HELP! I need help with a taper plan, please

I just got off the phone with my new provider, and she is agreeable to assisting with any taper plan that makes me most comfortable. The one she provided took me immediately off my afternoon dose of 10mg diazepam and alternated 5 and 10 mg doses twice daily, going up and down, every 3-4 days through December. I took the plan to my pharmacist this afternoon and he was totally confused by her method. “You can’t just make a 33% decrease by immediately discontinuing a dose, how will you know what caused any problems should they occur, and why is she increasing and decreasing?” He suggested that I do some intense self advocating. I have been crossing over from 0.5mg of alprazolam three times a day to 10mg diazepam three times. I will complete this on 12/9. As my brain is not functioning on all 4 cylinders, I can’t seem to figure out where to start. Would one of you please help me? Thank you in advance.

We generally suggest reduction rates of 10-30% a month.  This can be done as a liquid or dry taper.  You get to decide which one - they each have their advantages and disadvantages.  Some people prefer to do cut and hold tapering; some prefer daily micro tapering.  If you do a dry taper, you'll need a scale (many people use a Gemini-20 from Amazon).  If you'd rather dissolve your pills into a suitable liquid, I'd suggest checking out the daily micro tapering group to learn more about how to make your solutions (you can't just toss your pills into water).

 

An example of a semi-monthly cut and hold taper with 5% cuts:  Dec 1-15 - 10mg; Dec 16-31 - 9.5mg; Jan 1-15 - 9.02mg; Jan 16-31 - 8.57mg...  Just multiply the previous dose times 0.95 (your actual reduction rate could be different)

 

An example of a daily micro taper with with 0.5% cuts:  Dec 1 - 10mg; Dec 2 - 9.95mg; Dec 3 - 9.9mg; Dec 4 - 9.85mg; Dec 5 - 9.80mg...  Just multiply the previous dose times 0.995 (again, your actual reduction rate could be different.

 

The most important thing to do is to listen to your body and adjust your tapering schedule as appropriate.  Hope this helps.

Hi, bodsocref,

I am hoping to avoid withdrawal symptoms, but also liquid or micro tapering. I have school aged grandchildren currently living with me, and don’t want to draw attention to my current situation. Has one system proven to work better? I live in an area with no Ashton providers, but have been lucky enough to find a provider with psychotropic medication experience who has offered to help me. The schedule I drew up today, using the Ashton method, tapering from 30mg three times a day to a 0.5mg jump will take 44 weeks. Seems so long right now. My crossover has gone without any surprises at 3 day changes in 18 days. Does 44 days sound average to you? I so appreciate all of the support I have received from this group.

Thank you,

Mary

 

If you want to avoid liquid and micro-tapering, then you're pretty much stuck doing a cut and hold style taper by weighing out powder with a milligram scale.  It's fairly easy to do.  You just shave off some pill until the weight is right, then take the pill.  Or you crumble the pill and weigh pieces until you get the weight you want.  Remember that most of the pill weight is not medicine.  It's mostly fillers and binders.  Only a small fraction of the pill weight is diazepam.  So your pill might weight 200mg (0.2 grams).  A 5% cut would leave you with a 190mg piece of your pill.  Again, that's really easy to weigh out on a milligram scale.  (note that the actual weight will almost certainly not be 200mg - you'll need to weigh your pills to determine that weight).

 

44 weeks seems like a reasonable time frame, but you really need to remember to listen to your body.  Maybe you can taper faster at times.  Maybe you'll need to go slower or hold at times.  It rarely ends up being a linear thing despite the best planning.

badsocref,

I think I’m ready. I’ve written out a taper plan with no expected dates. I’ll trust my body. Wish me luck.

Thanks,

Mary