Ashton Manual Taper Schedule
Heather Ashton's schedules for benzo tapering may be too aggressive and patients' experience shows a slower taper may be better,.Current NHS advice is hereThese guidelines are informed by Ashton's experience and in their detail and consideration for the patient certainly surpass any official US guidelines.They were partially based on 2006 NHS PRODIGY advice for doctors about benzo tapering, available from the UK's Battle Against Tranquilisers as an MS Word document download from (at bottom of list). The full scenario from (Go to this page to see information under links embedded in the text below.)Benzodiazepine and z-drug withdrawal - ManagementHow do I assess someone who wants to stop benzodiazepines or z-drugs?. Assess whether this is a suitable time for the person to stop taking the drugs. The chances of success are improved when a person's physical and psychological health and personal circumstances are stable. In some circumstances it may be more appropriate to wait until other problems are resolved or improved before starting drug withdrawal. Enquire about:. Symptoms of depression.
Withdrawing these drugs can worsen symptoms of clinical depression. The priority is to manage depression first, before attempting drug withdrawal — see the CKS topic on Depression. Symptoms of anxiety. Withdrawing treatment when significant symptoms of anxiety are present is likely to make symptoms worse and is therefore unlikely to succeed. However, when symptoms are reasonably well controlled and stable it may be possible to attempt careful drug withdrawal.
Ashton Taper Protocol
Symptoms of long-term insomnia. If insomnia is severe, consider treating this with non-drug treatments prior to starting withdrawal of a benzodiazepine or z-drug — see the CKS topic on Insomnia. Any medical problems and whether these are well controlled and stable. Gradual withdrawal of benzodiazepines and z-drugs.
Although good quality evidence for this is lacking, withdrawing benzodiazepines gradually is recommended to allow a smooth, gradual fall in the level of drugs in the blood, thus minimizing withdrawal symptoms Lingford-Hughes et al, 2004; Ashton, 2005; BNF 56, 2008; Lader et al, 2009. Abrupt drug withdrawal can produce confusion, toxic psychosis, convulsions, or a condition resembling delirium tremens bNF 56, 2008; Lader et al, 2009. How should I withdraw a benzodiazepine or a z-drug?. Withdrawal should be gradual (dose tapering, such as 5–10% reduction every 1–2 weeks, or an eighth of the dose 12.5% fortnightly, with a slower reduction at lower doses), and titrated according to the severity of withdrawal symptoms. This may take 3–4 months to a year or longer. Some people may be able to withdraw in less time.
For advice on withdrawal, see Advice. Withdrawal may be undertaken with or without switching to diazepam. See Additional information for examples of withdrawal schedules. What should I advise people undergoing withdrawal?. Advise that drug withdrawal should be gradual to minimize the risk of withdrawal effects. Offer reassurance that the person will be in control of the drug withdrawal and that they can proceed at a rate that suits them.
The Ashton Manual Taper Schedule
Drug withdrawal may take 3 months to a year or longer if necessary. Some people may be able to withdraw in less time. If the person reaches a difficult point in the drug withdrawal schedule, maintain the current dose for a few weeks if necessary. Should a person with benzodiazepine or z-drug dependency drive?. People who take benzodiazepines at doses recommended by the British National Formulary (BNF) and have no evidence of impairment do not need to inform the Driver and Vehicle Licensing Agency (DVLA). The non-prescribed use of benzodiazepines and/or the use of supra-therapeutic dosage, whether in a substance withdrawal/maintenance programme or otherwise, constitutes misuse/dependency for licensing purposes. I'm sure the NHS means well, and I expect.
I have absolutely no doubt that my doctor truly meant well when he gave me a 'very slow' taper schedule for paxil that had me off in six weeks.And I'm sure some of this information works for some people. Most taper schedules for psych meds works for some people.But I've been seening for a long time that a lot of this kind of advice has been disastrous for far too many people and made them very, very ill. I would never do most of what this advice for doctors suggests. Particularly the advice about the lower doses.Not saying that some of this isn't valid or useful. But urging people to be very, very cautious.Especially if this is not the first time you've come off a med affecting the CNS. Even if you never had problems from previous withdrawals.
Ashton Manual Taper Schedule 2017
What should I advise people undergoing withdrawal?. Advise that drug withdrawal should be gradual to minimize the risk of withdrawal effects. Offer reassurance that the person will be in control of the drug withdrawal and that they can proceed at a rate that suits them. Drug withdrawal may take 3 months to a year or longer if necessary. Some people may be able to withdraw in less time. If the person reaches a difficult point in the drug withdrawal schedule, maintain the current dose for a few weeks if necessary.