Should I taper off 60mg of my medication?

Should You Taper Off 60mg of Your Medication?

Yes, you absolutely need to taper off 60mg of most medications rather than stopping abruptly, as sudden discontinuation can cause withdrawal symptoms, disease relapse, or serious medical complications. The specific tapering schedule depends entirely on which medication you're taking, but gradual dose reduction is the standard of care across nearly all drug classes.

Critical Safety Principle

Never abruptly discontinue medications without medical supervision. Abrupt discontinuation is considered unacceptable medical care for most medications and can lead to:

• Severe withdrawal symptoms 1
• Rapid disease destabilization 2
• Return of original symptoms 2
• Potentially dangerous medical complications 1

Medication-Specific Tapering Approaches

For Antidepressants (e.g., SSRIs like Escitalopram)

• All SSRIs must be slowly tapered due to risk of withdrawal effects 3
• Reduce by approximately 10% of the current dose every 2-4 weeks 3
• If withdrawal symptoms occur (dysphoria, irritability, insomnia, anhedonia), extend time between reductions to 4-6 weeks 3
• Consider smaller reductions (5% instead of 10%) to minimize symptoms 3
• Protracted withdrawal can persist for months after complete discontinuation 3

For Antipsychotics (e.g., Risperidone, Aripiprazole)

• Begin with reduction from 60mg to a lower dose and maintain for 2-4 weeks 2
• Continue with 0.5mg reductions every 2-4 weeks 2
• The entire tapering process may take 8-16 weeks or longer 2
• For patients on medication for years, tapers may require several months to years 2
• If withdrawal symptoms occur, temporarily return to the previous dose before attempting smaller reductions 2

For Corticosteroids (e.g., Prednisone at 60mg)

• Taper by 10mg every 2 weeks down to 30mg/day 1
• Then slow to 5mg every 2 weeks until reaching 20mg/day 1
• Below 20mg/day, taper by 2.5mg every 2 weeks 1
• At 10mg/day, may need to slow to 1mg every 2-4 weeks 1
• Rapid tapers below 5mg/day are associated with higher relapse risk 1

For Opioid Analgesics

• Dose tapering is advisable to reduce risk of discontinuation syndrome 1
• Use small increments at intervals allowing adequate observation, usually at least a week at each dose level 1
• Patients on opioids for years may require very slow tapers with pauses to allow gradual accommodation 1
• Monitor for anxiety, depression, and opioid use disorder during taper 1

Essential Monitoring During Tapering

Schedule regular follow-up appointments every 2-4 weeks to assess for:

• Return of original symptoms that prompted medication treatment 2
• Withdrawal symptoms (anxiety, insomnia, irritability, physical symptoms) 2, 3
• Need to adjust tapering schedule based on individual response 3

Document baseline symptoms and functioning before initiating the taper to track changes 2

Managing Withdrawal Symptoms

If symptoms emerge during tapering:

• Temporarily return to the previous dose and stabilize before attempting smaller reductions 1, 2
• Consider adjunctive medications for specific symptoms:
  • Trazodone or mirtazapine for insomnia 3
  • NSAIDs or acetaminophen for headaches and muscle aches 3
  • Anti-nausea medications for gastrointestinal symptoms 3

Critical Pitfalls to Avoid

• Do not use a fixed timeline - the taper must be adjusted based on individual response, not a predetermined schedule 2
• Do not abandon care if the patient struggles - consider pausing at a stable dose rather than pushing forward 2
• Do not make "cold referrals" to other clinicians during taper without ensuring they have agreed to accept the patient's care 2
• Patient agreement and collaboration are essential - ensure the patient understands the plan and can request slower tapering if needed 2

When Tapering May Not Be Appropriate

• Buprenorphine for opioid use disorder should not be reduced in an attempt to comply with analgesia guidelines, as most patients relapse to more dangerous opioids 1
• Medications showing clear benefit without adverse effects may not require tapering unless there are specific medical indications 1

Bottom Line

The determination that you need to taper depends on your specific medication, but the answer is almost certainly yes. Contact your prescribing physician immediately to develop an individualized tapering schedule. Do not attempt to stop 60mg of any medication on your own, as this carries significant medical risks 1, 2.