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October 4th, 2011
02:57 PM ET
Is there a wrong way to detox off Xanax?Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health. Question asked by D. Epps from Georgia: Is there a wrong way to detox off Xanax? Expert answer: Sadly, there are probably more wrong ways to detox off Xanax than right ones. Lots of people have a very hard time getting off Xanax if they’ve been on it for awhile no matter what approach they take. This is one of the reasons Xanax has fallen from favor in the last decade. These medications can be spectacularly helpful when used appropriately. But their use comes at a price. When taken on a daily basis for more than a few weeks, the brain develops a dependency on them for normal functioning. Xanax has a very short half-life, which is a fancy way of saying that it goes into and out of the body very quickly. This property appears to make Xanax even more likely to cause emotional and physical dependency than other benzodiazepines. The short half-life means people will often start withdrawing from Xanax between scheduled doses, which tends to powerfully reinforce their psychological dependency of the medication. This property has, over time, made Xanax among the least popular of benzodiazepines among psychiatrists. If you take Xanax long enough, you will become physiologically dependent on it. This does not mean that you are an addict or that you are abusing it. It only means that if you stop the medication suddenly you are at risk for a very dangerous withdrawal syndrome that can include delirium and seizures and can be lethal. So the wrongest way to detox off Xanax is to just suddenly stop taking it. This can literally be a fatal mistake. Another very common “wrong way” of trying to detox from Xanax is to attempt to get off the medication too quickly, which can cause such discomfort that people become afraid to continue the detox process. It can take months to successfully come off Xanax, and often the last little bit is the hardest to get off. So patience is of great importance for successfully weaning oneself from Xanax. Under the guidance of a physician, the detox can often be made easier by switching from Xanax to an equivalent dosage of a benzodiazepine with a long half-life such as Klonopin or Librium, and then gradually tapering off that agent. Sometimes this works. But in my experience, this switch is so uncomfortable for some people that they can’t tolerate it. Benzodiazepines get a bad rap because they do have abuse potential and they do cause dependency. But they can be wonder drugs for some people. Many year’s worth of long-term data suggest that they do not cause significant harm, even when taken for long periods. I like benzodiazepines, but I would never start anyone on Xanax for the reasons I’ve outlined above. On the other hand, more than once I’ve seen people - especially older folks - who have literally ended up in the psychiatric hospital trying to get off Xanax. Most of the time they had been doing just fine for years and it was some new doctor who decided they had to get off the Xanax “no matter what.” This seems crazy to me. Not being on Xanax is better than being on it. But living a reasonable life on Xanax is considerably better than making yourself sick trying to get off it. A final important point. No matter what you do, make sure you work closely with a clinician with expertise in detoxing off benzodiazapines.
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I have been on Xanax daily for almost 9 years now and there is a reason to start tapering off. I am in my 30's now and would like to someday have children. It would not be healthy for me to be pregnant while being on it. I have been slowly, very slowly tapering off it and so far (almost 2 months) I have been doing great. The idea is to do it in small doses and over a long period of time.
Good luck to you April. If you have the opportunity, let us know how you're doing.
Hi April, I asked you a question below in my comment, but I see we can reply directly to people – here is my question (and all the best to you!!)
@April – if you don't mind me asking, what daily dosage were you on for 9 yrs, and how much are you reducing by (and do you reduce it by the week?).
Replying to April, I am so proud of you keep up the good work! I myself have been on it for a little over 9 years now. I want so bad to come off. I have tried but the withdrawl gets the best of me. I have to take it twice a day. But I have given it to Godand I know that he will fix it for me. Please continue to keep in your prayers and I will do the same for you. May God Continue to Bless You and shine his light upon you with joy! No weapons form against me shall not proser God said so!
What is, however, a fatal literal mistake is the use of the non-word "wrongest".
There is nothing wrong with the work wrongest. You are the wrongest you may be est.
My fiance's mother suffers from anxiety and took xanax for years, which inevitably lead to dependence and addiction. This culminated in her taking extra, which led to running out early, and the days when her prescription ran out early she would go into withdrawal. Ended up having a seizure one morning, we found her passed out in the hallway with a huge lump on her head and unresponsive. She was fine, and has since weaned off of xanax (for the most part, or so i think). Although I don't suffer from anxiety and cannot give a fully non-bias opinion, I don't think long-term usage of benzodiazepines are the answer. They're dangerous and really mess with the body.
Does she have to take another medication now? If so, how is she doing?
Very interesting article. I have been taking Xanax as needed over the past 5 or 6 years. At times I have gone days or weeks without it, and then have taken it everyday when my anxiety gets bad.
