A Short Overview of the Three Supported Methods of Benzodiazepine Withdrawal

[Today]

Today at 10:37:46 AM thatismytruck - morning sweets, is the sky falling; it didn't fall here! OMG it finally didn't!

Today at 01:20:53 AM L123 - i've been wondering the same thing, laura....where is cupcake?

Today at 01:18:55 AM helpme123 - Hey wheres cupcake?

Today at 12:05:30 AM Bevoir - Have a great night, buddies!!!

Yesterday at 11:11:34 PM vita64 - Lyrica is similar to Neurontin. If you take it, when you stop, you'll need to taper it.

Yesterday at 10:59:47 PM keryn - You're very welcome Bev x

Yesterday at 10:48:44 PM Bevoir - Keryn, you are AWESOME!!!! I love my chipmunk pic x

Yesterday at 10:42:39 PM helpme123 - Look up Lycria Stero ,I was given that perscribtion for burning w/d , I refused it 

Yesterday at 10:20:21 PM Pamster - stereo, check this board http://www.benzobuddies.org/forum/index.php?board=60.0

Yesterday at 10:17:43 PM stereomarlowe - anyone know anything about lyrica?  My doc is asking me to take it before I start my taper....

[Colin]

Direct Taper

Overview: straightforward taper by gradually reducing the number of tablets (or fractions of tablets - pill-splitting) you take per day. You should obtain the lowest dose tablet available in your particular benzodiazepine.

Advantages: simple; wide support from doctors; probably all that's required by the majority of people in the general community looking to quit benzos.

Disadvantages: many benzos are too potent to allow a smooth taper for some people (or the pills prescribed are too large in dose for successful pill-splitting); many benzos have too short a half-life to allow a smooth taper (interdose withdrawal is often a problem); can be tricky to split pills accurately.

We suggest that unless past experience of attempted tapering indicates otherwise, members should initially try cutting their dose by no more than about 10%, and will probably make new cuts (about 10% of their dose at the time of the new cut) every 7-14 days. These figures are intended as ballpark estimates - mileage will vary.


Substitution Taper

Overview: gradually reducing your dose of one benzodiazepine while, at the same time, introducing a second, more suitable benzodiazpine. Some benzodiazepines are easier to taper than others. So, switching to another benzodiazepine might aid withdrawal. You must talk to your doctor about sustitution. Valium (diazepam) is the benzo of choice (for the purposes of substitution) of the vast majority of our members.

Advantages: switching to an equivalent dose of Valium from a short half-life benzo (this must be carried out gradually) virtually guarantees that you will experience no interdose withdrawal effects; switching from a very potent benzo to Valium allows for much smaller cuts to your dose (more frequent small cuts are better tolerated than less frequent large cuts); if you have had problems sleeping, you may benefit from the sedating effects of Valium.

Disadvantages: some planning is required with a switch to Valium (but we will help you with this); an equivalent dose must be calculated and tweaked where necessary to suit the individual; many doctors (particularly in the USA) do not support a switch to Valium; switching will likely add to the overall time taken to withdraw; a small number of people appear to not tolerate the switch to Valium very well (this sometimes might be due to the wrong equivalent dose being prescribed or a failure to tweak the dose for the individual concerned according to how they react).

Prof. Ashton achieved very good results in her clinic by switching patients to Valium. Usually, her patients had already failed to quit benzos via the Direct route. If your doctor is supportive, and willing to adjust the equivalent dose as required, you are more likely to benefit from substitution.


Titration Taper

Overview: Titration involves the daily preparation of a liquid using your benzodiazepine pill. This allows you to make small reductions to your dose.

Advantages: allows for a very smooth taper, even when tapering from a large dose pill and/or potent pills; does not require a sympathetic doctor (one that is willing to discuss the potential use of substitution).

Disadvantages: ties you down to the kitchen, as a fresh batch must be prepared each day, and refrigeration is required too; your doctor might be unsupportive if you explain that you are 'titrating your benzos'; interdose withdrawal effects still might be a problem if you are taking a benzo with a short half-life; it is more complicated, and requires the purchase of some equipment.

We will work up a titration schedule for you, and post it to this website - just print it off. It will include the exact dose to be taken and the dates of changes to your dose. It might appear a little complicated at first sight, but once you have gone through the preparation once, you will find it is pretty straightforward.

[LittleTreesGrow]

   Colin,

Thank you for posting this.  It was very helpful for me.  It helped me to validate that just decreasing the Klonopin via pill-splitting is the way for me to taper.

God bless!

I hope you are doing well.

Warmly,

LTG 

[Colin]

Hi,

I'm glad you found it useful. There is too much promotion of one method over another by some people. They all have a place, and different methods suit different people, and, sometimes, at different stages of their withdrawal. They all amount to the same thing in the end: a gradual reduction of dosage.


Edit: typo.

[jewels]

i would like to know if temazipam is a short half life or long, and if it is a good one to taper with    thankyou jewels

[Theresa2]

i would like to know if temazipam is a short half life or long, and if it is a good one to taper with    thankyou jewels

We would consider that a short acting one. Here is the link to all the benzos and their half life from The Ashton Manual... http://www.benzo.org.uk/manual/bzcha01.htm#24

[EmJoy139]

What would you recommend for tapering off .5mg of Klonopin, the direct taper or titration? Also what exactly is titration taper??
Thank you

[Colin]

Hello EmJoy,

I really should edit the opening post to give an overview of the methods, rather than just list the advantages and disadvantages.

Titration involves making a liquid from your benzodiazepine tablets. It is much easier to make small cuts with a liquid. However, the majority of people manage to taper off (even from a potent benzo such as Klonopin) by pill-splitting (Direct Taper). You will need 0.5mg Klonopin tablets (2mg tablets are unsuitable for tapering).

More about Titration: http://www.benzobuddies.org/benzodiazepine-withdrawal-methods/titration.

[EmJoy139]

Thanks for the info. I am on .5mg right now so it won't be a problem splitting them in half and then quarters. I'll update once I start the taper (Friday).

[Colin]

The chances are that you will be able to taper off by splitting your 0.5mg pills. If you find quarter-pill reductions too difficult (realistically, these are probably the smallest reductions you will be able to manage reliably), you might then consider titration. Think of titration as something to keep in your back pocket in case the need should arise to make smaller cuts.