Brief Answer: Go slow. Detailed Answer: Hi, Welcome to Healthcare Magic! I expect you will have to go slower than that or you will find it very difficult. Try taking three quarters of a 0.5 mg tablet for a few days. If you feel fine within ten days of lowering the dose, then it is good. Otherwise, take as much time as is needed, maybe two or three weeks. Once you are comfortable on the new dose, then only lower it again to 0.25 mg. Again give your body ample time to adjust. Lower to half of 0.25 mg before finally stopping. The ability of the body to develop tolerance and withdrawal symptoms varies from person to person. If you are able to sleep well with the lowered dose within a few days, it is great. But if not, just have patience and wait till the body is able to adjust to the new dose. Since you may have some sleep difficulty when the lower the dose or stop, try following sleep hygiene practices like: Here are some tips for how you can improve your sleep hygiene: 1. Don’t go to bed unless you are sleepy. If you are not sleepy at bedtime, then do something else. Read a book, listen to soft music or browse through a magazine. Find something relaxing, but not stimulating, to take your mind off of worries about sleep. This will relax your body and distract your mind. 2. If you are not asleep after 20 minutes, then get out of the bed. Find something else to do that will make you feel relaxed. If you can, do this in another room. Your bedroom should be where you go to sleep. It is not a place to go when you are bored. Once you feel sleepy again, go back to bed. 3. Begin rituals that help you relax each night before bed. This can include such things as a warm bath, light snack or a few minutes of reading. 4. Get up at the same time every morning. Do this even on weekends and holidays. 5. Get a full night’s sleep on a regular basis. Get enough sleep so that you feel well-rested nearly every day. 6. Avoid taking naps if you can. If you must take a nap, try to keep it short (less than one hour). Never take a nap after 3 p.m. 7. Keep a regular schedule. Regular times for meals, medications, chores, and other activities help keep the inner body clock running smoothly. 8. Don’t read, write, eat, watch TV, talk on the phone, or play cards in bed. 9. Do not have any caffeine after lunch. 10. Do not have a beer, a glass of wine, or any other alcohol within six hours of your bedtime. 11. Do not have a cigarette or any other source of nicotine before bedtime. 12. Do not go to bed hungry, but don’t eat a big meal near bedtime either. 13. Avoid any tough exercise within six hours of your bedtime. You should exercise on a regular basis, but do it earlier in the day. (Talk to your doctor before you begin an exercise program.) 14. Try to get rid of or deal with things that make you worry. If you are unable to do this, then find a time during the day to get all of your worries out of your system. Your bed is a place to rest, not a place to worry. I hope this helps you. Please feel free to ask in case you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry

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