How do you taper your antidepressant and your benzo?
When it comes to gradually stopping antidepressants and benzodiazepines, there are several common approaches people use. One well-known technique is the Ashton method, which is frequently applied for benzodiazepines. Another popular strategy is the “reduce by 10%” method, where you lower the dose by 10% of the previous amount — this approach is often used by those tapering Cymbalta and other antidepressants. More recently, there’s been a method called hyperbolic tapering.
I’ll briefly explain each method and share how I personally recommend guiding people through tapering.
The early Ashton method suggests a fairly straightforward, linear reduction — for example, if someone is taking 20 mg of Valium, they reduce by 1 or 2 mg each week until fully off the medication. Later versions advise slowing the taper as you approach the end, which I believe makes a lot of sense. The 10% method means you calculate 10% of the current dose and reduce by that amount — so starting at 20 mg, you go down to 18 mg, then take 10% of 18 mg (1.8 mg) for the next reduction, and so on.
Hyperbolic tapering is based on how much the drug occupies receptors in the brain at various doses. At high doses, large dose reductions cause only small changes in receptor occupancy, but at very low doses, even tiny reductions can significantly affect receptor binding. For example, dropping from 60 mg to 40 mg of Prozac might slightly decrease receptor occupancy, while going from 2 mg to 1 mg can cause a much larger change.
This means you can taper more aggressively when doses are high but need to slow down considerably as you near the lowest doses.
Which method should you choose? The safest approach tends to be reducing by 10%, followed by hyperbolic tapering, with the Ashton linear taper being the least conservative. Personally, I prefer to combine elements from all these approaches — usually starting with a 5 to 10% reduction and then following some key principles.
The most important principle is monitoring the person’s level of functioning. Even if someone is dealing with long-term withdrawal and significant difficulties, they still have a baseline of what they can do daily. After each dose reduction, I check in over the following weeks to see if they can still manage regular tasks like cooking or caring for their children. If yes, we continue tapering at that pace; if not, I slow down. Sometimes I even restore the previous dose if symptoms are severe, or reduce the size of each step to make the process more manageable.
Timing between dose reductions is also crucial. Usually, waiting 2 to 4 weeks between cuts works well, and I never recommend tapering faster than every 2 weeks using the “cut and hold” method. Ideally, people should be back to their baseline for at least a week before making another reduction. If recovery takes longer, the tapering schedule is extended accordingly.
By paying close attention to the body’s response, most people find the right tapering speed. Typically, larger reductions are possible at higher doses, but the pace must slow significantly as the dose gets lower.
There is also something called microtapering — either liquid or dry — where reductions happen every day or every few days instead of every few weeks. This approach suits people who are highly sensitive and experience symptoms even with very small dose cuts (like 2–5%). For example, rather than dropping 1 mg all at once, that 1 mg is split into tiny daily amounts over a month to help the body adjust more gently.
While this can be complicated to calculate, help is available through consultations, and microtapering is recommended in these cases.
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