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)

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