Chapter 14
How To Taper Anti-Anxiety,Anticonvulsants, Benzodiazepine,And Sleep
Medication
THE FDA HAS published approved guidelines for tapering off these
medications. Those guidelines are what the authors published a decade ago and
this approach is as effective now as it was in 1999.
Reduce the medication gradually and if side effects begin that are too severe, go
back to the last dosage you were doing fine with, get stable again and then reduce
the medication again, but this time at a slower reduction amount.
Gradual – Most of us take the word gradual to mean slowly, but there is a need
to give a good example of gradual. Imaging you are in an airplane that is about to
descend for the landing. What would you like that landing to be like? Would you
prefer to not feel the decent and when the plane touches the runway you do not even
feel the tires touch ground? This is a landing where I have heard the passengers
cheer and thank the pilot when they get off the plane. This is also the gradual
landing we want for you when reducing your medication.
“Gradual” when tapering off a medication would be; a slow and steady decent
that does not jar and bump the person reducing the drug. Gradual would also be a
speed of reduction that would allow the person to still function in life and reduce to
a minimum the chance of withdrawal side effects.
If you agree with the above, this removes the idea of skipping days of the
medication in order to reduce the dosage and get off the drug. Skipping days or
alternating from a higher dosage to a lower dosage every other day is not gradual.
One only needs to examine the half-life of the medication to establish that fact.
You go into withdrawal every other day and feel an overdose effect the days you
are going back up on the dosage.
Never Skip Days of the Drug
All drugs in this class come in completely different dosages and with some being
in a time-release, the variances are too vast to list in a book of this type. We will
first discuss what to do with a non-time release medication.
ONLY REDUCE MEDICATION EVERY 14-DAYS
Non-Time Release Medication
If you are taking a non-time release medication, reduce the medication as close to
5% as possible. I understand the 5% is an arbitrary number but this is what most
have found to work well.
With most medications being different there is no way for us to describe each one
and your physician and pharmacist should be involved in this process regardless.
Some medications can be compounded into exact and precise reductions.
Compounding is when the pharmacist takes the medication and grinds it to a
powdered form and then encapsulates to a new dosage. This is the ideal way to
reduce all medications but some cannot be compounded and the cost can also be
out of reach for some individuals.
With your pharmacist, see if purchasing a pill slicer will work for you. These
typically cost about $5 at a pharmacy.
You can also purchase a relative low cost digital scale that will measure milligram
amounts.
Talk with your pharmacist about putting the medication in a solution for measuring
reductions. Some medications dissolve well and can be crushed and put in water
and then you pour out of a flask the reduction amount.
An experienced pharmacist will be of great value to you during this process.
Time Release or Extended Release Medication
When it comes to reducing medication that is time release, the process needs to be
a little different with the program. Sometimes time release medications are also
offered in a non-time release form and it is best to cross-over to the non-time
release form of the drug. Your physician and pharmacist are the ones to guide you
through how to take the medication. Cross over to the non-time release form of the
medication if that is at all possible. The cross - over would be the first reduction.
How to Adjust Supplements During the Taper
Keeping good notes with your Daily Journal during the pre-taper is worth its
weight in gold during the tapering of the medication.
A rule of thumb: The supplement that got rid of a side effect or symptom during
the pre-taper is the supplement to increase during the taper if that symptom returns
while tapering off the drug. An example of this can be made with the Neuro Day.
If all of your anxiety vanished during the pre-taper after starting the Neuro Day
and anxiety creeps back when you start reducing the medication, adjust the time
you take the Neuro Day to fit the time the anxiety begins. You would take the
Neuro Day an hour before the anxiety tends to start.
Keep in mind you can adjust the supplements around to fit your current symptoms.
JNK Formula – Only take 1 capsule at a time. No more than 2 capsules in a day.
The second capsule needs to be at least 3 hours after the first.
Neuro Day - Only take 1 capsule at a time. No more than 2 capsules in a day. The
second capsule needs to be at least 3 hours after the first.
Neuro Night – Only 1 capsule a day.
If the information above is not making a smooth and relative withdrawal free
program for you, it is time to reduce the drug at a slower pace.
We do not advise switching from one drug to another drug because the new one
has a longer half-life. This does not work and will cause more problems and
symptoms than you currently are experiencing. Some people promote crossing
over to Valium because of the longer half-life. DO NOT DO THIS.
Reread and keep in mind Chapter 3, “Nutritionals Used in The Road Back
Program” for tips and how to increase the supplements.
Reducing the medication is actually the easy part of the program.
Note: If you have had difficulty reducing the medication in the past, compounding
the drug for a 2% reduction is advised. Reduce every 14-days, have success and
then try reducing by 5% every 14-days.
If this is your first attempt tapering the medication, start with a 5% reduction,
reduce again in 14-days and repeat at the 5% reduction two additional times. If
successful, you can try a further increase of reduction, but that is not advised. If
withdrawal side effects begin, go back to the last dosage you were doing fine with
and for the next reduction, reduce at a more gradual rate.
