Xanax (Alprazolam) Withdrawal: Symptoms, Timeline, & Coping

What Is Xanax Withdrawal?

Xanax is a benzodiazepine, which is a class of medications prescribed to treat anxiety.¹ Like other benzos used for anxiety treatment, Xanax can cause dependence in people who take it. Dependence is a physiological adaptation of the body to a substance, wherein the body becomes so used to the drug being present in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge.

With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms. When a person who is dependent on Xanax stops taking it or reduces their dose, they may experience withdrawal symptoms.

Taking Xanax for as little as three weeks may lead to dependence and when stopped or reduced, withdrawal.² The risk of developing dependence and subsequent withdrawal is greatest when people take more than 4 mg of Xanax per day for over 12 weeks.³

Around 60% of long-term users experience mild withdrawal symptoms and 40% experience moderate to severe withdrawal symptoms.² Xanax withdrawal can include physical symptoms like aches and pains, and psychological symptoms like anxiety, depression, and cravings.

In severe cases, Xanax withdrawal may even cause seizures.⁴ Many providers only prescribe Xanax for brief periods of time or on an as-needed basis to help calm anxiety, rather than as a daily medication. If Xanax is negatively affecting how you feel or function, and you want to stop, it is important that you talk to your provider first before stopping on your own.

Xanax Withdrawal Symptoms

Xanax withdrawal symptoms can be uncomfortable and, in some cases, may lead to medical complications, like delirium, a state of extreme confusion, and seizures.⁴ Because of the risks of Xanax withdrawal, it’s highly recommended that you don’t stop taking it on your own. Xanax withdrawal symptoms can be safely managed by developing a gradual taper with your doctor, slowly decreasing your dose over weeks or months.

Common and serious Xanax withdrawal symptoms include:^1,4

• Anxiety
• Depression
• Panic attacks
• Irritability
• Poor memory and concentration
• Cravings
• Headaches
• Sweating
• Palpitations
• Sleeping problems
• Delirium
• Hallucinations
• Seizures

When to Speak With Your Doctor

You should speak to your doctor before stopping Xanax.⁴ It is never a good idea to stop Xanax “cold turkey.” Your doctor will assist you in tapering off of the medication to help minimize your withdrawal. If you experience any severe symptoms, like extreme confusion, hallucinations, or seizures, call your doctor or 9-1-1 right away.

Can You Die From Xanax Withdrawal?

Xanax withdrawal can cause death in severe cases.⁵ However, this can be avoided by working closely with your healthcare provider on a plan to safely and gradually taper off of the medication. Severe complications like death are more likely to happen when the medication is stopped abruptly without medical support.

How Long Does Xanax Withdrawal Last?

Xanax withdrawal symptoms can last days to weeks and depend on how long the individual has been taking Xanax, the dosage of Xanax, and whether other benzodiazepine or alcohol was being used when the individual was taking Xanax. The risk of having a seizure from Xanax withdrawal is greatest one to two days after the last Xanax dose.³

Up to 25% of people who take Xanax may also experience protracted withdrawal, which are milder symptoms that persist after acute withdrawal is over.^2,6 These symptoms can include anxiety and depression and may persist for months or up to a year. They may also wax and wane over time.

What Can Lead to Xanax Withdrawal?

Xanax withdrawal can happen in anyone who regularly takes the medication for more than a few weeks. For this reason, it is important to gradually taper, rather than stop taking Xanax abruptly. People who are addicted to Xanax, or anyone who misuses Xanax are at greater risk of experiencing withdrawal.

Factors that may increase the risk of Xanax withdrawal include the following:

Xanax Addiction

People who take Xanax are at risk of developing a substance use disorder (addiction), which is a condition where a person continues to use substances even though they have negative effects on different areas of their life.⁷ A person is more likely to become addicted to Xanax if they misuse their prescription by taking more than prescribed or using it to “get high.”

Anyone with a Xanax addiction is at high risk of experiencing withdrawal if they try to stop on their own or if they’re unable to get more of the medication.

