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TherapistMarryAnn, Therapist
Category: Mental Health
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Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Kate: Today is day one of my withdrawal from Xanax XR. As

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Hi Kate: Today is day one of my withdrawal from Xanax XR. As you know I've been taking .5 in the morning, noon, and at 5 P.M. and 1 mg at bedtime.
We started with the 5 PM dose since that seemed to be when I felt the least sedation. Dr. told me to start taking .25 instead of the .5 for 5 days and then just stop.
Now tell me, what do you think of this way of doing it? I was told years ago by a neuorologist the best way to wean off or down was to take 1/2 dose one day, full dose the second day and to do this 4 times. Then take 1/2 dose two days in row, full dose third day, etc. for three times. I believe he said I could then stop, or continue on if I didn't feel comfortable enough yet to stop altogether.
Dr. said it was easier to wean off extended release pills than short-acting ones. Do you know anything about this?
What I'd like to know is what you know about weaning down with little or no withdrawal symptoms. Or if there are symptoms, how do I handle them?
I'd really like to know your thoughts on all this. BTW, I'm seeing the doctor about my thyroid on the 12 of August unless she has a cancellation before then.
Can't wait to hear what you have for me.
God bless,

Hi Rita,

I'm thinking that the neurologist is not right on this one. It makes no sense to have your body get used to 1/2 a dose one day then increase your medication the next day. That provides an uneven dose to your body and will only make your symptoms worse.

Your current doctor sounds right on target. Extended release medication is easier to withdrawal from because there is a steady stream of it in your system. Your levels stay constant. So as you wean off, the medication levels in your system gradually lower. If you were taking short acting pills, then your body would be at full dose when you take the medication then gradually have no medication until your next dose. Cutting back would be a greater level change than weaning off extended release offers.

You may have withdrawal symptoms. It would be very natural and it's a part of your body adjusting. But I do not believe they will be more than you can handle. Since your withdrawal will be so slow and gradual, any reaction is going to be mild. Some ways you can make the symptoms better is by altering your diet. Try asking your doctor if it is ok to take folate. This helps a lot with anxiety. B vitamins are best for helping neurons and the nervous system. Add an Omega 3 fish oil to help balance your diet.

Also, load up on vegetables and fruits. Stay away from red meats or anything sugary. Try to eat as naturally as possible. That gives your body the best opportunity to have the vitamins and minerals to naturally reduce your anxiety.

Remember deep breathing, relaxation, and stress reducing options. Surround yourself with books, DVD's, and other resources so they are easily within reach. Plan easy days for a while and try to remain as calm as possible. Sleep and rest are best.

I'm am here for you any time. If you feel you are having a bad day or just need to talk, let me know. I'll check in as often as possible to see if you post.

Hang in there, Rita. You are brave and you will be just fine. You are in good hands with your doctor.


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Customer: replied 6 years ago.

Hi Kate: Thanks again for your help. If I remember correctly, if there are any withdrawal symptoms, they only last a couple of days, right?

I am going to follow your advise as much as possible regarding what to eat, etc. Especially taking the B vitamins. Remember my lab test showed I was really low on vitamin B. I'm going to start taking them today. My husband takes fish oil every day, so we have that here and I'll pick up folate.



It all depends on your body chemistry as to how your body will react. But with all the additional support like the vitamins, Omega and the diet, it should minimize and shorten any reactions. And this is a nice and slow withdrawal so it should also minimize any reaction you could have.

If you look up fish oil (Omega 3) on the internet, it is really amazing what taking it does for you. Try any reputable sites like WebMD. They have the most accurate information.

Let me know how it goes for you!


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Customer: replied 6 years ago.

I was wrong about having low levels of vitamin B - it's vitamin D. So I'll pick up the B when I go out,

As for withdrawal, according to my doctor, I'm stand alone from anyone he's known because he says I metabolize meds so quickly. That's why I have such a problem taking meds in the first place and why we're doing this so slowly, Since I metabolize so quick, is that good or bad for me regarding withdrawal symptoms?


Another question....if I should have some withdrawal symptoms, do they occur during the withdrawal period (5 days of lowering of meds) or after wards? I know everyone is different but I figure I can tolerate anything for 5 days...I think!

My own worst enemy is me! I really have to work on relaxing and stop catastrophe-like thinking. I just realized since I started weaning off yesterday, I only have 4 more days to go, one of which is today already. OK, quick, Kate, if I'm going to have withdrawal, when will it start? I need to get myself ready! I'm bad, aren't I?

It's hard for me to believe that I'm ever going to feel any different than I do today. I'm tired of dealing with it. I've seen more different type of doctors in the past year than I have my whole life. Orthopedic, surgeons, psychiatrist, endocrinologists, severe spinal stenosis, panic and anxiety attacks, allergic reactions to narcotics - all one on top of another. Needles, ablations, physical therapy. The only one I'm looking forward to seeing is the endo doctor. I believe once I get my thyroid under control, a lot of my other problems with anxiety and maybe even panic will also be lessened.

Enough of the pity party. I personally know three people that would love to have what I'm dealing with than what they are. Thank the good Lord I don't have to go through this alone. And I have my husband right here with me. I am blessed, aren't I?

Ok, give me the bad news of what to expect and I'll be on my merry way.


Yes, I do believe you are blessed. But everyone has their trial and this just happens to be yours. Being anxious about it is ok. God exposes us to these types of things for a reason. Maybe your anxiousness now will help someone else in the future. Any time anyone you know has to go through seeing an orthopedic doc, a surgeon, or they have to face needles, you will be a saving grace to them. You never know when you will be needed for God's work. He is just equipping you right now.

I think that most likely you will notice symptoms within a day or two. If you metabolize quickly, then most likely you would see a reduced reaction to withdrawal. Metabolizing quickly would mean your body adjusts faster to changes.

