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Chapter 14

How to Taper Anti-Anxiety, Anticonvulsants, Benzodiazepines, 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. Imagine 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 descent 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 relatively 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 – Two capsules 15 minutes before bedtime.

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 at 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 in 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.