Help with tapering off Xanax

[[Ja...]]

Hello all. I am seeking guidance on a taper plan to get myself off Xanax. I currently take .75mg per day and have been using Xanax consistently for about a year. I’ve done quite a bit of reading and research on the internet that ultimately led me here. There is so much conflicting information and recommendations, I was hoping that this forum may provide guidance from folks who have real world experience with tapering off this dosage amount. Any guidance will be greatly appreciated. Timeframes, single/multiple dosages a day, best practices to ensure I am doing this as safely and cautiously as possible. Thank you all. 

Edited November 21, 2023 by [Ja...]

[[Ja...]]

I should also note, I have been taking in only as needed for about 10 years but have increased to daily use over the last 10-11 months. 

[[Br...]]

Hello @[Ja...] - welcome to BenzoBuddies!

You've come to the right place for guidance in planing your taper off Xanax.  

It would be helpful if you answer a few questions.  What is you current dosing schedule (times and amounts)?  Are you experiencing any difficult symptoms in between doses?  Have you ever started and stopped a benzo in the past?

We're glad you found us!

Brighterday

[[Ja...]]

Hello and thank you. To answer your questions,

1) .75mg at 9pm. Very rarely do I take any during the day. 
2) only when I have tried to scale back but I believe I cut back too much. I halved my usual amount and experienced chest pain and restlessness. 
3) 18 years ago I was taking 8-10mg at a time in the evenings. I would take enough throughout the day to not experience withdrawal. I stopped cold turkey and dealt with the detox. I am now under supervision of my PCP to make sure that I am not abusing my prescription, we meet every 3 months. 
 

Last year I was to the point where my prescription (60 .50mg pills) would last 6 months. In April my PA prescribed hydroxazine and advised me to stop taking my Xanax and I ended up in the ER thinking I was having a heart attack but it was just severe anxiety. 

[[Br...]]

Hello @[Ja...] - It's helpful to get your answers.  

I think you're absolutely right that cutting your dose by half was too much.  It's no wonder you were hit with rough withdrawal symptoms like chest pain and restlessness.  The reason I asked about your use of benzos in the past is that prior experience starting and stopping a benzo can make your system sensitive to subsequent tapers.  All it means is it's good for us to be mindful to go slowly as you taper.

We generally suggest tapering with cuts of no more than 5-10% of your most recent dose every 14 days or longer.  It's very important to remain flexible and adjust your taper if you experience symptoms that are difficult to manage.  This means you may need to make smaller cuts, sometimes even smaller than 5%, and hold longer between cuts.  It's also important to be patient and not try to rush your taper because it will backfire on you and you'll experience rougher withdrawal symptoms.  

As far as making cuts, some people choose to use a jeweler's scale like this one which helps with the accuracy of cuts: https://www.amazon.com/gp/product/B0012TDNAM/ref=ppx_yo_dt_b_asin_title_o00_s01?ie=UTF8&psc=1

Xanax can be difficult to taper from because of it's short half life. Many choose to dose several times a day in order to avoid interdose withdrawal as you taper.  You may want to consider dividing your daily dose into 2 or more doses spread through the day as a way to avoid having symptoms become too much for you during the day.  It's also important to take the drug at the same time each day to keep an even amount in your system. 

 

Please be sure to ask questions and reach out for support!

 

[[Ja...]]

Thank you for this information! @[Br...]

That makes a lot of sense with the starting/stopping. I was doing really good last year but then I got covid this January and they put me on all sorts of meds that shot my anxiety through the roof so I started taking it regularly again.  Around that time I knew I was in a really dark place - PTSD and anxiety raging out-of-control. I decided that if I didn’t address both that I wasn’t going to make it much longer.  Happy to say that I’ve been in weekly therapy since April!  Completed many rounds of EMDR to process trauma, practice CBT exercises, meditate…journal…the triggers I’ve had in the past rarely bother me now!  I feel like if there’s any time to get off Xanax, it’s now!!! 
 

If I wanted to start tonight, do I take my .75mg (I have that scale btw lol, been lurking) and decrease it by 5% and divide it into the three doses?  How many hours would you suggest spreading them out?

I actually contacted a medical detox facility but my therapist told me no way - she said that with my PTSD related to my lack of control in those past traumas would re-traumatize me.  So I’m here 🫶🏻

[[Br...]]

