Fixed quantity reduction

[[Ji...]]

Hi micedana

 

I've been tapering Clonazepan original dose 1 MG. After 5 weeks Im on 0.5. Reduced at 0.125 per week.

I'm happy it works for you. In my case it took about 9 months to taper of .5 mg of Clonazepam. In your case it is 12.5%/week reduction. It seems to me a little fast based on the general recommendations to taper between 5%-10% every 10-14 days.

 

-when it comes to titration, do you start weighting one pill and then do the math of of how much you want to reduce after grinding some pills, and then take out say 5/10 % of the original pill weight?

No. Have a look here.

 

-Do you have to put the weighted powder in certain amount of water or any other fluid?

Yes. But weighing the pills is NOT necessary for Liquid Taper.

 

-Have you ever heard of people been able to cut a 0.5 pill in 1/8 ths?

Very rarely and I have serious doubts about the accuracy of the cut parts. Instead buddies reduce a number of pills to fine powder with a mortar and pestle or just with the back of a spoon. Then in case of Direct Taper they use a precision gram scale to weigh out the quantity they will take.

 

-Can I use time instead of dose reduction ? ie: reduce 0.125 every 2 weeks instead of weekly?

Both, weekly or bi-weekly, are based on a reduction of a fixed quantity each number of days. That quantity will be divided to tiny parts to enable a daily basis reduction. You don't take the same dose during a period of 7 or 14 days but you lower your dose every day of that tiny quantity.

 

Hope it helps.

[[za...]]

HI JIm,

 

For some reason I cannot see the Attenuated section on the document in Help function http://bzo.spes-lavaux.ch/titration/titrationHelp.htm?help=Help

 

What am I missing?

 

Thanks much

[[Ji...]]

Hi zack55

 

You are absolutely right! This new function has been added recently and the documentation has not followed . I apologize. I'll find some time the coming days to update it. Meanwhile have a look at the clarifications at the top of this same thread .

 

Hope it helps.

[[za...]]

Thanks a lot, Jim...no worries. So in my case based on what is provided at the top of this thread, giving the fact that I started with 30mg oxazepam, when I get to 10mg then reduction should be 1/3 of 1.25mg, which is 0.4mg, right? I think I'm wrong...I don't know the jump dose...and cutting this amount from a 10mg pill (there is no one smaller than 10mg) is pretty hard.

 

Right now i am reduction 1.25mg every month.

 

When there is 1/3 of the road to go before the jump dose, the reduction is recalculated to 1/3 of the initial cut.

 

What is your opinion?

 

Much appreciated,

Mary

[[Ji...]]

Hi Mary

 

when I get to 10mg then reduction should be 1/3 of 1.25mg, which is 0.4mg, right?

Right. This is the exact way the option "Attenuated ending" works.

 

I don't know the jump dose

The Jump dose for Oxazepam calculated based on the table of equivalencies from Ashton's is 1 mg/day

 

cutting this amount from a 10mg pill (there is no one smaller than 10mg) is pretty hard.

You have been amazing to cut 1.25 mg out of a 10 mg tablet That means split a tablet to 8 tiny parts! I remember I was unable to split to 4 equal parts my 0.5 mg tablet. They kept on crumbling. I felt so miserable that I went to my doctor and asked for a liquid medication. From here I diluted it with water and started the micro taper.

 

There a 2 ways to address this problem:

1. Use a batch of several tablets (Eg: 5) that you will previously weigh (E.g: 78 mg) and then crush them to fine powder. Each day by means of a gram scale you weigh out the dose you need (E.g: 0.015 gr) and swallow it with water. The problem is that you will have to buy a gram scale (20 USD Amazon).

 

2. You transform your medication liquid or tablets to a solution with a solvent plus water. Each day you will draw up the dose you need (E.g: 1.72 ml) by means of a syringe. The problem is that you will probably have to prepare your solution by yourself.

 

[[za...]]

Hi Jim,

 

Thanks so much for your suggestions.  I did get a scale from Amazon and we'll use the first method you described it in your message.  You ROCK!!

 

Best regards,

Mary

[[za...]]

Jim, I was thinking to reduce 1.25mg every month (fixed reduction).  What is your opinion on this approach?

 

Thanks again

[[Ji...]]

Hi Mary

 

You are tapering 1.25 mg/28 days from 30 mg Oxazepam. This is equivalent to 4.2%/28 days or 2.1%/14 days. Compared to the general recommendations to reduce between 5-10% every 10-14 days, your taper pace is slow. If you feel no symptoms then continue with that pace or perhaps increase a little bit if you wish.

 

When you arrive at 1/3 before the jump point, you will be at 10 mg. At that point the reduction pace based on 1.25 mg cut will become 12.5%/28 days or 6.25%/14 days. It is still in the recommended range.

 

To answer your question, if you feel no major symptoms and are able to be functional in your daily life then it is a good taper.

 

"A slow and steady benzodiazepine withdrawal, with you in control, is nearly always successful." H. Ashton

 

 

 

[[za...]]

