Suggest Treatment For Insomnia After Abruptly Stopping Alprazolam

Posted on Fri, 8 Jul 2016

Question: I was taking alprazolam and stopped taking it abruptly last Tues. I didn't realize you slowly need to go off this drug. I took it for about a month==25mg in the am and 25mg in the pm. I am now suffering from insomnia. What should I do?

Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)

Brief Answer:
Some suggestions:

Detailed Answer:
Hello XXXXXXX

I'm sorry about the insomnia, and yes, it needs to be tapered slowly. As you were on a total of 50 mg/day, I suggest you restart the evening dose of 25 mg, and then go in to see your doctor to follow up.

If the alprazolam was being taken for anxiety, and if you are still having problems with anxiety, you may need a medication specifically for this, such as an SSRI medication. Escitalopram (Lexapro) is in this class and generally has fewer side effects and earlier onset of action (1-2 weeks) than some of the other SSRIs. You can continue the evening alprazolam while you are on it until the SSRI starts working adequately (such as around a month). Escitalopram is not a sleep aid like alprazolam can be, but if the underlying problem is anxiety, it can treat that.

I hope this information helps. Please let me know if I can provide further information or clarification.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Bonnie Berger-Durnbaugh (1 hour later)

The dosage was .25mg in the am and pm. Does this make any difference.

Answered by Dr. Bonnie Berger-Durnbaugh (2 hours later)

Brief Answer:
Take 0.25 mg alprazolam in the evening.

Detailed Answer:
Yes, you are right - I'm sorry I didn't catch that.

And no, it doesn't make a difference in terms of going back on half as much (per day) after having discontinued too quickly.

I hope you have a better night sleep!

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar