Module 4: Therapeutics

Lesson 4

Benzodiazepines rotating and tapering (cont’d)

An approach to tapering benzodiazepines is as follows:

  • Taper slowly
    • Consider a longer acting agent or taper using current agent (see equivalent table)
  • Use scheduled doses
    • Taper by no more than 5 mg diazepam equivalent per week and adjust to response
    • Slow taper to 1–2 mg diazepam equivalent per week once below 20mg/day


  • Taper by 10% of the dose every 1–2 weeks until at 20% of the original dose then taper by 5% every 2–4 weeks
    • Consider controlled dispensing if appropriate
  • Stop taper if severe anxiety or depression occurs
  • Assess for response to taper at scheduled follow-up visits (every 1–4 weeks)