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Guide: Tips for Medication Tapering and Titration

Last Updated on April 18, 2024 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

Why Taper or Titrate Medication?

For many individuals seeking to come off of medication safely, stories of dramatic symptoms caused by medication withdrawal may create some doubts about the process. One can reduce the chances of extreme symptoms caused by coming off medications cold turkey, medication tapering, and titration done too aggressively 1 by seeking guidance from a local doctor or inpatient mental health facility.

But why is titration tapering so much safer and less dangerous than quitting medications cold turkey?

For some individuals, the medication withdrawal process could lead to symptoms that overwhelm a person and negatively affect mental health, physical health, or both. In fact, many medications such as opioid pain pills, or benzodiazepines, have withdrawal effects as dangerous as alcohol withdrawal. The potential for extreme acute symptoms leads many to check-in at an inpatient detox or inpatient mental health center to monitor their withdrawal. However, a rapid detox (usually 3-7 days) is not recommended for someone wanting to avoid lingering withdrawal symptoms, or severe adverse effects. In fact, the practice has been banned in certain areas.2

Many forms of tapering methods have been developed to assist in the safe reduction of prescribed or abused prescription medications. A person usually seeks treatment that leads to long-term recovery from medication dependence, not a new addiction or poly-drug addiction. Sadly, these outcomes are more common than we would like to report. Our program is quite different than all others out there. Follow the associated links to read more about methods of medication tapering used at the licensed, holistic Alternative to Meds Center. You can read about them below, including Substitution Tapering, Medication Cross-Over, the use of Bridge Medications, and others. You can also read about the most common symptoms associated with Inter-Dosing Withdrawal.
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Why Consider Titration Tapering vs Quitting Cold Turkey?

You are likely looking at safe options to titrate down medication or seeking information on tapering methods to reduce the dose of prescribed medication. For some types of medications, such as benzodiazepines, antidepressants, or ADHD medication, coming off of the drug cold turkey could lead to some damaging and traumatic symptoms for the user.3 The goal of any medication taper, or titration schedule, is to effectively lower the dose to a safe level, and if possible, totally eliminate the need for the drug, without causing severe or acute medication withdrawal symptoms.

In any case, it is wise to seek the assistance of your local doctor, naturopath, or holistic mental health practitioner when attempting to alter medications. At Alternative to Meds Center, we provide an inpatient holistic center to assist in medication withdrawal. Our program uses methods of medication titration tapering that guide our patients safely through the process of withdrawal, and to a point of independence from psychiatric meds, or pain pills, whenever possible. In order to understand why tapering and titration have become so popular, it can help to understand what these methods involve.

What Does It Mean to Titrate Medication?

medication taper and titrationThe term “titrate” refers to the process of working with your doctor or an inpatient mental health provider to adjust the amount or concentration of medication to find the lowest dose possible needed for therapeutic results. Titration can increase or decrease medication to gradually find the most effective levels. When symptoms can also be addressed with alternative therapies and treatments, some can titrate down to zero and remain symptom-free. The process is helpful in reducing any medication withdrawal symptoms to as minimal as possible when trying to eliminate a medication or find an effective lower dose of the drug.

Rather than rely on a “one-size-fits-all” approach, a prescriber can analyze the best stopping point of a medication dose. For individuals prescribed medication such as Xanax, a doctor or licensed practitioner may recommend titration of medication as a means to locate the most effective dose.

The usual recommended dose of Xanax (alprazolam) is .25mg to .5mg. It may seem that .5mg of Xanax is a low dose, but depending on the user’s level of sensitivity, the standard .5mg dose could cause symptoms and therefore would need to be adjusted. A doctor supervising Xanax titration may feel it’s wise to observe the patient for a period of time on reduced doses to see what the most comfortable baseline level is. As an example, Xanax could be reduced by a slight fraction, and then time would be given to observe the patient for any abnormal reactions or symptoms.

What Is a Medication Tapering Schedule?