I've heard from certain doctors the same thing that was mentioned here, about it being the most unpopular of all benzo's, but I found ativan and others not as effective.
@April – if you don't mind me asking, what daily dosage were you on for 9 yrs, and how much are you reducing by (and do you reduce it by the week?).
Because certain doctors dislike of Xanax, I am always fearful of taking too much of it – so I am always cautious. But I wonder if I am doing myself any harm in taking as much as I need when I need it – for ex, if I have a lot of anxiety and take more than I normally do – (I have .25mg's) if I take 3 a day for a week – I am quite fearful of messing up my system ... do I need to be afraid of this? Because I just want to reduce my anxiety and get back on track!
I must chime in, and say that I disagree with this article. I spent a year and a half on Klonopin...and am just coming back to life after going through "Benzo-Hell" getting off of it. The doctor's statement that "many year's worth of long term data shows they do not cause significant harm" is untrue. These drugs are very dangerous. More and more research is proving that they should not be used for more than 3-6 weeks.Benzodiazapines get into and affect every system in your body. Cognitive function is impaired. The endocrine system is affected. Digestive system, muscular system, nervous system...all affected. Even REM sleep is impaired.You do not realize this is happening, until you try to go off the drug. And then, everything the drug did for you...relieved anxiety, helped you sleep, made you feel comfortable...will have the reverse affect. Not everyone experiences all withdrawal symptoms..but many are very common..extreme anxiety, extreme insomnia, nightmares, skin crawling sensations, vomiting and diarrhea, depersonalization. And it feels like it will never end. Hyper-sensitivity to light, sound, smell. The muscles are affected...twitching..even the small muscles of the eye are affected causing blurry vision. The musician, Stevie Nicks, has gone public about her experience quitting Klonopin, and stated "My hair turned grey, my skin molted." She considered quitting cocaine "a cake-walk compared to the hell I went through getting off klonopin." The doctor's statement about "..living a reasonable life on Xanax is better than making yourself sick trying to get off it." Are you kidding me!?!? Of course people think everything is good. You are doped up. And it is going to take more and more of that drug, over time, just to get you through the day. Your body and mind are addicted. And someday, you going to have to quit the drug. If you go off the drugs too fast, it can literally kill you. And yes, many people end up in the psychiatric ward trying to come off of them. The leaflet that came with Klonopin states "Sudden stoppage of this drug can cause seizures that do not stop, or death." Most doctors and psychiatrists do not understand how important it is to come off the drug very, very slowly. Prof. Heather Ashton, of the U.K. published "The Ashton Manual: Benzodiazapines : What They are and How to Get Off Them." I highly recommend reading her findings. She ran a benzo withdrawal clinic for 10 years, and knows the severity of the situation. Most of the information is available online for free. I believe that much more education is needed regarding these drugs. Do not go on this drug without a plan on when and how to get off. When the time comes to wean off, make sure you do it slowly...do not let your doctor set the timetable..you decide by how your mind and body react, the time you need and have a good support system.
As someone beginning her second year of tapering from a benzodiazapine presecibed for over 8 years, having fundimentally lost her livelihood, whose quality of life has been serverly dimished while also watching the ongoing debate currently occurring as to whether or not this drug causes permanent damage, I am very curious to your interpretation of "significant harm".
Everyone in my family is addicted to benzoes. I have seen the horrible effects of these medications first hand. Having suffered from severe anxiety I understand the attraction and use of Xanax but the price is too great. Between the anti-depressants and benzos my family's motivation for life has been greatly diminished. I was prescribed Xanax and Paxil and it did help briefly but with daily usage the negatives outweighed the positives. I quit Xanax cold turkey, and stepped down on the anti-pressant over six months. It was rough but definitely worth it. "Significant harm".....it is devastating. Sounds like someone has stock in a pharmaceutical company. As far as medications go, my personal experience is the less the better. I use to take a handful of medications daily. Bp, Cholesterol, pain, anxiety, anti-deppresant.....I am down to only the bp med and have started taking holistic medicines and an exercise program to drop it...heal yourself.
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"But living a reasonable life on Xanax is considerably better than making yourself sick trying to get off it." This is such an ignorant statemant. I think Dr. Raison has a lot more research to do. What happens when after 23 years of use, the medication turns paradoxical on the patient? When it feels like pure adrenaline is pulsing through every cell? Why would you take the chance to begin with? Do you just refer them to a different doctor to fix it? Detox facilities will detox you in five days, but don't tell you that you'll have a couple of years of hell to go through afterwards.
Whatever happened to "DO NO HARM"?
