“Tapering off diazepam?”
I'm tapering from diazepam have extreme anxiety and panic. I took them for anxiety.
Female | 67 years old
Complaint duration: 1 years
Medications: Paroxetine buspar diazapan tappering
Conditions: Anxiety
5 Answers
It’s not uncommon to have withdrawal anxiety when tapering off a benzodiazepine. Please follow up with your provider about your concerns. Sometimes slowing down the process can help manage the anxiety.
Tapering off diazepam or any benzodiazepine can be challenging, especially if the anxiety which was the reason for taking the diazepam is still there. You may consider increasing the other two meds you have, which are the Buspar and the paroxetine which also treat anxiety. Also, tapering very slowly is helpful. Additionally, I believe natural supplements/vitamins, a healthy lifestyle that includes exercise, adequate rest (8 hours of sleep, vacations), and a healthy diet that avoids processed food are beneficial to reducing anxiety and making it easier to come off the diazepam.
What is your question?
You raise a very popular question. First, it is wise to try and withdraw from the medicine, however, certain questions are necessary to make the right suggestions. First, how long have you been on them and at what doses? Second, have you engaged in any meaningful psychotherapy during this time?
If you have been or are in therapy that makes it easier because you can use the strength of your therapeutic relationship to ease you through the withdrawal. If not you may want to consider it.
Let's separate the two. Paroxetine is not difficult to stop...I would cut you does in half for several days to a week and then again. If this is difficult, consider shifting days...e.g. take two pills M, W, and F and one pill T, Th and Sat. and then drop down again.
Diazepam is a different and more complex issue however, I would use the same approach...depending on the dose, drop by 25% for five to seven days and then by another 25% for a week until you are down to a very small dose and then either stop it fully or alternate days for a week or two then stop it fully.
I would strongly recommend that you taper the diazepam first while remaining on the Paroxetine and then stay on the Paroxetine for several weeks to ensure stability before withdrawing from that.
During the period of tapering/discontinuing, you would benefit from creating a routine in which you make each day similar to the others. For example, going to sleep at the same time, awakening at the same time...doing roughly the same events in the morning and afternoon etc. Of course, changes can be made but should be restricted to either necessary or emergent changes and/or pleasant changes such as staying out late to celebrate an occasion. An exercise routine would be helpful and can include anything from simply walking a mile or more three times per week up to daily gym workouts with both cardio and weight training...again the goal is not to become a body-builder but rather to "gobble up" excess anxiety and to give yourself a sense of mastery of your own body and spirit. Most importantly you should be extra cautious about using alcohol, cigarettes or other approaches to help keep you at ease while withdrawing from the medicines.
A serious concern is to both be proud of stopping the medicines but not foolish...if you sense depression returning or anxiety growing be sure to return to your provider and keep them apprised along the way of your progress. It may be possible that you have to return to Paroxetine and if so you should, under the direction of your doctor. Although I find Diazepam and its cousins, Xanax and Klonopin to be very useful and beneficial medicines, we have to be especially cautious as we age. Feeling a little light-headed or unsteady is one thing at age 46 and quite another at age 70, especially if one gets up and out of bed at night. It is all too common for these medicines to leave an elderly person unsteady leading to a fall in the middle of the night and then serious problems develop...
I congratulate you on your insight and decision and wish you luck with the process....as always your own personal physician, hopefully psychiatrist is your best guide.
If you have been or are in therapy that makes it easier because you can use the strength of your therapeutic relationship to ease you through the withdrawal. If not you may want to consider it.
Let's separate the two. Paroxetine is not difficult to stop...I would cut you does in half for several days to a week and then again. If this is difficult, consider shifting days...e.g. take two pills M, W, and F and one pill T, Th and Sat. and then drop down again.
Diazepam is a different and more complex issue however, I would use the same approach...depending on the dose, drop by 25% for five to seven days and then by another 25% for a week until you are down to a very small dose and then either stop it fully or alternate days for a week or two then stop it fully.
I would strongly recommend that you taper the diazepam first while remaining on the Paroxetine and then stay on the Paroxetine for several weeks to ensure stability before withdrawing from that.
During the period of tapering/discontinuing, you would benefit from creating a routine in which you make each day similar to the others. For example, going to sleep at the same time, awakening at the same time...doing roughly the same events in the morning and afternoon etc. Of course, changes can be made but should be restricted to either necessary or emergent changes and/or pleasant changes such as staying out late to celebrate an occasion. An exercise routine would be helpful and can include anything from simply walking a mile or more three times per week up to daily gym workouts with both cardio and weight training...again the goal is not to become a body-builder but rather to "gobble up" excess anxiety and to give yourself a sense of mastery of your own body and spirit. Most importantly you should be extra cautious about using alcohol, cigarettes or other approaches to help keep you at ease while withdrawing from the medicines.
A serious concern is to both be proud of stopping the medicines but not foolish...if you sense depression returning or anxiety growing be sure to return to your provider and keep them apprised along the way of your progress. It may be possible that you have to return to Paroxetine and if so you should, under the direction of your doctor. Although I find Diazepam and its cousins, Xanax and Klonopin to be very useful and beneficial medicines, we have to be especially cautious as we age. Feeling a little light-headed or unsteady is one thing at age 46 and quite another at age 70, especially if one gets up and out of bed at night. It is all too common for these medicines to leave an elderly person unsteady leading to a fall in the middle of the night and then serious problems develop...
I congratulate you on your insight and decision and wish you luck with the process....as always your own personal physician, hopefully psychiatrist is your best guide.
My input would be to say that the taper must be very very gradual. Diazepam is habit forming. You might benefit from a different type of medication that is not an “anxiolytic”. You might also benefit from psychotherapy that is focused on anxiety skills.
Please discuss this with your prescriber. I am not an MD.
Nancy J Warren, PhD
Please discuss this with your prescriber. I am not an MD.
Nancy J Warren, PhD
