How To Wean Off Xanax (Alprazolam)

In our latest question and answer, the pharmacist discusses Xanax (alprazolam) withdrawal and how to safely wean off the medication.

How To Wean Off Xanax (Alprazolam)
Jun 16, 2018

Boo asked

How do I taper taking 1 mg Xanax 3 times daily for 3 months?

Answer

XanaxFor any discussion that involves how to safely discontinue a medication, such as Xanax (alprazolam), it is important to note that there is no "one-size-fits-all approach", as every situation is different and there are many factors to take into account. These include:

  • Patient medical history
  • Dose of medication you are taking
  • How long you have been taking the medication

It is important that you speak with your doctor and discuss the best weaning method for your particular situation.

Xanax (Alprazolam) Withdrawal

In regard to Xanax (alprazolam), it is classified as a benzodiazepine, which are well known to cause withdrawal and rebound symptoms. Withdrawal reactions are especially common with Xanax as it has a short duration of action and withdrawal can precipitate quickly.

Symptoms of Xanax withdrawal include:

  • Relapse or rebound of condition being treated
  • Sweating
  • Fast heart rate
  • Muscle cramps
  • Muscle tremors
  • Insomnia
  • Anxiety
  • Agitation
  • Nausea
  • Vomiting
  • Hallucinations
  • Seizures

Risk factors for Xanax withdrawal symptoms include:

  • Use over one year, although use of Xanax for as short as a few weeks has been reported to cause significant withdrawal symptoms in some individuals.
  • High doses (>4mg per day)

Xanax Weaning Methods

As mentioned at the beginning of this answer, there is no single approach that is recommended for all individuals. The method you choose to discontinue Xanax should be based on a conversation you have with your doctor.

Nevertheless, it is commonly recommended to reduce the dose of Xanax rather than extend the dosing interval, and this is especially true of Xanax. Xanax is short acting and extending the dosing interval could cause an increase in the risk of withdrawal symptoms occurring in-between doses.

A commonly utilized tapering method for Xanax is to:

  • Reduce your dose by 10% every week, and monitor yourself for withdrawal effects.
  • If withdrawal effects occur, it would be prudent to slow your taper or return to your last well tolerated dose and begin your taper again, but more cautiously, with smaller dose adjustments.

If withdrawal effects are particularly troublesome, even when utilizing a slow taper, some sources recommend switching to a longer acting benzodiazepine (such as Valium or Xanax XR), as this may reduce withdrawal symptoms in-between doses.

As your medical situation is unique to you, speak with your doctor about the best weaning method for the dose of Xanax you are taking. They may recommend a similar taper to what is discussed above or they may alter it to better suit your needs and concerns.

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