Xanax | How to Reduce Dosage

Xanax gives results for stopping panic attacks and decreasing severe anxiety. But, for some, developing a tolerance or a dependency to this benzodiazepine calls for an end to its use. Carefully supervised and slow dosage reduction can take the edge off going through severe withdrawal symptoms. There are simple, reasonable ways to relieve discomfort and this can help to get through the rough periods.


The brand names is called Alprazolam, a powerful, fast-acting drug. It's considered a central nervous system and a
'breathing' depressant. That is, the drug slows down function in these areas.

It is very effective for short term relief of severe anxiety. It also keeps panic attacks from taking place.

One of its properties acts as an anxiolytic...It prevents or reduces anxiety. It's known to be effective for anxiety with depression. However, its main use, in treatment, is for panic disorder with or without agoraphobia, and generalized anxiety disorder.

It can also be prescribed for treating mild to moderate depression when panic disorder is present.

The drug can be pressed into service for short term relief of anxiety due to traumatic experiences. For example, feeling the deep loss of a loved one. Or again, when there is extreme alertness and agitated periods as a result of post traumatic stress disorder.

Off label, it can be prescribed for agitation, insomnia, social anxiety disorder, irritable bowel syndrome or premenstrual syndrome - PMDD.

However, it's important to remember,...

Xanax is not designed to relieve run-of-the-mill nervousness or
tension caused by everyday stress.


The Brain and Xanax

The central nervous system - CNS - plays a key part in how we...

  • Process and interpret experiences.
  • Control body positioning.
  • Coordinate body movement.
  • Play out behaviors driven by the way we're 'pre-wired' - our instinctive behavior.
Excessive, never-ending anxiety, a marker in anxiety disorders, sets into motion the 'fight or flight' response and keeps it there. How situations are interpreted, body language and alertness are affected. Fear and anxiousness can bring out harmful instead of useful behaviors. Surviving, no matter what the cost is, rules. As a result, quality of life can fall apart.

The most common inhibitory neurotransmitter in the brain is GABA - gamma aminobutyric acid. It holds back the delivery of 'messages' from one nerve cell to another. It's to keep the cells from getting overexcited. Taking Xanax boosts the 'GABA effect'. This is what gives the relaxing, anti-anxiety feeling.


The Doctor Needs To Know

The anti-anxiety medication can stop cold the onset of an anxiety attack. Or, be used to ease severe symptoms of anxiety so daily activities can go on. This relief is particularly helpful for generalized anxiety disorder.


Drinking alcohol while on the drug, may increase it's effects. It can also trigger a bad reaction. For example, breathing can become difficult. Or, heart rate can slow down too much.

That's not all,...

Smoking can really cut back the drug's ability to 'do its thing'. How this affects dose reduction is revealed later on this page.

What's more,...

There are more than 600 drugs known to interact with alprazolam. An over-the-counter medication such as, an antacid or a cough syrup, can change the way it works.

This is why...

It's important for your doctor to know of every medicine you are taking or might want to take while on this medication. How much the prescribing health professional knows can have an influence on your well-being.

Despite unfavorable comments about the use of Xanax and its problems,...

The majority of patients who take it...

  • Do well.
  • Respect the drug's advantages and its dangers.
  • Closely follow their doctor's recommendations.

Xanax is a godsend to many who go through hell with crippling anxiety or have to deal with panic attacks.

But, for some, it may be time to think about...


Giving Up Xanax

One of its most serious side effects is dependency - be it physical or psychological. It can manifest as a craving because of its 'feel-good' effect. Or, your body is telling you, in no uncertain terms, that you need alprazolam because withdrawal symptoms appear as the drug effects wear off.

Xanax has a short half-life - It goes in and out of the body fast. Because of this, many who take Xanax can start to experience withdrawal symptoms between doses. And, that can increase the possibility of developing a dependency.

Larger doses tend to increase physical dependence. Lengthy use, over time, can also lead to a dependency on Xanax.

To avoid this problem, you can...

  • Pay close attention to Xanax's therapeutic effect.
    How well it's working and how much is taken to get the effect.
  • Understand and respect it's powerful side effects.
  • Take steps to avoid possible dependence. Using the pills "as prescribed" is one way to do this.

