Alprazolam, whose trade name is Xanax, is a drug belonging to the benzodiazepine family; it is used to treat anxiety disorders, panic attacks and other psychiatric problems. This family of medicines increases the action of a neurotransmitter, a chemical messenger in the brain, called GABA. Prolonged intake of alprazolam can cause dependence and addiction; abruptly stopping its use can therefore cause withdrawal symptoms, which may be moderate or severe in intensity. If you stop taking benzodiazepines, such as alprazolam, you risk even life-threatening withdrawal syndrome. For this reason, it is important to take certain precautionary measures to stop therapy safely and correctly. Follow the guidelines described in this tutorial.
Steps
Part 1 of 3: Gradually Reduce Dosage
Step 1. See your doctor
Whenever you want to stop taking benzodiazepines, you need to be supervised by a doctor who is experienced in this process. In this way he can check that everything is happening safely and will monitor progress adapting the reduction program from time to time according to your needs.
Tell your doctor about all medications and supplements you are taking. Remember to report any medical conditions you suffer from, as both of these factors play an important role in the drug reduction program
Step 2. Follow the doctor's schedule
The worst withdrawal reactions are caused by abruptly stopping alprazolam. Experts recommend not to stop taking benzodiazepines abruptly. A gradual reduction allows you to decrease the dosage slowly over time. Withdrawal symptoms can be controlled and minimized by lowering the dosage step by step over a long period; in this way the organism has plenty of time to adapt. Once your body has stabilized at the new dosage, you can decrease it once more. Do not stop taking it until you reach the minimum dose.
If you've been taking benzodiazepines for a year, the neurological receptors will most likely take longer to recover. In this case, you need to follow a slower "detox" program
Step 3. Discuss switching to diazepam with your doctor
If you have been taking alprazolam for a long time (more than six months), your doctor may recommend that you switch to a benzodiazepine with a long half-life, such as diazepam. Generally, this solution is recommended for patients being treated with a high dose of alprazolam. Diazepam works just like alprazolam, but has a longer lasting effect. This means that it stays in the body for a longer time and consequently the withdrawal symptoms are less severe.
- The fact that this alternative drug is available in liquid and low-dose tablet form is another useful advantage in the tapering process. The transition from prazolam to diazepam can be immediate or progressive.
- If your doctor decides to change your medication, he will initially prescribe a dose equivalent to that of alprazolam. Typically, 10 mg of diazepam corresponds to 1 mg of alprazolam.
Step 4. Divide the daily dosage into three intakes
Your doctor may recommend this strategy, but it may depend on the dose and how long you take the drug. For example, if you have been taking alprazolam for a long time, your "detox" schedule will be longer or the reduction in weekly doses will be less.
The schedule can be changed according to the reactions of the organism
Step 5. Reduce the amount of medicine every two weeks
If you are taking diazepam, your doctor will usually suggest you decrease the dose by 20-25% every two weeks or always by 20-25% in the first and second weeks and then keep a 10% reduction in the following weeks. Some doctors prefer to set a schedule that includes a 10% decrease every week or two, until the patient reaches 20% of the starting amount. At this point we move to a 5% reduction every two or four weeks.
If you are taking diazepam to replace alprazolam, you shouldn't lower your dosage by more than 5mg per week. You should reduce this by 1-2 mg per week until you reach the 20 mg dosage
Step 6. Remember that the drug withdrawal schedule is tailored for you
There is no universally valid plan, just like there is no one pair of shoes that will suit everyone. The schedule set by your doctor takes into account several factors, such as your current dose, how long you have been taking it and the withdrawal symptoms you are experiencing.
- If you have been taking alprazolam sporadically and on a low dose, your doctor may also advise you not to taper off gradually or plan a faster taper than in long-term patients on a consistent high dose.
- Usually, all people who have taken benzodiazepines for more than eight weeks need a tapering program.
Part 2 of 3: Taking Care of Yourself While Reducing Your Dosage
Step 1. Talk to the pharmacist, he is one of your "best friends" during this process
His knowledge and expertise are vital for your "detox" to be successful. Your pharmacist can be of great help in telling you which combinations of over-the-counter and prescription medicines to avoid and how to avoid other unpleasant drug problems.
If your doctor prescribes different medications than alprazolam, then your reduction plan will need to take this into account
Step 2. Stay healthy as you go through the process
In some cases the side effects interfere with daily life. However, it is important to take care of yourself throughout the drug reduction program to help the body detoxify. Although there are no studies that directly prove this, physical activity and good general health are beneficial and minimize the unpleasant effects.
- Drink lots of fluids;
- Eat a healthy diet full of fresh fruits and vegetables. Avoid refined and industrially processed foods;
- Try to sleep as much as you can;
- Exercise regularly.
Step 3. Don't drink caffeine, alcohol and don't use tobacco products
While you are busy cutting down on psychiatric drugs, you should limit your caffeine intake, as well as alcohol and tobacco use. Alcohol, for example, generates toxins within the body that prevent the recovery process.
Step 4. Do not take over-the-counter medications without consulting your pharmacist first
However, these medicines (including antihistamines and sleeping pills) should still be taken under medical or pharmacist supervision, as they can alter the central nervous system while reducing benzodiazepines.
