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How To Wean Off Xanax?

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Posted on Wed, 7 Oct 2015
Question: Would this be a good schedule to drop off 7MG Xanax monthly at .25MG daily?

7 MG /4 = 1.75 MG
1.5 MG + .25 MG

6.75 MG /4 = 1.687 MG
1.5 MG + .125 MG + .064 MG

6.5 MG /4 = 1.625 MG
1.5 MG + .125 MG
doctor
Answered by Dr. Dr. Matt Wachsman (38 minutes later)
Brief Answer:
You are talking about a alprazolam taper.

Detailed Answer:
I'm not exactly sure I'm getting the question right
four times a day of 1.75 mg using 1.5 +0.25 to make 1.75.
Then lowering the dose by 0.25 mg every day.

I really cannot say in your particular case; there are a huge number of particular features that change everything.
FIrst.... if someone is at increased risk of seizures (previous seizures, previous delerium tremens, other risk factors for seizures, if they look like they are about to have one) then inpatient titration over about a week. period.
Second, depends on ther medications and conditions everything from alcoholism, liver disease to fancying grapefruit changes everything.
Third, how reliable are they
fourth how the heck did they get into this situation? Just having a panic attack and being prescribed this last week, would be a context in which I would take them off of it in about a week and the taper described is actually SLOW. If they have a lot of psychological issues, if this includes drug abuse, then, things have to go slower, with close supervision, and other modalities also being included.
Fifth, is the pharmacology of alprazolam. It is a short acting potent benzodiazepine metabolized by the liver and lasting about 4 hrs at a time. This can be drastically changed in a few hours by giving someone LUVOX. This doubles the duration the drug stays in the system and causes it to accumulate to about double. I often put people onto LUVOX, the make alprazolam no more than a THREE time a day drug and also lower the dose... perhaps 1.5 mg three times a day the day after starting luvox (an anti-depressant that is good for anxiiety). Then taper the dose by about 0.5 mg PER WEEK. 1.5 mg 3 x a day for a week, then 1 mg 3x a day for a week, then 0.5 mg 3x a day, then.... it gets tricky. Some people stay on a slightly lower dose, most get tapered off of xanax and stay on the LUVOX. depends.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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How To Wean Off Xanax?

Brief Answer: You are talking about a alprazolam taper. Detailed Answer: I'm not exactly sure I'm getting the question right four times a day of 1.75 mg using 1.5 +0.25 to make 1.75. Then lowering the dose by 0.25 mg every day. I really cannot say in your particular case; there are a huge number of particular features that change everything. FIrst.... if someone is at increased risk of seizures (previous seizures, previous delerium tremens, other risk factors for seizures, if they look like they are about to have one) then inpatient titration over about a week. period. Second, depends on ther medications and conditions everything from alcoholism, liver disease to fancying grapefruit changes everything. Third, how reliable are they fourth how the heck did they get into this situation? Just having a panic attack and being prescribed this last week, would be a context in which I would take them off of it in about a week and the taper described is actually SLOW. If they have a lot of psychological issues, if this includes drug abuse, then, things have to go slower, with close supervision, and other modalities also being included. Fifth, is the pharmacology of alprazolam. It is a short acting potent benzodiazepine metabolized by the liver and lasting about 4 hrs at a time. This can be drastically changed in a few hours by giving someone LUVOX. This doubles the duration the drug stays in the system and causes it to accumulate to about double. I often put people onto LUVOX, the make alprazolam no more than a THREE time a day drug and also lower the dose... perhaps 1.5 mg three times a day the day after starting luvox (an anti-depressant that is good for anxiiety). Then taper the dose by about 0.5 mg PER WEEK. 1.5 mg 3 x a day for a week, then 1 mg 3x a day for a week, then 0.5 mg 3x a day, then.... it gets tricky. Some people stay on a slightly lower dose, most get tapered off of xanax and stay on the LUVOX. depends.