Coming off psychiatric medication, low and slow.
Real stories and plain-English science about coming off psychiatric medication safely, from the team behind MyDeprescriber.com (http://MyDeprescriber.com). For people on a taper, the people who love them, and the providers who guide them.
Coming off an antidepressant, a benzodiazepine, a sleeping pill or an antipsychotic is a medical process, and most people go into it with less guidance than they had going on. MyDeprescriber.com (http://MyDeprescriber.com) is the podcast for that gap.
Each episode takes one question people actually ask and answers it plainly: Why do the last few milligrams feel harder than the first? What is the difference between withdrawal and relapse, and why do they get confused? What does "low and slow" really mean in practice? What is a hyperbolic taper? When should a taper pause?
You will hear from providers trained in deprescribing, from people partway through a taper or on the other side of one, and from the MyDeprescriber team, who read the research so you do not have to. Everything we say is backed by published evidence, and we tell you when the evidence is thin.
This show is for three kinds of listeners: people who are tapering or thinking about it, the family and friends supporting them, and clinicians who want to do this well. If that is you, welcome.
MyDeprescriber.com (http://MyDeprescriber.com) is a directory of providers who help people taper psychiatric medication safely, and the home of The Deprescriber's Playbook, a certification course for clinicians. Find a provider near you at mydeprescriber.com/find-a-provider.
This podcast is education, not medical advice. Never stop or change a medication without talking to your own provider first.
Why do the last steps of a benzodiazepine taper hurt the most?
Coming off a benzodiazepine turns out to be less about willpower and more about arithmetic. This episode works through why cutting the same number of milligrams each time stops working as the dose gets smaller, and what a percentage-based (hyperbolic) taper looks like in practice: starting at 10 mg, then 9, then 8.1, then 7.3.
We cover the pace the 2025 ASAM guideline sets out, which is reducing the dose by 5% to 10% every 2 to 4 weeks for most people, and never faster than 25% every 2 weeks. Faster schedules do not hold up: with weekly 25% cuts, 1 in 4 to 1 in 2 people dropped out before finishing the taper. A typical taper runs 2 to 12 months, and 12 to 18 months for people who have been on a higher dose for many years.
We also look at timing and at what helps. Withdrawal symptoms tend to start 1 to 4 days after a dose cut on a short-acting benzodiazepine and 4 to 10 days on a long-acting one, usually peaking within a week of each cut and then settling. And in older adults tapering a benzodiazepine for sleep, 70% who added CBT-I were off the medication at 3 months, compared with 24% of those who tapered alone.
Full guide: How to Safely Come Off Benzodiazepines (https://mydeprescriber.com/how-to-safely-come-off-benzodiazepines/). Find a provider trained in deprescribing: mydeprescriber.com/find-a-provider (https://mydeprescriber.com/find-a-provider/). The hosts of this episode are AI-generated from the written guide.
Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.
27 Oct 2026
Why stopping daily Zyrtec can set off an itch, and how to step down instead
If you have taken cetirizine (Zyrtec) or levocetirizine (Xyzal) every day for months, stopping all at once can set off intense itching. This episode walks through why that happens, when it usually starts, and what the gentler ways off look like.
We cover the FDA warning required in May 2025, the pattern in the reported cases (most involved daily use for more than 3 months, with the itch usually starting 1 to 5 days after the last dose), two practical ways to step down (spacing doses out every other day for a week or two and then every third day, or lowering the dose from 10 mg to 5 mg for two weeks), what was reported when people restarted the medicine, and the signs that mean it is time to call your provider.
Read the full guide: How to safely come off cetirizine (Zyrtec) without the itch (https://mydeprescriber.com/how-to-safely-come-off-cetirizine/)Find a provider trained in deprescribing: mydeprescriber.com/find-a-provider (https://mydeprescriber.com/find-a-provider/)
The hosts of this episode are AI-generated from the written guide.
Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.
24 Oct 2026
Can you just stop Ambien? What a safe Z-drug taper looks like
Zolpidem (Ambien), eszopiclone (Lunesta) and zaleplon (Sonata) are labeled for short-term use, often 7 to 35 nights, because the benefit shrinks over weeks and months while the risks creep up. This episode walks through what that means if you have been taking one every night for far longer, and what the 2019 FDA boxed warning for complex sleep behaviors covers.
We cover the taper itself: cutting the dose by about 25% every two weeks, a worked zolpidem example from 10 mg down to alternate nights, why the last step is usually the hardest, and why the whole thing often takes 8 to 16 weeks and sometimes six months or more. We also cover rebound insomnia, the short stretch of worse sleep after a cut that usually fades within a week or two, and CBT-I, the structured 4 to 8 session program that is first-line for long-term insomnia.
Read the full guide: How to Safely Come Off Z-Drugs (https://mydeprescriber.com/how-to-safely-come-off-z-drugs/). Find a provider trained in deprescribing: mydeprescriber.com/find-a-provider (https://mydeprescriber.com/find-a-provider/).
The hosts of this episode are AI-generated from our written guide.
Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.
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