Daily Micro-Tapering Support Group

[[Ma...]]

Deciding which PPI is up to you.  The signs seem to be there that the updose helped from what you said.  It seems logical that continuing it would continue to bring relief.  If you go back on the protonix the updose probably won't be needed.

The updose did help, but just not as much as I needed. now I'm wishing I never started taking a PPI. I can't deal with two med probs at once. I am going to go back on the protonix because it's the one causing the problem. I took a pill even though it's not the normal time I would take it. I don't know how soon it will work. I think I'm going to take 1mg at 3 instead of .81mg because I'm feeling bad. Do you think that would be bad? I just really want things to be tolerable. Hopefully, I will stable soon and I can start my MT. I can't believe all the drug interactions. I think my body is just more sensitive right now.

 

Well, the protonix should restore your dose where it was as it builds up, but I don't think the extra K is bad right now as you need it at the moment.  Hopefully the combination of the rescue doses and the protonix will quickly bring things back to where they were.  You can help yourself by dosing both meds on time.  Do we know the half life of the protonix?  Either way I'd think breaking it into multiple doses would help even out your K levels.

Ok, I am going to take 1mg at 3pm. I don't want to, but I feel really bad. The half life of protonix is like 5 hours I think. It's not long. I know it takes about a week to start working. I don't really understand how it works. I imagine it need to build in your bloodstream. I didn't dose on time today because I didn't want to wait. I have always taken one pill in the evening. Do you think I should take it in the morning and at night? Thanks so much for all your help! I don't know what I would of done without you.

[[sh...]]

Hi All,

 

I am checking in with a status update.  I just went below 0.150 mg K and it feels kind of like a milestone.  The end is getting closer, hopefully mid-October.  A couple weeks ago I ran into trouble with a 0.004 mg/day taper rate.  I updosed the equivalent of about 4 days and then immediately started tapering at 0.003 mg/day, which is the rate I am at now and seems to be working fine.  That was the third time I did a mini-updose with an immediate slower taper and have found that this technique works great for me.  When I ran into trouble I didn't hit the wall, but there was a gradual worsening of symptoms over the course of a week such that I was getting headaches every day, sleep was deteriorating and cog fog was getting so bad I really couldn't think straight most of the day.  This changed almost immediately after I updosed and started the slower taper.  I am now back to baseline with tolerable symptoms that consist of fatigue, sporadic headaches, some nausea from time-to-time, and cog fog normally in the morning and clearing by mid-morning.  My sleep is back to normal for me, which means I wake most nights once, but then use breathing and insight meditation techniques to get back to sleep within an hour or less.  I have used the water titration technique the entire duration of my taper with a 250 ml graduated cylinder, mortar and pestle to crush the tablet, a blender to mix it into suspension and a 10 ml syringe to help measure.  I have never tried milk or used alcohol to dissolve a tablet.  I hope this information is helpful to some of you.  I know that I liked to see progress reports when I was early in my taper.  The micro-tapering technique is really the way to go.  It allows us to stay in control and manage the withdrawal pace such that our symptoms remain within a tolerable range.

 

Thanks for the update Ben!  You need to be the advocate on daily reduction rate.  You have really managed that well.  Glad to see your plan is working for you.  Keep sending the updates!

 

Stay strong!

sharkey

[[...]]

Well, the protonix should restore your dose where it was as it builds up, but I don't think the extra K is bad right now as you need it at the moment.  Hopefully the combination of the rescue doses and the protonix will quickly bring things back to where they were.  You can help yourself by dosing both meds on time.  Do we know the half life of the protonix?  Either way I'd think breaking it into multiple doses would help even out your K levels.

Ok, I am going to take 1mg at 3pm. I don't want to, but I feel really bad. The half life of protonix is like 5 hours I think. It's not long. I know it takes about a week to start working. I don't really understand how it works. I imagine it need to build in your bloodstream. I didn't dose on time today because I didn't want to wait. I have always taken one pill in the evening. Do you think I should take it in the morning and at night? Thanks so much for all your help! I don't know what I would of done without you.

 

You're welcome

 

You're short - extra K is what you need right now.  A five hour half life puts protonix on a par with Ativan or Xanax.  I'd think it would help to break it into four or more doses a day since it is effecting your K levels.  Maybe that is something to run past the doctor or google online - if it is okay to take it 4x a day.  Can't see why not, but best to check.

 

[[Ma...]]

Well, the protonix should restore your dose where it was as it builds up, but I don't think the extra K is bad right now as you need it at the moment.  Hopefully the combination of the rescue doses and the protonix will quickly bring things back to where they were.  You can help yourself by dosing both meds on time.  Do we know the half life of the protonix?  Either way I'd think breaking it into multiple doses would help even out your K levels.

Ok, I am going to take 1mg at 3pm. I don't want to, but I feel really bad. The half life of protonix is like 5 hours I think. It's not long. I know it takes about a week to start working. I don't really understand how it works. I imagine it need to build in your bloodstream. I didn't dose on time today because I didn't want to wait. I have always taken one pill in the evening. Do you think I should take it in the morning and at night? Thanks so much for all your help! I don't know what I would of done without you.

