How do I taper off temazepam from 10mg to 5mg and then stop?

Temazepam Tapering Regimen: 10mg to 5mg to Discontinuation

A gradual taper of temazepam from 10mg to 5mg and then discontinuation over 6 weeks is the most effective approach to minimize withdrawal symptoms while successfully discontinuing the medication.

Recommended Tapering Schedule

1. Weeks 1-2: Continue 10mg temazepam nightly
2. Weeks 3-4: Reduce to 5mg temazepam nightly (cut 10mg tablet in half)
3. Weeks 5-6: Take 5mg every other night
4. After Week 6: Discontinue completely

This tapering schedule aligns with evidence showing that gradual reductions of approximately 25% every 1-2 weeks minimize withdrawal symptoms 1, 2. The FDA label for temazepam specifically recommends a gradual taper to reduce the risk of withdrawal reactions 3.

Monitoring During Tapering

• Monitor for withdrawal symptoms during the tapering process:

  • Anxiety
  • Insomnia
  • Irritability
  • Tremors
  • Sweating

• If withdrawal symptoms become problematic:

  • Pause the taper temporarily
  • Return to the previous dose for 1-2 weeks
  • Resume tapering at a slower rate (e.g., extend each phase by 1-2 weeks)

Managing Sleep During Tapering

• Implement good sleep hygiene practices:

  • Maintain consistent sleep and wake times
  • Avoid caffeine and alcohol near bedtime
  • Create a comfortable sleep environment
  • Limit screen time before bed

• Consider non-pharmacological approaches:

  • Relaxation techniques
  • Cognitive behavioral therapy for insomnia (CBT-I)
  • Regular exercise (but not close to bedtime)

Important Considerations

• Research shows that patients on lower doses (10mg) have higher success rates in discontinuation compared to those on higher doses (15-20mg) 4.

• Avoid substituting with other benzodiazepines or sedative medications, as this may simply transfer dependence rather than address it 5.

• The American Academy of Sleep Medicine recommends against using clonazepam or other benzodiazepines for long-term sleep management due to risks of dependence and adverse effects 2.

• If you experience significant difficulties with the taper despite following this schedule, consult your healthcare provider for personalized adjustments to the plan.

Potential Challenges and Solutions

• Rebound insomnia: This is common during tapering. Focus on sleep hygiene and non-pharmacological approaches.

• Anxiety symptoms: Practice relaxation techniques and mindfulness. If severe, discuss with your healthcare provider.

• Difficulty cutting tablets: Use a pill cutter to ensure accurate dosing when cutting the 10mg tablet in half.

Remember that successful discontinuation of temazepam is achievable with a gradual approach. Research shows that approximately 52-59% of patients remain off hypnotics several months after a properly managed withdrawal program 4.