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Xanax Tapering for All the Right Reasons

Last Updated on December 29, 2023 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

The art and science of Xanax tapering can baffle even licensed professionals, let alone the person who is suffering through the process.

Xanax, like all benzodiazepine drugs, cannot be tapered haphazardly. The level of care needs to be absolutely precision-based, keenly attentive, using tried and tested protocols for success.

Do Your Symptoms
Require Xanax?


getting off xanax
Alternative to Meds has been the expert on benzo tapering for over 17 years. We invite you to review our published evidence regarding our successful client outcomes. Some people can come off of benzodiazepines easier than others, especially after short-term use. More often though, we find that people really do struggle with Xanax tapering especially after longer use, high dosages, neurotoxic accumulations, and lingering symptoms. Without proper preparation and guidance, the process can be excruciating. The body needs to be cleansed of neurotoxic load, and given the essential (natural) precursors to allow transmitter repair. We soften the process by finding and addressing the root causes of symptoms that led to being medicated in the first place.
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Intro to Alternative to Meds Center’s Xanax Tapering Program

xanax tapering program Sedona drug rehabThere is no one-size-fits-all approach to tapering Xanax. Many factors will determine the time it will take to successfully get off Xanax.

We founded our Xanax tapering program upon three main goals. One goal is to stop Xanax (alprazolam) gradually and safely, and the second goal is to use natural Xanax alternatives to avoid being left with debilitating side effects.

The third goal is to discover and treat (reduce, eliminate, fix, repair) the root causes of the original symptoms that led to starting the prescription in the first place. The result is what we call “natural mental health.”

Fortunately, much information has become available about benzodiazepines, and how they affect one’s neurochemistry and central nervous system. Our programs are orthomolecular in nature, and are medically supervised on site with a complement of over 50 licensed and well-trained staff to assist our clients.

For those who enroll in our program, the clients receive a thorough educational component on how benzodiazepines and other drugs affect the CNS, and how diet, nutrition, and rebuilding healthy neurochemistry can provide the keys to recovery.7

Inpatient care at Alternative to Meds Center provides a wealth of safe Xanax tapering and strategies that comfortably support medication tapering and recovery, such as IV treatments, holistic pain management, nebulized glutathione, and neurotoxin removal. You can learn much more about the services delivered to clients in treatment by visiting our services overview pages.

Xanax for Treating Unwanted Symptoms

Benzodiazepines like Xanax are intended for short-term use only, at the lowest dose possible, and for specific, severe conditions. Benzodiazepines do nothing to alleviate the underlying causes of conditions such as severe anxiety or panic disorders, and only a minority of patients should be taking them. However, large numbers of patients continue to receive prescriptions far longer than the recommended maximum timeframe of 2 – 4 weeks, at higher dosages than the recommended minimum, and for a host of conditions that are less than “severe” in nature, according to a 2019 review in the British Journal of General Practice.18

As of 2018, Xanax prescriptions topped the list of ALL psychotropic medications in the US, with about 48,000,000 prescriptions written in 2013 alone.16

Off-label use of benzodiazepines is reportedly rampant. A 2019 study out of Barcelona found that of patients taking benzodiazepines long-term, over 96% were for off-label indications.19-21,23

The soaring use of prescription drugs is particularly concerning in the western world. A review published in the Journal of Demography studied the historic patterns in the US population, and predicted that newborns born in 2019 will be taking prescription drugs for half their lifetimes.22

Xanax is licensed to treat:
  • Acute generalized anxiety disorder in adults
  • Acute panic disorder in adults, with or without agoraphobia
Off-label uses include:
  • Depression
  • Insomnia
  • PMS
  • Substance Use disorders
  • Seizures
  • Alcohol withdrawal
  • Epilepsy
  • Muscle spasms
  • Catatonia that presents in Bipolar and schizophrenia

benzo panic attacks

While Xanax can very quickly dampen anxiety or insomnia for a brief period, and is effective at aborting an acute seizure, drug tolerance sets in rapidly. Symptoms can return and sometimes with a vengeance. This is why dosages are so often raised over the course of treatment. However, in addition to the original symptoms returning, new drug-induced effects may also occur. It is truly tragic that GPs prescribe the majority of Xanax prescription, but receive inadequate training on the drugs used for mental health. After all, medical doctors are not mental health specialists.