 

You're welcome

 

You're short - extra K is what you need right now.  A five hour half life puts protonix on a par with Ativan or Xanax.  I'd think it would help to break it into four or more doses a day since it is effecting your K levels.  Maybe that is something to run past the doctor or google online - if it is okay to take it 4x a day.  Can't see why not, but best to check.

 

I do have the extended release tablets. I have heard of people dosing twice a day, but never more and usually just once. I will google it. I don't want to talk to my GI right now. She acted like I was crazy when I mentioned it throwing off my klonopin levels. She thinks I'm crazy or a drug addict.

 

Also I just remembered that my depo shot is prob out of my system. I don't know if progesterone affects klonopin.

[[...]]

You're welcome

 

You're short - extra K is what you need right now.  A five hour half life puts protonix on a par with Ativan or Xanax.  I'd think it would help to break it into four or more doses a day since it is effecting your K levels.  Maybe that is something to run past the doctor or google online - if it is okay to take it 4x a day.  Can't see why not, but best to check.

 

I do have the extended release tablets. I have heard of people dosing twice a day, but never more and usually just once. I will google it. I don't want to talk to my GI right now. She acted like I was crazy when I mentioned it throwing off my klonopin levels. She thinks I'm crazy or a drug addict.

 

Also I just remembered that my depo shot is prob out of my system. I don't know if progesterone affects klonopin.

 

Oh well, extended release might take care of the problem.  And they may be made in such a way that it is not good to split them.  IDK, I've never used that form of med.

 

It's good to research all your meds, and foods too, to check them all for effects on 3A4.  Make a list, then you know.  That would make a good sticky thread on the forum.

[[Be...]]

Maya,

 

Oh dear, we keep learning more about the drugs you are on. YES! Progesterone DOES effect taking benzos. Progesterone is cross tolerant. So if your progesterone level is dropping for whatever reason, that's likely going to make you feel bad while withdrawing. This is why I hold around the time of my period, because I can't cut K and have my progesterone rock bottom at the same time. When do you get your next Depot shot?

 

Bennie

[[Ma...]]

You're welcome

 

You're short - extra K is what you need right now.  A five hour half life puts protonix on a par with Ativan or Xanax.  I'd think it would help to break it into four or more doses a day since it is effecting your K levels.  Maybe that is something to run past the doctor or google online - if it is okay to take it 4x a day.  Can't see why not, but best to check.

 

I do have the extended release tablets. I have heard of people dosing twice a day, but never more and usually just once. I will google it. I don't want to talk to my GI right now. She acted like I was crazy when I mentioned it throwing off my klonopin levels. She thinks I'm crazy or a drug addict.

 

Also I just remembered that my depo shot is prob out of my system. I don't know if progesterone affects klonopin.

 

Oh well, extended release might take care of the problem.  And they may be made in such a way that it is not good to split them.  IDK, I've never used that form of med.

 

It's good to research all your meds, and foods too, to check them all for effects on 3A4.  Make a list, then you know.  That would make a good sticky thread on the forum.

I will research it and see. I am not really on any other meds. I've been on terbinafine for the last 3 months and I go off Tues. I looked it up and it doesn't seem to have any interactions with benzos. I also just supplements and vitamins. I also take antihistamines which don't affect klonopin. I went off all my other psych meds. I will definitely make a list. Thank you, that is a good idea. I don't know if it's just me feeling calmer because I feel like things are figured out or if the protonix is starting to work, but I'm feeling a little better.

[[...]]

Oh well, extended release might take care of the problem.  And they may be made in such a way that it is not good to split them.  IDK, I've never used that form of med.

 

It's good to research all your meds, and foods too, to check them all for effects on 3A4.  Make a list, then you know.  That would make a good sticky thread on the forum.

I will research it and see. I am not really on any other meds. I've been on terbinafine for the last 3 months and I go off Tues. I looked it up and it doesn't seem to have any interactions with benzos. I also just supplements and vitamins. I also take antihistamines which don't affect klonopin. I went off all my other psych meds. I will definitely make a list. Thank you, that is a good idea. I don't know if it's just me feeling calmer because I feel like things are figured out or if the protonix is starting to work, but I'm feeling a little better.

 

Google them all!  Everything...all meds, all foods, all supplements.  Check them all for 3A4 induction and inhibition.  Write them down.  Easy to do.  I think most will have no effect but there are surprises every now and then.  To your body even plain food is a collection of chemicals.  Everything you ingest contains chemicals.

[[Ma...]]

Oh well, extended release might take care of the problem.  And they may be made in such a way that it is not good to split them.  IDK, I've never used that form of med.

 

It's good to research all your meds, and foods too, to check them all for effects on 3A4.  Make a list, then you know.  That would make a good sticky thread on the forum.

I will research it and see. I am not really on any other meds. I've been on terbinafine for the last 3 months and I go off Tues. I looked it up and it doesn't seem to have any interactions with benzos. I also just supplements and vitamins. I also take antihistamines which don't affect klonopin. I went off all my other psych meds. I will definitely make a list. Thank you, that is a good idea. I don't know if it's just me feeling calmer because I feel like things are figured out or if the protonix is starting to work, but I'm feeling a little better.

 

Google them all!  Everything...all meds, all foods, all supplements.  Check them all for 3A4 induction and inhibition.  Write them down.  Easy to do.  I think most will have no effect but there are surprises every now and then.  To your body even plain food is a collection of chemicals.  Everything you ingest contains chemicals.

