Diazepam Tapering Guidelines

Tapering Approach

The Centers for Disease Control and Prevention recommends tapering should be individualized based on the patient's duration of use, with longer-term users (≥1 year) requiring slower tapers 1
Patient agreement and involvement in the tapering plan is essential for success, as recommended by the Centers for Disease Control and Prevention 1
For patients on diazepam 10mg daily, the Mayo Clinic recommends an initial reduction of 1mg (10%) to 9mg daily for 2-4 weeks, with subsequent reductions of approximately 10% of the most recent dose 2, 3

The Mayo Clinic recommends considering adjunctive medications to manage specific withdrawal symptoms, such as α2-agonists like clonidine or tizanidine for autonomic symptoms 2
The Mayo Clinic also recommends incorporating non-pharmacological approaches, including cognitive behavioral therapy 4, exercise and physical activity 4, and stress management techniques 2, 4

The Centers for Disease Control and Prevention recommends that if the patient is also taking opioids, consider tapering the benzodiazepine first 5
For patients with a history of seizures, even slower tapering is recommended, as suggested by Gastroenterology 6
Patients with substance use disorders may require specialized addiction treatment, according to the Mayo Clinic 7

The Centers for Disease Control and Prevention recommends monitoring patients at least monthly during the tapering process 1
The Centers for Disease Control and Prevention also recommends providing education about increased risk of overdose if returning to previous doses, and screening for anxiety, depression, and substance use disorders that may emerge during tapering 1
The Mayo Clinic and the Centers for Disease Control and Prevention recommend never abandoning patients who are struggling with the taper; consider pausing rather than discontinuing care 1, 3