.

The main concern when discontinuing or reducing Xanax use is seizures. These seizures are of the generalized tonic-clonic type, also known as tonic-clonic seizures, and can be fatal.

Physical Withdrawal Symptoms

When stopping Xanax, people can have various physical withdrawal symptoms. They can range from mild to severe. Some of the physical symptoms of Xanax withdrawal include:

• Profuse sweating (diaphoresis)
• Dizziness, light-headedness
• Numbness and tingling, pins and needles sensation
• Visual disturbances
• Ringing in the ears
• Muscle spasms and twitching
• Muscle pain and stiffness
• Heart palpitations
• Insomnia
• Nausea
• Loss of appetite
• Diarrhea
• Seizures

Psychological Withdrawal Symptoms

Mental withdrawal symptoms from Xanax can be quite noticeable and lead to unusual behaviors. It’s important not to go through Xanax withdrawal alone. These behaviors may put you at risk, and you might not be aware of what you are doing. Typical psychological Xanax withdrawal symptoms include:

• Xanax withdrawal depression
• Confusion, disorientation
• Delirium
• Delusions, paranoia
• Visual or auditory hallucinations
• Nightmares
• Anxiety, panic attacks
• Memory difficulties
• Agitation/irritability/aggression
• Stimulation
• Feelings of separation from reality

Symptoms of Post-Acute Withdrawal Syndrome (PAWS)

Xanax post-acute withdrawal syndrome (PAWS) refers to lingering symptoms that may persist after acute withdrawal. They often last for months if not longer. 

While PAWS is mainly associated with alcohol use disorder (AUD), it can also occur following withdrawal from other drugs.

Protracted Withdrawal Symptoms

Protracted withdrawal syndrome can impact up to one-third of people with withdrawal symptoms. This can occur after long-term use of benzodiazepines, even at low doses. The syndrome includes symptoms such as anxiety, sleep problems, and depression. These symptoms persist for an extended period, beyond the typical withdrawal timeframe.

Xanax Withdrawal Timeline

Symptoms of Xanax withdrawal emerge within a few hours after stopping the drug. These symptoms generally peak within the first 1–2 days after quitting Xanax. They may last for several days. Some symptoms may persist beyond this initial acute withdrawal phase, lasting for several weeks or months. 

Acute Xanax Withdrawal

The acute withdrawal phase begins several hours after discontinuation of the drug. It may last for 4 to 5 days. Xanax is often used for the treatment of anxiety and panic. These symptoms may reappear after discontinuation of Xanax. They are referred to as rebound symptoms. These rebound symptoms occur at a higher intensity than the pre-treatment levels. They will then return to pre-treatment levels over time. 

Besides these rebound symptoms, new symptoms are also observed during withdrawal from Xanax. These include headaches, diarrhea, nausea, visual disturbances and other such symptoms listed above. These symptoms generally recede after discontinuation of drug use. However, some symptoms may linger for longer periods.

Protracted Xanax Withdrawal

Protracted withdrawal, or post-acute withdrawal syndrome (PAWS) can make a small number of people experience lingering Xanax withdrawal symptoms. They can last weeks or even months after stopping Xanax. Symptoms of protracted Xanax withdrawal can include anxiety and depression.

Factors Affecting Withdrawal Duration

Withdrawal from Xanax is somewhat unpredictable. This is because the duration and amount of drug use do not necessarily predict how Xanax withdrawal duration will go. However, the duration and severity of Xanax withdrawal symptoms may be influenced by many factors. These include:

• The age and gender of the individual
• The general health of the individual
• The health of the liver and kidneys
• The genetic and biological makeup of the individual
• Whether there was concurrent use of other drugs
• Whether there is a co-occurring mental health disorder
• Whether the withdrawal is being medically assisted

What Causes Xanax Withdrawal?

Xanax works by binding to specific receptors called gamma-aminobutyric acid (GABA) receptors. They allow brain cells to communicate with each other and pass on electrical charges. By doing so, Xanax reduces the excitability of the brain, producing a calming effect. That is why Xanax helps reduce or prevent anxiety or seizures.

When people take Xanax for even short periods, the brain tries to compensate for the calming effects of Xanax. It does so by activating fewer GABA receptors and less GABA. When someone suddenly stops taking Xanax or reduces the dose too quickly, the brain rebounds and becomes hyperexcitable.