I will google them all. I definitely don't want another reaction like this!

[[Be...]]

Oh well, extended release might take care of the problem.  And they may be made in such a way that it is not good to split them.  IDK, I've never used that form of med.

 

It's good to research all your meds, and foods too, to check them all for effects on 3A4.  Make a list, then you know.  That would make a good sticky thread on the forum.

I will research it and see. I am not really on any other meds. I've been on terbinafine for the last 3 months and I go off Tues. I looked it up and it doesn't seem to have any interactions with benzos. I also just supplements and vitamins. I also take antihistamines which don't affect klonopin. I went off all my other psych meds. I will definitely make a list. Thank you, that is a good idea. I don't know if it's just me feeling calmer because I feel like things are figured out or if the protonix is starting to work, but I'm feeling a little better.

 

Google them all!  Everything...all meds, all foods, all supplements.  Check them all for 3A4 induction and inhibition.  Write them down.  Easy to do.  I think most will have no effect but there are surprises every now and then.  To your body even plain food is a collection of chemicals.  Everything you ingest contains chemicals.

I will google them all. I definitely don't want another reaction like this!

 

Maya,

Clonazapem is acetylated through NAT2. Check out how you metabolize through NAT2, ok?

See chart here, as someone else posted.

https://www.pharmgkb.org/pathway/PA165111375

Bennie

[[Ma...]]

Oh well, extended release might take care of the problem.  And they may be made in such a way that it is not good to split them.  IDK, I've never used that form of med.

 

It's good to research all your meds, and foods too, to check them all for effects on 3A4.  Make a list, then you know.  That would make a good sticky thread on the forum.

I will research it and see. I am not really on any other meds. I've been on terbinafine for the last 3 months and I go off Tues. I looked it up and it doesn't seem to have any interactions with benzos. I also just supplements and vitamins. I also take antihistamines which don't affect klonopin. I went off all my other psych meds. I will definitely make a list. Thank you, that is a good idea. I don't know if it's just me feeling calmer because I feel like things are figured out or if the protonix is starting to work, but I'm feeling a little better.

 

Google them all!  Everything...all meds, all foods, all supplements.  Check them all for 3A4 induction and inhibition.  Write them down.  Easy to do.  I think most will have no effect but there are surprises every now and then.  To your body even plain food is a collection of chemicals.  Everything you ingest contains chemicals.

I will google them all. I definitely don't want another reaction like this!

 

Maya,

Clonazapem is acetylated through NAT2. Check out how you metabolize through NAT2, ok?

See chart here, as someone else posted.

https://www.pharmgkb.org/pathway/PA165111375

Bennie

Bennie,

I am not really sure what I am supposed to learn from this chart. I know that sounds stupid. I am very out of it. I'm guessing my level of NAT2 acetylation is rapid. I am confused 

[[...]]

Maya,

Clonazapem is acetylated through NAT2. Check out how you metabolize through NAT2, ok?

See chart here, as someone else posted.

https://www.pharmgkb.org/pathway/PA165111375

Bennie

 

I suspect something is not right about this chart.  The 3A4 pathway for K is missing and also some of the V pathways are missing.  V (and its metabolites) are metabolized by five different CYP450 enzymes and this only shows two.

[[Ul...]]

I checked and protonix is a 3A4 inhibitor and dexilant does not seem to do any interacting with your K enzyme.  So the switch would amount to a dose cut on 8/11.  The problem is we don't know how much it reduced your K.  I think you are better off not depending on the protonix to maintain your dose as it may make your levels waver, but to do that you would need to ride this out.  So maybe it makes sense to go back on it.  IDK, that's up to you.  I would think going back on protonix would give you quick relief.

I looked it up too. It said the interaction between protonix and klonopin is unknown, but it does inhibit 3A4. I felt stable and didn't have bad sxs until Sunday. I notice a Difference on 8/11. but I guess maybe there was still protonix in my system then? I really don't think switching doses alone would do this to me. I feel as if I took a really big cut and CNS is freaking out. It reduced my k by way more than I can handle. I think maybe I should try to ride this out. I haven't noticed any difference with my stomach with the dexilant. I want to do what's best for me. I don't want to be on protonix if it can make my levels waiver. Also I metabolize k fast as it is. Being off protonix means I metabolize it faster? I am so drained right now. I guess I will just see how I feel tomorrow. Thank you so much for taking the time to help me!

 

Drugs interact through the liver enzymes.  K is metabolized by 3A4 and protonix slows the action of 3A4 so any drug metabolized by 3A4 gets removed more slowly, so yes protonix was effectively making you metabolize K more slowly and being off it will speed you up.  I don't know what the half life of protonix is, but that would help delay the onset of the symptoms if it were long I would think.

 

It may not be so bad being on it.  After all, you got this far with it and it does lengthen the half life, which may be helpful.  You just would need to be aware of its effect and now you know.  But I think if you can ride this out and get rid of it, in the long run your blood levels would be more steady without it and that may help your taper.  Of coarse, the ideal solution would be to know how much K you are short so you could updose that amount to get rid of the lousy symptoms and stay off it too.

 

This all assumes that this is what is really going on.  It makes sense to me.  I don't really buy the other stuff about dose switching and the tiny updose.

