How Severe Can Xanax Withdrawal Symptoms Be?

What Are the Most Common Symptoms of Xanax Withdrawal?

Xanax withdrawal can differ significantly between individuals, depending on how long it’s been used, your dose, and whether it has been taken with other substances such as alcohol or ambient. Symptoms usually start within 6 to 12 hours after the last dose and reach their peak within the first week.

Here are the most common symptoms of Xanax withdrawal:

• Anxiety and Panic Rebound: Since Xanax lowers excess activity in the brain, suddenly stopping it can trigger a surge of anxiety, panic attacks, and agitation that are often worse than the original symptoms that led to Xanax use.

• Insomnia: Many individuals experience trouble sleeping during withdrawal, struggling to fall asleep, stay asleep, or both. Insomnia can intensify anxiety and irritability.
• Tremors and Muscle Spasms: Hand tremors, muscle twitching, and spasms are common as the nervous system recovers from sedation.
• Nausea and Vomiting: Digestive issues like nausea, vomiting, and stomach cramps are commonly reported. These symptoms can also lead to dehydration if not properly managed.
• Sweating and Flushed Skin: Many people experience excessive sweating, chills, or hot flashes as their bodies attempt to regulate and restore balance.
• Headaches and Muscle Pain: Withdrawal frequently causes tension, headaches, and general muscle aches, body pains, or stiffness. 
• Sensory Disturbances: Visual distortions, hypersensitivity to light or sound, and feelings of unreality (depersonalization and derealization) may occur.
• Seizures: One of the most serious dangers of Xanax withdrawal is seizures, which can happen even if you’ve been taking a therapeutic dose. Seizures are a medical emergency requiring immediate attention.
• Mood Swings and Depression: Emotional instability, including feelings of depression and irritability, is common. In severe cases, suicidal thoughts may develop.

Everyone’s withdrawal experience is different. Some symptoms may improve or disappear within a week or two, while others—especially anxiety and insomnia—can linger for months, a condition known as post-acute withdrawal symptoms (PAWS).

Why Are Benzodiazepine Withdrawals More Dangerous Than Other Substances?

Unlike many other drugs, benzodiazepines directly affect the brain’s GABA receptors, which regulate the nervous system’s calming functions. Over time, your brain becomes accustomed to having Xanax in your system to maintain balance. Suddenly stopping Xanax leaves the GABA system unregulated, leading to an overexcited nervous system. That is why benzo withdrawal is considered more dangerous than other substances such as opioids or stimulants.

Here are several reasons why Xanax withdrawals are more dangerous:

• Seizure Risk: Suddenly stopping can cause life-threatening seizures, even in individuals with no prior seizure history.
• Delirium and Psychosis: Some individuals experience confusion, hallucinations, or psychotic episodes during withdrawal.
• Autonomic Instability: Vital signs, including heart rate, blood pressure, and body temperature, may become dangerously unstable.
• Prolonged Withdrawal: Some symptoms may persist for months or longer, requiring continuous treatment.

Due to these factors, medical professionals strongly advise tapering benzodiazepines under close supervision rather than quitting abruptly.

What Happens If Xanax Is Mixed With Other Substances Like Alcohol or Opioids?

Combining Xanax with alcohol or opioids is extremely dangerous and significantly increases the risk of Xanax overdose, respiratory depression, and death.

Here’s why combining substances is so dangerous:

• Synergistic Sedation: Both Xanax and alcohol (or opioids) depress the central nervous system. When taken together, their effects multiply rather than accumulate, leading to profound sedation.
• Respiratory Depression: Your breathing may slow to dangerous levels or stop completely, causing hypoxia, brain damage, or even death.
• Memory Loss and Blackouts: Mixing substances often results in severe memory loss and impairment, which also increases the risk of accidents.
• Increased Dependence: Polysubstance use (using multiple substances) heightens dependence and leads to withdrawal symptoms that become more unpredictable.

During withdrawal, the body must adapt to the absence of multiple depressants, which further complicates detox and recovery. This is why medically supervised detox is the safest option for anyone who has been mixing Xanax with alcohol or opioids.