Alprazolam (brand name Xanax) is a medication known as a benzodiazepine used to treat anxiety disorders, panic attacks, and other psychiatric disorders. Alprazolam and other benzodiazepines work by increasing the activity of a neurotransmitter, or chemical in the brain, called GABA. Long-term use of alprazolam can lead to dependence or addiction, and abrupt discontinuation of use can cause severe withdrawal symptoms. In some cases, discontinuation of alprazolam without medical supervision is fatal. Discontinuation of the use of benzodiazepines is very serious, it is necessary to do several things so that discontinuation of use can proceed safely and smoothly.
Stopping Use Gradually
Consult a doctor. Discontinuation of benzodiazepines should be supervised by a doctor familiar with the process. This doctor will pay close attention to the safety and progress of your discontinuation, while rescheduling the discontinuation schedule as needed.
Tell your doctor about all medications and supplements you are taking. Also mention the various medical conditions that you suffer from. Both of these can affect your gradual discontinuation schedule.
Follow the dose reduction schedule given by your doctor. Most of the worst-case discontinuation scenarios result from abrupt discontinuation of alprazolam. Stopping benzodiazepines suddenly is not safe and is not recommended by benzodiazepine experts. You can relieve withdrawal symptoms from alprazolam by reducing the dose in small increments and over a long period of time. You need to allow your body to adapt to each step of decreasing your dose. After the body adapts, then you can lower the dose again. You will not be able to stop using this medicine until you get to the minimum dose.
The dosage reduction schedule will vary for each individual. This schedule depends on the length of use, the size of the dose, and other factors.
Consult a doctor for the use of diazepam. If you have been using alprazolam for a long time (more than six months, your doctor may prescribe a benzodiazepine that lasts longer in the body, namely diazepam. Your doctor may recommend this option if you are taking high doses of alprazolam. Diazepam works in the same way with alprazolam, it’s just that it lasts longer in the body, thus reducing withdrawal symptoms.
Diazepam is also superior because it is available in liquid form and light-dose tablets. Both of these forms can help with the discontinuation of use. Switching from alprazolam to diazepam can be done immediately or slowly.
If your doctor finally decides to switch your medication to diazepam, he or she will initially set the initial dose to be equivalent to the dose of alprazolam you are currently taking. Broadly speaking, 10 mg of diazepam equals 1 mg of alprazolam.
Divide your daily dose into three small doses. Your doctor may suggest dividing the total daily dose into three smaller doses, taken three times a day. Of course, this division will depend on the dose and duration of your previous use of benzodiazepines. For example, if you have been taking alprazolam for a long time, you may be given a longer schedule of gradual dose reductions or fewer dose reductions per week.
Your dosing schedule can also be adjusted based on the body’s response to dose reduction.
Reduce the dose every two weeks. If you are taking diazepam, your doctor will generally recommend reducing your total dose by about 20-25% every two weeks, or 20-25% in the first and second weeks and 10% every week thereafter. Some doctors also recommend lowering your dose by 10% every week or two, until you are at 20% of your initial total dose. Then drop 5% every two to four weeks.
If you are taking diazepam instead of alprazolam, your total dose should not be reduced by more than 5 mg of diazepam per week. This reduction should also drop to 1 to 2 mg per week, when you reach small doses such as 20 mg of diazepam.
Know that this dose reduction schedule is designed especially for you. There is no one right schedule for everyone, just as there is no one right shoe style for everyone. Your dose reduction schedule will depend on things like how long you have been using alprazolam, how large the dose is, and any withdrawal symptoms you are experiencing.
If you have been taking alprazolam in small, non-constant doses, your doctor probably won’t recommend lowering your use any faster than a chronic, constant, or high-dose user.
In general, a person who has been using a benzodiazepine for more than eight weeks requires a schedule of discontinuation of use.
Taking Care of Yourself During the Discontinuation Process
Consult a pharmacist. Your best friend when lowering your dose is the pharmacist. His knowledge will greatly help your success. He or she will provide solutions, such as combining prescriptions, informing you about over-the-counter medications you should not take, and other pharmacological knowledge that may be important to you.
If the doctor prescribes drugs other than alprazolam, the dose reduction schedule will also be arranged according to this additional drug.
Take care of your physical health while lowering the dose. Sometimes withdrawal symptoms can be overwhelming and you won’t be able to function normally. However, you will still need to take care of yourself during the dose reduction process. Thus, the body will be helped in detoxification. So far, there are no studies that show this directly, but activity and physical health may help you and reduce withdrawal symptoms.
Drink lots of fluids.
Eat lots of healthy foods: fresh fruits and vegetables. Avoid processed foods and foods with preservatives.
Get quality and plenty of sleep.
Avoid caffeine, tobacco and alcohol. While lowering the dose, also limit the intake of caffeine, tobacco, and alcohol. Alcohol, for example, causes toxins in the body that can complicate the healing process.
Do not take over-the-counter medications without first consulting a pharmacist. Avoid using over-the-counter medications without first consulting a pharmacist or doctor. Many over-the-counter drugs can put additional stress on the central nervous system in the process of decreasing the dose. Such over-the-counter medications include antihistamines and sleeping pills.
Make a note. The dosage reduction schedule is based on how long you have been using alprazolam and how large the dose was. Record your dose reduction. Write down when you take the medicine and how much. That way, you can see when you are successful/failed, and set a schedule as needed. Keep in mind that you may need to make some changes.
An entry in the diary in the form of a spreadsheet might look like this:
1) January 1, 2015
3) Dosage: 2 mg
4) Dosage reduction: 0.02 mg
5) Total dose reduction: 1.88 mg
You can also add other entries on the same day, if you drink several in one day.
Also take note of any withdrawal symptoms or mood changes you experience.
Consult your doctor regularly. During the dose reduction process, you will need to consult your doctor every 1 to 4 weeks, depending on the schedule. Tell the various difficulties and problems you are facing.
List any withdrawal symptoms you may be experiencing, such as restlessness, irritability, agitation, trouble sleeping, panic, or headaches.
If you experience severe symptoms such as hallucinations or seizures, contact your doctor immediately.
Ask your doctor about other medications. If you do experience severe withdrawal symptoms, your doctor may prescribe another medication to help relieve those symptoms. Your doctor may also give you an antiepileptic drug such as carbamazepine (Tegretol). The risk of convulsions increases greatly as the process of discontinuing alprazolam takes place.
If you have a slow down schedule, this is not something you usually need to do.
Consult a mental health professional. You need to pay special attention to your mental health after you stop using benzodiazepines. Healing of the neurological effects of this type of drug can take weeks, months, years. The core process may take three months, but complete healing may take at least two years. It’s best to consult a psychologist or psychiatrist at this point.
Consider continuing to see this mental health professional after you have successfully lowered your dose to 0.
Consider joining a 12-step rehabilitation program. If you have been taking high doses of alprazolam, you may be able to follow a 12-step rehabilitation program. Your discontinuation schedule runs separately from this rehabilitation program. If you are addicted, this program may be of great use to you.
Understanding the Termination Process
Be aware that it is dangerous to stop taking alprazolam without medical supervision.Alprazolam, also known as Xanax (brand name), is a drug known as a benzodiazepine. This medication is used to treat anxiety disorders, panic attacks, and other related psychiatric illnesses. Alprazolam and other benzodiazepines increase the activity of a neurotransmitter, or chemical in the brain, called GABA. Long-term use of alprazolam can lead to dependence or addiction. If you stop taking this drug suddenly, you may experience withdrawal symptoms which can be severe, as the brain tries to restore its chemical balance. Stopping the use of benzodiazepines such as alprazolam has the potential to cause withdrawal symptoms that can be life-threatening.
In some cases, discontinuation of alprazolam without medical supervision results in death.
Recognize the withdrawal symptoms of alprazolam. Before you stop taking alprazolam gradually, you need to recognize the various withdrawal symptoms of benzodiazepines. This will reduce the fear or shock of not knowing what is going to happen to you. By gradually discontinuing use under the supervision of a doctor, your withdrawal symptoms will subside. When you stop taking alprazolam, you will experience different symptoms with different intensities. Included in these symptoms are:
Easy to get angry
Recognize severe withdrawal symptoms. Severe withdrawal symptoms from alprazolam include hallucinations, delirium, and seizures. If you experience any of these symptoms, seek medical attention immediately.
Know how long withdrawal symptoms will last. Withdrawal symptoms for alprazolam begin about six hours after the last dose. These symptoms will then peak around 24 to 72 hours after the last dose, and persist for two to four weeks.
You need to remember that until you have completed the gradual discontinuation of your benzodiazepines, your body will be in a constant, mild withdrawal state. This is the reason why you should stop using it gradually and very slowly.
Be patient with the process. In general, stopping alprazolam should proceed at a pace that is comfortable for you. If you run the slower stages, your withdrawal symptoms will be lighter. Keep this in mind, however, that a slower stage of discontinuation results in milder withdrawal symptoms. The goal is to complete discontinuation of use without long term side effects and not resolve as quickly as possible, which will end up with side effects and GABA receptors that are not corrected and affect the healing process. The longer you take a hypnotic such as alprazolam, the longer it will take for your brain to return to normal after you stop using it.
Estimated time to discontinue use is between 6 to 18 months, depending on the number of doses, age, general health, stress factors and time of use. In addition to the schedule given by the doctor, this phase of discontinuation of use must:
Slowly and gradually.
scheduled. Your doctor will ask you to take one dose at a time and not on a “need” basis.
Organized by withdrawal symptoms, or return of symptoms of anxiety or illness.
Monitored every week to every month, depending on the situation.