Coming Soon - Guy's CrossTaper Planner!

Guy's CrossTaper Planner

⏳ Coming Soon! A dedicated desktop app for planning benzodiazepine and Z-drug cross-tapers — built on the Ashton Manual, step by step. Your data never leaves your device.

If you've been following my channel, you know I spend a lot of time reviewing the clinical literature on psychiatric drug tapering — checking the maths, pulling apart the evidence, and trying to figure out what's actually useful for real people in real situations. What I don't talk about as much is the practical side: once you understand the science, how do you actually plan a cross-taper? That gap is exactly what I've been building Guy's CrossTaper Planner to fill — and it's nearly ready.

What Is a Cross-Taper?

A cross-taper is a strategy used when someone wants to switch from one benzodiazepine (or Z-drug) to another — usually to a longer-acting equivalent like diazepam — as a stepping stone to tapering off entirely. As the source drug is gradually reduced, the target drug is gradually increased to compensate, keeping the total receptor load stable throughout.

Done correctly, it allows someone to move from a short-acting, difficult-to-taper drug like lorazepam or alprazolam onto a longer-acting drug with more manageable dosing. Done incorrectly — or planned on the back of an envelope — it can significantly destabilise someone who is already vulnerable.

Until now, the tools available for planning this have been rudimentary: rough equivalence tables, handwritten schedules, and a lot of guesswork. Guy's CrossTaper Planner changes that.

A 7-Step Wizard That Does the Hard Work

The planner walks you through seven clearly explained steps to build a personalised cross-taper schedule. Every decision is explained — not just what to enter, but why.

Step 1 — Your Current Medication

Enter your source drug, total daily dose, how many times per day you take it, and your planned start date. Brand names and half-life are shown for the selected drug, and the planner immediately shows you the diazepam equivalent — sourced from the Ashton Manual (benzo.org.uk, revised April 2007).

Step 2 — Dosing Frequency (Benzos Only)

For short-acting benzodiazepines, the Ashton Manual recommends a preparatory step: spreading the total daily dose across more doses per day before the cross-taper begins. This smooths the peaks and troughs that cause interdose withdrawal — without any dose reduction at all. The planner also explains clearly when this step doesn't apply, such as for Z-drugs.

Step 3 — Target Medication

Choose your target drug — diazepam or clonazepam — and see the full equivalence summary immediately: your source dose, its diazepam equivalent, and the exact target dose you'll be crossing to. The equivalence summary updates instantly as you change your selection.

Step 4 — Cross-Taper Method

The planner uses gradual substitution: the source drug is reduced in equal steps while the equivalent target dose is added. You choose how many steps and how many days between each. The total overlap period is calculated live — more steps with shorter intervals means a slower, more cautious transition.

Step 5 — Dosing Format & Physical Measurements

This is where the planner goes beyond anything else available. You tell it whether you're using tablets or liquid for each drug, and enter your actual pill weight and tablet strength. The planner then calculates the exact physical amount to weigh on a precision scale at every step of the schedule.

Why this matters: Pill weight is not the same as active ingredient weight — each tablet contains fillers and binders. If you're cutting or weighing tablets to achieve sub-dose reductions, you need the ratio of pill weight to active ingredient to measure accurately. The planner shows this ratio, the per-dose weight, and the total daily weight for every row in your schedule.

Step 6 — Important Considerations

Before generating any schedule, the planner requires you to read a detailed page of clinical considerations — covering things that matter and are rarely explained clearly elsewhere:

• Not everyone tolerates diazepam — some do better on clonazepam, or no switch at all

• CYP2C19 pharmacogenomics:2–5% of Caucasians and 13–23% of East Asians are poor metabolisers of diazepam, potentially accumulating twice the expected blood level

• Diazepam's long half-life means withdrawal symptoms can be delayed and harder to attribute to a specific dose change

• Equivalence ratios are population averages — individual responses vary significantly

• Rushing the process significantly increases risk of destabilisation

Step 7 — Review & Generate

A clean summary of every setting before the schedule is generated. Go back to adjust anything, or hit Generate to produce the full table.

The Generated Schedule

Once generated, you get a complete cross-taper schedule as an editable table, with a visual dose-over-time chart above it. Every row shows the exact physical amount to weigh or measure for both drugs on that date. Comments are auto-generated for every step. You can add diary notes per row and export the plan as a .gcu file to save and reload later.

The chart matters. Seeing the two drugs cross each other visually — source declining, target rising, total equivalence staying flat — makes the logic of a cross-taper immediately intuitive in a way that a table alone cannot.

Who Is This For?

• People tapering who want a rigorous, evidence-based plan to discuss with their doctor or pharmacist

• Peer supporters and taper coaches who need to explain and document cross-taper plans clearly

• Informed clinicians who want a structured planning aid that includes physical measurements at every step
  

Why I Built This

I've spent years reviewing the tapering literature, and the consistent gap I find is not in the science — it's in the translation from science to practice. Clinicians and patients alike are working from rough equivalence tables and general principles, but nobody has built a tool that takes those principles all the way through to "here is exactly how many milligrams your scale should read on 14th April."

That last mile — from theory to physical measurement — is where people get destabilised. This tool closes that gap.

Coming Soon

Guy's CrossTaper Planner is a standalone desktop app for Windows and Mac. Stay tuned — release announcement coming to this site and YouTube channel.

Medical disclaimer: Guy's CrossTaper Planner generates planning schedules based on published Ashton Manual equivalence values. It is not medical advice. Equivalence ratios are population averages and individual responses vary. Always discuss any medication changes with a suitably informed clinician before making them.