Medication Tapering is a way of slowly reducing a prescribed medication down to the most effective dose. This process is also effective in eliminating medication completely. A medication tapering schedule could be developed by a willing prescribing doctor, or at a licensed facility. There are instances that would demand a medication taper schedule be altered or changed from time to time to provide the maximum benefit. A tapering schedule is not always rote but needs to be flexible to address the individual, their reactions, and tolerance level, etc. And, someone needs to be observing these minute changes to manage the process well.

For Example:

A person on a standard dose of 10mg Lexapro (escitalopram) may be recommended by their doctor to taper the dose of an antidepressant, let’s say by 1mg a month. This process is used by thousands of people who feel over-medicated, or feel it’s time to quit Lexapro. But, a month between each medication cut might see symptoms come up in between the taper levels. If an individual begins to experience withdrawal symptoms that are abnormal, extreme, or lead to medical concerns, the medication tapering schedule may need to be reviewed by the doctor or licensed professional in order to prevent further physical symptoms, or lingering mental health symptoms.

At Alternative to Meds Center medication tapering facility, we find that the best way to achieve medication taper success is to participate in treatments that focus on underlying areas of the brain chemistry. Our neurotransmitter rehabilitation program helps those who are in need of reworking the brain chemistry to provide balance to the moods and overall health. An effective benzodiazepine taper schedule, combined with adjunctive treatments focused on brain chemistry rehabilitation is known to get the highest chance of success eliminating the addictive benzo medications.

What Successful Medication Tapering Looks Like

medication taperingComing off of prescribed medication for pain, anxiety, depression, trauma, or mood disorders, is often a very rewarding experience for those who are successful in the process. However, the likelihood of problems or symptoms is so high during a medication taper schedule, that monitoring symptoms and seeking professional care is always recommended. A person seeking to taper off of benzodiazepines, for instance, can expect some symptoms of discomfort, regardless of their dosage, or how long they have been on the medication. Coming off antidepressants too fast can also be problematic.4,5 Each person will have experienced changes in the brain chemistry that need to be addressed in order to fully recover from benzo withdrawal or from their former drug dependence.

Being able to continue daily life obligations such as work, school, and family, often become too difficult while withdrawing from benzodiazepines. For anyone going through a medication taper, simply making it through the process with steady progress, means you are doing okay.

At Alternative to Meds Center, we use a host of adjunctive therapies, constant medical observation, and oversight, in order to help patients succeed in minimizing the negative effects of their medication taper process. In our center, we realize that having the right team of professionals is essential and for this reason, we have gathered the best, most competent licensed experts from various medical backgrounds to provide our clients the highest chance of success. Psychiatric medication tapering is not offered by every doctor of inpatient facility in the world, and our program is one of the oldest most experienced centers offering a holistic approach.

To learn more about our successful medication taper programs, please explore the following success stories from real Alternative to Meds Center clients:

Benzodiazepine Taper Success – 24 Years on Valium
Ambien Titration Success – Helping Back Pain and Medication Withdrawal
Withdrawal from psychiatric meds – Helping with Anxiety and Depression
Weaning off antipsychotics – 10-Year History of Psychosis Treated!

Sources:


1. Harvard Health authors, “Going off antidepressants.” Women’s Health Watch [online] 2020 March 25 [cited 2020 Dec 6]

2. CDC authors, ” Deaths and Severe Adverse Events Associated with Anesthesia-Assisted Rapid Opioid Detoxification — New York City, 2012” as published in the Morbidity and Mortality Weekly Report, 2013 Sep 27 / 62(38):777-780 [cited 2020 Dec 10]

3. Darke S, et al., “Yes, people can die from opiate withdrawal.” National Drug and Alcohol Research Center, University of Sydney [online] 2016 Aug 11 [cited 2020 Dec 10]

4. Hall-Flavin D, “Antidepressant Withdrawal- Is there such a thing?” Mayo Clinic [online} N.D. [cited 2020 Dec 10]

5. FDA drug label “Xanax (alprazolam page 6 – Dependence and Withdrawal Reactions Including Seizures” [online] 2016 Sept [cited 2020 Dec 10]


Originally Published Jan 18, 2019 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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