An Overview of the Process of Tapering Benzodiazepines and Z-Drugs - Flowchart

An Overview of the Process of Tapering Benzodiazepines and Z-Drugs - Flowchart

An Overview of the Process of Tapering Benzodiazepines and Z-Drugs - Flowchart Tapering Benzodiazepines and Z-Drugs in Practice Tapering Benzodiazepines and Z-Drugs in Practice

«Flowchart»

Step 1: Make initial dose reduction

Step 1: Make initial dose reduction

Step 1: Make initial dose reduction

Step 1:

Step 2: Monitor withdrawal symptoms

Step 2: Monitor withdrawal symptoms

Step 2: Monitor withdrawal symptoms

Step 2

Continue similar-sized reduction (in terms of receptor occupancy, i.e. hyperbolic reductions)

Continue similar-sized reduction (in terms of receptor occupancy, i.e. hyperbolic reductions)

Continue similar-sized reduction (in terms of receptor occupancy, i.e. hyperbolic reductions)

Return to dose at which patients was last stable

Return to dose at which patients was last stable

Return to dose at which patients was last stable

Step 3: Repeat cycle of reduction, monitoring, and decision on next reduction (as above)

Step 3: Repeat cycle of reduction, monitoring, and decision on next reduction (as above)

Step 3: Repeat cycle of reduction, monitoring, and decision on next reduction (as above)

Step 3

End

End

End

Return to dose at which patient was last stable

Return to dose at which patient was last stable

Return to dose at which patient was last stable

Delay further reduction until symptoms resolve or increase dose

Delay further reduction until symptoms resolve or increase dose

Delay further reduction until symptoms resolve or increase dose

Symptoms do not resolve

Symptoms do not resolve

Symptoms do not resolve

Allow time to stabilise.
Make reductions more gradually (e.g. shift to slower regimen)

Allow time to stabilise.
Make reductions more gradually (e.g. shift to slower regimen)

Allow time to stabilise.

Allow time to stabilise.
Make reductions more gradually (e.g. shift to slower regimen)

Allow time to stabilise.
Make reductions more gradually (e.g. shift to slower regimen)

Allow time to stabilise.
Make reductions more gradually (e.g. shift to slower regimen)

Step 2: Monitor withdrawal symptoms

Step 2: Monitor withdrawal symptoms

Step 2: Step 2: Monitor withdrawal symptoms

Step 4: Reduce dose to zero when the reduction is no larger than previously tolerated reductions, in terms of receptor occupancy (see drug-specific guidance)

Step 4: Reduce dose to zero when the reduction is no larger than previously tolerated reductions, in terms of receptor occupancy (see drug-specific guidance)

Step 4 Step 4: Reduce dose to zero when the reduction is no larger than previously tolerated reductions, in terms of receptor occupancy (see drug-specific guidance)

Pre-existing condition might emerge as medication is reduced, which might require specific management

Pre-existing condition might emerge as medication is reduced, which might require specific management

Pre-existing condition might emerge as medication is reduced, which might require specific management

^*What constitutes tolerable withdrawal symptoms will vary from person to person.

^*What constitutes tolerable withdrawal symptoms will vary from person to person.

^*What constitutes tolerable withdrawal symptoms will vary from person to person.

^*

No or tolerable^* withdrawal symptoms (e.g. 0-4 out of 10)

No or tolerable^* withdrawal symptoms (e.g. 0-4 out of 10)

^* ^* No or tolerable

Moderately severe withdrawal symptoms (e.g. 5-8 out of 10)

Moderately severe withdrawal symptoms (e.g. 5-8 out of 10)

Moderately severe withdrawal symptoms (e.g. 5-8 out of 10)

Severe withdrawal symptoms (e.g. 9-10 out of 10)

Severe withdrawal symptoms (e.g. 9-10 out of 10)

Severe withdrawal symptoms (e.g. 9-10 out of 10)