A middle-aged male had success rapidly reducing fast-acting alprazolam (Xanax) dosage by taking very high doses of niacin, along with gamma-aminobutyric acid (GABA) and vitamin C. The individual had been on 1 mg/day Xanax for 2 years, a moderate dose but a long duration. As a result, he had been presenting increased anxiety, personality changes, and ringing in the ears (tinnitus), all side effects likely due to long-term alprazolam use. Typical withdrawal from this drug would involve substitution medication, about a 10% dose reduction per week, and take a matter of months.1 A fast withdrawal is a 12.5 to 25% reduction per week.2 On very high doses of niacin, vitamin C, and also GABA, this individual reported being able to cut the dose 60% down to 0.4 mg in one week. The dose was reduced by 90% (to 0.1 mg/day) in less than a month. He reported residual anxiety, but that it was substantially less than when fully medicated. After 5 weeks, the medication intake was zero, with minimal residual anxiety.
Dosage
Niacin doses were between 6000 and 12,000 mg/day. The individual reported reduced anxiety when taking the highest levels of niacin. Bowel-tolerance levels of vitamin C were taken daily, with 750 mg of GABA twice daily. The individual also drank a quart of beet/cabbage soup broth daily for the first week, took 400 mg magnesium citrate/day, and took sublingual methylcobalamin (high-absorption B12), 5000 mcg twice a week. During the initial total withdrawal from alprazolam, intake of GABA was 750 mg 3 times daily. The patient experienced side effects of daily but manageable anxiety. He also reported occasional nausea, possibly attributable to the GABA and almost certainly attributable to the extremely high niacin intake. He experienced increased frequency of urination, especially at night. Evening niacin doses as inositol hexaniacinate (a semi-sustained-release, no-flush niacin) reduced nighttime urination. The individual used regular-flush niacin about three-quarters of the time; inositol hexaniacinate constituted the balance. Dosage was divided into 8 to 10 1000 mg doses in 24 hours. Niacinamide was specifically not used, as its nausea threshold is low (under 6000 mg day).