Developing a tolerance to Xanax is always a possibility. The body gets used to the dosage and it may need more to get the same effect. Changes in the brain could be occurring with respect to the GABA and benzodiazepine receptors. They might not respond as well. This contributes to slow the effect of reducing anxiety.

Tolerance to Xanax's sleep-inducing effect can develop quickly. It does happen more slowly for its anxiolytic - anti-anxiety - effect. But, this can develop after long term use of alprazolam. The body makes adjustments to the continued presence of the drug. And, these adjustments tend to get around the effects of the antianxiety medication.

Xanax is highly addictive. There can be memory problems after long term use. Strong responses to its property as a muscle relaxant can affect breathing. This, alone, can be the reason for wanting to stop taking Xanax.

Other disturbing side effects can push for a decision to stop using the drug...

  • Depression.
  • Coordination troubles.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Constipation.
  • Blurred vision.
  • Palpitations.
  • Irritability.
  • Weight gain.
  • Weight loss.


Once the decision's been made to reduce dosage, it's time to know about the scary part...

Stop suddenly taking Xanax and the result can be,...
Bad news for brain activity.

The brain needs systematic, coordinated and an organized release of electrical impulses to function normally. With the presence of Xanax, the brain has made adjustments.

But, take it away all at once,...

And, brain activity can race out of control. The whole brain is affected by abnormal electrical activity. There are chances of having a seizure. It can happen 1-3 days after suddenly stopping to take the medication.

You can black out and have convulsions - strong muscle contractions. A lack of oxygen in your system can occur. You can fall, bite your tongue or bite the inside of your cheek. These can result in injury.

If the seizure lasts longer than 5 minutes - brain damage is a real possibility. Emergency medical care is needed as fast as possible.

And, that's not all,...

Even if a seizure doesn't occur,...

Psychosis can take place. There can be loss of contact with reality. Changes in the way of thinking. The difference between what's believed to be real or imagined becomes blurred. Behavior can be affected. You can feel unstable and intensely worked-up.

Now, let's suppose, there's a decision to cut down sizable doses,...fast.

Severe withdrawal symptoms can take place.

So, here's the deal,...

Careful, supervised, and very small reductions of the scheduled dosage is key to lessen the chances of going through dangerous reactions. Slow cutback can also decrease the intensity of uncomfortable withdrawal symptoms.


Reducing Xanax Dosage

Physical dependence of Xanax is the body's reaction to the absence of the drug. Withdrawal symptoms are the reminder of what's missing.

Psychological dependency can last far longer than physical dependency. The 'hook' is strong. This can be connected with...

  • The memory of pleasant feelings tied up with use of the drug.
  • There can be a craving for the return of this 'feel-good' state.

The manufacturer's recommendation is .5 mg dose reduction every 3 days. A psychiatrist, Dr. Stephen Cox, uses a slower approach for discontinuing the drug. The article describes, in an understandable way, what he suggests to his patients and why.

It's important to resist the urge to speed up Xanax dose reduction. But, it's tough,...

Depending on the daily quantity taken, it could several months to more than 1 year for the process to complete itself.


A slow schedule decreases the chances of experiencing total upheaval while withdrawing from the drug. It gives your body the time it needs to adjust to the smaller dose. Withdrawal symptoms can be more tolerable. And, neurotransmitter production can return to some measure of stability.

It's important to closely pay attention to the drug reduction process when panic disorder is present. Panic attacks may come back. Sometimes, an additional medication can be prescribed to decrease severe distress.

Psychological support, in the form of psychotherapy, might be needed during this time to deal with anxiety. Or, provide depression help. Cognitive behavioral therapy can take care of these areas. Cbt can be quite effective, too, for preventing a relapse after the use of Xanax has completely stopped.

Once alprazolam use reaches a low dosage, say .5 mg, there still can be a lot of discomfort felt. The general line of thinking would be to endure the hardship till it subsides before moving on to the next dose reduction.
Dr. Stuart Shipko offers a different approach when this low dose stage is reached for drug discontinuation.


Mixing Medicines While Giving Up Xanax

Alprazolam can be affected when combined with certain medicines. It's absorption ability, how it breaks down, and the drug's elimination could go through changes in the bloodstream, intestines, liver and kidneys. This may have an effect on the progress of drug reduction.