Prescription Difficulties

Having issues with getting your prescription refilled in time or running out of your medication can lead to withdrawal. Because Xanax is a short-acting medication, you should not miss doses of your medication without speaking to your doctor.³ If you experience problems filling your prescription, be sure to reach out to your healthcare provider right away to resolve the problem.

Warnings About Xanax Withdrawal

Xanax withdrawal can be dangerous because of the risks of delirium and seizures.⁴ In rare cases, it may even lead to death.⁵ The most common symptoms of Xanax withdrawal are anxiety and depression. Though most acute symptoms resolve within a few weeks, emotional symptoms may persist for months or up to a year.¹ People with a mental health disorder may have a harder time coping.

Xanax withdrawal may also pose challenges for pregnant women. Experts recommend that pregnant women gradually taper off of the medication to help avoid the infant experiencing withdrawal.⁸ Babies who are exposed to Xanax in utero may experience symptoms like irritability, fussiness, sleeping problems, and, in rare cases, seizures.

How to Cope With Withdrawal From Xanax

Even though Xanax withdrawal poses risks, you can work with your healthcare team to safely come off of the medication. Developing a taper with your doctor and finding other ways to manage anxiety, like other medications or coping skills, can help you get through the withdrawal process.

Here are strategies to help relieve and minimize symptoms of Xanax withdrawal:

Develop a plan with your doctor.

Tapering off of Xanax with the help of a healthcare provider is highly recommended for managing withdrawal symptoms.² This allows your body to gradually adjust to less of the medication over a period of time, rather than all at once. Your taper will depend on how long and how much Xanax you have been taking, but generally takes place over several weeks or months.

Consider other medications to help manage your symptoms.

There are many other medications available to help manage anxiety, such as selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant that includes Zoloft, Prozac, and Lexapro, and Buspar (buspirone).⁹ These medications are less addictive and though they can also cause withdrawal, the symptoms tend to be milder than Xanax withdrawal. Your doctor can talk to you about whether one of these medications might be right for you.

Practice self-care.

Self-care means attending to your physical and mental needs, which is important especially when coming off of a medication like Xanax. Try to eat healthy, nutritious meals, sleep at least 8 hours per night, and exercise if possible.

Avoid alcohol and drugs.

Alcohol and certain medications, like other benzos and barbiturates and alcohol, affect the body in a similar way as Xanax, which can interfere with your taper.^3,4 Mixing Xanax with alcohol and other drugs like opioids is very dangerous and can lead to an overdose. Therefore, it is important to avoid these when taking Xanax.

Use natural remedies to cope with anxiety and depression.

Finding other outlets for your anxiety is also important to help you cope during withdrawal. This may include practicing meditation, exercising, spending time in nature, or doing something creative.

Speak with a therapist.

Because Xanax withdrawal can cause symptoms like anxiety and depression, it can be beneficial to talk to a therapist while going through withdrawal. A therapist can teach you tools to cope with negative emotions and also help you develop a plan for coping with anxiety without Xanax in the future.

Questions to Ask Your Health Team About Stopping Xanax

It is important to talk to our health care team before stopping Xanax on your own. If you’re interested in stopping Xanax, you likely have questions about the process, including what to expect and how to proceed. It can help to write down your questions beforehand so you can bring them up to your provider during your appointment.

Here are seven questions to ask your care team about stopping Xanax:

1. How long should I take Xanax?
2. How should I taper off of Xanax?
3. What type of symptoms will I experience when I taper or stop taking Xanax?
4. How long will I taper?
5. What type of symptoms are dangerous and indicate that I should contact you?
6. What is my Xanax withdrawal timeline?
7. What can I do to help manage my withdrawal symptoms?

Final Thoughts

If you’ve been taking Xanax and want to stop, you may experience withdrawal. Xanax withdrawal can be dangerous, so it is important to talk to your healthcare provider before stopping on your own. With the help of your provider, you can safely and comfortably come off Xanax.