 

Well SG, I've been reading all of the thread about her situation, and I wonder what I should do. As you may know, I just recently got fully switched to all liquid. I was titrating down a 1mg tab via liquid taper, but the other two 1mg tablets I was taking dry each day (liquid titration dose in the morning, 1mg dry in the afternoon, then 1mg dry in evening). So, now I'm steady and have been holding at .20mg liquid in the morning, 1mg liquid in the afternoon, and 1mg liquid in the evening. You may remember that I was having lots of problems, and we figured it may be due to titrating down with liquid on one dose only while the other two remained dry. Obviously, dosing got really lopsided. I wasn't aware that I was to do anything differently. I'd like to have all three doses somewhat even and then titrate down each dose alternately each day. I understand that that's preferable, right? If yes, then should I just change all at once to three even liquid doses, or should that be a gradual change too? Originally, I was advised to make the change all at one time.

 

Thanks!

 

Jeff

[[Ul...]]

That makes sense. I never knew anything about liver enzymes. It doesn't have a long half life, but it takes about a week to build in your system and start working. I also was on the extended release pills.

I don't know how long it would stay in my system in that case. I am going to try riding it out. If I at least see improvent tomorrow I think I can do it. I don't have a lot that I have to do coming up. I am now scared about dexilant. I hope that doesn't affect me badly. I feel like I cut .25mg. This is how I felt after cutting that much. Hopefully I will not have to hold a month and half to stabilize.

 

It is the only thing that makes sense to me. This kind of reaction is exactly like a big cut. A little more klonopin and slightly changing doses would not make my CNS go crazy. I am also thinking of going back on gabapentin tonight, but I'm nervous to. I was on it when I tapered from 6mg to 4mg. I wish my Drs could be of help. You should get paid instead of them!

 

The way to really take this by the horns is to updose.  We think we know what happened and the way to compensate is to put back the missing K.  I am always very hesitant to suggest someone go backwards, mainly because it does not always bring relief depending on how much time has passed.  We also don't know how much your effective cut was.  A way to cheat the system and try to get an idea of what an updose would do would be to take a one-time rescue dose and see what happens.  Just floating these ideas.

 

I would also consider a small up dose or one-time rescue dose if I were in your shoes. I actually did a small up-dose once when my choices were up-dose or live in a psych ward. Being on Xanax, I was able to up-dose pretty quickly and returned to miserable-but-functioning. And then I held and then I was able to go back to tapering. I haven't tried an emergency dose but I do know Dr. Shipko will use them with his tapering patients. It is one time only and will often help a person get their feet back under them enough to make decisions about how to proceed and shouldn't affect the taper too much because it is one time only. However, people who have a strong emotional addiction issue with their drug (rather than just physical dependence) should be cautious about either of these options.

 

Gardener, does that really mean taking just one higher dose one time, and that's it? I'm not sure I see how that would benefit a person if they're taking multiple doses each day, then suddenly just take one higher dose one day but then go back to normal dosing. What am I missing?

 

Hugs!

 

Jeff

[[NY...]]

I have found all of this so incredibly helpful.  Since 2000 when I started taking klonopin, I have always dosed once per day, and never understood why I wasn't exp interdose wd.  I am now making the assumption that I got "lucky", and simply metabolize k slowly.  If I were ever to do a crossover, for example, these are tests I would most certainly get prior to doing so.  If someone (nudge... Gardener, SG) could consolidate some of this info, it would make a very useful "sticky" post for the tapering section.  This may also explain why some have such an awful reaction to crossovers, never truly stabilizing.

[[Ul...]]

I found this in Shipko's Xanax book:

 

"In my tapering strategy sometimes patients do take a step backwards, up dosing at times or episodically taking small extra doses of Xanax outside of the tapering schedule--but only in the interest of taking two more steps forward."

 

"Extra doses as low as .0625mg may be enough to insure a good night's sleep."    (You'd have to convert that to K.)

 

"… it is unusual for a patient to require more than an extra .25mg."

 

"My experience is that patents will see extra doses as a failure and minimize the use of extra doses."

 

Hope this helps.

 

And now I am of to    Sure hope you find some relief soon!

 

Would you recommend the book? I really don't like updosing and rescue doses. I am only considering it because I'm in hell. Maybe I can take 1mg tonight instead of .81mg? Xanax and klonopin have the same potency. It would be the same exact amount of klonopin. Thanks for all the help! I hope you get a good nights sleep!

 

Taking 1mg instead of .81mg is a reasonable choice.  That is 6% higher for the day.  I wish I had used updosing more in my taper.  Pay attention to its effect as it may give clues of what a permanent updose would do for you.  BTW, this is really not an updose if stopping the protonix cut your dose.  You are just correcting back to where you need to be, right?

 

SG, would you mind explaining "updosing" to me (the updosing that YOU did)? For example, if I'm taking 3 doses each day, then does "updosing" mean increasing ALL three doses for a number of days until things chill out, or does it mean going up on just one of the three doses for one day only, etc.? (I'm hoping that question even makes sense).

 

Jeff

 

HANG IN THERE MAYA!!!!!

[[Ul...]]