Some medicines to watch out for are...

  • Cold remedies.
  • Allergy medicine.
  • Antacids.
  • Certain vitamin supplements.
  • Herbs.
  • Cough syrup.
  • Oral contraceptives.

To make sure there are no troubling experiences, let the doctor, who cares for you, know of every drug, vitamin supplement, herbal remedy and over-the-counter medication you are taking or might want to take. The physician can then, suggest which medicines have the least impact on your system while reducing Xanax use.


Withdrawal Symptoms

Several factors can influence the severity of withdrawal symptoms during dose reduction.

  • How long Xanax has been used for.
  • A person's personality traits.
  • The dose amount and how often it's taken daily.
  • Past use of alcohol or other sedatives and sleep-inducing drugs.
  • Actual use of alcohol or drugs that give a calming effect or bring on sleep.
  • How Xanax is generally used.

Dosages greater than 4 mg a day increase the chances of having a severe withdrawal reaction. If panic disorder is what's being treated, there is a greater possibility of going through...again...symptoms of this anxiety disorder.

By the way,...

Smoking can affect Xanax's elimination process and decrease the drug's concentration in the bloodstream. If the prescribing medical practitioner doesn't know you smoke or you're thinking of quitting, it's time to tell. There may be a need to make adjustments with the planned dosage reduction.


Coping With Less Xanax

Withdrawal symptoms from Xanax can be alarming, confusing, and terribly uncomfortable to go through.


There are simple, low-key ways to get through tough periods. The actions help build up confidence and support the intention to come off the drug.

Sensitivities to light, sound, and heat may come up.

Here are a few tips to soothe them...



Soft lighting in your home can ease the strain on your eyes. Dim just enough so you can move around safely. Keep lighting to a minimum as long as you feel the need.

Wear a sleep mask at bedtime. Complete darkness improves the chances of having a better sleep.

When outside, wearing polarized sun glasses reduces glare from water, snow or surfaces that can strain your eyes. Color of lens makes a difference. And, they do need to be dark. Gray works well for general use. Brown does the job for daytime driving and light outdoor exercising. Amber is great for low light conditions.



Keeping your home at a cool temperature can ease hot flushes. Light, breathable clothing can wick away sweat and keep you comfortable. Cool, short showers can help you stay refreshed.

On the other hand, should chills occur, keep light layers of clothing and blankets close by. They can be quickly added on or taken off to keep you comfortable.

In the late afternoon, between 4-7 pm, body temperature normally goes up. Mind you, this process may be messed up with withdrawal. But, you can still,...

Go for a light walk, do mild stretching, or have a light massage during this 4-7 pm window. It will raise the body temperature. It leaves enough time for your body to cool down and relax before bedtime. This improves chances for better sleep.

And, let's not forget...

Blood circulation improves with gentle exercise. This helps to bring more oxygen throughout the body. And, it's particularly helpful for the brain. The more oxygen you get, the better the brain functions. Better circulation also helps to flush out toxins.

While going through the dose reduction, light exercising in the late afternoon gives you a good chance to feel better overall and reduce stress.



Sound can startle and be irritating while your body is working its way out of Xanax use. White noise can temper ringing in the ears, help for sleep, encourage relaxation, and have a calming effect. Ear plugs can block out noise when it's time to rest or be used as an aid to sleep better.


Caffeine and Alcohol

Drinking coffee, teas and sodas as little as possible can keep withdrawal symptoms from briefly flaring up.

Alcohol is a problem when you want to stop using Xanax. When the effects of alcohol wear off, withdrawal symptoms can get worse. And, drinking alcohol can slow down the dose reduction process.

You want to increase the odds in your favor for going through as little discomfort as possible when tapering off Xanax.


An Easy 'Pick-Me-Up'

One of the most powerful ways to get through the process of discontinuing alprazolam is,...

Drinking water,...often.


Drinking pure water helps almost all parts of the body, including the brain, to function smoothly. Not enough water,...and, the whole system has to work much harder to get the same result. Signaling in the brain can become distorted. You can feel sluggish, become constipated, and have lower energy.

