Which statement about benzodiazepine taper strategies is true?

• A. Taper should be rapid and completed within 3 days
• B. Taper should be performed under medical supervision, often with a longer-acting benzodiazepine
• C. Taper is unnecessary if patient agrees to stop
• D. Taper should involve switching to barbiturates

Answer: (B)

Tapering benzodiazepines should be done under medical supervision, often by converting to a longer-acting benzodiazepine and then gradually reducing the dose. This approach minimizes withdrawal symptoms, prevents rebound anxiety, insomnia, and autonomic symptoms, and reduces the risk of more serious complications like seizures. Longer-acting agents—such as diazepam or clonazepam—provide steadier blood levels, making the dose reductions smoother and easier to manage, while allowing healthcare providers to tailor the pace to the individual’s symptoms and comorbidities.

Abrupt or very rapid stopping is unsafe because dependence means the body has adjusted to the drug; stopping quickly can provoke intense withdrawal that can be difficult to control and potentially dangerous. Simply having a patient agree to stop does not ensure safety or readiness for withdrawal. Switching to barbiturates is not a recommended strategy due to higher risks of overdose, dependence, and adverse effects, and because barbiturates have a narrower safety margin.

So, tapering under medical supervision with a longer-acting benzodiazepine is the best-supported strategy.