Before You Stop Taking It
The boxed warning on the Xanax label states that abrupt discontinuation or rapid dosage reduction of Xanax after continued use may precipitate acute withdrawal reactions, which can be life-threatening.1
If you have been taking it regularly, do not stop and do not cut the dose on your own. Speak to the prescriber. This is not a willpower question.
Sol is an outpatient program and does not provide detox. If withdrawal needs medical management, we will help you find that first.
Clinically reviewed by Tania Acevedo, MA, LPCC, Founder and Chief Clinical Officer
What Xanax Is and What It Does
Xanax is a brand name for alprazolam, which MedlinePlus describes as used to treat anxiety disorders and panic disorder.2 The FDA label is narrower still: it is indicated for the acute treatment of generalized anxiety disorder in adults, and for panic disorder with or without agoraphobia in adults.1 It is a Schedule IV controlled substance.1
The word doing the most work in that label is “acute”. Xanax was approved for short-term use. Many women reading this have been taking it longer than that, and that is worth talking through with the prescriber.
Key Takeaways
- Xanax is FDA-approved for the acute treatment of generalized anxiety disorder and for panic disorder, in adults.1
- FDA’s boxed warning states that abrupt discontinuation or rapid dose reduction may precipitate acute withdrawal reactions, which can be life-threatening.1
- The label notes that even after relatively short-term use, there is some risk of dependence.1
- Anxiety returning between doses and in the early morning has been reported with Xanax.1
- A pill bought outside a pharmacy may contain no alprazolam at all. CDC has documented overdose deaths involving pills that appeared to be alprazolam with none detected.3
Show all 5 takeaways
What the Label Actually Documents
Here is what the label itself says.
The boxed warning covers three things. First, that using benzodiazepines including Xanax exposes users to risks of abuse, misuse and addiction, which can lead to overdose or death.1 Second, that taking them alongside opioids may result in profound sedation, respiratory depression, coma and death.1 Third, that stopping abruptly or reducing the dose too quickly may precipitate acute withdrawal reactions which can be life-threatening.1
On dependence, the label is clear: even after relatively short-term use, there is some risk of dependence.1 And it notes that in some cases benzodiazepine users have developed a protracted withdrawal syndrome with symptoms lasting weeks to more than 12 months.1
MedlinePlus puts the consumer version plainly: alprazolam may be habit-forming, and you should not take a larger dose, take it more often, or take it for longer than your doctor tells you to.2
Why the Anxiety Comes Back Before the Next Dose
This is one of the most common experiences women describe and one of the least explained. The FDA label records it directly: early morning anxiety, and the emergence of anxiety symptoms between doses of Xanax, have been reported.1
The label says these interdose symptoms “may reflect the development of tolerance or a time interval between doses which is longer than the duration of clinical action.”1
What matters practically is simpler. If the anxiety is arriving earlier each day, that is worth telling the prescriber about rather than absorbing.
The Pill May Not Be Xanax
DEA reports that many fake pills are made to look like prescription medications including alprazolam.4 These are pressed to look identical to the real thing.
CDC’s surveillance of overdose deaths with evidence of counterfeit pill use found cases identified by pills that appeared to be alprazolam with no alprazolam detected on postmortem toxicology.3 The pill looked right. There was no alprazolam in it.
On what is in them instead: of the fentanyl-laced fake prescription pills DEA analyzed in 2022, six out of ten contained a potentially lethal dose of fentanyl.5 DEA states that two milligrams of fentanyl can be lethal depending on a person’s body size, tolerance and past usage.6
The practical line is short. If a Xanax did not come from a pharmacy, nobody knows what is in it, including the person who sold it.
Read about fentanyl.
If You Are Pregnant or Might Be
The FDA label states that Xanax use late in pregnancy can result in sedation, meaning respiratory depression, lethargy and low muscle tone in the newborn, and withdrawal symptoms.1
MedlinePlus advises that if you become pregnant while taking alprazolam, call your doctor, and that alprazolam may harm the fetus.2
Please do not stop on your own. Stopping abruptly carries its own serious risk, and the decision belongs to a doctor who knows your history. Call the prescriber first.
If You Want Treatment
Xanax is a benzodiazepine, so treatment for Xanax dependence is treatment for benzodiazepine dependence. Everything about how that works, what it involves and what Sol offers is on one page rather than two.
If anxiety or panic is what the prescription was for, that is treated here too, in the same plan. See anxiety or dual diagnosis.
Starting Treatment
1
Call or Send Your Insurance Details
Admissions answers 24 hours a day, seven days a week.
2
Assessment
A clinician looks at the medication, the dose, how long you have taken it, and whether withdrawal needs medical management first.