Many withdrawal symptoms can be eased by drinking plenty of pure water. There can be less headaches, dizziness, muscle cramps and, yes, even depression, can decrease.

Routinely drinking water also helps for better digestion, regular bowel movements, and flushes out toxins. Body temperature can even out. And, your eyes, nose and mouth stay moist.

Purified water is refined to remove impurities, contaminants, harmful micro-organisms and now, a growing concern, pharmaceuticals. For the purposes of drug discontinuation, drinking water processed by reverse osmosis with a carbon filter greatly reduces the chances of particles interfering with Xanax dose reduction. Once discontinuation is complete, you can continue by drinking mineral water, which contains trace minerals essential for good health.

The norm for keeping your body well supplied - hydrated - with water is to drink 32 oz. - 1 liter - or 4 cups - a day. However, during dosage reduction, the body is feeling the pressure of adjusting to the absence of Xanax. It's working hard to gain balance. Drinking more than the standard amount, keeps things moving inside, then out, towards wellness.

Drinking water at room temperature makes less demands on your body to absorb the water.

Air can be gulped in while drinking straight from a glass. Use a straw and get all of the water with no air. This will keep you from feeling bloated.

For best effect, drink water between meals. No closer than 30 minutes before mealtime and more than 2 hours afterward. That way, your digestive system works efficiently while processing food.



There may be days when regular food intake just doesn't cut it. Clear soups or broth, crackers or soft, pureed foods, can help you get by till appetite improves.

On better days,...

Eating light meals puts less of a strain on digestion. Steamed vegetables add value to your food intake. Raw veges are good, too...As long as they're easily digestible. High quality, low fat, protein foods add nourishment while you recover.

A few examples of high quality protein foods are,...

  • Chicken - white meat - avoid frying.
  • Cottage cheese.
  • Yogurt.
  • Wheat germ.
  • Sock-eyed salmon.
  • Yellow fin tuna.
  • Shrimp.
  • Eggs.
  • Soy.
  • Peanut butter - with no added sugar.

Oats, honey, 'flour-less' bread, and squash are examples of quality carbohydrates you can eat. Taking in a reasonable amount keeps serotonin levels from becoming unstable.

Adding healthy food, everyday, to your diet, nourishes the body with what it needs to cope with Xanax dose reduction.


Distracted and Relaxed

Staying busy keeps your mind off what you're going through while reducing Xanax use. Playing online games, doing puzzles, playing cards or board games with friends, can bring relief from the daily struggle to cope.

You can also,...

Go through favorite photo albums or play video games. Listen to quiet music for stress management. They are time-fillers that can take your mind off uncomfortable symptoms.

Watch funny movies or stand-up comics. It can make you laugh - a terrific stress reliever.

Deep rhythmic breathing - belly-breathing - brings on the relaxation response and stimulates the lymphatic system. The lymphatic system helps clear away toxins in the body. So does body movement.

Yoga delivers both...deep breathing and body movement.


You can go through a deep breathing technique and go for light walks or do some light stretching.

Either way, the benefits are there for relaxation, clearing away toxins and supplying more oxygen to your body.

Guided imagery has been found to be effective for stress relief. The technique begins with the end in mind - relaxation. Visualizing it, feeling it, and experiencing it before actually bringing it about. This can soothe your nerves and have a calming effect.



True friends and trusted family members can do activities with you so you can 'get out of your head' for awhile. Or, just simply be with you because you enjoy their company.

Discussion forums, specific to benzodiazepine discontinuation or on withdrawal, can be a way to connect with others going through the same thing. Sometimes, information will come up and 'ring a bell'. It could be a solution to a problem or a valuable tip that helps you feel better.



Rest restores, strengthens, and gives your body the time it needs to get through the rough periods of withdrawal. Every opportunity to lie down, take a time out, or get involved in quiet activities gives your body the chance to recover.

'Doing nothing', every now and then, is one of the very best ways to reduce the stress of going through withdrawal.


Hanging Tough

Xanax gives results as a fast-acting drug to relieve anxiety that's become destructive. But, when it's time to stop its use, careful, supervised, and slow dosage reduction, can lessen the severity of withdrawal symptoms. Patience, grit and treating yourself kindly, by doing the 'little' things to keep you comfortable, helps to get past the periods of misery.

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