Titration: FAQs

Q: What is titration?


Source: https://en.wikipedia.org/wiki/Drug_titration

"Drug titration is the process of adjusting the dose of a medication for the maximum benefit without adverse effects."

In the case of individuals wishing to withdraw from benzodiazepines, titration means making small reductions in dose with the goal of discontinuing the drug while minimizing withdrawal symptoms.


Q: Do I have to use a liquid to titrate my dose?


No. Members titrate their doses using regular tablets, liquids, or a combination of both.


Q: Do I have to use a particular taper schedule to titrate my dose?


No. Members use a variety of tapering schedules. Some members make reductions on a daily basis, others make reductions every other day or every three days, still others make reductions every other week or every month. It takes some experimentation to find a taper schedule that works for your individual physiology given the pharmacokinetic properties of the specific benzodiazepine you are taking.


Q: Can I start my taper using the Simple Direct Taper and then switch to titration if I need to?


Yes. The Simple Direct Taper is all that is required for the majority of members. For example, members beginning their taper at a relatively high dose of their particular benzodiazepine may be able to use the Simple Direct Taper until they get to a lower dose at which point their individual withdrawal symptoms may signal that a switch to titration might be helpful.


Q: What are some of my options for titrating my dose?


Dry
  Prescription compounded capsules or tablets prepared by a qualified, experienced compounding pharmacist
  Grind tablets to powder/use a digital scale to weigh successively smaller amounts
  Same as above but put powder into capsules

Wet
  Prescription oral solution
  Prescription compounded suspension prepared by qualified, experienced compounding pharmacist
  Make your own suspension using OraPlus/OraSweet or OraBlend
  Make a homebrew liquid using:
    Whole fat, homogenized milk
    Vodka/water
    Propylene glycol/water
    
  


Q: Is using liquid accurate?


It depends. Here's what is known and what is unknown.

Accuracy is the degree to which the result of a measurement conforms to the true/correct value of the quantity being measured.

Assuming that you can use an oral syringe properly to measure the desired dose, then using a prescription oral solution of your benzodiazepine is accurate. That is, what you measure is what you get in terms of the amount of benzodiazepine you are ingesting.

However, if you are using a "home brew' liquid made with regular tablets, it is unknown if you are getting an accurate dose. Why? To our knowledge, none of the home brew liquids have been tested for homogeneity (we do not know if they are true solutions), potency, or stability over time. We also do not know the pharmacokinetic properties of home brew liquids (i.e. absorption, distribution, metabolism, elimination).



Q: Is it safe to make modifications in a prescription drug?


Making modifications in any prescription drug confers a degree of risk.  As a general rule of thumb, the greater degree of modification, the higher the degree of risk.


Q: If I make extremely small daily or near daily reductions to my dose, will I avoid having withdrawal symptoms?


At this point in time, there is no empirical evidence to support the claim that a particular taper schedule will provide a symptom-free withdrawal.

The key to success is to find a taper schedule (and a taper rate) that works for your individual physiology and the pharmacokinetic properties of the specific benzodiazepine you are taking.