Expert: Daniel S. Harrop, M.D. - 7/19/2007

Question
QUESTION: i am 44 yr old male. i have been on .5 mg xanax 2 x day for 4 mths for anxiety. i feel this med is not working well and would prefer to get off this med. i am very concerned about what i have read regarding withdrawal symptoms and addiction. can you advise me the best way to taper off this med to minimize the withdrawal symptoms. am i likely already addicted? should i have another med to assist as i taper off xanax. i have noticed i feel it's harder to get a breath after the xanax starts to wear off. is this a symptom it's becoming less effective. i am just so worried about the terrible stories i've read about people ridding themselves of this drug. please let me know what i can do. thank you so much.


ANSWER: It's fairly easy to get off the medication: reduce it by 0.25mg every other week.

The problem is: How will you control your anxiety?  As you decrease the medication, the anxiety will increase.  Many people mistake this for a withdrawal side effect, but it is not.  For example, at this time you notice that when the medication begins to wear off, you have trouble breathing.  Therefore, as you reduce your Xanax your breathing will worsen -- not a side effect of the Xanax withdrawal but a side effect of not having your anxiety treated.

So, what you really should do is keep yourself under the care of an MD while you change medications or treatments.

---------- FOLLOW-UP ----------

QUESTION: thank you for your response. my md basically says what you say... reduce by .25 each 2 wks. she offers no other suggestions on how i can cope w/ the incresed anxiety as i taper off. can you offer any help/suggestions? i never had the shortness of breath w/ anxiety before xanax. now i do whan the med starts to wear off. how will i deal w/ this as i wean myself off the med? why do i now feel this shortness of breath, but not before when i had anxiety? should i take another med to assist in the tapering off? my current MD is little help w/ suggestions. i can handle feeling anxious, but the breathing issue is hard and i can't imagine it getting worse. will it ease up after a while? please... any help you can offer would be greatly appreciated. this xanax stuff is not the answer and i want to be off all meds long term. thank you.

Answer
This is one reason you probably need to be in psychotherapy.  There are various nonmedical ways to handle the anxiety symptoms: increase exercise, meditation, biofeedback, but they all take traing and support over a long period of time.  Anxiety symptoms vary over time: sometimes breathing problems, sometimes panic, sometimes rashes, sometimes dizziness.  The breathing issues is unlikely to worsen in intensity, although it may in duration (more frequent episodes).