Chapter 14
How To Taper Anti-
Anxiety,Anticonvulsants,
Benzodiazepine,And Sleep
Medication
THE FDA HAS published approved
guidelines for tapering off these
medications. Those guidelines are what
the authors published a decade ago and
this approach is as effective now as it
was in 1999.
Reduce the medication gradually and if
side effects begin that are too severe, go
back to the last dosage you were doing
fine with, get stable again and then
reduce the medication again, but this time at a
slower reduction amount.
Gradual – Most of us take the word
gradual to mean slowly, but there is a
need to give a good example of gradual.
Imaging you are in an airplane that is
about to descend for the landing. What would you
like that landing to be like? Would you
prefer to not feel the decent and when the
plane touches the runway you do not
even feel the tires touch ground? This is a
landing where I have heard the
passengers cheer and thank the pilot when they get
off the plane. This is also the gradual
landing we want for you when reducing
your medication.
“Gradual” when tapering off a
medication would be; a slow and steady
decent that does not jar and bump the person
reducing the drug. Gradual would also
be a speed of reduction that would allow the
person to still function in life and reduce
to a minimum the chance of withdrawal
side effects.
If you agree with the above, this removes
the idea of skipping days of the
medication in order to reduce the dosage
and get off the drug. Skipping days or
alternating from a higher dosage to a
lower dosage every other day is not
gradual. One only needs to examine the half-life
of the medication to establish that fact.
You go into withdrawal every other day
and feel an overdose effect the days you
are going back up on the dosage.
Never Skip Days of the Drug
All drugs in this class come in
completely different dosages and with
some being in a time-release, the variances are too
vast to list in a book of this type. We will
first discuss what to do with a non-time
release medication.
ONLY REDUCE MEDICATION
EVERY 14-DAYS
Non-Time Release Medication
If you are taking a non-time release
medication, reduce the medication as
close to 5% as possible. I understand the 5% is an
arbitrary number but this is what most
have found to work well.
With most medications being different
there is no way for us to describe each
one and your physician and pharmacist
should be involved in this process
regardless. Some medications can be compounded
into exact and precise reductions.
Compounding is when the pharmacist
takes the medication and grinds it to a
powdered form and then encapsulates to
a new dosage. This is the ideal way to
reduce all medications but some cannot
be compounded and the cost can also be
out of reach for some individuals.
With your pharmacist, see if purchasing
a pill slicer will work for you. These
typically cost about $5 at a pharmacy.
You can also purchase a relative low cost
digital scale that will measure milligram
amounts.
Talk with your pharmacist about putting
the medication in a solution for
measuring reductions. Some medications dissolve
well and can be crushed and put in water
and then you pour out of a flask the
reduction amount.
An experienced pharmacist will be of
great value to you during this process.
Time Release or Extended Release
Medication
When it comes to reducing medication
that is time release, the process needs to
be a little different with the program.
Sometimes time release medications are
also offered in a non-time release form and it
is best to cross-over to the non-time
release form of the drug. Your physician
and pharmacist are the ones to guide you
through how to take the medication.
Cross over to the non-time release form
of the medication if that is at all possible. The
cross - over would be the first reduction.
How to Adjust Supplements During the
Taper
Keeping good notes with your Daily
Journal during the pre-taper is worth its
weight in gold during the tapering of the
medication.
A rule of thumb: The supplement that
got rid of a side effect or symptom
during the pre-taper is the supplement to
increase during the taper if that symptom
returns while tapering off the drug. An example
of this can be made with the Neuro Day.
If all of your anxiety vanished during the
pre-taper after starting the Neuro Day
and anxiety creeps back when you start
reducing the medication, adjust the time
you take the Neuro Day to fit the time
the anxiety begins. You would take the
Neuro Day an hour before the anxiety
tends to start.
Keep in mind you can adjust the
supplements around to fit your current
symptoms.
JNK Formula – Only take 1 capsule at a
time. No more than 2 capsules in a day.
The second capsule needs to be at least 3
hours after the first.
Neuro Day - Only take 1 capsule at a
time. No more than 2 capsules in a day.
The second capsule needs to be at least 3
hours after the first.
Neuro Night – Only 1 capsule a day.
If the information above is not making a
smooth and relative withdrawal free
program for you, it is time to reduce the
drug at a slower pace.
We do not advise switching from one
drug to another drug because the new
one has a longer half-life. This does not work
and will cause more problems and
symptoms than you currently are
experiencing. Some people promote
crossing over to Valium because of the longer
half-life. DO NOT DO THIS.
Reread and keep in mind Chapter 3,
“Nutritionals Used in The Road Back
Program” for tips and how to increase
the supplements.
Reducing the medication is actually the
easy part of the program.
Note: If you have had difficulty reducing
the medication in the past, compounding
the drug for a 2% reduction is advised.
Reduce every 14-days, have success and
then try reducing by 5% every 14-days.
If this is your first attempt tapering the
medication, start with a 5% reduction,
reduce again in 14-days and repeat at the
5% reduction two additional times. If
successful, you can try a further increase
of reduction, but that is not advised. If
withdrawal side effects begin, go back to
the last dosage you were doing fine with
and for the next reduction, reduce at a
more gradual rate.