I found this in Shipko's Xanax book:

 

"In my tapering strategy sometimes patients do take a step backwards, up dosing at times or episodically taking small extra doses of Xanax outside of the tapering schedule--but only in the interest of taking two more steps forward."

 

"Extra doses as low as .0625mg may be enough to insure a good night's sleep."    (You'd have to convert that to K.)

 

"… it is unusual for a patient to require more than an extra .25mg."

 

"My experience is that patents will see extra doses as a failure and minimize the use of extra doses."

 

Hope this helps.

 

And now I am of to    Sure hope you find some relief soon!

 

Would you recommend the book? I really don't like updosing and rescue doses. I am only considering it because I'm in hell. Maybe I can take 1mg tonight instead of .81mg? Xanax and klonopin have the same potency. It would be the same exact amount of klonopin. Thanks for all the help! I hope you get a good nights sleep!

 

It's an ebook so only $4.75. I downloaded a kindle reader onto my computer for free and could read it on my computer. It was interesting and could be helpful for anybody trying to taper off of a fast benzo rather than converting. He uses a cut-and-hold method to taper straight off of X. He tells his thinking on benzos and how it changed, what kinds of things worked for his patients, what his patents were like (all highly motivated and needing to function during their tapers). All I had read about up to that point was Ashton, so it was interesting to read his thoughts about her work, how his typical patient differed from her typical patient, and how his views were different from hers on some topics. But he was not overbearing or saying he knew better than everybody else. It broadened my thinking. If you'd find that interesting, it's worth $4.75.

 

I read that "book" too, Gardener. I then emailed him and he and I went back and forth for a while, and then we talked on the phone. Great guy! Helped so much with my heart palps among other things. Nothing really changed in my approach, but it was nice to talk to a doc who definitely has a clue as to what's going on with all of this. I like his style, but I could never go back to dry cutting, holding, etc. We'll see what happens though. I really hate being 55 years old and making a new career in K tapering. All of these 2+ decades of being on the mega size benzo (among tons of other trash that was thrown in my system) practically ruined my life. I do well now just to be able to do some consulting every so often. It's not near enough, but we don't have a lot of choice. Praying for a winning lottery ticket!! And....just PRAYING!!! I pray for you and the entire rest of the gang on here too. No kidding.

 

Lots of hugs to you!

 

Jeff

[[Ul...]]

I found this in Shipko's Xanax book:

 

"In my tapering strategy sometimes patients do take a step backwards, up dosing at times or episodically taking small extra doses of Xanax outside of the tapering schedule--but only in the interest of taking two more steps forward."

 

"Extra doses as low as .0625mg may be enough to insure a good night's sleep."    (You'd have to convert that to K.)

 

"… it is unusual for a patient to require more than an extra .25mg."

 

"My experience is that patents will see extra doses as a failure and minimize the use of extra doses."

 

Hope this helps.

 

And now I am of to    Sure hope you find some relief soon!

 

Would you recommend the book? I really don't like updosing and rescue doses. I am only considering it because I'm in hell. Maybe I can take 1mg tonight instead of .81mg? Xanax and klonopin have the same potency. It would be the same exact amount of klonopin. Thanks for all the help! I hope you get a good nights sleep!

 

It's an ebook so only $4.75. I downloaded a kindle reader onto my computer for free and could read it on my computer. It was interesting and could be helpful for anybody trying to taper off of a fast benzo rather than converting. He uses a cut-and-hold method to taper straight off of X. He tells his thinking on benzos and how it changed, what kinds of things worked for his patients, what his patents were like (all highly motivated and needing to function during their tapers). All I had read about up to that point was Ashton, so it was interesting to read his thoughts about her work, how his typical patient differed from her typical patient, and how his views were different from hers on some topics. But he was not overbearing or saying he knew better than everybody else. It broadened my thinking. If you'd find that interesting, it's worth $4.75.

I don't think it would be the book for me. I definitely can't handle a fast benzo and I don't want to cut and hold anymore. It sounds like it would be helpful to others.

 

I have one cat. He is really kne my bf's cat even though he's lived with me for 8 years and know me longer. He just loves my be and tolerates other people. I do love him anyway and he is very handsome. I want another cat, but he doesn't get along well with other animals and he is 15. I spend time with my sister's cats. I will post a pic. I am not quite sure how though. I'm very tired and out of it.

 

I hope you are having a good day!

 

XO Maya

 

You're strong and a winner, Maya. Obviously intelligent too. You'll get there. As I've said before, you're an inspiration. Your persistence is awesome. I'm truly proud of you!

 

Hug your cat for me. I'm the biggest wimp in the world when it comes to animals. They're therapy!

 

Hang tight, and hugs coming your way.

 

Jeff

[[Ma...]]

I found this in Shipko's Xanax book:

 

"In my tapering strategy sometimes patients do take a step backwards, up dosing at times or episodically taking small extra doses of Xanax outside of the tapering schedule--but only in the interest of taking two more steps forward."

 

"Extra doses as low as .0625mg may be enough to insure a good night's sleep."    (You'd have to convert that to K.)

 

"… it is unusual for a patient to require more than an extra .25mg."

 

"My experience is that patents will see extra doses as a failure and minimize the use of extra doses."

 

Hope this helps.

 

And now I am of to    Sure hope you find some relief soon!

