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Cold Turkey Withdrawal from Xanax: Dangers and What to Expect

Xanax is the brand name of alprazolam, a fast-acting benzodiazepine drug. Medications in this family of sedatives are designed to treat anxiety disorders like generalized anxiety, panic attacks, and anxiety with depression.

Although some kinds of benzodiazepines may also be prescribed on a short-term basis to treat sleep disorders like insomnia, or on a long-term basis to treat seizure disorders like epilepsy, Xanax is not one of the preferred benzodiazepine formulas prescribed for these conditions.

This benzodiazepine acts so quickly and metabolizes out of the body so fast that it works best as needed for panic or anxiety problems. It should not be considered a consistent treatment for any condition even when it is prescribed for less than a week.


Tapering with the oversight of a medical professional is the best course of action. Entering a detox program, getting assessed by a physician, receiving a diagnosis, and undergoing a medically supervised treatment plan is the best way to avoid severe, dangerous symptoms from Xanax withdrawal.

Your doctor may determine that you can safely follow a plan at home through an outpatient detox program. This may involve small doses of prescription drugs like anti-nausea medications, over-the-counter painkillers, and vitamin supplements.

You may receive a prescription for Valium, which is a longer-acting benzodiazepine, and then begin a tapering regimen from the starting dose. You will go into your doctor’s office regularly for checkups to make sure your withdrawal symptoms are appropriately managed, and you are not at risk of life-threatening problems.

If you develop any issues with serious insomnia or muscle twitches that could indicate seizures, you may be transferred to inpatient detox for safety.

If your doctor determines that you can safely manage detox at home, you will also be able to work with social workers or counselors to manage psychological problems. You should also speak with your friends and family to get social support, plan several healthy meals for yourself, determine if you would benefit from a mindfulness meditation program, stock up on movies and books you enjoy, and find a low-impact exercise you can regularly do so that you feel better mentally and physically. These will all help you through detox.

“Because of how benzodiazepines, especially Xanax, impact the brain, there is not a safe way to detox cold turkey at home without medical oversight. You need to know how your withdrawal symptoms will impact your life, so you know if you are safe during this process. The risk of dangerous, life-threatening symptoms from withdrawing from Xanax are too risky to take on by yourself.”

However, the desire to stop abusing this drug is a good impulse, so make sure you pursue evidence-based methods for protecting yourself during detox. 

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Fast-acting intoxicating sedatives like Xanax are very addictive because they bind to receptors in the brain so quickly. In general, benzodiazepine medications are risky. They are not often prescribed for longer than two weeks of regular use because the brain becomes dependent on them so easily. This dependence leads to severe withdrawal symptoms, which are at the least uncomfortable and worst life-threatening.

Many people struggle with being physically dependent on benzodiazepines like Xanax even if they took the medication as prescribed. If you work with an overseeing physician or psychiatrist, ask how you can safely quit abusing this drug. The medical professional will work with you to taper your dose of Xanax down until you no longer need the medication to manage neurotransmitters, and you feel normal. In some cases, they may switch you to a long-acting benzodiazepine before beginning the taper.

If you abused Xanax without a prescription or without appropriate medical oversight, working with a detox program to safely stop taking this drug is equally important. While most people experience uncomfortable withdrawal symptoms from quitting Xanax, some people are at risk of suffering from seizures or hallucinations because of how Xanax and other benzodiazepines work in the brain. 


Benzodiazepines, including Xanax, bind to receptors that are part of the gamma-Aminobutyric acid (GABA) system. This system manages the GABA neurotransmitter, which is involved in slowing down the firing between motor neurons. Without enough naturally produced GABA, you will feel anxious, experience panic attacks, or even experience seizures. With normal amounts of the GABA neurotransmitter, either from natural brain chemistry or with the help of prescription medications, these symptoms will not show up.

People who struggle with benzodiazepine abuse may feel afraid to quit the drug because the rebound experience of anxiety and insomnia can be so stressful. They may worry that their anxiety or panic attacks will never be well managed.

