Tapering (medicine)
In medicine, tapering is the practice of gradually reducing the dosage of a medication to reduce or discontinue it. Generally, tapering is done to avoid or minimize withdrawal symptoms that arise from neurobiological adaptation to the drug.
Prescribed psychotropic drugs that may require tapering due to this physical dependence include opioids, selective serotonin reuptake inhibitors, antipsychotics, anticonvulsants, and benzodiazepines.
Hyperbolic tapering
Hyperbolic tapering is where the size of dose reductions become progressively smaller over time as the total dose itself becomes smaller. It is often used when tapering antidepressants to avoid antidepressant discontinuation syndrome. Rather than being based on a linear reduction of total medication dose in milligrams, the goal of hyperbolic tapering is to achieve linear reductions of brain receptor occupancy.For example when tapering citalopram, a hyperbolic tapering regimen of 20 mg, 9.1 mg, 5.4 mg, 3.4 mg, 2.3 mg, 1.5 mg, 0.8 mg, 0.4 mg, then 0 mg equals an approximate 10% reduction in serotonin receptor occupancy with each dose decrease. The decrease in dose is hyperbolic, getting smaller over time, while the effect on receptor occupancy is linear, equaling about 10% per dose reduction.