This sudden hyperexcitability produces Xanax withdrawal symptoms, including anxiety. For people who had anxiety problems before taking Xanax, this rebound anxiety can be worse. The brain’s rebound symptoms include jitteriness, muscle tension, stiffness and seizures. Many other symptoms can occur during Xanax withdrawal.

Xanax Withdrawal Treatment

Recovering from substance misuse, like Xanax misuse, involves detoxification. Detox is the process of removing drugs and their harmful byproducts from the body. As the body gets rid of the drugs, the brain must adapt to their absence. This is how uncomfortable withdrawal symptoms occur. 

Many people who use Xanax are aware that the drug should not be suddenly discontinued. However, they do not know how to detox from Xanax properly. Xanax withdrawal treatment, or medical detox, makes the Xanax withdrawal much safer and easier.

Medical Xanax Detox

For many people who use Xanax, the fear of withdrawal symptoms is a major barrier to getting off the drug. That fear may keep them from even trying. Fortunately, professional help is available for drug detox and withdrawal management. A medical detox program, like the one at The Recovery Village Palm Beach at Baptist Health Drug and Alcohol Rehab, allows people to go through detox safely under the supervision of medical experts.

Medical detox involves staying at a detox facility during the withdrawal period. People can receive medications to reduce uncomfortable symptoms and prevent dangerous withdrawal effects. With 24/7 medical supervision, they have help immediately available.

Medical detox also has other benefits. It enables staff to assess individuals for the physical and mental effects of their drug use. They can also identify and discuss the presence of other substance use and mental health disorders. This process allows for making a treatment and recovery plan that addresses the reasons behind the substance use.

Medical detox also allows people to connect with other people in recovery. In doing so, they benefit from the fellowship of a network of recovery.

Outpatient Detox

This approach has some drawbacks. It can be risky because severe withdrawal symptoms might happen without a proper drug taper. Also, there’s no professional support available in case of a medical emergency. And without addiction counselors, there’s no one there to help create a treatment and recovery plan.

Detoxing at Home

Benzodiazepine withdrawal syndrome can be dangerous and unpredictable. For that reason, people should take care when deciding whether to attempt a Xanax detox at home. When making the decision, individuals should do so in conjunction with their physician. They should also be forthcoming about the extent of their Xanax usage, as well as any other drug use.

The major risk in detoxing at home is being alone without help if a seizure, psychosis or delirium occurs. Even if not alone, people should ensure that others at home are aware of the withdrawal symptoms and what to do if serious side effects occur.

People who decide to detox off Xanax at home should be sure to get appropriate medical advice on how to do so.

Tapering off Xanax

Because of these concerns, weaning off Xanax is appropriate rather than sudden discontinuation. Tapering off Xanax and discontinuing the drug should only be done under a doctor’s supervision. The FDA recommends a Xanax taper by decreasing the dose by no more than 0.5 mg every three days. Tapering should be even less rapid if the drug has been used for an extended period or at high doses.

Finding a Xanax Detox Center

Finding the right detox center can be daunting. There are many options, and the terms used to describe treatment may be difficult to understand. However, there are a few points to consider in the search:

• Location
• Cost
• Effectiveness
• Staff-to-patient ratio

The location should be a primary consideration because some people may want to detox close to their homes. However, other people may wish for a fresh environment that will allow them to better focus on their health and healing. 

Cost is another important consideration. People should check if facilities accept their insurance plans or can work with them to establish a payment plan.

If you struggle with Xanax addiction, contact The Recovery Village Palm Beach at Baptist Health Drug and Alcohol Rehab. Our Recovery Advocates can discuss how professional addiction treatment can help you achieve the healthier future you deserve. Take the first step toward that healthier future by calling today.

Common Questions About Xanax Withdrawal

How long does Xanax stay in your system?

Xanax is rapidly absorbed into the bloodstream and reaches its peak concentration one to two hours after intake. Xanax or alprazolam is primarily metabolized by the liver and eliminated through urine. Xanax has a plasma half-life of around 11.5 hours. This is the time required to reduce the amount of drug in the plasma to half.

Xanax has a shorter half-life than other benzodiazepines like diazepam. In fact, it is categorized as a short-acting benzodiazepine. Due to its shorter half-life, Xanax tends to have more severe withdrawal symptoms. However, these symptoms last for a shorter duration relative to long-acting benzodiazepines.

