On average, it takes 15 weeks to safely taper off benzodiazepines.
How Benzodiazepines Work
Benzodiazepines are sedatives that are commonly used to treat anxiety, panic attacks, and seizure disorders. These drugs work by enhancing the activity of the neurotransmitter gamma-aminobutyric acid (GABA), which causes a decline in the activity of the central nervous system. The result is a calming effect that can provide relief from any condition that causes muscular or nervous system tension, such as anxiety.
However, these drugs can be habit-forming and may also cause side effects. It is ideal to taper off benzodiazepines, particularly if you have been taking them for more than three days and/or in high doses.
Benzodiazepine Tapering Guidelines & Schedule
According to the National Center for Post-Traumatic Stress Disorder, the following tapering guidelines and schedule should be used in order to prevent withdrawal symptoms and severe side effects associated with an immediate cessation of benzodiazepines.
| Milestone Recommendations | Action | Dosage |
| Week 1 | 35 mg/day | |
| Week 2 | Decrease dose by 25% | 30 mg/day (25%) |
| Week 3 | 25 mg/day | |
| Week 4 | Decrease dose by 25% | 20 mg/day |
| Week 5–8 | Hold dose for 1–2 months | Continue 20 mg/day for 1–2 months |
| Week 9–10 | 15 mg/day | |
| Week 11–12 | Decrease dose by 25% by week 11 | 10 mg/day |
| Week 13–14 | Decrease dose by 25% by week 13 | 5 mg/day |
| Week 15 | Discontinue use |
Dangers of Tapering Off Benzodiazepines Incorrectly
Ensure that you adhere to the specific recommendations of your doctor when tapering off benzodiazepines. A failure to do so can present some risks.
Some of the dangers and risks that have been identified when tapering off benzodiazepines incorrectly or too quickly include the following:
- Symptoms of withdrawal, such as shakiness, nervousness, sleeplessness, irritability, and increased tension
- Suicidal ideation and self-harming behaviors
- Panic attacks
- Weight loss
- Headaches
- Difficulty concentrating
- A failure to discontinue usage
- Seizures
- Relapse
Withdrawal Symptoms & Why They Occur
Withdrawal symptoms are unpleasant physical reactions that occur within the body following the cessation of a drug for which a physiological dependence has developed. These symptoms occur because the body has grown accustomed to the presence of a foreign chemical in the body and adapted to this presence at the cellular level.
The consumption of benzodiazepines impacts the brain’s dopaminergic reward system and influences the production and uptake of neurotransmitters like GABA. The sudden discontinuation of this drug disrupts the homeostasis that has been established through prolonged use. Time is needed before it can achieve a sense of balance again.
The following withdrawal symptoms have been reported with benzodiazepine discontinuation:
- Appetite changes
- Nausea
- Depression
- Anxiety
- Chills and shivering
- Fatigue
- Sleep disturbance
- Restlessness
- Shakiness
- Irritability
- Changes in mood
- Sweating
- Tremors
Can Properly Tapering Off Benzodiazepines Help With Withdrawal Symptoms?
It may not always be possible to completely avoid symptoms of withdrawal when discontinuing the use of benzodiazepines, particularly if you have been using high doses or taking them for extended periods of time, such as more than four weeks. However, you can avoid and/or reduce the severity of many of these symptoms if you adhere to a proper tapering schedule.
Tapering is not just important because of the physiological dependence that has developed with extended use, but also due to the psychological difficulty of managing a dopaminergic reward system that has been significantly impacted. Over time, through cessation of use, the brain will achieve homeostasis in regard to its balance of neurotransmitters. But initially, the depression and anxiety that can result from withdrawal can be unbearable for many people.
Withdrawing gradually according to a tapering schedule can help to reduce the severity of both psychological and physical aspects of dependence.
Why Is Medical Supervision Needed for Benzodiazepine Tapering?
Medical supervision is critical when tapering off benzodiazepines. This supervision is necessary to monitor your dosage and its impacts on your central nervous system. Since some symptoms of benzodiazepine can be dangerous, medical supervision is essential to keep you safe.
With medical supervision, symptom relief can be provided, so you are more comfortable throughout the withdrawal process. When symptoms are controlled, the urge to relapse is mitigated.
Medical supervision also enables practitioners to modify the dosage based on your specific reactions, and additional support can be provided based on how the tapering schedule is working.
If considering benzodiazepines or discontinuing their use, make sure to speak with your health care provider first and to establish a tapering schedule that is customized to your specific needs and circumstances. You should never attempt to quit benzodiazepine use suddenly on your own. Doing so is not safe.
- Effective Treatments for PTSD: Helping Patients Taper from Benzodiazepines. (January 2015).
- Experiences With Benzodiazepine Use, Tapering, and Discontinuation: An Internet Survey. (April 2022). Advances in Psychopharmacology.
- Opioid and Benzodiazepine Withdrawal Syndromes in Trauma ICU Patients: A Prospective Exploratory Study. (April 2020). Critical Care Explorations.
- Challenges of the Pharmacological Management of Benzodiazepine Withdrawal, Dependence, and Discontinuation. (February 2018). Therapeutic Advances in Psychopharmacology.