Step 5. Keep a journal
The "detox" program is based on factors such as dosage and duration of therapy. For this reason, it is important to monitor drug reductions, note when they occur and the new dosage. You should also write down the effects of these changes and the symptoms you experience, so that your doctor can adapt the process to your physical and emotional reactions. Remember that as the program continues, you will make minimal changes and modifications.
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A journal organized on a spreadsheet might follow this pattern:
- 1) Date: January 1, 2015;
- 2) Hours: 12:00;
- 3) Current dose: 2 mg;
- 4) Reduction: 0.02 mg;
- 5) Total reduction: 1,88 mg.
- You can also add a lot of details for the various dosages you take throughout the day.
- Also remember to write down withdrawal symptoms and mood fluctuations.
Step 6. Go to the doctor for regular check-ups
During the process, you should see your doctor every 1-4 weeks, depending on your schedule. Tell them about any concerns and difficulties you encounter.
- Tell them any withdrawal symptoms you experience, such as anxiety, irritability, agitation, insomnia, panic, or headache.
- If you experience severe symptoms, such as seizures and hallucinations, go to the emergency room immediately.
Step 7. Find out about other medicines
If you experience severe withdrawal symptoms, your doctor may prescribe medications to relieve them. Antiepileptics may be useful to control seizures, such as carbamazepine. During the alprazolam detoxification process, seizures are a frequent problem.
If the doctor has developed a slow reduction plan, anticonvulsants are usually not needed
Step 8. Get examined by a psychiatrist
You need to pay attention to your mental health after you stop taking benzodiazepines, as it can take weeks, even months or even years, before the neurological changes caused by this class of drugs can be reversed. The acute phase can last up to three months, but full recovery takes about two years. When you are fully healed, you will be able to enjoy emotional security and physical well-being. However, it is a process and you need to take care of your overall health gradually, just as healing occurs after drug detox. For this reason, it is worth going to a psychologist or psychiatrist during this phase.
Consider continuing psychological therapy even after stopping the drug
Step 9. Consider the twelve point rehabilitation programs
If you have been taking large doses of alprazolam, you may want to sign up for one of these programs. Although they are different from the process developed by your doctor to reduce the amount of the drug, they are very useful in case you become addicted to benzodiazepines.
Part 3 of 3: Understanding the Medication Discontinuation Process
Step 1. Understand why stopping medication is dangerous without a doctor's supervision
Alprazolam, known as Xanax, is a medicine that belongs to the benzodiazepine family. It is used to treat anxiety disorders, panic attacks and other psychiatric problems. This family of drugs increases the action of a neurotransmitter, or brain chemical messenger, called GABA. When taken for a long time, alprazolam is addictive and addictive. If therapy is stopped abruptly, you may experience severe withdrawal symptoms as your brain chemistry tries to regain balance. Remember that stopping benzodiazepines, such as alprazolam, can lead to life-threatening withdrawal syndrome.
In some cases, discontinuation of the drug without medical supervision led to the patient's death
Step 2. Learn to recognize withdrawal symptoms
Read up on these reactions triggered by reducing the dosage of benzadiazepine before starting the "detox" process. This way, you can find some relief from the mental anguish caused by not knowing what will happen and you will not have any nasty surprises. Gradual reduction of the dosage under medical supervision minimizes the intensity of symptoms; you may experience different combinations (and varying in intensity) of the discomforts listed below:
- Anxiety;
- Irritability;
- Agitation;
- Insomnia;
- Panic;
- Depression;
- Headache
- Nausea;
- Exhaustion;
- Blurred vision;
- Muscle aches and general malaise.
Step 3. Be aware of severe symptoms
Important reactions to drug withdrawal are hallucinations, delirium and convulsions. If you experience any of these symptoms, go to the emergency room immediately.
Step 4. Find out how long your symptoms last
Alprazolam can trigger withdrawal reactions approximately six hours after the last dose. These reach maximum intensity within 24 to 72 hours and can last from 2 to 4 weeks.
Remember that until you have completed the reduction program, your body will always be in a mild state of abstinence. This is why a slow and gradual detox is recommended
Step 5. Be patient during your recovery
Generally, it is recommended that you follow a slow schedule that suits your reactions. If you set a slower taper, your symptoms will be less severe. The goal is to be able to stop taking the drug without experiencing prolonged side effects and not to stop the medicine as soon as possible. In this second case the only results you would get would be those of suffering from severe symptoms, of not being able to properly restore the GABA receptors and therefore of altering the recovery process. The brain will take longer to return to its normal functions after stopping the drug, depending on how long the therapy with this type of sedative and hypnotic lasted.
- It is generally estimated that the reduction process should last six to eighteen months, depending on the dosage, age and general health of the patient, the stressors to which he is subjected and the duration of therapy. Regardless of what your doctor recommends, the program should be:
- Slow and gradual;
- Organized: the doctor must establish the exact dosage and frequency of intakes, not limiting himself to a prescription "as needed";
- Modifiable according to the symptoms you manifest or to the exacerbation of the disease or anxiety;
- Checked on a weekly or monthly basis, depending on your specific situation.