High profile doctors should complete their research before making such statements. This statement, in effect, is telling doctors and patients that there is no harm in staying on these hellish drugs.
The medical community needs to be educated about these drugs, and not by greedy pharmaceutial companies.
Please Dr. Raison, I know your smarter than this! Shame on you...
I have been on Xanax for over 25 years and am trying to come off ... but I am coming off faster than I feel I should due to a new Doctor (new to me because I have moved to another State) and this Doctor says he will not give me anymore after January 1st 2013. So, I must try hard. I was put on Xanax for panic disorder with agoraphobia. ...1 mg 3 times a day. I am on .25 mg once a day now however I am light headed ... having a difficult time driving and my heart is beating really fast and many times during each day my heart is irregular. I am underemployed so I do not have the finances just to go to any doctor ... This doctor I see now makes me feel like an addict and I am humiliated. I am a 60 year old woman. How this will affect my life I do not know and Yes I am scared. But I am not a druggy. Never used medication for recreational use ever.
Realize the objections here come from a cult that has been built up around Prof. Heather Ashton of the UK. They fear MSG. They fear Western medicine. Many of them have been incarcerated for mental health reasons via a 5150. They are rabidly anti-doctor and want to actually "force feed" MDs BZDs to "get even" with them (not making that up – wish I was). They haunt the Internet in packs going from site to site attacking doctors. I should know. I used to be one of them.
cesspoolofmadnesscom
The use of xanax prescribed by specialist psychiatrists is very good to combat disorders anxiety caused by the misuse of drugs or trauma, but it would be dangerous to stop taking medications without consulting to the doctor.
Taj Burrow Yho
Antianxiety-drugs.com
There most certainly is a wrong way to detox from Xanax. IMO, in the majority of cases benzodiazepines should not be prescribed for longer than 2-4 weeks. I was prescribed Xanax for something other than anxiety or a psychiatric condition. My GP assured me it was a safe medication. I believed him.
Patients may develop a psychological dependency on a benzo–Xanax being the worst because of its high potency, short half-life and action of duration– but the main thing is that patients become PHYSIOLOGICALLY DEPENDENT and cannot stop suddenly or even taper quickly without having very dangerous withdrawal symptoms. I know, I nearly died. When I asked my GP to give me a taper plan– he had no idea what a safe taper plan would be . I ended in the ER of a very good hospital and was in intensive care for three days and I was on a low dose.
Finding a good medical professional who will work with you on a slow taper plan is the best option. It's important to listen to your body when tapering, as it takes different people different lengths of time for their brains to re-introducing the natural anti-anxiety chemicals it normally produces.
There are some benzodiazepine withdrawal support forums on the internet that can help doctors and patients inform themselves about withdrawal methods and give emotional support.
As an aside, the poster mike59 has a harassment site, as he's mentioned above, Cesspool of Madness, where he scrapes the content of benzodiazepine withdrawal support forums, harasses people who are trying to withdraw from BZD's and displays very disturbing graphics. Sometimes members of the BZD forums vent their shock, frustration and disbelief about how difficult it is to withdraw and why some medical professionals have prescribed them a BZD without giving them fair warning as to the debilitating affects BZD's can have.
I myself have great respect for the medical profession and realize some medical professionals have unknowingly caused an iatrogenic dependency to a patient, may not know how to taper them and then the patient needs to find another medical professional to help them taper safely. It's frustrating all around for patients and medical professionals. I believe the answer is better education, informed consent and stricter prescribing laws.
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Benzos and "Z" drugs destroy the GABA receptors throughout the human body – especially in the brain and the gut. Big pharma has convinced US doctors to had out benzos like candy. If you want to know anything about drugs, ask a pharmacist – not a doctor. Pharmacists are not so easily "snowed" by big pharma's sales force of former used car salesmen. While it's true that perhaps only 10% to 20% of the people who take prescription doses of benzos for more than a few months have to go through years of living hell to recover, I am convinced that everyone who uses prescription doses of benzos for an extended period of time does suffer some ill effects. These drugs should be avoided by everyone.
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Please AVOID benzodiazepines, they should be taken off the market and anyone writing a precription for them should explain the dangers of these mind and body wrecking pills. Save your life and realize, benzos are the worse thing to put into your body!
I was on a low dosage 6 mo ago them it went up to a 1mg 2times a day then 3 now 2. I had an operation and went down to 1x a day 3 days into it i was in er withdrawing this is bad niw today i started half for 2 weeks then a quater for 2weeks them off for good
I had tyroid surgery and prier yo that gad tyroid storms thats ehy i was first perscribed kalinipin liw dosage but found i didn't work
I do not recommend this drug at all im a mother if 2 small kids