Healthy Living

Xanax: Side Effects, Withdrawal Symptoms, & the Safe Way to Get Off the Drug

Xanax: Side Effects, Withdrawal Symptoms, & the Safe Way to Get Off the Drug

Xanax is a medication used to treat patients suffering from panic disorders, anxiety, and depression due to anxiety. Xanax is a part of the drug family or class benzodiazepines.

Effects of this drug usually start within twenty-five minutes of taking it and provide relief for up to a few hours.

Before taking this medicine

Inform the doctor if you have any of the below details before Xanax is prescribed:

  • If you are suffering from narrow angle glaucoma
  • If you are pregnant
  • If you are allergic to Xanax or any similar drugs such as Ativan, tranxene, serax, and all others from the same drug class.
  • Epilepsy or convulsions
  • History of drug abuse or addiction to alcohol
  • History of depression or any suicidal behavior
  • Disease of the liver or kidney
  • Any breathing problem such as asthma
  • If there is any usage of narcotic medicine

Dosage and storage

Xanax should be taken exactly as prescribed by the doctor. All the directions should be followed as per the prescription. It is not to be taken in larger amounts or for a period longer than prescribed. Xanax should not be crushed, chewed, or broken into pieces. The tablet should be taken orally as a whole. If the medicine does not work as it should, immediately call your doctor. Xanax should be stored at normal room temperature and kept away from heat and moisture.

If the person is suffering from anxiety, the initial dose will be between 0.25 mg and 0.5 mg, three times a day. Gradually, the dose will be increased by the doctor if needed. The maximum daily dose the doctor will recommend is 4mg, which will be divided during the course of the day.  For a person who suffers from panic attacks, the initial dose will be 0.5 mg, taken orally as whole, three times a day. This limit will gradually increase every three to four days as required. For the extended release tablets, the initial dose starts from 0.5 mg to 1mg once a day, and will be gradually increased by not more than 1 mg, if needed by the patient. This will be supervised by the doctor. In cases of persons suffering from depression, the dose starts at 0.5mg. This is to be taken orally three times a day. This dose will gradually be increased to 1 mg at the most every three to four days. The maximum oral dose a person will be prescribed is 4.5 mg.

Since Xanax can cause severe withdrawal symptoms if stopped abruptly, it would be best to check with the doctor on how one can safely stop taking this medication. Do not suddenly stop using this medicine.

Xanax is a medicine that, if taken in larger doses or more frequently than prescribed, can become a habit. Any of the habit-forming drugs, if misused, can cause addiction, and even an overdose at times, and thus can lead to death. This medication should be stored in a safe place away from anyone else’s reach. Also, check on the dosage every time you take it.

If you miss a particular dose, make sure to take it as soon as you remember. However, if it is close to the next scheduled dose, forego taking the missed dose, since it can cause an overdose. In case the individual has overdosed on the medicine, urgently seek medical attention. Some of the symptoms of overdose are weakness in the muscles, loss of coordination, drowsiness, a feeling of confusion, and fainting.

Xanax has the side effect of impairing your thinking and reactions; hence, be careful if you are driving or carrying out any work that requires mental alertness. Avoid drinking alcohol.

Side effects of Xanax

If you experience any signs of an allergic reaction after taking Xanax, inform your doctor as soon as possible.
The symptoms of an allergic reaction are:

  • Difficulties in breathing
  • Swelling of the face, tongue, lips, and throat

Common side effects of Xanax are:

  • Tiredness and drowsiness
  • Early morning anxiety
  • Insomnia
  • Fatigue
  • Sudden changes in weight
  • Constipation
  • Muscle twitching
  • Lack of balance
  • Memory problems
  • Slurred speech

Meanwhile, you should notify your doctor if you experience any of the major side effects below:

  • Irregular or pounding heartbeat 
  • Convulsion
  • Hallucination
  • Feelings of hostility
  • Sudden change in behavior, including risk-taking behavior
  • Racing thoughts, displaying more energy than needed or usual
  • Suicidal thoughts
  • Constant depressed mood
  • Feelings of confusion
  • Anxiety, including getting very anxious all of a sudden

Drug Interactions

This drug may have serious repercussions if taken with other drugs. It could cause you to feel drowsy or have problems in breathing, or it could lead to death. Inform your doctor about all the medications you are currently and have been taking, so he can tell you whether any of them needs to be stopped or the dosages need to be modified. Inform the doctor especially in case you are taking any of the below:

  • Cimetidine
  • Digoxin
  • Fluvoxamine
  • Nefazodone
  • Ritonavir or other medicines used in treating HIV or AIDS
  • Antifungal medicine - fluconazole, voriconazole.

Risk factors

Xanax is designed for short-term use since it has a high potential for addiction if used for longer than the prescribed duration.

This drug can be dangerous if taken during pregnancy. It can cause serious birth defects. Also, since this is a habit-forming drug, there are chances the baby would become dependent on the drug. If you have been taking Xanax while pregnant and suddenly stop, the baby will have severe withdrawal symptoms. Hence, one must inform the doctor that one is pregnant so an alternative can be prescribed. Also, if you are planning to get pregnant, you will need to postpone your plan and take an effective birth control pill until the Xanax treatment is completed.

