I, like Taz, have tried coming off it both ways. Cold turkey was awful. Had to go back on it 8 months later. 2nd attempt was more gradual, but same result. However, now on my 3rd attempt. This time very, very gradual reduction. Now using half of lowest dose patch. Yes, I get hot occasionally, maybe 3 times a day on average, but I'm sticking with it this time round as determined to get off it eventually.