From the Guidelines
The best way to get someone off chronic Xanax is through a gradual tapering process under medical supervision, reducing the dose by 25% every 1-2 weeks, as this approach has been shown to be safe and effective in minimizing withdrawal symptoms 1.
Key Considerations
- A personalized tapering schedule should be created, taking into account the person's starting dose and how long they've been taking Xanax.
- The tapering process should be gradual, extending over several weeks or months, to allow the brain's GABA receptors to slowly readjust to functioning without the drug.
- Adjunctive medications like propranolol or hydroxyzine may be prescribed to manage mild withdrawal symptoms like anxiety, insomnia, or irritability.
- Therapy or counseling is crucial throughout the tapering process to develop coping strategies for the anxiety that led to Xanax use initially.
Tapering Schedule
- A commonly used tapering schedule involves reducing the benzodiazepine dose by 25% every 1-2 weeks, as suggested by Mugunthan and colleagues 1.
- For example, someone taking 2mg of Xanax daily might reduce to 1.5mg for two weeks, then 1mg for two weeks, and so on.
Importance of Medical Supervision
- Medical supervision is essential to monitor the person's progress, adjust the tapering schedule as needed, and manage any withdrawal symptoms that may arise.
- A doctor should be involved in creating the personalized tapering schedule and providing ongoing support and guidance throughout the process.
Additional Strategies
- Cognitive-behavioral therapy (CBT) has been shown to increase tapering success rates and may be particularly helpful for patients struggling with a benzodiazepine taper 1.
- Other non-pharmacological interventions, such as education and self-empowerment, may also be effective in supporting the tapering process, as demonstrated by the EMPOWER trial 1.
From the FDA Drug Label
In all patients, dosage should be reduced gradually when discontinuing therapy or when decreasing the daily dosage. Although there are no systematically collected data to support a specific discontinuation schedule, it is suggested that the daily dosage be decreased by no more than 0.5 mg every 3 days. Some patients may require an even slower dosage reduction.
If significant withdrawal symptoms develop, the previous dosing schedule should be reinstituted and, only after stabilization, should a less rapid schedule of discontinuation be attempted
It is suggested that the dose be reduced by no more than 0.5 mg every 3 days, with the understanding that some patients may benefit from an even more gradual discontinuation.
The best way to get someone off their chronic Xanax without causing withdrawals is to gradually reduce the dosage. The recommended reduction is no more than 0.5 mg every 3 days. However, some patients may require an even slower dosage reduction. It is essential to monitor the patient closely and adjust the reduction schedule as needed to minimize the risk of withdrawal symptoms. If significant withdrawal symptoms develop, the previous dosing schedule should be reinstituted, and a less rapid schedule of discontinuation should be attempted after stabilization 2.
From the Research
Tapering Off Chronic Xanax
To minimize the risk of withdrawal symptoms when discontinuing chronic Xanax use, a gradual tapering approach is recommended.
- The current treatment for benzodiazepine withdrawal, including Xanax, involves tapering with a medication like clonazepam 3.
- This approach allows for a gradual reduction in the dose of the benzodiazepine, reducing the severity of withdrawal symptoms.
- However, it is essential to note that clonazepam itself can lead to physical dependence and tolerance with prolonged use 4.
Alternative Methods
Research is ongoing to explore alternative methods for treating benzodiazepine withdrawal, as the current approaches may not be effective for all individuals 3.
- Few drugs have been proven to be efficacious in randomized control trials for treating benzodiazepine withdrawal.
- Further research is needed to develop safer and more effective treatments for benzodiazepine dependence and withdrawal.
Importance of Medical Supervision
It is crucial to seek medical supervision when attempting to discontinue chronic Xanax use, as withdrawal symptoms can be severe and potentially life-threatening 3.
- A healthcare professional can help develop a personalized tapering plan and monitor the individual's progress to minimize the risk of complications.
- Regular monitoring and adjustments to the tapering plan can help ensure a safe and successful discontinuation of Xanax use.