Xanax, like all benzodiazepines, has a high risk of addiction and dependence after even short-term use. Most people would never choose a drug that is so troublesome to stop taking. Benzodiazepines can produce harsh discontinuation effects even after taking them for a short time, and even after drug tolerance has developed. Never abruptly stop taking a benzodiazepine, even if you feel it “isn’t working” anymore.1,6

Frequent Errors in Prescribing

As early as 1988, the British Association of Pharmacology issued warnings against using benzodiazepines longer than 2 to 4 weeks.1 This was based on several safety studies that concluded benzodiazepines should be given only in the lowest dose possible and only for 2 to 4 weeks at the absolute maximum. This was because tolerance tends to develop quite quickly, and this can result in new symptoms emerging and original symptoms returning and even intensifying.

A person may go back to their prescriber with concerns about drug reactions they are experiencing. The typical response is for the prescriber to increase the dosage. Also common, the doctor may switch the patient to another drug or multiple drugs. This type of experimentation approach often induces worsening symptoms. This can cause a cascade of unpredictable outcomes. Doctors are trained to think they are preventing a relapse, or mistakenly interpret these symptoms as newly developing mental illness and put a label on it. In many cases, the more drugs they prescribe the worse their patient gets.

In 2018, published guidelines indicated that benzodiazepines prescribed for acute insomnia or disabling anxiety should be considered a “one-off” and the 2- to 4-week period includes coming off the drug. Additionally, tapering to zero was to be done as quickly as possible. While this is much preferable to taking Benzos for 20 years and then being unable to stop taking them at all, tapering Xanax quickly is NOT recommended. Typically, it takes longer than a few days or a week to achieve safe cessation.1,6,7

Researchers concluded that physicians should not prescribe benzodiazepines at all in treatment for mild anxiety or long-term insomnia. While the drug can mask symptoms, benzodiazepines can in no way be considered to cure anything. And after stopping Xanax, or other benzos, the symptoms will typically return, sometimes referred to as “relapsing.”

Safe Guidelines vs Prescription Errors

With the above guidelines, it seems likely that doctors may have prescribed benzodiazepines to many patients in error. Also, a patient may have taken Xanax for much longer periods of time than the guidelines say. Trying to quit Xanax or similar drugs under these circumstances may devolve into quite a complex issue. Actually, this is probably closer to the “norm” rather than the exception, as most doctors seem to be surprisingly unaware of these cautions, safety studies, and guidelines. This, unfortunately, may have caused many patients to suffer from inadvertent drug dependence or addiction. And, sets up a kind of trap where a person feels they must continue to take the drug or else suffer harsh and intolerable withdrawal effects. Yet, doctors are ill-equipped to give very much help or information about how to get off Xanax. We can help.

Xanax Tapering Before Pregnancy

Studies such as the 2021 report from the Agency Healthcare Research inform us about many troubling consequences occurring in infants where the mother was taking Xanax either early in pregnancy or before conception. Unfortunately, such outcomes include ectopic pregnancy and a higher incidence of needing newborn intensive care.5

It follows then, a significant health risk arises if a woman taking benzodiazepines is of child-bearing age and especially when a woman is planning a pregnancy. This data should be given appropriate attention since we additionally learn from the Psychiatric Textbook of Psychosomatic Medicine published in 2011 that between 21-33% of all pregnant women in the US were on prescription medication and that the most frequently prescribed psychotropic medicine of all is benzodiazepines.16,17

Finding and Treating Root Causes

For anxiety and insomnia, the effort to delve into root causes could have prevented simply offering the patient a prescription for benzodiazepines. root causes of your anxietyFor instance, did you know that Cambridge University published a study in 2018 that outlines a relationship between gut bacteria, anxiety, and depression? 2

