Note
The BuddiesGuide is provided as a source of additional information and does not claim to be complete, nor 100% correct for all people. Although we aim for accuracy and a balanced approach, the BuddiesGuide should be considered as informed opinion only and not authoritative. Please regard the BuddiesGuide and the Community as additional resources and not replacements for professional health care. It is important that you discuss any ideas from the BuddiesGuide or the Community with your health care practitioner.The Direct Method
~ Keeping it simple
As previously explained on the Methods introduction page, a direct taper is the most straightforward method of withdrawal, and is perfectly adequate for many or most people withdrawing from benzodiazepines.
Within benzo-circles, cuts of about 10% (one tenth of your dose) are regarded as a reasonable figure for most to aim for. For many, cuts can be made every 1-2 weeks, but this is just a rough guideline and far from being any kind of rule. The important thing to remember is that each experience of tapering-off is a very individual thing; you should taper at rate with which you feel comfortable. If 10% cuts are too large, perhaps try cuts of about 5%, or even smaller. Small cuts are where the Titration and Compounding techniques may be useful. If two weeks have passed and you feel that you need more time to adjust to your last cut, you should allow for changes in your tapering schedule.
Having a plan before you start is sensible, but as they say, "if wish to make God laugh, make a plan"! Plans can provide focus and something to aim for, but do not allow yourself to be hemmed in by them. You should be willing to make adjustments according to the prevailing circumstances and how you are feeling. You may feel some cuts more than others, and most often there is no apparent reason for this. It is better to hold steady and delay your next cut until you feel ready to continue. When you continue making cut-upon-cut without allowing yourself to make a reasonable recovery between them, these tough cuts can mount up. Sometimes this results in the whole taper falling apart and a return to your original full dose or perhaps an even higher one! If a major life event should crop up during your taper, it is perfectly reasonable, and even sensible, to take some time out from your taper schedule, hold steady, and make no more cuts until your life has stabilised again. You should always be willing to make adjustments to your taper plan!
Alert
Slow Release (SR), Extended Release (XR), and Capsules
If you are using a slow release or an extended release benzo preparation, you should never crush or break these tablets! These tablets are formulated differently from an ordinary benzo tablet. Never attempt to make taper cuts to an extended or slow release tablet. For a successful direct taper, you may need to consider switching to the standard delivery benzo tablets taken at regular intervals.The vast majority of us take benzodiazepine tablets; a few may use a liquid benzodiazepine preparation. However, if your benzos come in capsule form and you intend to split these capsules in order to make your cuts, you must first consult with your doctor or pharmacist. Some of the contents in capsules can be caustic when outside the protective capsule; this can result in burns or other bad reactions when released. Never ingest the contents from a split capsule outside its protective cover! If you intend to try and cut your dose by removing a portion of the contents from a capsule, you must first consult your pharmacist to be sure that this process will not be harmful to you.
Sometimes we find that the early stages of the taper go well, but as we get down to lower doses the cuts become more difficult. If we have been making cuts of approximately 10% (It should be remembered that this is 10% of your present dose, and not 10% of the dose at which you started your taper.), this becomes nearly impossible to manage with half of a single tablet, for example. There are no benzo tablets that can be reliably split beyond a quarter (some would say beyond a half), so this raises some potential problems. Many can cope with the inevitable larger cuts (in percentage terms) at small doses, but for those who find it does become a problem, switching to Valium or using one of the Titration/Compounding techniques may be a good option. You can make use of the Substitution, Titration, or Compounding options at any time; these decisions do not have to be made at the beginning of your taper. You will discover that there are many options, few rules, and you can take control of the situation! This is probably the most important aspect of withdrawal; the knowledge that all decisions are yours to make. You are in control!
So how much is 10%, exactly? Firstly, 10% is intended only as a very rough guide. Rarely will your tablets easily split into an amount that equates to a cut of 10% (one-tenth). We would advise that you should treat the 10% figure as an upper limit, at least for the first cut, so that you have a reasonable idea of how you react to a cut of a given size. You should bear in mind that you will almost certainly fair better by making smaller, more regular cuts than making larger, less regular cuts. Rather than us explain the mathematics of percentages, we have provided tables instead.
If you have any questions concerning the direct taper process, or any aspect of benzodiazepine withdrawal, please join the BenzoBuddies forum. You will find others in similar circumstances as yourself; your questions and experiences are almost certainly shared by other members. Sometimes just reading that someone else shares some of the same problems as ourselves can help us to feel that we are not alone in this battle. Joining the forum allows you the ability to reply to existing discussions, or to start a new topic of discussion. If you would prefer to not join the forum at this time, you are welcome to read all posts as the forum boards and search facilities are open to guests.
We wish you good luck and much success with your taper!