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How To Taper Off Xanax With Less Withdrawal Side Effects?

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Posted on Fri, 11 Jul 2014
Question: Hi, I have XXXXXXX taking xanax for 14 yrs. and my Doctor just stopped giving me a Rx. I have 90 pills left. I was taking 4 mg qid and now I'm at 0.25 mg a day. I have had some withdrawal problems but I am determined the stop with or without my Doctors help. I was also taking Klonopin but have stopped taking them and did ok. But now with the xanax it seems to be a lot harder to stop. I was on the meds for panic problems and agoraphobia. I still have problem with them but getting off the benzos is my main goal. Forget the panic problems. I just need help and a shoulder to support me. I do not have the money to pay for help but would like some feed back. Please help I have been referred to a mental health clinic but they do not give Rx for any benozs. I need to know if I need to stop taking the xanax and start back on Klonopin and then detox off of the klonopin again. Help is needed.
Sorry, I am taking 0.25 qid instead of 0.25 daily
doctor
Answered by Dr. Sunil Gupta (3 hours later)
Brief Answer:
Shifting to klonopin will make it easier.

Detailed Answer:
Hi,

I read your query in detail and do appreciate your determination to stop benzodiazepines. It was nice to know that you have already come down from 4 mg qid to 0.25 mg qid. That is indeed remarkable.

Xanax is Alprazolam which is comparatively a shorter acting drug. As a result it has more tendency to cause withdrawal effects when you try to taper it off. The best way to taper off is to shift to a longer acting agent like chlordiazepoxide (librium) or even clonazepam (klonopin) can be used. You can start taking equivalent amount of clonazepam (it will be around 2 mg per day, can be taken in divided doses) and then taper it gradually. I will recommend the tapering to be not more than 0.25 mg per week, since you are on benzodiazepines for very long.

You have also mentioned that you are suffering from Panic with agoraphobia. It would be a good idea to start treatment for the same as it will help getting off benzodiazepines in a much easier way. You can consider one of the selective serotonin reuptake inhibitors (SSRI) like sertraline or paroxetine for the same. In addition, start doing some amount of exercise daily. That will help you relax.

Hope, I was able to answer your query. Please feel free to ask any further questions that you might have.

Best wishes and happy quitting,

D. Sunil Gupta
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sunil Gupta (29 hours later)
Dr. D. XXXXXXX XXXXXXX

I stopped taking the Xanax on Sunday and started the Klonopin. So far I am not having many side effects. However, on Sunday I only took a 0.5mg at 11 am and
0.5mg at 11 pm. But, on Monday I had to take 0.5mg at 11 am, 0.5mg at 5 pm and 0.5mg at 11 pm. I think stopped everthing to fast on Sunday. I really did not know what to expect. May I dropped the dose to much a once. I thing I will try to stay on 0.5 mg at 11 am, 5pm and 11pm this week. I need to know if you agree on this and I ask you what the next step should be. I sure do not want to go back to Xanax. I think I have enough Klonopin to last a few weeks. My next fear is running out of the Klonopin. Also, I will need your advice on how to stop the Klonopin. I had already stopped it but since I started it back to help with the withdrawal from Xanax, I fear what it will take to stopped taking it. Also, how many weeks do you think it will take to be on Klonopin before stopping the it and what will be the best way to decrease the Klonopin. I hope you will be available to help me on this difficult time in my life. I hope I will be able to stay in contact with you during this. Thank you so much for what you have done to help me so for. My Doctor hear at XXXXXXX Tennessee just stopped giving me these Rx without a reason. I have never abused the meds. So I do not understand. He and I basicly grew up together and I was his father's Medical laboratory director and also worked in every department in his hospital. His father died in 1982 and I continued to work for the family. My goal now is to get off of the benzos for good. With your help I know we can do this. I will give you an update on Tuesday. Stay with me during this low time in my life. I need a friend even if is through e-mail.
Thanks for letting me cry on your shoulder.
doctor
Answered by Dr. Sunil Gupta (1 hour later)
Brief Answer:
Please see details below.

Detailed Answer:
Hello,

Thanks for following up and more importantly putting your faith on me. I am glad that you feel I will be able to help you. I can assure you that I will do my best to help you in these circumstances. You can totally depend on me for any advice. You are determined to do it and I am sure, like you said, we both can do it together.

Getting back to your stopping klonopin, I would suggest you go a bit slow. You are currently taking 0.5 mg three times a day and I would advice that you continue taking it for another 3-4 days. Thereafter, you can decrease the dose by 0.25 mg. Going slow will make sure that you don't have nay exacerbation of anxiety. I think it will take at least 3-4 weeks if we go this way and I hope that you have that much kolonopin left. You can decrease the dose by 0.25 mg every 5 days accordingly.

I also mentioned bout starting a SSRI like sertraline for panic disorder. Please do consider that too as it will help tapering and stopping klonopin efficiently.

