Deprescribing/Tapering
Stopping a medication safely is a process, not an event. Our approach to tapering is gradual, individualized, and supported at every step.
Why taper slowly?
Abruptly stopping certain medications, including benzodiazepines and antidepressants, can cause withdrawal symptoms and, in some cases, serious complications such as seizures and protracted withdrawal injuries. A slow taper lowers these risks and gives your body time to adjust.
Is tapering right for you right now?
Not everyone should taper immediately. Sometimes the safest choice is to stay on the benzodiazepine you are currently taking. We will review your history, current dose, other medications, stability, and goals together before recommending a plan. Deciding to wait is a valid, safe outcome.
Our approach
Individualized. There is no one-size-fits-all schedule. Your plan is built around your medication, dose, history, and how you respond.
Slow and flexible. You set the pace with us. Your schedule can be held or adjusted at anytime.
Supported. We ask that every patient works with a taper coach and/or therapist during the process. Tapering is physical and emotional, and support significantly improves outcomes.
Taper methods we may use
Ashton Method (when appropriate). This approach involves switching to a longer-acting benzodiazepine (diazepam), then reducing the dose in small, steady steps. It is not right for everyone, and we will discuss whether it fits your situation.
Cut and hold. The dose is reduced, then held steady while your body adjusts. The next reduction happens once symptoms have settled. This allows recovery time between steps.
Microtapering. Very small, frequent dose reductions, using liquid or compounded formulations. This requires careful tracking.
Which method is best depends on you. We will explain the reasoning behind our recommendation.
What to expect
Appointments: Visits are scheduled anywhere from weekly to monthly, depending on your stage and how you are feeling.
Taper coach and/or therapist: Required throughout the taper, we will provide some options.
Written schedule: You will receive a taper plan (which is always just a plan and can be adjusted depending on your symptoms).
Symptom tracking: You may be asked to log symptoms so we can adjust the plan.
Do not stop or change your dose on your own.
Taper length varies widely. Slower is often better than faster.
This page is general information and not medical advice. Your plan will be tailored to you by your care team.
Frequently Asked Questions
How long does a taper take?
It depends on your medication, dose, how long you have taken it, and how your body responds. Many tapers take several months, and some take a year or longer. Slower is often better than faster, and we adjust the pace as we go.
Will I have withdrawal symptoms?
Some people have few symptoms and others have more. Common ones include anxiety, trouble sleeping, irritability, headaches, muscle tension, and sensitivity to light or sound. A slow, flexible taper is designed to keep symptoms manageable, however, with benzodiazepines there will likely be symptoms. Tell us how you are feeling so we can adjust your plan.
What if my symptoms get worse?
Let us know. We may hold the taper until stability or neuroadaption is acheived. Pausing is a normal part of the process and does not mean you have failed.
Can I stop on my own if I feel ready?
Please don't. Stopping suddenly can cause serious withdrawal effects, including seizures and protracted withdrawal injury. Contact us first so we can make a safe plan.
Do I have to taper?
No. Tapering is a shared decision. For some people, the safest choice is to stay on their current medication. We will review your situation together and talk through the risks and benefits of each option.
Why do I need a taper coach or therapist?
Tapering affects the body, spirit, and mind. A coach or therapist helps you manage symptoms, build coping skills, and stay on track, and we have found that people with this support do better.
What is the difference between cut and hold and microtapering?
Cut and hold means reducing your dose, then staying at the new dose until you feel stable before the next step. Microtapering means making very small, frequent reductions so changes are less noticeable. We will recommend the approach that best fits you.
Why might I be switched to a different medication?
Some tapers, such as the Ashton Method, switch to a longer-acting benzodiazepine because it is easier to reduce in small, steady steps. If you are experiencing interdose withdrawal, we will likely switch to a longer acting benzo. This is not right for everyone, and we will explain our reasoning if we recommend it.
How often will I have appointments?
Anywhere from weekly to monthly, depending on your stage and how you are doing.
Can I take other medications or supplements during a taper?
Tell us about everything you take, including over-the-counter products, supplements, and alcohol. Some can interact with your medication or worsen withdrawal symptoms. If there is protracted withdrawal injury, we do not recommend any supplments. Please check with us before adding or stopping anything.
What should I do if I have an emergency?
Seek urgent care or call 911 right away if you have a seizure, severe confusion, hallucinations, or thoughts of harming yourself. We do not have after hours and are not a crisis center.