Benzodiazepine Withdrawal Timeline: What to Expect After Xanax

Xanax (alprazolam) is one of the most commonly prescribed medications for anxiety and panic disorders. While it can provide quick relief, it also carries a high risk of dependence. Many people start taking Xanax as prescribed but find it difficult to stop because of withdrawal symptoms.

If you or someone you love is considering quitting Xanax, understanding the withdrawal timeline is essential. This guide explains what to expect, why withdrawal can be dangerous, and how to manage it safely.

Why Xanax Withdrawal Happens

Xanax belongs to the benzodiazepine class of drugs, which work by enhancing the effects of gamma-aminobutyric acid (GABA). GABA is a calming neurotransmitter that reduces overactivity in the brain. When taken regularly, Xanax changes the brain’s chemistry. Over time, the brain becomes dependent on the drug to feel calm.

When someone stops taking Xanax, the brain struggles to adjust, leading to withdrawal symptoms such as anxiety, insomnia, and in severe cases, seizures.

According to the National Institute on Drug Abuse (NIDA), nearly 4.8 million Americans misused prescription benzodiazepines in 2021【NIDA, 2022】. Many of these individuals experienced withdrawal when attempting to quit.

Symptoms of Xanax Withdrawal

Withdrawal symptoms can range from mild discomfort to severe, life-threatening conditions.

Common Symptoms

• Anxiety and panic attacks
  
• Insomnia or disturbed sleep
  
• Irritability and mood swings
  
• Muscle pain and stiffness
  
• Sweating and tremors
  
• Headaches and blurred vision
  

Severe Symptoms

• Seizures
  
• Hallucinations
  
• Delirium (confusion and agitation)
  
• Suicidal thoughts
  

These symptoms make quitting Xanax without medical help very risky.

The Xanax Withdrawal Timeline

The length and intensity of withdrawal depend on factors such as dosage, duration of use, and individual health. Xanax is a short-acting benzodiazepine, which means withdrawal symptoms begin sooner compared to longer-acting drugs like Valium (diazepam).

6–12 Hours After Last Dose

• Early withdrawal begins.
  
• Anxiety, irritability, and insomnia often appear first.
  

1–3 Days (Acute Stage)

• Symptoms intensify.
  
• Panic attacks, sweating, nausea, and tremors are common.
  
• Seizure risk is highest during this period.
  

4–7 Days

• Symptoms remain strong but may begin to stabilize.
  
• Sleep problems, mood swings, and cravings persist.
  

1–2 Weeks

• Most physical symptoms improve.
  
• Emotional symptoms like depression, anxiety, and irritability continue.
  

Weeks to Months (Post-Acute Withdrawal Syndrome – PAWS)

• Some individuals experience ongoing symptoms such as anxiety, poor concentration, or sleep disturbances.
  
• PAWS can last for several months and requires long-term management.
  

Why Tapering Is Safer Than Stopping Suddenly

Stopping Xanax “cold turkey” can be life-threatening. Instead, doctors recommend tapering, or gradually lowering the dose over time.

Benefits of Tapering

• Reduces the risk of seizures
  
• Eases anxiety and insomnia
  
• Allows the brain and body to adjust slowly
  
• Increases the chance of long-term recovery
  

The American Society of Addiction Medicine (ASAM) emphasizes tapering as the safest way to discontinue benzodiazepines【ASAM, 2020】.

Medical Support for Withdrawal

Professional medical supervision makes withdrawal safer and more comfortable.

Medical Detox

• Conducted in hospitals or detox centers
  
• Doctors monitor vital signs and provide medications to ease symptoms
  
• May involve switching from Xanax to a longer-acting benzodiazepine for tapering
  

Medications Used During Detox

• Anticonvulsants (to prevent seizures)
  
• Antidepressants (to stabilize mood)
  
• Sleep aids (non-addictive options)
  
• Beta-blockers (to reduce rapid heart rate and tremors)
  

Rehab and Therapy Options

Detox addresses the physical side of withdrawal, but long-term recovery requires therapy and support.

Inpatient Rehab

• Patients stay in a structured environment for 30–90 days.
  
• Provides 24/7 support and intensive therapy.
  
• Best for severe addiction or high relapse risk.
  

Outpatient Rehab

• Patients live at home but attend therapy sessions several times a week.
  
• Offers flexibility for work, school, or family responsibilities.
  
• Suitable for mild to moderate cases.
  

Therapies That Work

1. Cognitive Behavioral Therapy (CBT): Helps individuals manage anxiety and change harmful thought patterns.
   
2. Dialectical Behavior Therapy (DBT): Teaches emotional regulation and coping skills.
   
3. Motivational Interviewing (MI): Builds motivation and commitment to recovery.
   
4. Family Therapy: Involves loved ones in the healing process.
   

Aftercare and Long-Term Recovery

Even after withdrawal, many people face ongoing anxiety or cravings. Aftercare helps maintain progress.

Options Include:

• Support Groups: Narcotics Anonymous (NA) or SMART Recovery provide peer encouragement.
  
• Ongoing Therapy: Weekly sessions with a counselor or therapist.
  
• Sober Living Homes: Structured, drug-free housing for those transitioning back to daily life.
  
• Healthy Habits: Regular exercise, mindfulness, and good nutrition strengthen recovery.
  

The NIDA notes that relapse rates for addiction are 40–60%, similar to other chronic illnesses like diabetes or hypertension【NIDA, 2018】. Continued support is key to lowering this risk.

Supporting a Loved One Through Withdrawal

Family and friends can make a big difference in recovery. Here’s how:

• Encourage professional treatment rather than home detox.
  
• Provide emotional support without judgment.
  
• Learn about benzodiazepine addiction to better understand the process.
  
• Watch for warning signs of relapse or mental health struggles.
  

When to Seek Emergency Help

Seek immediate medical care if:

• Seizures occur
  
• The person experiences hallucinations or delirium
  
• Severe depression or suicidal thoughts appear
  

In the U.S., call 911 for emergencies or 988 for the Suicide & Crisis Lifeline. For treatment referrals, call SAMHSA’s Helpline at 1-800-662-4357.

Conclusion

Xanax withdrawal can be one of the most difficult and dangerous experiences, but recovery is possible. Symptoms usually begin within hours, peak in the first few days, and may last weeks or longer. A safe tapering plan, medical supervision, and ongoing rehab support make withdrawal manageable.