I hope that you will be able to do it easily and my answers are helping you. I will be right here whenever you need me. You can also contact me directly at:
http://doctor.healthcaremagic.com/doctors/dr-sunil-gupta/67657

Best wishes and happy quitting,

D. Sunil Gupta

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sunil Gupta (22 hours later)
Dr. D. XXXXXXX XXXXXXX
I am having a hard time today. I have contuined taking Klonopin as before. But I am having a panic attack or bad withdrawal. They seem to be a whole lot alike.
You wanted to know my other meds. They are as follows.
Lexapro 20mg daily morning
Seroquil 300mg daily at night
Doxepin 100mg tid
Hydrocodone 10/325 for chronic pain
I do not know what to do. Today is the third day I have not taking any Xanax.
Using Klonopin 0.5mg in the morning and 0.5mg at night I seemed to be managing and not having any side effects. But, today and tonight I have not done as well as Sunday and Monday. It is a bad feeling. My question is what do I do? Do I need to take 0.5 of Klonopin as a breakout dose or just try to hang in and wait until my next dose tomorrow. I probably can do that but it will be a long night. I have not had my normal dose of Hydrocodone for 3 days I have been trying to cut it back also. So may be I need to take a whole dose of the Hydro.
Stopping the Xanax has been so hard and a eye opening event for me. I now know why so many people just throw in the towel and continue taking it. But I do not have that option with a limit amont of meds so I am going through with this and come out on top. With your help to guide me in the right direction. So what do I need to do tonight? Also you gave me your e-mail address, is it a way I can contact you without having to pay, since I am short on money?
Oh, I have been doing pushups and breathing excerises. They help but not as effected today. I hope or I know you can help. And again with you help we/I will get through this. I am giving you my name and hope it does not get splashed all over the internet. You have to be a good person to help people like me. Thank you for being there for me to vent. This way of talking is a good thing. I have never had a friend like you. That is I guess a text friend. If I send to many
e-mails just let me know and I will stop. I do not want to do something wrong.
Please help.
With hope, XXXXXXX Blankenship
doctor
Answered by Dr. Sunil Gupta (26 minutes later)
Brief Answer:
Try to hang in, if possible.

Detailed Answer:
Dear XXXXXXX

Thanks for following up. I am sorry that you are facing symptoms now and I can understand that it must be very distressing for you.

First of all regarding your current situation. I think you should try to hang in there as much as you can and avoid taking the extra dose. I know it will be difficult but I feel you can do it. Usually, I would have recommended the extra dose, but in your case since you have limited amount of klonopin, it is better you use it on the minimal possible side. You should continue taking the normal dose of hydrocodone though. I would not recommend tapering both the drugs together. It is very much possible that you are having anxiety because of that. So, continue taking hydrocodone at the usual dose. Think about tapering it only after completely stopping klonopin.

You have been on Lexapro 20mg daily morning together with seroquil and doxepin. Since you are having anxiety symptoms even on these drugs, I would suggest that you talk to your doctor regarding reviewing the medicines. I would have though of something like venlafaxine in place of lexapro (although lexapro would have been my first choice too).

You don't have to worry about your name being revealed. Even i your question is accessible, you name is omitted from it. We do take care of the confidentiality issues.

Regarding my email, I usually don't do that. But then I thought, I am here to help people. So here it is: YYYY@YYYY . I will try to respond to your health queries in best possible way. If I will be able to help you out of this situation, I would be glad.

You can now close this discussion and please don't forget to rate the answer.

Best wishes,

Dr. Sunil Gupta

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sunil Gupta

Psychiatrist

Practicing since :2005

Answered : 637 Questions

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How To Taper Off Xanax With Less Withdrawal Side Effects?

Brief Answer: Shifting to klonopin will make it easier. Detailed Answer: Hi, I read your query in detail and do appreciate your determination to stop benzodiazepines. It was nice to know that you have already come down from 4 mg qid to 0.25 mg qid. That is indeed remarkable. Xanax is Alprazolam which is comparatively a shorter acting drug. As a result it has more tendency to cause withdrawal effects when you try to taper it off. The best way to taper off is to shift to a longer acting agent like chlordiazepoxide (librium) or even clonazepam (klonopin) can be used. You can start taking equivalent amount of clonazepam (it will be around 2 mg per day, can be taken in divided doses) and then taper it gradually. I will recommend the tapering to be not more than 0.25 mg per week, since you are on benzodiazepines for very long. You have also mentioned that you are suffering from Panic with agoraphobia. It would be a good idea to start treatment for the same as it will help getting off benzodiazepines in a much easier way. You can consider one of the selective serotonin reuptake inhibitors (SSRI) like sertraline or paroxetine for the same. In addition, start doing some amount of exercise daily. That will help you relax. Hope, I was able to answer your query. Please feel free to ask any further questions that you might have. Best wishes and happy quitting, D. Sunil Gupta