October 4th, 2011
02:57 PM ET
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?
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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