​​Dr. Steve's Guidelines For Going Off Xanax

​By Stephen M. Cox, MD

     You should never, never, never decide to go off Xanax on your own without your physician's counsel and guidance.  Xanax is a remarkably safe medicine except in two instances

1. Overdosing on it can be extremely hazardous to driving safety.  

2. Sudden or rapid stopping Xanax at daily doses of 4 mg or more can cause moderate to severe withdrawal and, in rare instances, a convulsion could occur. 


    You should carefully weigh the decision to go off Xanax with medical counsel.  Is this a good time to go off it?  Is this a stressful time?  If so, you should wait until a calmer time.

   If you live in the United Kingdom or continental Europe, one of the complementary treatments you could consider would be to try non medicinal alternatives like the bCalm device https://bcalm.co , a safe medical device that helps sufferers overcome trapped sensations, anxiety and panic attacks. The bCalm device is MHRA approved for the UK. This device is not yet approved by the FDA for marketing in the USA.

    Are you being pressured into going off Xanax prematurely by well-meaning, but uninformed family or friends who value more your 'being off medicine' than they do the relief of your suffering with panic attacks and disabling, miserable avoidance behavior.  Panic disorder is not a trivial thing.  It, untreated, is associated with the highest suicide attempt rate of all medical disorders.  It, untreated, also has a very small higher mortality risk from cardiovascular cause than non-panic disorder persons.  The general principles we have discussed with Xanax also holds true for other high potency benzodiazepines like lorazepam (Ativan) and clonazepam (Klonopin). The dosages however are all different and the milligram reductions do not apply to these other medicants. 

     Despite popular belief, it is my clinical opinion that Xanax is under-utilized by clinicians in their patients due to the Xanax prescribing pendulum going from overuse a decade ago to dangerous underuse at this time. Such medicines are remarkably safe. Compliance problems (patients not following doctor’s orders) by panic disorder patients on Xanax are infrequent; and, when seen are sometimes a matter of the patient not taking as much medicine as is prescribed, rather than taking too much medicine.
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