The Beginners Guide to Tapering
Dr Peter Breggin in his book Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Drugs suggests tapering of benzodiazepines and other psych drugs can be accomplished by making cuts of around 10%.
Dr Heather Ashton says this in the Ashton Manual
"The precise rate of withdrawal is an individual matter. It depends on many factors including the dose and type of benzodiazepine used, duration of use, personality, lifestyle, previous experience, specific vulnerabilities, and the (perhaps genetically determined) speed of your recovery systems. Usually the best judge is you, yourself; you must be in control and must proceed at the pace that is comfortable for you. You may need to resist attempts from outsiders (clinics, doctors) to persuade you into a rapid withdrawal. The classic six weeks withdrawal period adopted by many clinics and doctors is much too fast for many long-term users. Actually, the rate of withdrawal, as long as it is slow enough, is not critical. Whether it takes 6 months, 12 months or 18 months is of little significance if you have taken benzodiazepines for a matter of years."
Based on the above, a very general guideline for tapering might be to start with a cut of no more than 10% of your current dose. So if you were taking 2mg of a benzo you might want to make a cut of .2mg or less. If your current daily dose was 1mg your cut might be .1mg or less. Having made an initial cuts, the size of subsequent cuts can be adjusted downwards according to the individuals ability to tolerate. Ashton suggests that cuts every 1 - 4 weeks may be appropriate.
It can be very hard with some of the more potent benzos to achieve the 10% cuts if you are dry cutting.
Here are some options that others have found doable that you may like to investigate and discuss with your doctor.
The first is using a Valium crossover and taper. The Valium crossover and taper is a tried and tested protocol for getting off benzos. Valium has the advantage of having a very long half-life which makes for a smoother withdrawal and eliminates inter dose withdrawal that can be associated with the shorter half-life benzos and it comes in pills that are an ideal size for making the small cuts needed at the end of a taper. A details description of this methodology can be found in the Ashton Manual. Even if the valium option doesn't appeal the information on withdrawal in the manual is excellent.
A second option is to use water titration to get you directly off the benzo you are on. Water titration is merely a method of mixing your pill with water to allow you to precisely measure your dose. Then you slowly reduce your dose every day, instead of cutting pills every two weeks. This method allows your body to adjust to the reductions in a very subtle and gentle way and allows you to have greater control over the rate of your taper. A detailed description of Water Titration can be found at either of the following sites
The PowerPoint displays will give you a good overview of the methodology and the other files will give you the detail.
For those on larger doses of benzo it may be possible to dry cut at the higher doses and then change to water titration at the lower doses.
Disclaimer: The information contained in this website was not compiled by a doctor or anyone with medical training. The advice contained herein should not be substituted for the advice of a physician who is well-informed in the subject matter discussed. Before making any decisions about your health or treatment you should always confer with your physician and it is always assumed that you will do so.
Last updated 22 July 2015