Benzodiazepine Deprescribing
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- Benzodiazepine Deprescribing
A gradual, planned way off of a benzodiazepine
- alprazolam (Xanax, Xanax XR)
- chlordiazepoxide (Librium)
- clobazam (Onfi)
- clonazepam (Klonopin)
- clorazepate dipotassium (Tranxene)
- diazepam (Valium)
- lorazepam (Ativan)
- temazepam (Restoril)
- triazolam (Halcion)
What long-term use can do
Tolerance
With regular use, the same dose gradually does less than it once did, and symptoms can return between doses, known as interdose withdrawal.
Physical dependence
Within weeks of regular use the nervous system adapts to the medication, and stopping suddenly brings on withdrawal. That is an expected result of continued use, not a personal failing.
Withdrawal reactions
In 2020 the United States Food and Drug Administration (FDA) added physical dependence and withdrawal reactions to the boxed warning on every benzodiazepine, even at prescribed doses.
Memory, coordination, and falls
Long-term use can affect memory, concentration, and coordination and raise the risk of falls, especially in older adults.
How Dr. Leeds plans a taper
Dr. Leeds follows the Ashton Manual and the Maudsley Deprescribing Guidelines. Both teach the same lesson: come down slowly, in steps that shrink as the dose falls, and let the patient’s symptoms set the speed. When symptoms flare, the answer is a hold, not a lecture. More on how he adapts each taper and on medically supervised benzodiazepine tapering.
Assessment
The first visit covers the medication, the dose, how long it has been taken, and the patient's goals.
1
A plan the patient shapes
Some patients cross over to diazepam, a longer-acting benzodiazepine, where it helps; others stay on their own medication. Liquid formulations allow small, precise reductions.
2
Smaller steps as the dose falls
Each reduction is smaller than the last, with holds when symptoms flare. Follow-up continues through the taper and, where needed, through protracted withdrawal.
3
One physician, by telemedicine across Florida
Dr. Leeds is an osteopathic physician and deprescribing specialist in Fort Lauderdale who serves on the medical advisory board of the Benzodiazepine Information Coalition. He also helps patients taper other prescribed medications that cause dependence.
His practice is concierge rather than insurance based. He sees patients by telemedicine throughout Florida, Monday to Friday, 10 AM to 2 PM.
Many people arrive after searching for benzo detox. What Dr. Leeds offers is a gradual, medically supervised taper over months, with no facility stay and no fixed timeline.
The patient sets the pace
Nobody is pushed faster than their nervous system allows, and a taper that is going well may move a little faster, as tolerated.
Informed consent comes first
Risks first, then alternatives, an exit plan from the start, and the patient's right to decline at any point.
Ready to talk about a taper?
The first step is the contact form. A telemedicine consultation follows for patients in Florida, and the taper plan takes shape from there.
Most Popular Questions
Frequently Asked Questions About Benzodiazepines
Short answers to the questions patients ask most often.
Benzodiazepines are a group of medications prescribed for anxiety, insomnia, muscle spasms, and seizures. They work by increasing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that calms the nervous system.
Benzodiazepines enhance the effects of GABA, a neurotransmitter that inhibits brain activity. By boosting GABA’s calming effect, these medications help reduce anxiety, promote sleep, and relax muscles.
Common benzodiazepines include Diazepam (Valium), Lorazepam (Ativan), Clonazepam (Klonopin), and Alprazolam (Xanax). Each has different durations of action and is used for specific conditions.
Side effects of benzodiazepines may include drowsiness, dizziness, impaired coordination, and memory problems. Long-term use can also lead to dependence and withdrawal symptoms.