Alprazolam: Withdrawal Symptoms & Overdose Treatment

Instructor: Amy Albert

Amy is a Physician Assistant and certified professional coder. She holds a masters degree and has taught at the graduate school level.

Alprazolam, or Xanax, is a widely prescribed medication for anxiety. When not taken as prescribed, alprazolam can cause life threatening withdrawal symptoms and requires specific overdose treatment.

True Life Story

Patient X came to see me in the office for a sick visit. Normally I saw her monthly to follow up on her diabetes and high blood pressure. Today she appeared agitated and anxious. She was pacing in the room and fidgeted when she attempted to sit and talk. Sweat was beaded up on her brow and she had tremors in her hands. She appeared exhausted, with dark circles under her eyes. She said that she had been unable to sleep for the past several days. Today, Patient X stated that she woke up with widespread muscle pain and was worried that she was coming down the flu. She felt nauseated and vomited once. Patient X did not have the flu. She was experiencing acute withdrawal from Alprazolam, also known as Xanax.

Alprazolam pills, also known as Xanax
alprazolam pills

Hold it, What ?

Alprazolam is a medication prescribed to treat anxiety and panic disorder. It belongs to a class of medications known as benzodiazepines. Benzodiazepines are anxiolytics, meaning they treat anxiety. Alprazolam is the most widely used benzodiazepine. It works quickly and can decrease anxiety in a matter of minutes. Even though it is very effective, Alprazolam should only be used for several days. This is because it has the potential to be addictive, or habit forming. Also, individuals can build up tolerance to the medication. Tolerance means that over time people need to take an increased amount of the drug to get the same effect that a smaller dose once had. Problems arise if Alprazolam is stopped abruptly, since Alprazolam can cause withdrawal symptoms. Withdrawal is a syndrome of painful psychological and physiological symptoms that occur when an addictive medication is no longer taken. The severity of the withdrawal symptoms depends upon the dosage and length of time taking the medication. The higher the dose, the worse the withdrawal symptoms can be. Withdrawal from Alprazolam can range from mild discomfort to potentially life-threatening conditions.

Back to Patient X

Patient X was prescribed Alprazolam by her psychiatrist. She was instructed to take one pill three times daily and was given ninety pills per month. She had been taking the medication for several months. Patient X was under a lot of stress at home with her children and husband, so she decided to start taking four pills daily. She had built up tolerance to the medication and needed a higher dose to get relief from her anxiety. As a result, she ran out of her medication early, before she could get a refill. About 6-12 hours after her last dose she started to experience acute withdrawal symptoms. Acute withdrawal symptoms include anxiety, nervousness, and insomnia. Patient X came to see me two days after her last dose, just as the more severe withdrawal symptoms started. These symptoms include extreme anxiety, tremors, sweating, nausea, vomiting and possibly seizures. Seizures are abnormal brain activity that can result in loss of consciousness and irreversible brain damage. Seizures are the most severe withdrawal symptom of Alprazolam and can be life threatening.

How to prevent withdrawal symptoms

It is almost impossible to discontinue Alprazolam without any withdrawal symptoms. If attempting to stop the medication, it is best to do so under the care and guidance of a physician or in an addiction treatment center. Never go cold turkey. Going cold turkey means stopping the medication suddenly. This will produce the greatest withdrawal symptoms and possibly seizures. Slowly taper down the medication. To taper down a medication means to slowly cut back on the amount taken daily over the course of several days. Also, there are medications that can be used to treat some of the withdrawal symptoms, such as insomnia and nausea.

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