Tapering Recommendations for Discontinuing Low-Dose Valproate

Rationale for Tapering and Monitoring

Anxiety, insomnia, and irritability are potential withdrawal symptoms to monitor during tapering, as recommended by the Centers for Disease Control and Prevention, based on MMWR Recommendations and Reports 1
The risk of withdrawal symptoms increases with longer duration of previous therapy, according to the Centers for Disease Control and Prevention, based on MMWR Recommendations and Reports 2
Avoid tapering too quickly, as this may increase the risk of withdrawal symptoms, as advised by the Centers for Disease Control and Prevention, based on MMWR Recommendations and Reports 1

Monitor the patient frequently during the tapering process, at least monthly, as recommended by the Centers for Disease Control and Prevention, based on MMWR Recommendations and Reports 2
If withdrawal symptoms occur, consider slowing the taper or temporarily returning to the previous dose before attempting a more gradual reduction, as suggested by the Centers for Disease Control and Prevention, based on MMWR Recommendations and Reports 2