We highly recommend one investigate the root causes of unwanted symptoms before starting on benzos. For example, overlooked contributing factors could include a dysfunctional thyroid, cardiovascular health issues, a body that has accumulated toxins, urban-living stress, poor diet, and food allergies. All of these factors may contribute to or trigger anxiety.3,8-15

Fortunately, lab testing can explore biological, genetic, dietary, and toxic areas of interest, so they can be effectively addressed in treatment. Treating the underlying causes — neurotoxin removal for example — will relieve conditions like anxiety, stress, depression, and insomnia. These and other areas should be carefully checked to discover what may actually be causing their anxiety or insomnia. That will open the door to reducing or entirely eliminating the symptoms. And, doing so can reduce or eliminate the need to take anti-anxiety benzodiazepines. This stands at the very heart of the programs at Alternative to Meds Center.

Holistic Methods Provided by Alternative to Meds

At Alternative to Meds Center, we use a wide range of holistic treatments before, during, and after Xanax tapering.

Holistic Xanax tapering steps include:

Find Out More About the Xanax Tapering Program at Alternative to Meds

Perhaps you or your loved one are in the difficult position of wanting to get off Xanax, but you are feeling trapped and frustrated, not knowing exactly how to proceed. Do not despair.

We have been helping our clients complete their Xanax tapering programs with consistent success and significant improvements in natural mental health for over 17 years. Please feel free to contact us at Alternative to Meds Center. Xanax tapering is our specialty, and we have helped thousands of clients to reach their health goals.

Sources:


1. Ashton H, Protocol for the Treatment of Benzodiazepine Withdrawal [revised 2002] [cited 2023 April 18]

2. Abautret-Daly, Á, Dempsey, E., Parra-Blanco, A., Medina, C., & Harkin, A. (2018). Gut–brain actions underlying comorbid anxiety and depression associated with inflammatory bowel diseaseActa Neuropsychiatrica, 30(5), 275-296. doi:10.1017/neu.2017.3 [cited 2023 April 18]

3. Gomi C, Yokota Y, Yoshida S, Kunugi H. Relationship of food allergy with quality of life and sleep in psychiatric patients. Neuropsychopharmacol Rep. 2022 Mar;42(1):84-91. doi: 10.1002/npr2.12231. Epub 2022 Jan 28. PMID: 35090099; PMCID: PMC8919116. [cited 2023 April 18]

4. “FDA Label Xanax (alprazolam hydrochloride) tablets, for oral use [approval 1981, revised 2016 Sept] [cited 2023 April 18]

5. Viswanathan M, Middleton JC, Stuebe A, Berkman N, Goulding AN, McLaurin-Jiang S, Dotson AB, Coker-Schwimmer M, Baker C, Voisin C, Bann C, Gaynes BN. Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Apr. Report No.: 21-EHC001. PMID: 33950611. [cited 2023 April 18]

6. Guina J, Merrill B. Benzodiazepines I: Upping the Care on Downers: The Evidence of Risks, Benefits and AlternativesJ Clin Med. 2018;7(2):17. Published 2018 Jan 30. doi:10.3390/jcm7020017 [cited 2023 April 18]

7. Higgitt A, Fonagy P, Lader M. The natural history of tolerance to the benzodiazepines. Psychol Med Monogr Suppl. 1988;13:1-55. doi: 10.1017/s0264180100000412. PMID: 2908516. [cited 2023 April 18]

8. Lader M, Tylee A, Donoghue J. Withdrawing benzodiazepines in primary care. CNS Drugs. 2009;23(1):19-34. doi: 10.2165/0023210-200923010-00002. PMID: 19062773. [cited 2023 April 18]

9. Aucoin M, LaChance L, Naidoo U, Remy D, Shekdar T, Sayar N, Cardozo V, Rawana T, Chan I, Cooley K. Diet and Anxiety: A Scoping Review. Nutrients. 2021 Dec 10;13(12):4418. doi: 10.3390/nu13124418. PMID: 34959972; PMCID: PMC8706568. [cited 2023 April 18]