It is important to know that any psychiatric drug, especially potent sedatives like Xanax, should be taken alongside cognitive behavioral therapy or a related form of talk therapy. Working on behavioral changes will help to reduce the symptoms of anxiety on a long-term basis. Taking a pill will stop the symptoms immediately, but it can lead to problematic behaviors in the long run.

In low-to-moderate doses, Xanax can cause various symptoms, including:


  •  Euphoria
  •  Sleepiness
  •  Impaired thinking and memory
  •  Confusion
  •  Depression
  •  Changes to vision or speech
  •  Vertigo
  •  Tremors
  •  Respiratory depression

Higher doses will lead to symptoms that are similar to being drunk because alcohol also works on the GABA system. Typically, people who try to quit Xanax cold turkey, or all of a sudden, will experience uncomfortable withdrawal symptoms such as:


  •  Nausea and vomiting
  •  Malaise
  •  Blurry vision
  •  Sweating
  •  Nightmares
  •  Insomnia
  •  Depression
  •  Rebound anxiety and panic attacks
  •  Loss of muscle coordination
  •  Twitching or spasms in the muscles
  •  Tinnitus

For a medication as short-acting as Xanax, these symptoms are likely to last about one week after the last dose; however, this depends on how large the doses of Xanax were and how long you abused the drug. People who abuse Xanax for months or years, especially in doses much larger than prescribed, are more likely to develop a protracted withdrawal syndrome (PWS), in which uncomfortable symptoms, especially rebound anxiety and insomnia, can continue for several weeks.

If you abuse a lot of Xanax, for a long time, you are also at risk of life-threatening withdrawal symptoms.


  •  Hallucinations
  •  Extreme confusion (delirium)
  •  Psychotic symptoms
  •  Detachment from reality
  •  Seizures

Xanax abuse is associated with a higher risk of life-threatening symptoms. Trying to quit Xanax cold turkey is also associated with a higher risk of relapse. People who cycle through several attempts to quit followed by relapse back into substance abuse are at risk of acute overdose, and they are at higher risk of developing life-threatening symptoms like seizures when they try to quit again later.


Xanax and other benzodiazepines are among the most widely abused drugs, and they are also widely available. The National Institute on Drug Abuse (NIDA) reported that benzodiazepines were responsible for most of the admissions to the emergency room that involved central nervous system (CNS) depressants in 2009.

Abusing Xanax in high doses or for a long time can change how your brain manages neurotransmitters, which makes it a difficult drug to stop using. Because of the life-threatening withdrawal symptoms, it is crucial to get a diagnosis of your withdrawal condition from a medical professional, like a physician working with a medical detox program, so you know if you can safely detox at home or if you need more medical supervision.

Another important aspect of benzodiazepine detox, especially from Xanax, is that you can get referred to rehabilitation after you have ended your body’s dependence on the sedative.

If you try to quit at home, cold turkey, you are less likely to continue on to behavioral therapy, which is a core component of overall addiction treatment.

Overcoming substance abuse is a long-term process of which detox is the first step. You also need therapy to understand compulsive behaviors and learn to manage these differently. You then need to create an aftercare plan that will keep you healthy.

A doctor holding a pill bottle and speaking to a patient

NIDA recommends this long-term process in its Principles of Effective Treatment, noting that relapse is not a sign that your treatment failed because addiction is a chronic illness. Instead, it is a sign that you should return to evidence-based treatment to keep yourself healthy.


(May 10, 2017). What is Xanax (Alprazolam)? Everyday Health. Retrieved from

(January 2013). Benzodiazepines. Drug Enforcement Administration (DEA), Office of Diversion Control, Drug & Chemical Evaluation Section. Retrieved from

Center for Substance Abuse Research (CESAR) . Benzodiazepines. Retrieved from

Benzodiazepines: What are the Dangers of Benzodiazepine Withdrawal? RxList. Retrieved from

Benzodiazepine Withdrawal Management: Withdrawal Syndrome. SA Health, Government of South Australia. Retrieved from

(August 2014). Benzodiazepines: Information for GPS. Drug and Alcohol Services South Australia. Retrieved from

Benzodiazepine Withdrawal. HealthyWA, Department of Health, Government of Western Australia. Retrieved from

(January 2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse (NIDA) Retrieved from




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