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

OR

• 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)