Once your body gets used to the reduced level of medication (within a day or so), you should notice your reaction reducing as well. I have seen patients experience this many times. The slow reduction of your medication should produce almost no reaction. When you figure it, you are only reducing .25 at a time. That is hardly a drop in the bucket! Your body should adjust pretty quickly.

Although the medication issues are important, a good focus might be on your anxiety around this. Your anxiety is high, and that is understandable. But you are not out of control. This all is very much in your control. You have a great doctor who is working with you on this and is focused on helping you resolve this. You have a supportive husband and I'm here for you as well. You are intelligent and you have experience with this sort of thing. That makes you strong. Keep that in mind as you face this trial.


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Customer: replied 6 years ago.

Kate, you said: "

I think that most likely you will notice symptoms within a day or two. If you metabolize quickly, then most likely you would see a reduced reaction to withdrawal. Metabolizing quickly would mean your body adjusts faster to changes."

Well, that's good to know. I know any anxiety I'm experiencing is from all the bad stuff that's come my way for quite a while. Part of it is that I've heard so many bad things about getting off Xanax that it would scare anyone. But now I know differently and once my mind accepts that, I'll be in a better place. What I really need is rest from all this medical stuff. Too much, one on top of another would stress anyone out. But I'm on to road to getting there.

I have verses 28 - 31 of Isaiah 40 outlined in my Bible and I wrote on the sidelines

I went to a nutritional store and picked up the supplements you suggested. I also picked up a two-week supply of L-Theanine. Someone told me a while back about it so I thought this might be a good time to try it. I read up on it and it seems to work well for stress and anxiety, so hopefully I didn't get taken. Time will tell.


It sounds like you are facing this very well! A lot of the symptoms you feel can be attributed to your anxiety around this withdrawal. The mind is a very powerful thing and once you are sure you are going to have a bad reaction, you will make yourself believe that it will happen.

That is why I think focusing on your strength and your resources will get you through. Turning your thoughts around to good things is going to combat the bad and make this an easier experience for you.

The supplements will help. Any good thing you can do to counteract your anxiety is going to help you feel better.

Keep me up to date on how you feel. I'll be praying for you.


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Customer: replied 6 years ago.

Hi Kate: I just made a decision that I don't know if you'll agree with but I think it will work for me.

As I was taking my shower I was thinking about me and how anxious I am about this new experience and trying to talk myself out of it. I realized I put myself under more stress trying to be something I'm not, so I decided the heck with it, I'll just take it one day at a time and I know once I've gone through this first process, the rest will come much easier for me to handle.

My stress is because I don't know what's going to happen and that drives me crazy but instead of trying so hard to be at ease with the whole process, I'm just telling myself "truth". Truth is I'm on my way to getting rid of the sedation that has been holding me back from enjoying life. Way to go!! Truth is once my body adjusts to having one less .5 in it, I'm going to be clearer headed and on my way to reducing one more .5.

I don't know how low I can go to keep the panic attacks under control but I still have the endo doc to see for added help. Tomorrow is finally August, so I only have 11 more days to go before I see her.

What I haven't told you before, Kate - I don't know why - but for weeks I've been feeling so depressed to the point that I wished I were dead. I feel (felt?) like I just can't take it anymore. Not that I thought of doing anything about it but that's how I've been feeling most of the time. Dr. Hernz knows about it but right now his hands are sort of tied until I see the endo and see what the situation with my thyroid is. BUT, now that I'm accepting I'm on my way to getting rid of this terrible sedation I've been living with, things don't seem so bad.

I know it has to take a while for my body to readjust but then again, maybe not. I'm not doing too bad with withdrawal...a little weird feelings last night and I had a hard time falling asleep but that's about it. I've lived with this groggy sedation for so long it's hard to remember what it's like without it.

You've been so good to me. It's great knowing you're here for me. More a relief than you'll ever know. God did put you in my life as His helper because He knew I needed someone with His Spirit to help me get through this.

God bless,



I am glad to be here for you. Talking with you gives me a boost as well. I also believe God put us together so I feel useful and you could have support. We are blessed to have each other!

You know, you would make a great therapist! Your insight into your issue and the truth you found about handling your feelings and thoughts is excellent. I agree, accepting the truth about your circumstances is a good way of handling it. And those are important truths. You are well on your way to recovery from the sedation and looking forward to enjoying your life.

I think you made an interesting point when you mentioned keeping the panic attacks under control. Panic attacks are scary and for most people, avoiding them at all costs is a priority. But the key to panic is to let go, and let yourself feel those feelings. That does not mean you will experience a full blown panic attack. What it means is that panic is best controlled by not controlling it. Panic is escalated by fighting it. You feel the panic come on, you react by being afraid and tensing up, you then introduce more adrenaline into your system, then the panic spirals out of control. The key is stopping the pattern. Instead, when you feel the panic, accepting the feeling and letting yourself relax into it is what actually stops it. Your thoughts are the cause of the panic. Once you train yourself to think about acceptance (sort of like the truth you are thinking about now), then you can be free of the panic.

I am glad you shared your feelings with me about feeling depressed. You are in a rough place and you are in a battle to recover. Feeling like you want to escape is very natural. Who wants to struggle with anxiety and medication? Trying to figure out if it is your body or your feelings that are causing you to feel so distressed? Feeling foggy all day is no fun either. Those are very hard things to cope with. But you are strong and you continued to search for hope, which shows you will recover. However, if you do feel like that again, I would like to help. I doubt you will feel that again, but know that the offer is there.

It's good to know you are feeling better. You have struggled for a while now and it is a testament to your strength and to you as a person as to how far you have come. It's amazing to see. Good for you, Rita!


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