3
Verify Your Insurance
We contact your plan confidentially and explain what we learn.
4
Start Date
Set around what your week can hold.
Have the prescription in front of you on that first call. What it says on the label, who signed it and roughly when it started is most of what gets asked.
In crisis right now? Call or text 988.
Looking up what your own prescription is doing to you is not paranoia. It is a caring, sensible step.
Frequently Asked Questions
Our admissions line is answered 24 hours a day, 7 days a week at (951) 972-5085.
What Are the Side Effects of Xanax in Women?
The FDA label does not report sex-specific side effects for Xanax. What the label does document applies to everyone taking it: risk of abuse, misuse and addiction; profound sedation, respiratory depression, coma and death when combined with opioids; and acute withdrawal reactions that can be life-threatening if it is stopped abruptly. It also notes early morning anxiety and anxiety between doses have been reported.
Is It Dangerous to Stop Taking Xanax?
It can be. The boxed warning states that abrupt discontinuation or rapid dosage reduction after continued use may precipitate acute withdrawal reactions, which can be life-threatening. Speak to the prescriber before changing anything.
How Long Does It Take to Become Dependent on Xanax?
The label states that even after relatively short-term use, there is some risk of dependence. For benzodiazepines as a class, FDA states physical dependence can occur after several days to weeks of steady use, even as prescribed.
Why Does My Anxiety Come Back Before My Next Dose?
The FDA label records that early morning anxiety and the emergence of anxiety symptoms between doses have been reported with Xanax. The label says these symptoms may reflect the development of tolerance or a time interval between doses which is longer than the duration of clinical action. It is worth telling the prescriber if it is happening.
Is Xanax Withdrawal Worse Than Other Benzodiazepines?
The FDA label does not say that. It states the half-life and notes interdose anxiety, and it does not compare Xanax withdrawal with other benzodiazepines. Your prescriber can talk through what to expect for you.
How Do I Know If My Xanax Is Real?
If it came from a pharmacy against a prescription, it is. If it did not, you cannot know. DEA reports fake pills are pressed to look identical to alprazolam, and CDC has documented overdose deaths where pills appearing to be alprazolam contained none.
Can I Take Xanax While Pregnant?
That is a question for your doctor, and the answer is not automatically no. The FDA label states that use late in pregnancy can result in sedation and withdrawal symptoms in the newborn, and MedlinePlus says to call your doctor if you become pregnant while taking it. Stopping abruptly carries its own serious risk, so do not stop on your own.
Does Sol Treat Xanax Dependence?
Yes, as part of treatment for benzodiazepine dependence, alongside the anxiety or panic the prescription was written for. The full picture is on our benzodiazepine page.
Show all 8 questions
If the Prescription Has Stopped Being Something You Choose
Coming off a benzodiazepine is a medical process, and the first step is a conversation, not a commitment.
4175 Brockton Avenue, Riverside, CA 92501
Confidential. Bring the bottle or a photo of the label.
Sources6
- 1.US Food and Drug Administration. XANAX (alprazolam) prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/018276s059lbl.pdf
- 2.MedlinePlus, National Library of Medicine. Alprazolam. https://medlineplus.gov/druginfo/meds/a684001.html
- 3.Centers for Disease Control and Prevention. Drug Overdose Deaths with Evidence of Counterfeit Pill Use, United States, July 2019-December 2021. MMWR 2023;72(35). https://www.cdc.gov/mmwr/volumes/72/wr/mm7235a3.htm
- 4.US Drug Enforcement Administration. Fake Prescription Pills fact sheet. https://www.dea.gov/factsheets/fake-prescription-pills
- 5.US Drug Enforcement Administration. DEA Laboratory Testing Reveals that 6 out of 10 Fentanyl-Laced Fake Prescription Pills Now Contain a Potentially Lethal Dose of Fentanyl, 2022 analysis. https://www.dea.gov/alert/dea-laboratory-testing-reveals-6-out-10-fentanyl-laced-fake-prescription-pills-now-contain
- 6.US Drug Enforcement Administration. Facts about Fentanyl. https://www.dea.gov/resources/facts-about-fentanyl
Medical Disclaimer
This page is educational and is not medical advice. It does not contain tapering instructions, dosing information or a withdrawal schedule, and it should not be used to decide whether or how to reduce a prescribed medication. Withdrawal from this class of medicine can be life-threatening and the prescriber decides how it is managed. Sol Women’s Treatment is certified by DHCS for outpatient and intensive outpatient services (330246AP) and licensed by CDSS (facility 331881576), and does not provide detox, inpatient or residential care. No two women respond identically and nothing here promises a result. In a medical emergency call 911. If you are in crisis, call or text 988.