@[Ja...]  - Sounds like you've been doing some amazing work!  I agree all of that will help you through benzo withdrawal.  But I hope you'll slow down a little first! Please don't start your taper until you've got your taper plan in place. I understand you want to get started and it's great that you're so motivated.  But when it comes to benzos it never pays to rush.  I think a good first step would be to start taking your daily Xanax dose divided into 3 doses  to get your system used to it.  I would do this for no less than a week before starting to make cuts.  

When it comes to weighing your doses on the scale, remember you will be weighing the pills and they will weigh more than .75mg because of filler and coating.  Have you been taking .75mg in a single pill? or three .25mg pills?

[[Ja...]]

@[Br...] Thank you - I’ve been putting in hard work.  I can/will slow down, this will be a great lesson in patience for me, thank you for the reminder 🫶🏻 

I have .5mg tablets and have been taking a whole pill and half every evening an hour before bed.  I didn’t consider the filler and coating weight - very good to know. 

[[ou...]]

Hi Jaychan and welcome.

I know from experience that it can be hard to do math while tapering but it's good to have a general idea of where you're heading, so here's an example of a slow direct taper from .75mg Xanax:

From .75mg reductions of .04mg until reaching .71mg then
from .71mg reductions of .03mg until reaching .29mg then
from .29mg reductions of .02mg until reaching .05mg then
from .05mg reductions of .01mg until completely stopped.

If you take a week between each step (28 in total) the whole process would take about 7 months. Most important is to listen to your body and adjust the rate of withdrawal accordingly.

[[Li...]]

Hello @[Ja...].  @[Br...] asked me to stop by. I agree with all of her suggestions thus far!  My only additional suggestions are:

(1) Make one change at a time to get a clear read on the impact of the change. For example, if you are experiencing intolerable interdose withdrawal on the Xanax and wish to trial dosing multiple times a day, do this first before making a reduction in dose. 

(2) Plan your taper one reduction at a time; refrain from following ‘start to finish’ tapering regimens suggested by others or generated by online calculators/spreadsheets. Taper plans must be individualized and adjusted to fit each individual’s unique history, current situation, and — most importantly — response to reductions.

Edited November 22, 2023 by [Li...]
typo; clarification

[[Br...]]

@[Ja...]  To get a good idea of the weights you'll be aiming for I would start by weighing 10 pills and divide the total weight by 10 to get the average weight of a pill.  It might be helpful to start a spreadsheet or journal for yourself to track your cuts and your symptoms.  

Once you have know the average weight of a .5mg tablet.  Once you know that weight you'll multiply it by 1.5 to know what the total mgs of pill weight are for your starting dose.

Please let us know what average weight your pills are and we'll go from there.

[[An...]]

Hi @[Ja...] and welcome to BB. @[Br...] gave you some great starting advice. I wish you much luck my friend. The micro dry taper using a scale like what Brighter posted with the (5-10)% 2 week reductions is probably the best way to go if you are doing a direct taper from the 3 most potent benzos>>> Xanax, Ativan, or Klonopin. I am doing more of a linear style Ashton taper from Valium that I have tweaked a little. I also decided to add the SSRI Lexapro to aid in the w/d process. After I am off the valium, I will slowly start to detox the Lexapro at some point.

[[Ja...]]

@[ou...] @[Li...] @[Br...] @[An...]

Thank you all for the warm welcome and the guidance!  I have questions 🙂

1. Is it better to move from 1x a day dose to two or three?

2. When I move to my new schedule of 2-3x a day dosing will I notice a physical change?  Is that why you’re saying to do that first without making a cut to the dose amount?

3. How in the heck do I cut these things to get to the tapered doses?  They crumble into a million pieces lol!

4. I’m currently getting off caffeine this week and about to be done with the horrid headaches. I’m thinking it best to make any changes to my Xanax start of next week when I get back to my regular schedule post holiday and post caffeine withdrawal. Agree?

5. Are there things I can do to help support my body through this process?  I’ve read eating well, staying hydrated…things of that nature are helpful. 
 

I plan to continue my weekly therapy sessions - plenty of work left to do.  She is very supportive and responds quickly when I’m struggling in general 🙂

[[An...]]

Dosing multiple times per day might reduce the interdose w/d somewhat during tapering.