Can Xanax withdrawal kill you?

A case report discussed the death of a woman after having Xanax withdrawal seizures. However, she had been taking massive doses. She took 200 mg in six days, and the maximum safe dose in six days is less than 24 mg. The woman stopped Xanax use after running out of her supply of the drug.

The danger of Xanax withdrawal death lies in the seizures if they occur. The type of seizures seen with Xanax withdrawal can be deadly, especially in people who are alone when a seizure happens.

What medications are used in Xanax detox?

Tapering using benzodiazepines is the mainstay method for Xanax detox. 

People who are addicted to substances tend to overestimate their ability to control their drug use. For this reason, they may try to taper themselves off the drug. However, experience has shown that this method seldom works. After all, one of the core characteristics of addiction is an inability to control substance use.

The medication clonidine is occasionally used to reduce withdrawal symptoms during detox. However, clonidine may not be especially useful for benzodiazepine detox. Its key benefit is reducing blood pressure.

The muscle relaxant baclofen may be helpful for short-term use in benzodiazepine detox.

The medication trazodone is periodically used for treating insomnia during Xanax withdrawal. It works differently than benzodiazepines do, so it is not affected by benzodiazepine tolerance.

Various non-benzodiazepine anti-seizure medications may be useful for preventing withdrawal seizures as well.

Beta-blocker medications like propranolol are used to treat high blood pressure, heart attacks and other heart problems. However, they are also sometimes used to reduce the physical Xanax withdrawal symptoms.

What alternative treatments are available for Xanax withdrawal?

Alternative therapies can be useful, especially for anxiety symptoms that return after stopping Xanax use. These therapies are part of a holistic treatment approach. This means focusing on treating the whole person, not just the disease.

Some drugs and chemicals are marketed as “natural” Xanax withdrawal treatment. Before trying these remedies, it is always a good idea to check with a physician or pharmacist first.

Can I quit Xanax cold turkey?

Xanax withdrawal dangers greatly increase if the drug is abruptly stopped. Risks include serious withdrawal effects, such as seizures, psychosis and delirium. Even if you’re using Xanax without a prescription, you should consult with a doctor. They can help you taper off the drug and avoid going into sudden withdrawal.

How can I cope with Xanax withdrawal symptoms?

Xanax is a benzodiazepine with a short half-life. It causes more severe withdrawal symptoms than observed with long-acting benzodiazepines. Abrupt cessation of Xanax use results in very severe withdrawal symptoms. 

Instead, you should change from Xanax to a long-acting benzodiazepine like diazepam. Then, you can gradually reduce or taper the dose. This is considered the best method to avoid withdrawal. Withdrawal symptoms will be less intense and there is a lower chance of seizures.

Other remedies for Xanax withdrawal involve medications for its specific symptoms. For example, they could be for muscle cramps, insomnia or nausea. Exercise and relaxation techniques like yoga and meditation can help in coping with the Xanax withdrawal symptoms.

Can I detox from Xanax alone at home?

The symptoms of Xanax withdrawal are severe and can be life-threatening. This is because seizures and psychotic episodes are possible. Psychotic episodes may result in agitation and distress. This could then lead someone to harm others or themselves. For this reason, detoxification at home is not recommended. However, if you decide to detox at home, enlist the help of a family member or friend.

Quitting Xanax cold turkey means abruptly discontinuing Xanax use. This process can lead to severe withdrawal symptoms. The dose of Xanax must be gradually tapered over several weeks or longer. A doctor can help set up a taper schedule and advise you about medications for coping with withdrawal symptoms. Detoxification must be undertaken in a calm and safe environment. Call 911 immediately if seizures or other life-threatening symptoms occur.

Get Help with Xanax Withdrawal Today

Xanax withdrawal is not something you should try to face alone. Withdrawal symptoms can cause severe discomfort, even if you have only been taking Xanax for a few weeks. The risk for relapse is high during withdrawal. A supportive home environment can tremendously aid recovery. However, it can only take you so far. If you or a loved one would like to explore options for Xanax addiction treatment, our Recovery Advocates are available to assist you 24/7.

If you are ready to take your life back from Xanax, The Recovery Village at Baptist Health is here to help. From detox to aftercare, our addiction experts will provide you with an evidence-based treatment plan that fits your unique situation. We’re here for the first step, and our mission is to help see you through to a Xanax-free life.