Xanax Taper

I am currently taking 1.5mg of xanax daily.  I take .5 upon waking, and .25 at about 4 hours intervals the rest of the day, until I hit 1.5mg.  If I stop at this amount am I at risk of a seizure?  What would be the safest way for me to taper down my usage.  I was taking it for debilitating panic attacks which have subsided.  I am a recovering addict and I do not want to be tied to a medication any longer.  A normal schedule for me is to take .5 at 6am, .25 at 10am, 2pm, 6pm and 8:30pm.  I would like to get off this medication, but safely.  I get anxiety thinking about having a seizure from tapering or stopping.

PLEASE HELP!

[J T Junig, MD PhD]

Yes, there is some risk of seizure from sudden cessation of even small doses of Xanax, particularly if the person has taken the medication for a long time.  The main problem with Xanax is that is has a short half-life, and so the level in the bloodstream drops quickly.  A common way to taper Xanax is to replace it with a benzodiazepine with a longer half life, typically clonazepam, and then to taper the clonazepam.  Another technique is to give the patient a short course of an anticonvulsant like Depakote for a week or two after the Xanax is discontinued.

I cannot give you an exact amount of Xanax that has no risk of seizure from withdrawal.  In general, though, seizures occur along with other withdrawal symptoms such as anxiety, tremor, and muscle tension;  it would be unusual for a seizure to occur in a patient who was not manifesting any other signs of withdrawal.