After stopping alprazolam, what is the best next step for a patient experiencing symptoms of anxiety?

The best next step for a patient experiencing symptoms of anxiety after stopping alprazolam is to switch to a benzodiazepine with a longer half-life. This approach is effective because longer-acting benzodiazepines can help manage withdrawal symptoms and anxiety more smoothly due to their extended duration of action, which can provide a more stable blood level of the medication. Medications such as diazepam or clonazepam may be appropriate choices, as they may offer relief from anxiety while minimizing the risk of rebound effects that can occur with shorter-acting medications like alprazolam.

On the other hand, admitting the patient for close monitoring and intravenous benzodiazepine might be necessary for severe cases or if there are significant withdrawal symptoms and potential safety concerns, but it is not typically the first-line response for most patients experiencing manageable anxiety symptoms. Continuing alprazolam at a higher dosage would not address the underlying issue and could potentially exacerbate dependence. Similarly, recommending herbal supplements is not an evidence-based approach in the immediate context of managing withdrawal and anxiety symptoms and lacks the robustness of pharmacological options.