Detoxification from benzodiazepines: schedules and strategies.
Management of benzodiazepine (BZD) tolerance is divided into low- and high-dose withdrawal. Low-dose withdrawal includes patients who have received manufacturer-recommended doses of BZD on a daily basis for longer than 1 month. Gradual tapering of the BZD over 4 weeks on an outpatient basis is suggested. High-dose withdrawal includes patients who have been ingesting doses of BZD greater than the equivalent of diazepam 40 mg/d for longer than 8 months. It is recommended that the patients be tolerance tested with diazepam and, if tolerant, tapered off medication as inpatients at a rate of 10% per day. Triazolobenzodiazepines may be exceptions to these recommendations. Alprazolam should be titrated at a rate of 0.5 mg three times a day regardless of whether the patient is being tapered for low- or high-dose withdrawal.
Division of Clinical Pharmacy, College of Pharmacy, University of Iowa, Iowa City 52242.
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D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000534:rehabilitation*
D014151:Anti-Anxiety Agents; D001569:Benzodiazepines