Benzodiazepines are a class of prescription drugs with sedating properties that stem from their ability to increase the activity of the inhibitory neurotransmitter known as GABA.
One of the most popular of these medications is Xanax, or alprazolam in its generic form, used in the management of panic and anxiety disorders. Xanax is commonly abused because, in addition to its sedative effects, its use is associated with increased dopamine release in the reward pathways of our brains.
Understanding Xanax Withdrawal
The experience of Xanax detoxification and withdrawal can be unpleasant, but it is a necessary step that paves the way for long-term healing.
Xanax has a half-life of about 11 hours, meaning that it takes about 50 hours for the body to remove it altogether. This may seem like a long time, but Xanax has one of the shortest half-lives compared to other benzodiazepines. Therefore, withdrawal symptoms can set in more quickly compared to similar drugs.
To stop taking the drug, Xanax use should usually be tapered for safety. Stopping “cold turkey” can lead to severe side effects like seizures and can be fatal.
Physical Withdrawal Symptoms of Xanax
Xanax withdrawal symptoms can take hold within hours of the last dose, and they can peak in severity within 1-4 days. During withdrawal, people can experience:
- Blurred vision
- Muscle pain
- Numb fingers
- Sensitivity to light and sound
- Loss of appetite
- Heart palpitations
Psychological Withdrawal Symptoms
The psychological symptoms of benzodiazepine withdrawal can be significant, as anxiety, panic, and paranoia may increase with the drug’s removal from the body. Depression and thoughts of suicide should also be closely watched for during benzodiazepine withdrawal. Xanax withdrawal can leave people feeling generally “out of sorts,” unable to control their emotions, irritable, and jumpy. Mood swings, nightmares, difficulty concentrating, short-term memory loss, and hallucinations are also possible side effects of Xanax withdrawal. Support from mental health professionals can be very beneficial, and therapy and counseling may help an individual control and manage the emotional symptoms of benzo withdrawal.
Those who have been prescribed Xanax for generalized anxiety disorder, panic disorder, or insomnia can experience rebound symptoms after quitting the use of the drug. Rebound effects are intensified symptoms of a pre-existing psychological disorder and may include anxiety, panic attacks, and inability to sleep. These rebound symptoms usually fade away after about a week, but the underlying disorder often requires specialized treatment.
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How Long Can Withdrawal Last?
Xanax is considered a short-acting benzodiazepine, with an average half-life of 11 hours, the FDA states. As soon as the drug stops being active in the plasma of the blood, usually 6-12 hours after the last dose, withdrawal symptoms can start.
For shorter-acting benzos like Xanax, acute withdrawal symptoms usually begin within 6-8 hours, peak around the second day, and resolve within 4-5 days. Protracted, or post-acute symptoms, may last for weeks or months. These lasting symptoms may lead to relapse if not addressed with continued treatment, such as regular therapy.
Some people may experience protracted withdrawal, however, which can include psychiatric symptoms and drug cravings. This protracted withdrawal can last for several weeks, months, or even years without being addressed by a mental health professional.
Factors That Affect Xanax Withdrawal
Xanax is a short-acting benzodiazepine, so its effects are felt sooner and are over quicker than most Benzos. Withdrawal starts as soon as the body and brain are deprived of the drug. Therefore, withdrawal can start in as little as a few hours and usually last for little more than a week.
A number of factors influence how long Xanax withdrawal takes. These include:
- The length of time the user took Xanax
- The average dose they regularly took
- How frequently Xanax is used
- Whether or not they combined Xanax with alcohol or other drugs
- The user’s mental health and medical history
In some cases, symptoms of Xanax withdrawal may appear up to two years after giving the drug up. This phenomenon is known as Post-Acute Withdrawal Syndrome (PAWS), or protracted withdrawal. Symptoms of PAWS are apparent for up to 18-24 months after detox. They slowly decrease in severity and frequency throughout the recovery process.
Common symptoms of PAWS for Xanax include:
- Persistent anxiety
- Chronic insomnia
- Aches and pains
- Difficulty performing complex tasks
- Poor concentration
- Sexual problems
|Xanax Withdrawal Timeline
|6 – 12 hours
|Within six hours, the effects of Xanax wear off and the effects of withdrawal start taking over. As the body is starved of the drug, users start experiencing anxiety and irritability that often gets worse throughout the withdrawal period.
|Days 1 – 4
|The symptoms of withdrawal are most intense within the first days. Rebound anxiety and insomnia are at their peak. Other symptoms, such as shaking, muscle pain, and sweating, are also common. After the fourth day, patients will begin to see an improvement in their symptoms.
|Days 7 – 14
|Withdrawal symptoms can last for up to two weeks after stopping use. At this point, the worst is over, and symptoms of withdrawal tend to be less severe. Anxiety and insomnia may still persist.
|Any lingering symptoms should be mild. For some, protracted withdrawal symptoms may begin suddenly, even if the initial symptoms are completely gone. Protracted withdrawal symptoms tend to fluctuate and can last up to two years.
Withdrawal can be safely controlled and side effects reduced with a slow and controlled tapering schedule set up by a professional. By gradually lowering the amount of Xanax taken over a safe period of time, the more severe withdrawal symptoms may be largely avoided. At times, a longer-acting benzodiazepine, like Valium (diazepam), may be substituted for Xanax during detox. By keeping a small amount of benzo in the bloodstream, drug cravings and withdrawal may be controlled for a period of time until the drug is weaned out of the system completely. Adjunct medications like antidepressants, beta-blockers, or other pharmaceuticals may be effective in treating specific symptoms of Xanax withdrawal.