Current Psychiatry featured a tapering protocol that is the Ashton Manual, simplified.

Some additional points to consider that they found essential:

  • Tapering one or more substances at a time—even nicotine—is not advised.

  • Before starting a tapering plan, inform the patient about the risks of withdrawal.

  • For persons who take a short-acting benzodiazepine—eg, alprazolam or lorazepam—convert the dosage into an equivalent dosage of a long-acting benzodiazepine—eg, diazepam. Metabolized slowly, with a long half-life, diazepam allows a consistent, slow decline in concentration while tapering the dosage. This helps avoid severe withdrawal.

  • Understanding the tapering regimen enhances compliance and outcomes.

  • Supportive psychotherapy improves the prognosis.

  • Slow tapering is safer and better tolerated than more abrupt techniques.

See Tapering Strategies for further ideas to assist your patient in safely tapering off of benzodiazepines.

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