Direct Tapers

Keeping it Simple

As discussed on the Overview of Benzodiazepine Withdrawal Methods page, a direct taper is the most straightforward method of withdrawal, and is perfectly adequate for the majority of people withdrawing from benzodiazepines.

The majority of our members make cuts of about 10% (one-tenth of their dose) every 1-2 weeks, but this is only a rough guideline – there is much variability. It is important to understand that benzodiazepine withdrawal is a very individual experience. Some manage to withdraw from benzodiazepines with few problems, but many others need to follow a relatively slow and planned withdrawal; very few experience major problems if they follow a sensible taper plan. Generally speaking, if you experience problems with your taper, you should make smaller cuts and/or allow more time between each cut. If you still experience unmanageable withdrawal symptoms, you might then try substitution with diazepam (Valium) or titration.

Having a plan before starting your taper is sensible, but flexibility is key. A plan can help drive you forwards, but you should adapt your plan according to how you react. Apart from great differences in what an individual will find tolerable, sometimes a single cut hits harder and for no discernable reason. In such circumstances, it is probably better to stabilise your dose until you improve, and then continue where you left off. It is generally a bad idea to keep cutting simply because this is what is required by your schedule. One of the main reasons people fail to complete a successful withdrawal is because they push too hard. If you have been taking benzos for some time (months or years), a successful benzodiazepine withdrawal typically takes many months to complete. You should control your schedule – do not let your schedule control you!

Sometimes, we find the early stages of the taper go well, but as our dose lowers, the cuts become more difficult to tolerate. If you have been making cuts of approximately 10% of your dose (this is 10% of your present dose, and not 10% of your starting dose), it becomes nearly impossible to apply such cuts when down to a dose of one or two tablets per day. There are no benzo tablets that can be reliably divided beyond a quarter (some would say beyond a half), so this raises some potential problems. Because our brains are operating more normally when on a low dose of benzodiazepine, those that have followed a sensible taper plan usually find that they can cope with the larger cuts (in term of percentage) at lower doses. However, for those who find these cuts do become a problem, switching to Valium or titration might be good options. You can make use of diazepam substitution or titration options at any time; these decisions do not need to be made at the beginning of your taper.

So how much is 10%, exactly? A percentage means parts per hundred. So, 10% is ten-hundredths (or, one-tenth), that's all. Additionally, 10% is intended only as a very rough guide. Rarely will your tablets split easily into an amount that equates to a cut of 10%. We suggest that you treat the 10% figure as an upper limit, at least for the first cut, so that you can gauge how you react to cuts to your benzodiazepines. If things go well, you might later try increasing the size and/or frequency of your cuts. You should also bear in mind that smaller more frequent cuts are almost always better tolerated than larger less frequent cuts, even if the overall taper rate is very similar.

Rather than us explain the mathematics of percentages, we provide tables, so there are no calculations for you to make. The next section on this webpage outlines a simple withdrawal schedule that is probably sufficient for most people looking to quit benzos.

Stepping-Off Table

For most, all that's required

The table to the right is an extrapolation of suggested taper schedules by Prof. Ashton and others. The Stepping-off table is probably all that is required by most people quitting benzodiazepines, but may not be suitable for all. The size of cuts and the taper rate are meant only as a suggestion of what most people find tolerable. Before commencement, you should discuss your planned benzodiazepine withdrawal with your doctor.

Start from your present number of tablets and work up the table, making a new cut every 1-2 weeks. Do not use a mixture of tablets strengths with this table. If you mix and match different dose pills, refer to the full explanation for a work-around. Only make a new cut once you feel reasonably recovered from the previous cut. You should switch to the lowest dose tablet available in your particular benzodiazepine.

Tailored Taper Plans

Taking the maths out of withdrawal schedules

We hope that by providing these tables, you will find it easier to manage the adjustments needed to make for a smooth and relatively pain-free withdrawal from benzodiazepines. When in a benzo-fog, it can be difficult to carry out what normally would be a simple calculation. We have performed these calculations for you in the following table.

Using percentages is a convenient way to keep track of your reaction to changes in your benzo dosage, as it allows you to make easy comparisions with earlier cuts. If mathematics was never your strong suit, and you are unsure of what a percentage actually means, all you need to remember is that a percentage is just a special type of fraction - how many parts are in a hundred. So, 2% is two-hundredths, 9% is nine-hundredths, and so on. However, using percentages is not a good way to proceed when you are trying to work out what those cuts mean when splitting your tablets. To convert a proposed percentage cut to the actual number of tablets (or fractions of tablets), we have provided this Pill-Splitting table.

For example, if you take seven tablets per day, you would start at "7" on the extreme left-side column and scan to the right in that row to a suitable percentage. If you are intending to make a cut of about 7.5%, you will come across the percentage figure of 7.14%. If you now scan upwards from this point to the very top row, you will see the fraction 1/2. This means that if you deduct 1/2 of a tablet from your daily dose of seven tablets, and your new daily dose will be 6 & 1/2 tablets. You have made a cut of 7.14%, and you have not had to make a single calculation!

You will notice that we provide for fractions of tablets as small as quarters and eighths in the table. Some manage to split their tablets into small amounts, while others struggle to do this. If you end up with a cut that you cannot reliably make with your particular tablet when using the Pill-Splitting table, you will need to select a different percentage cut to one that equates to a fraction that you can manage.

If you have any questions or would like to have someone double-check your intended reduction in dosage, you will find much help within the BenzoBuddies forum.