12
Recommendations
Patients with Co-occurring Psychiatric Disorders
24. Clinicians should optimize evidence-based treatment for any
psychiatric disorder prior to the BZD taper or concurrently if
clinically indicated (CC-S).
25. Clinicians should strongly consider tapering BZD medication in
patients with posttraumatic stress disorder (PTSD; CC-S).
26. Clinicians should monitor sleep closely during BZD tapering in
patients with mood or psychotic disorders, particularly for patients
with bipolar disorder as sleep disturbance can trigger episodes of
mania (CC-S).
a. If patients with a mood and/or psychotic disorder experience significant sleep
disturbance, clinicians should pause the taper until the symptoms resolve due to
the risk for destabilization (CC-S).
Older Adults
27. Clinicians should generally taper BZD medication in older adults
unless there are compelling reasons for continuation (See Table 6)
(CC-S).
Patients Who Are Pregnant or Lactating
28. Clinicians should weigh the risks and benefits for the maternal–fetal
dyad when considering continued BZD prescribing or tapering for
pregnant patients (See Table 4) (CC-S).
29. For infants who have been exposed to BZD in utero and are at risk for
neonatal withdrawal (see Table 3), clinicians should:
a. Encourage breastfeeding, which can reduce neonatal withdrawal symptoms
(CC-S);
b. Communicate with the infant's healthcare provider (with parental consent)
regarding exposure to BZDs (See Table 5) (CC-S).
