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.
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