Lactating mothers should also be very careful while taking this medicine. Xanax medication can harm the nursing baby since it can get into the breast milk of the lactating mother. Hence, consult your doctor and let him know that you are breastfeeding so he can be careful before prescribing the medicine and its dosage.

In case of elderly patients, the use of Xanax should be strictly as ordered by the doctor. Ensure compliance with the dosage. Since the sedative effects last longer when it comes to older adults, accidental falls are quiet common in those older adults who use Xanax.

During the course of Xanax, one should not drink alcohol. The alcohol effects multiply if Xanax is simultaneously taken.

Xanax is not approved for use by an individual younger than 18 years old.

An individual would experience the below signs and symptoms if they are addicted to Xanax:

Mood swings, anxiety, getting very agitated, restlessness, rage, getting very hostile, risky behavior, change in appetite, decreased urination, slurred speech, heart palpitations, sweating, puffy nose, tremors, dry mouth, feelings of confusion, memory loss problems, hallucinations.

Xanax withdrawal symptoms

Withdrawal is unique for every individual. The withdrawal timeline may be affected by several factors. The more dependent the body is on Xanax, the more intense and longer the withdrawal symptoms are. A variety of things contribute to how strong the dependence is: age at which the first dose of Xanax was taken, amount of dosage, length of using or abusing Xanax, whether Xanax is taken with other drugs or medications, method of ingestion, and use of alcohol along with Xanax. Apart from these the family history of the individual, any prior history of addiction to this drug, any mental health issues, the person’s medical history, health complications, and environmental factors also affect the duration of the withdrawal symptoms.

Withdrawing from Xanax when already addicted can be dangerous; hence, it should be done under the supervision of a medical professional. Also, the environment for the withdrawal process should be safe so that the person does not get more aggressive. The process of detoxification slowly reduces the amount of Xanax in an individual’s body, which in turn minimizes the chances of life-threatening withdrawal symptoms.

Benzodiazepines produce calming effects to specific sites on the GABA receptors, which are located in the brain. After continuous use of Xanax for a long duration, it can cause certain changes to the GABA receptors and make them less susceptible to stimulation. As time passes, the individual builds up tolerance for this medication, requiring more of it to produce the initial effects. Withdrawal in an individual starts when the medication leaves the bloodstream when the person has not had the medicine for long enough. The brain struggles to find order and balance. Thus, withdrawal should be strictly done under the guidance of a professional doctor so that any untoward incidents can be avoided.

Xanax has the ability to lower one's heart rate, temperature, and blood pressure. It also minimizes anxiety, stress, and panic attacks. Xanax also has the ability to reduce epileptic seizures. If it is suddenly stopped, these functions rebound. Within 6 to 12 hours of the last dose, the person will start experiencing withdrawal symptoms lasting for one to two days. Acute withdrawal symptoms come next and will last from a few days to a month.

The individual’s temperature, blood pressure, and heart rate may suddenly rise. The individual may experience seizures, which can lead to a coma or death in extreme cases. Below are the physical symptoms of Xanax withdrawal:

  • Sudden loss of weight
  • Vision seems blurry
  • Headaches
  • The individual has trouble sleeping
  • Profuse sweating
  • Muscle pain
  • Feelings of nervousness 
  • Insomnia
  • Diarrhea
  • Sensitivity toward light or sound
  • Tingling sensation in the hands and feet
  • Panic attacks
  • Convulsions
  • Cramps
  • Death resulting from suicide or other health complications

Apart from physical symptoms, an individual will also experience psychological issues. When the brain is used to a certain kind of drug and it is stopped all of a sudden, the brain needs some time to return to previous levels of functioning, which results in powerful emotional or psychological side effects. The person may start feeling lonely or depressed and have suicidal thoughts. They will be unable to control their emotions, and get very irritated and jumpy. Anxiety, panic attacks, aggressive behaviors, sudden changes in mood, having trouble concentrating on a particular thing, hallucinations, and memory loss for a short period are also the potential side effects of withdrawal.

During these instances, the person will need a lot of emotional support and backup from family, friends, and a thorough, caring medical practitioner.

Handling Xanax withdrawal symptoms

A professional environment is apt for handling such withdrawal symptoms.  There are various detox centers with expert supervision and monitoring to control the withdrawal symptoms in a safe environment without them causing harm to the patient. This can take weeks, or at times months, but it’s safer and far less unpleasant than cold turkey detox.

The various side effects can be reduced with a steady and controlled schedule set up by the team of professionals in the centers. The pace at which Xanax dosage would be reduced depends on the length of the dependency--longer duration dependencies require a slower reduction of dosages. The Xanax dosage is slowly lowered so that the withdrawal symptoms do not get worse over a period of time. One recommendation would be to reduce each dosage by 0.25 mg every two weeks. However, the recommendations should come from the doctor who has considered the case of the individual. Going slow is one key to avoiding the severe symptoms and causing the least discomfort to the individual. An additional advantage is that a doctor would be better able to gauge the individual’s need for the medication.

In some cases, the doctor or professional also recommends substitute medicines such as Valium during the detox process. A substitute is given so that the drug cravings and withdrawal symptoms can be controlled by maintaining small traces of the benzodiazepene class of drugs in the bloodstream. Adjunct medications such as antidepressants are also given at times to treat the symptoms.

A drastic withdrawal should never be attempted without proper guidance, since it could lead to fatal convulsions.