Thanks Jim...you are right that I am tapering too slow so I will go with 2.5mg reduction/28days until I reach 10mg oxazepam. My symptoms are a bit better since I reinstated on oxazepam after the 4 weeks detox in december.  My main symptoms now are high anxiety/fear and the sleeping is not great but better since reinstatement. In my opinion these are symptoms due to the rapid detox and not to the oxazepam tapering.  Or it can be both??? I asked the doctor but she was not clear about this ...she just said that the 4 weeks detox from 4mg ativan (even if I used for a short time) was too fast...btw, she is not the same doctor who recommended the detox and it was my fault that I did not do my homework to research before accepting to go with this quick solution... .

 

Thanks much,

Mary

 

 

[[Ji...]]

Hi Mary

 

It is not seldom to read stories of buddies who came out completely destabilized by a detox. The fast taper speed they went thru submitted their CNS to shocks with consequent rough and long lasting symptoms.

 

I'm tempted to think that your symptoms might have come from this unfortunate experience rather than from the taper that is itself slow and nice.

 

 

 

[[za...]]

Yes, this rapid detox is like cold turkey...I just looked at your signature and noticed that we went CT at some point and reinstated, right?

[[Ji...]]

Hi Mary ,

 

I did not CT. Tapered with fixed quantity but reinstated 2 days after the last drop due to unbearable muscle twitch in leg.

 

[Guest [mi...]]

Thanks a lot JIM for your explanation and kindness. Finally my Hernia surgery went ok and not major problems.

A week after the surgery I resumed my taper (I was on hold for three weeks during surgery 0.5 daily -0.25 at noon 0.25 at night-). I resume my taper as per my doctor cutting 0.125 the first week -dose became 0.375- and now I cut another 0.125 leaving the dose at 0.25 -half a pill-.

First week reduction was somewhat ok but now that I cut 0.125 and after 6 days hell started. Anxiety came back together with despersonalization feelings. No tremendously acute but very distressful. I don't know if just take it and keep going or do a more long taper reduction (0.125) every two weeks instead of weekly.

Question:

1-Would it be ok after 6 days to go back to my previous dose 0.375 and do the taper reduction every 2 weeks at 0.125 per week?

2-Can all this changes end up in a kindling situation?

3-As you will probably heard a lot, is difficult to think in this type of situations. You told me already but just to confirm the method , can i reduce the dose to less than 0.125 grinding the pills and weight 1/2 of 0.125 and take it with water?

Jim I will really appreciate your opinion on this. And sorry, I've been a little repetitive in my questions. All the best!

Miguel

 

 

[[Ji...]]

Hi micedana 

 

now that I cut 0.125 and after 6 days hell started

Those symptoms are reasonably expected due to the way you cut. Have a look here: http://www.benzobuddies.org/forum/index.php?topic=204178.0

 

1-Would it be ok after 6 days to go back to my previous dose 0.375 and do the taper reduction every 2 weeks at 0.125 per week?

Just hold until the storm passes. I suggest you think about liquid taper to cut much less than 0.125 mg every 2 weeks.

 

2-Can all this changes end up in a kindling situation?

Repeated failed attempts and reinstatements can lead to kindling. Like you tried a cold turkey, then decided to reinstate and now the old dose that used to work won't work anymore.  Or that you successfully tapered 5 years ago, but then eventually reinstated for some reason and now find that it's much more difficult to taper this time. In your case there are strong cuts but no reinstatements. Little risk for kindling, I would say.

 

can i reduce the dose to less than 0.125 grinding the pills and weight 1/2 of 0.125 and take it with water?

The last part of the taper journey is the most critical one. By doing it smoothly you will avoid protracted symptoms after the last dose. It would be best if you go Liquid Taper for these last doses and reduce tiny quantity much smaller than 0.0625 mg.

 

In case you need information to Liquid taper, have a look here: http://bzo.spes-lavaux.ch/titration/titrationHelp.htm?help=Help

 

Hope I answered your questions.

 

 

 

 

 

 

[Guest [mi...]]

Thanks Jim, I really appreciate your time and dedication to help others. What I told you above about the wake up of symptoms may be also helped by stresors like my two adult teen kids and my trip to Spain next week, just vacations in the "Costa del Sol".  I work for Delta airlines travel subject to spare seats on the flight-another stressor-  .

I'm coping with the symptoms but the anxiety  about the trip and how I would be able to stand those symptoms far from home are probably helping to the overall condition. I don't want to suspend it but sometimes my state of mine push me to do so. .

My doctor is telling me today to go back to 0.375 for another week or two while on traveling. I don't know if going back to the previous dose will worsen the taper afterwards. Also she offered to prescribed desvolved type of pills of .125 instead of cutting 1/4 from a 0.5 pill. She says that would help to be more exact on the dose that the dry cut ones. I don't know about this pills. Can you actually dissolve them and do liquid triaition out of them? I feel like changing horses in the middle of the river . . I've been on cut dry pill 0.125 twice daily for 6 days and that's when symptoms got worst.

Jim, you probably heard of a lot of people dealing with this kind of circumstances. Any input would be well appreciated.

Again I admire the help and dedication you show to help others. If I ever go back to Switzerland I would really like to meet you and give you a big hug!! GOD bless you!