Katie asked
Since asking my last question, I have stopped Wellbutrin due to the side effects. I am tapering Xanax, which I only took once a day at 0.5mg. I am concerned if I take Zofran for nausea, it will affect my taper from Xanax. How long should I expect nausea to be a problem? I took Xanax 0.5mg once a day for approximately one year.
Answer
Benzodiazepines, such as Xanax (alprazolam), are well known to cause withdrawal symptoms in those who have been taking the medication for a long time. Potential withdrawal reactions while discontinuing Xanax include:
- Sweating
- Increased heart rate
- Muscle cramps
- Tremors
- Insomnia
- Anxiety
- Nausea and vomiting
There are certain factors that put some individuals at a higher risk of experiencing withdrawal reactions with benzodiazepines, which include:
- Use over one year
- High doses
- Short acting benzodiazepines
Xanax is considered a "fast acting", short duration of action benzodiazepine and therefore, tends to cause more withdrawal symptoms when compared to longer acting benzodiazepines like Valium.
If withdrawal symptoms do occur when you try to discontinue Xanax, most studies note that they begin quickly, within 1-2 days of a dose decrease, and can last from several days to several weeks, depending on the individual and how you are taping the medication. However, if withdrawal symptoms, like nausea, are particularly bad, it would be prudent to go back to your last well tolerated dose and decrease in a slower manner.
Methods of tapering Xanax vary and no single method is "best". Appropriate tapering schedules of Xanax should be discussed with your doctor. Nevertheless, the prescribing information for Xanax states the following:
"To discontinue treatment in patients taking XANAX, the dosage should be reduced slowly in keeping with good medical practice. It is suggested that the daily dosage of XANAX be decreased by no more than 0.5 mg every three days. Some patients may benefit from an even slower dosage reduction. In a controlled postmarketing discontinuation study of panic disorder patients which compared this recommended taper schedule with a slower taper schedule, no difference was observed between the groups in the proportion of patients who tapered to zero dose; however, the slower schedule was associated with a reduction in symptoms associated with a withdrawal syndrome."
Summary
- Benzodiazepines, such as Xanax, should be tapered if they have been taken for an extended period of time or you have been taking high doses.
- If withdrawal symptoms occur, they generally begin 1-2 days after a dose decrease and can last from days to weeks, depending on your tapering schedule.
- It is important to discuss with your doctor an appropriate tapering schedule for your specific medical situation.