 

Would you recommend the book? I really don't like updosing and rescue doses. I am only considering it because I'm in hell. Maybe I can take 1mg tonight instead of .81mg? Xanax and klonopin have the same potency. It would be the same exact amount of klonopin. Thanks for all the help! I hope you get a good nights sleep!

 

Taking 1mg instead of .81mg is a reasonable choice.  That is 6% higher for the day.  I wish I had used updosing more in my taper.  Pay attention to its effect as it may give clues of what a permanent updose would do for you.  BTW, this is really not an updose if stopping the protonix cut your dose.  You are just correcting back to where you need to be, right?

 

SG, would you mind explaining "updosing" to me (the updosing that YOU did)? For example, if I'm taking 3 doses each day, then does "updosing" mean increasing ALL three doses for a number of days until things chill out, or does it mean going up on just one of the three doses for one day only, etc.? (I'm hoping that question even makes sense).

 

Jeff

 

HANG IN THERE MAYA!!!!!

Thank you Jeff! I'm trying. I know SG will explain it much better and know a lot more, but I will give you the info I know. There is a difference between updosing and a rescue dose. A rescue dose you takeone time and don't take it again. Last night I took 1mg instead of .81mg to see if it helped. If I didn't do it again it would be a rescue dose. Updosing means you go up in your overall dose. You don't have to updose all your doses. You can do one or all. I updosed this morn from .81mg to 1mg and will updose again tonight from .81mg to 1mg. I will hold at this does until I feel stabilized and then start my MT. I only updose if I really have to. I have been in hell. I stopped another med and I didn't realize it affected my k levels and I was left with less in my system and my body, particularly my CNS went crazy.

 

It seems like you want to even your doses. That is usually a good idea. Don't go by what happened to me. The evening of the doses was not the main prob. I hope I made sense. I'm am out of it.

 

I hope you have a good night!

 

XO Maya

[[...]]

Drugs interact through the liver enzymes.  K is metabolized by 3A4 and protonix slows the action of 3A4 so any drug metabolized by 3A4 gets removed more slowly, so yes protonix was effectively making you metabolize K more slowly and being off it will speed you up.  I don't know what the half life of protonix is, but that would help delay the onset of the symptoms if it were long I would think.

 

It may not be so bad being on it.  After all, you got this far with it and it does lengthen the half life, which may be helpful.  You just would need to be aware of its effect and now you know.  But I think if you can ride this out and get rid of it, in the long run your blood levels would be more steady without it and that may help your taper.  Of coarse, the ideal solution would be to know how much K you are short so you could updose that amount to get rid of the lousy symptoms and stay off it too.

 

This all assumes that this is what is really going on.  It makes sense to me.  I don't really buy the other stuff about dose switching and the tiny updose.

 

Well SG, I've been reading all of the thread about her situation, and I wonder what I should do. As you may know, I just recently got fully switched to all liquid. I was titrating down a 1mg tab via liquid taper, but the other two 1mg tablets I was taking dry each day (liquid titration dose in the morning, 1mg dry in the afternoon, then 1mg dry in evening). So, now I'm steady and have been holding at .20mg liquid in the morning, 1mg liquid in the afternoon, and 1mg liquid in the evening. You may remember that I was having lots of problems, and we figured it may be due to titrating down with liquid on one dose only while the other two remained dry. Obviously, dosing got really lopsided. I wasn't aware that I was to do anything differently. I'd like to have all three doses somewhat even and then titrate down each dose alternately each day. I understand that that's preferable, right? If yes, then should I just change all at once to three even liquid doses, or should that be a gradual change too? Originally, I was advised to make the change all at one time.

 

Thanks!

 

Jeff

 

My answer has always been just do it and get any effects over with.  The fact is you are taking the same dose - what you lack at one time you make up for at another so it will not be a big deal and will settle out.  Others say the brain gets "used to" getting the drug at a certain time so it needs to be gradual.  IDK, that's too non-factual for me.

 

I think even dosing is important as it is sends a consistent message to the brain that upregulation is needed.  Don't forget - the way the brain knows to heal is that it senses a benzo shortage (i.e., the neuron is getting too excited too much of the time).  If the drug is going up and down that is a less consistent message.  In the morning it is needed at night it isn't.

 

BTW, you don't need to taper different doses.  Make your full dose, take the cut from that, then divide into three equal doses by eyeballing even.

[[Ma...]]

I found this in Shipko's Xanax book:

 

"In my tapering strategy sometimes patients do take a step backwards, up dosing at times or episodically taking small extra doses of Xanax outside of the tapering schedule--but only in the interest of taking two more steps forward."

 

"Extra doses as low as .0625mg may be enough to insure a good night's sleep."    (You'd have to convert that to K.)

 

"… it is unusual for a patient to require more than an extra .25mg."

 

"My experience is that patents will see extra doses as a failure and minimize the use of extra doses."

 

Hope this helps.

 

And now I am of to    Sure hope you find some relief soon!

 

Would you recommend the book? I really don't like updosing and rescue doses. I am only considering it because I'm in hell. Maybe I can take 1mg tonight instead of .81mg? Xanax and klonopin have the same potency. It would be the same exact amount of klonopin. Thanks for all the help! I hope you get a good nights sleep!