10. Costa E Silva JA, Steffen RE. Urban environment and psychiatric disorders: a review of the neuroscience and biology. Metabolism. 2019 Nov;100S:153940. doi: 10.1016/j.metabol.2019.07.004. PMID: 31610855. [cited 2023 April 18]

11. Aucoin M, LaChance L, Cooley K, Kidd S. Diet and Psychosis: A Scoping Review. Neuropsychobiology. 2020;79(1):20-42. doi: 10.1159/000493399. Epub 2018 Oct 25. PMID: 30359969. [cited 2023 April 18]

12. Bakthavachalu P, Kannan SM, Qoronfleh MW. Food Color and Autism: A Meta-Analysis. Adv Neurobiol. 2020;24:481-504. doi: 10.1007/978-3-030-30402-7_15. PMID: 32006369. [cited 2023 April 18]

13. Owen L, Corfe B. The role of diet and nutrition on mental health and wellbeing. Proc Nutr Soc. 2017 Nov;76(4):425-426. doi: 10.1017/S0029665117001057. Epub 2017 Jul 14. PMID: 28707609. [cited 2023 April 18]

14. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci. 2015 Sep;17(3):337-46. doi: 10.31887/DCNS.2015.17.3/akaczkurkin. PMID: 26487814; PMCID: PMC4610618. [cited 2023 April 18]

15. Siegmann EM, Müller HHO, Luecke C, Philipsen A, Kornhuber J, Grömer TW. Association of Depression and Anxiety Disorders With Autoimmune Thyroiditis: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2018 Jun 1;75(6):577-584. doi: 10.1001/jamapsychiatry.2018.0190. Erratum in: JAMA Psychiatry. 2019 Jun 19;: PMID: 29800939; PMCID: PMC6137529. [cited 2023 April 18]

16. Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and WithdrawalJournal of addiction medicine12(1), 4–10. https://doi.org/10.1097/ADM.0000000000000350  [cited 2023 April 18]

17. Levenson, JL (2011) The American Psychiatric Publishing Textbook of Psychosomatic Medicine: psychiatric care of the medically ill. American Psychiatric Pub. 2011 ISBN 978-1-58562-379-2 [cited 2023 April 18]

18. Kennedy K M, O’Riordan J, British Journal of General Practice 2019; 69 (680): 152-153. DOI:https://doi.org/10.3399/bjgp19X701753 Prescribing benzodiazepines in general practice [cited 2023 Dec 5]

19. López-Pelayo H, Coma A, Gual A, Zara C, Lligoña A. Call for Action: Benzodiazepine Prescription Prevalence Analysis Shows Off-Label Prescription in One in Eleven Citizens. Eur Addict Res. 2019;25(6):320-329. doi: 10.1159/000502518. Epub 2019 Sep 6. PMID: 31494655. [cited 2023 Dec 5]

20. George TT, Tripp J. Alprazolam. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538165/  [cited 2023 Dec 5]

21. Waal H, Bramness JG. Benzodiazepiner til personer med rusmiddelproblemer? [Benzodiazepines to people with substance abuse problems?]. Tidsskr Nor Laegeforen. 2010 Mar 25;130(6):610-2. Norwegian. doi: 10.4045/tidsskr.09.0687. PMID: 20349006. [cited 2023 Dec 5]

22. Ho JY. Life Course Patterns of Prescription Drug Use in the United States. Demography. 2023 Oct 1;60(5):1549-1579. doi: 10.1215/00703370-10965990. PMID: 37728437; PMCID: PMC10656114. [cited 2023 Dec 5]

23. Edinoff AN, Nix CA, Hollier J, Sagrera CE, Delacroix BM, Abubakar T, Cornett EM, Kaye AM, Kaye AD. Benzodiazepines: Uses, Dangers, and Clinical Considerations. Neurol Int. 2021 Nov 10;13(4):594-607. doi: 10.3390/neurolint13040059. PMID: 34842811; PMCID: PMC8629021. [cited 2023 Dec 5]


Originally Published Dec 7, 2019 by Lyle Murphy


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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