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Dr. Mark,I am on a xanax dosage tapering plan. From 2 mg

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Dr. Mark,
I am on a xanax dosage tapering plan. From 2 mg a day
To 1.5 mg . That is from .5 qid to .5 tid.
Today I am supposed to drop another .5 but it is
Causing tightness in the chest, neck and shoulders again.
Besides I am going through colitis the past whole week!
Shall I go on ahead with tapering or remedy my colitis first?
Thank you !
Submitted: 2 years ago.
Category: Mental Health
Expert:  Camille-Mod replied 2 years ago.
Hi, I am a Moderator for this topic. I sent your requested Professional a message to follow up with you here, when they are back online. If I can help further, please let me know. Thank you for your continued patience.
Expert:  Doctor Rao replied 2 years ago.
Hi,
The question says "Expert Opted out". I want to step in as you might be looking for the answer soon. I hope this is ok.

Regarding tapering of Xanax and how to to do I will explain the rationale and reasons for doing so in this answer.
However, when people are having ongoing psychosocial stressors usually their anxiety would be slightly higher than normal. You mentioned you are having Colitis. If you think you can cope with the tapering off simultaneously continue to dot hat.If not it would be an idea to post pone until you feel better. The botXXXXX XXXXXne isn't is a gradual process and you should feel comfortable both physically and mentally.Regarding the other symptoms you mentioned I think they might be anxiety related. It is not unusual to have those symptoms. Below I would explain how to do very gradual reduction and reasons for that.

Xanax is a short acting Benzodiazepine, which stays in the body for short periods.That is why you might need to take more than once when required.

All the Benzodiazepines(including Xanax) do have two worrying properties. 1. Tolerance, means body needs more dosage in the long term as body would get used to the dosage. 2. Dependence. It would be difficult to come off if the person is on this medication for long time.

Now what can be done. In most of the situations one need to come off benzodiazepines very gradually as otherwise the anxiety nd withdrawal symptoms means the person might end back on the medication.

The way we usually recommend tapering off Xanax is to reduce slightly to by 0.25 mg every week.Once you have reached 1mg then you need to convert this to intermediate acting benzodiazepines like Diazepam as this can be helpful to deal with withdrawal symptoms in a slightly better way.

0.5 mg Xanax is equivalent to 10 mg Diazepam. So, when you get to 1mg Xanax then you might need to change to 10mg Diazepam twice daily. From here onwards you need to reduce by 2 mg every week(although some of my clients decided to reduce 5 mg every week to finish th process quickly). Usually reduce the day time dose first. So, once you moved to 10mg twice daily diazepam then you can reduce to 8 mg morning and 10 mg at night.Then further gradual reduction in a weeks time.

So, you have to do this very gradually.

In between if the anxiety is worsening please ask your Doctor to consider Vistaril 25 mg up to two or three times per day. This medication is not addictive and do need bit long time to develop tolerance .

I hope you find this information helpful.

Thank you.




Doctor Rao, Doctor
Category: Mental Health
Satisfied Customers: 641
Experience: MBBS,MD,DPM,MRCPsych
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