Have you always dosed just once a day since starting Xanax?

[[An...]]

OP said>>>

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3. How in the heck do I cut these things to get to the tapered doses?  They crumble into a million pieces lol!

I would not try to cut. Most people shave the pills with a razor I think. Are your Xanax tabs all .5 mgs?

[[An...]]

PS - some use a nail file.

[[Ja...]]

@[An...]

It’s complicated. I would say around 18-19 years ago I was abusing Xanax. I would take a few mgs throughout the day at work to stave off withdrawals but then would come home and take 8-10mg at a time and drink with them.  I quit those cold turkey but I was also in my 20s…I don’t remember much from the withdrawals because I was really out of it, sick, and in pain. Shortly after, I became pregnant and didn’t touch Xanax for 5-6 years.  I started taking them again about 10 years ago, under my PCPs care and with full disclosure of my past history of abuse.  I took them only during panic attacks and usually only .25mg at a time. Last year I could make a prescription of 60 .5mgs tablets last 6-8 months. This year my PTSD and anxiety were thrown into full blown crisis mode when I got covid.  I didn’t want to take them on a regular basis but my PCP thought I had little option with how severe everything had gotten.  I was taking them 2x a day as prescribed but then moved to once a day at night to sleep because I couldn’t shut off my brain.  I did go through a painful transition moving to once a day but now that’s where I’m currently at 🙂

Edited November 22, 2023 by [Ja...]

[[ou...]]

2 hours ago, [[J...] said:

1. Is it better to move from 1x a day dose to two or three?

Most people dose Xanax at least 3 times daily due to its very short half life, but half life varies from person to person and since you don't seem to have a problem with once daily dosing, I think you might be fine with just twice daily dosing.

Edited November 22, 2023 by [ou...]

[[Br...]]

@[Ja...]  Most people dose several times a day because Xanax is short acting.  During withdrawal it may help to dose several times a day in order to reduce interdose withdrawal.  It's also important to take your doses at the same time each day.  The brain and body crave consistency and multiple doses at the same time each day may keep your blood serum levels more consistent. 

To begin with I would take a week to get used to taking it in three doses each day, for example Dose 1 in the morning, Dose 2 in the afternoon and Dose 3 at bedtime.  

When the time comes to start making your cut, @[An...] is right that many of our members use a nail file to remove the desired percentage.  Remember, the percentage will be based on the actual weight of the tablet, not the 50mg of active ingredient in the tablet.

Have you had a chance to get an average weight of your pills? 

[[Ja...]]

@[Br...] yes, my pills average out to .1285 (did the 10 total as you suggested) 🙂

[[Br...]]

That's great @[Ja...].  It takes a little while to get used to the scale sometimes.  As you probably know the scale measures in grams, not milligrams, so it just takes translating the numbers a bit.  .1285g = 128.5mg.  I get 192.8mg for the weight of your .75mg dose. Is that what you get?  (I'm no mathematician!)

[[Ja...]]

@[Br...] yes, that’s what I get as well.  So I’ll take that number and divide by 3?  Then I can do the times you suggested and hold for a week and see how that feels?

[[An...]]

OP said>>>>

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5. Are there things I can do to help support my body through this process?  I’ve read eating well, staying hydrated…things of that nature are helpful. 

Yes, do everything you can to fortify your body during w/d. Mild to moderate aerobic exercise is great if you can do it. Not everyone going through benzo w/d can do it, however. I am exercising 3X per day for one hour total. I divide it up into (3) 20 min sessions to make it easier. I use an indoor stationary bike.

Staying hydrated and eating well are equally as important. Meditation is also very helpful for natural anxiety relief.

[[Br...]]

54 minutes ago, [[J...] said:

@[Br...] yes, that’s what I get as well.  So I’ll take that number and divide by 3?  Then I can do the times you suggested and hold for a week and see how that feels?

Yes, I think that's a good plan. 

I agree with @[An...]about ways you can support your recovery with good self care.  Also the importance of developing and practicing ways to cope with anxiety.

[[Ja...]]

@[Br...] @[An...]

Perfect!!! It sounds like I’ve got a great starting off point 🙂 You’ve both given me some great pointers as well - keep a schedule, dose journal, coping tools, meditation, diet, staying active, rest and PATIENCE!  Thank you so much!!!