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Benzodiazepine and z-drug withdrawal - Management
Basis for recommendation
These recommendations are in line with published reviews and guidelines on switching different benzodiazepines to diazepam and are based on expert opinion [Mant and Walsh, 1997; Ashton, 2002b; Australian Government Department of Health and Ageing, 2004; Taylor et al, 2007; BNF 56, 2008; Lader et al, 2009].
Switching to diazepam
- Despite the lack of good quality evidence, switching to diazepam is recommended for some people. It possesses a long half-life (20–100 hours), thus avoiding sharp fluctuations in plasma level. For further information, see Managing someone who wants to stop.
Examples of benzodiazepine and z-drug substitution schedules
- These are adapted from the Ashton Manual [Ashton, 2002c]. This widely published manual was developed on the basis of clinical experience of managing people withdrawing from benzodiazepines and z-drugs in an English specialist clinic over a 12-year period.
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