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Discontinuation Calculator

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How to use this tool
  1. Pick the medication (type to search) and enter the current daily dose.
  2. Pick a taper mode (hyperbolic, proportional, linear). Slider tunes step size.
  3. Read the schedule. Hover any row or chart dot for step-level info.
  4. Copy or print when ready to use.

For opioid-use-disorder transitioning to buprenorphine, switch to the Buprenorphine Microinduction tab.

These are decision-support tools, not substitutes for clinical judgment. The chart and schedule are starting points; pace by the patient's symptoms.

For educational purposes only — a decision-support tool, not a substitute for clinical judgment.

Related tools: Medication Switching Guide · Washout Period Calculator · Equivalent Dose Calculator · Drug Comparison Tool · Drug Reference

Disclaimer & full source list

Disclaimer: This tool generates discontinuation schedules from published pharmacokinetic parameters and receptor-occupancy mathematics. It does not replace clinical judgment. Individual patient factors (renal/hepatic function, treatment duration, prior withdrawal history, concurrent medications) may require modified schedules. Always monitor patients during dose reductions.

SERT occupancy data: Sørensen A, Ruhé HG, Munkholm K. Mol Psychiatry 2022;27(1):192-201 (PMID 34548628). Supplementary Table 2.

D2 occupancy data: Horowitz MA et al. Schizophr Bull 2021;47(4):1116-1129 (PMID 33754644). Supp. Tables S3–S11. Thresholds: Kapur S et al. Am J Psychiatry 2000;157(4):514-520 (PMID 10739409) — population averages, not drug-specific.

GABA-A occupancy data: Brouillet E et al. Brain Res 1991;557:167-176 (PMID 1660750); Ashton CH 2002; Abadie P et al. Eur J Pharmacol 1996;295:35-44 (PMID 8925872); Maudsley Deprescribing Guidelines 2024. Evidence Tier C.

Gabapentinoid data: No PET tracer for α2δ subunit; proportional and linear modes only. NICE NG215 (2024); Maudsley Deprescribing Guidelines 2024.

Tapering framework: Horowitz MA, Taylor D. Lancet Psychiatry 2019;6(6):538-546 (PMID 30850328); Horowitz MA et al. Schizophr Bull 2021. NICE NG222 (2022); NICE NG215 (2024); Royal College of Psychiatrists PS04/19 (2020).

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