 

It's an ebook so only $4.75. I downloaded a kindle reader onto my computer for free and could read it on my computer. It was interesting and could be helpful for anybody trying to taper off of a fast benzo rather than converting. He uses a cut-and-hold method to taper straight off of X. He tells his thinking on benzos and how it changed, what kinds of things worked for his patients, what his patents were like (all highly motivated and needing to function during their tapers). All I had read about up to that point was Ashton, so it was interesting to read his thoughts about her work, how his typical patient differed from her typical patient, and how his views were different from hers on some topics. But he was not overbearing or saying he knew better than everybody else. It broadened my thinking. If you'd find that interesting, it's worth $4.75.

I don't think it would be the book for me. I definitely can't handle a fast benzo and I don't want to cut and hold anymore. It sounds like it would be helpful to others.

 

I have one cat. He is really kne my bf's cat even though he's lived with me for 8 years and know me longer. He just loves my be and tolerates other people. I do love him anyway and he is very handsome. I want another cat, but he doesn't get along well with other animals and he is 15. I spend time with my sister's cats. I will post a pic. I am not quite sure how though. I'm very tired and out of it.

 

I hope you are having a good day!

 

XO Maya

 

You're strong and a winner, Maya. Obviously intelligent too. You'll get there. As I've said before, you're an inspiration. Your persistence is awesome. I'm truly proud of you!

 

Hug your cat for me. I'm the biggest wimp in the world when it comes to animals. They're therapy!

 

Hang tight, and hugs coming your way.

 

Jeff

Thank you so much! I don't feel intelligent with my cog fog and lack of sleep. I will get there and you will too! You are an inspiration. You have been through so much with klonopin and are still so positive and working. It gives me hope. I know that klonopin is poison and is really harming me, so I will do whatever I need to to get off it and heal. Knowing that I will heal keeps me going.

 

I will pet him for you. He doesn't like hugs or kisses. Animals really are therapy!

 

Thank you! I need them! 

 

XO Maya

[[Ul...]]

I found this in Shipko's Xanax book:

 

"In my tapering strategy sometimes patients do take a step backwards, up dosing at times or episodically taking small extra doses of Xanax outside of the tapering schedule--but only in the interest of taking two more steps forward."

 

"Extra doses as low as .0625mg may be enough to insure a good night's sleep."    (You'd have to convert that to K.)

 

"… it is unusual for a patient to require more than an extra .25mg."

 

"My experience is that patents will see extra doses as a failure and minimize the use of extra doses."

 

Hope this helps.

 

And now I am of to    Sure hope you find some relief soon!

 

Would you recommend the book? I really don't like updosing and rescue doses. I am only considering it because I'm in hell. Maybe I can take 1mg tonight instead of .81mg? Xanax and klonopin have the same potency. It would be the same exact amount of klonopin. Thanks for all the help! I hope you get a good nights sleep!

 

Taking 1mg instead of .81mg is a reasonable choice.  That is 6% higher for the day.  I wish I had used updosing more in my taper.  Pay attention to its effect as it may give clues of what a permanent updose would do for you.  BTW, this is really not an updose if stopping the protonix cut your dose.  You are just correcting back to where you need to be, right?

 

SG, would you mind explaining "updosing" to me (the updosing that YOU did)? For example, if I'm taking 3 doses each day, then does "updosing" mean increasing ALL three doses for a number of days until things chill out, or does it mean going up on just one of the three doses for one day only, etc.? (I'm hoping that question even makes sense).

 

Jeff

 

HANG IN THERE MAYA!!!!!

Thank you Jeff! I'm trying. I know SG will explain it much better and know a lot more, but I will give you the info I know. There is a difference between updosing and a rescue dose. A rescue dose you takeone time and don't take it again. Last night I took 1mg instead of .81mg to see if it helped. If I didn't do it again it would be a rescue dose. Updosing means you go up in your overall dose. You don't have to updose all your doses. You can do one or all. I updosed this morn from .81mg to 1mg and will updose again tonight from .81mg to 1mg. I will hold at this does until I feel stabilized and then start my MT. I only updose if I really have to. I have been in hell. I stopped another med and I didn't realize it affected my k levels and I was left with less in my system and my body, particularly my CNS went crazy.

 

It seems like you want to even your doses. That is usually a good idea. Don't go by what happened to me. The evening of the doses was not the main prob. I hope I made sense. I'm am out of it.

 

I hope you have a good night!

 

XO Maya

 

Thanks, precious lady. I appreciate the explanation. You deserve an awesome break, and I have a feeling that it's almost here. Then, you'll soar!!

 

Jeff

[[...]]

SG, would you mind explaining "updosing" to me (the updosing that YOU did)? For example, if I'm taking 3 doses each day, then does "updosing" mean increasing ALL three doses for a number of days until things chill out, or does it mean going up on just one of the three doses for one day only, etc.? (I'm hoping that question even makes sense).

 

Jeff

 

HANG IN THERE MAYA!!!!!

 

To me "updosing" means going back up permanently and then tapering that back down.  It could be on one dose or spread among all doses.  The one-day-only thing I tend to call a "rescue dose."  It is a one-time shot to help get out of a bind and is also good as a cheat to get free clues as to what an updose might do.

[[Ul...]]

Drugs interact through the liver enzymes.  K is metabolized by 3A4 and protonix slows the action of 3A4 so any drug metabolized by 3A4 gets removed more slowly, so yes protonix was effectively making you metabolize K more slowly and being off it will speed you up.  I don't know what the half life of protonix is, but that would help delay the onset of the symptoms if it were long I would think.

 

It may not be so bad being on it.  After all, you got this far with it and it does lengthen the half life, which may be helpful.  You just would need to be aware of its effect and now you know.  But I think if you can ride this out and get rid of it, in the long run your blood levels would be more steady without it and that may help your taper.  Of coarse, the ideal solution would be to know how much K you are short so you could updose that amount to get rid of the lousy symptoms and stay off it too.

 

This all assumes that this is what is really going on.  It makes sense to me.  I don't really buy the other stuff about dose switching and the tiny updose.

 

Well SG, I've been reading all of the thread about her situation, and I wonder what I should do. As you may know, I just recently got fully switched to all liquid. I was titrating down a 1mg tab via liquid taper, but the other two 1mg tablets I was taking dry each day (liquid titration dose in the morning, 1mg dry in the afternoon, then 1mg dry in evening). So, now I'm steady and have been holding at .20mg liquid in the morning, 1mg liquid in the afternoon, and 1mg liquid in the evening. You may remember that I was having lots of problems, and we figured it may be due to titrating down with liquid on one dose only while the other two remained dry. Obviously, dosing got really lopsided. I wasn't aware that I was to do anything differently. I'd like to have all three doses somewhat even and then titrate down each dose alternately each day. I understand that that's preferable, right? If yes, then should I just change all at once to three even liquid doses, or should that be a gradual change too? Originally, I was advised to make the change all at one time.

 

Thanks!

 

Jeff

 

My answer has always been just do it and get any effects over with.  The fact is you are taking the same dose - what you lack at one time you make up for at another so it will not be a big deal and will settle out.  Others say the brain gets "used to" getting the drug at a certain time so it needs to be gradual.  IDK, that's too non-factual for me.

 

I think even dosing is important as it is sends a consistent message to the brain that upregulation is needed.  Don't forget - the way the brain knows to heal is that it senses a benzo shortage (i.e., the neuron is getting too excited too much of the time).  If the drug is going up and down that is a less consistent message.  In the morning it is needed at night it isn't.

 

BTW, you don't need to taper different doses.  Make your full dose, take the cut from that, then divide into three equal doses by eyeballing even.

 

Thanks, coach!  And, sorry for the extra question, but what does "upregulation is needed" mean?

 

Jeff

[[Ma...]]

I found this in Shipko's Xanax book:

 

"In my tapering strategy sometimes patients do take a step backwards, up dosing at times or episodically taking small extra doses of Xanax outside of the tapering schedule--but only in the interest of taking two more steps forward."

 

"Extra doses as low as .0625mg may be enough to insure a good night's sleep."    (You'd have to convert that to K.)

 

"… it is unusual for a patient to require more than an extra .25mg."

 

"My experience is that patents will see extra doses as a failure and minimize the use of extra doses."

 

Hope this helps.

 

And now I am of to    Sure hope you find some relief soon!

 

Would you recommend the book? I really don't like updosing and rescue doses. I am only considering it because I'm in hell. Maybe I can take 1mg tonight instead of .81mg? Xanax and klonopin have the same potency. It would be the same exact amount of klonopin. Thanks for all the help! I hope you get a good nights sleep!

 

Taking 1mg instead of .81mg is a reasonable choice.  That is 6% higher for the day.  I wish I had used updosing more in my taper.  Pay attention to its effect as it may give clues of what a permanent updose would do for you.  BTW, this is really not an updose if stopping the protonix cut your dose.  You are just correcting back to where you need to be, right?

 

SG, would you mind explaining "updosing" to me (the updosing that YOU did)? For example, if I'm taking 3 doses each day, then does "updosing" mean increasing ALL three doses for a number of days until things chill out, or does it mean going up on just one of the three doses for one day only, etc.? (I'm hoping that question even makes sense).

 

Jeff

 

HANG IN THERE MAYA!!!!!

Thank you Jeff! I'm trying. I know SG will explain it much better and know a lot more, but I will give you the info I know. There is a difference between updosing and a rescue dose. A rescue dose you takeone time and don't take it again. Last night I took 1mg instead of .81mg to see if it helped. If I didn't do it again it would be a rescue dose. Updosing means you go up in your overall dose. You don't have to updose all your doses. You can do one or all. I updosed this morn from .81mg to 1mg and will updose again tonight from .81mg to 1mg. I will hold at this does until I feel stabilized and then start my MT. I only updose if I really have to. I have been in hell. I stopped another med and I didn't realize it affected my k levels and I was left with less in my system and my body, particularly my CNS went crazy.

 

It seems like you want to even your doses. That is usually a good idea. Don't go by what happened to me. The evening of the doses was not the main prob. I hope I made sense. I'm am out of it.

 

I hope you have a good night!

 

XO Maya

 

Thanks, precious lady. I appreciate the explanation. You deserve an awesome break, and I have a feeling that it's almost here. Then, you'll soar!!

 

Jeff

Anytime! Thanks! I hope so! I think things are going to get easier. You are doing great! You come so far!

 

XO Maya