Advice please! Does this method always work?

[[Me...]]

Hi again Jim,

 

Would you recommend perhaps even reinstating to 0.5mg on the Auden and starting again using all the Auden brand? I could try stabilising and then trying another liquid to use partially with 3/4 tablet using only this brand and if that doesn’t work, then wait for the scales to come and go down that way, using all the same brand? I’m just unsure of what to do now but maybe I should stick to all the same brand?

 

[[Ji...]]

Hi Mermaid2

 

Going back to 0.5 mg from 0.45 mg is a 10% up-dose. It does not seem justified by the fact that we are unable to measure out 0.45 mg. From a taper viewpoint, it is possibly to avoid.

 

As we have no more 0.45 mg tablets left from the strip, we can proceed either:

1- By using a combination of Auden's 0.5 mg and strip's 0.4 mg pill and by cutting each to halves we take one half of each (0.25 mg + 0.20 mg) for a total of 0.45 mg

or

2- By using only Auden 0.5 mg and 0.25 mg tablets:

3/4 of 0.5 mg + 1/4 of 0.25 mg = 0.4375 mg. Compared to the current 0.45 mg it would be a reduction of 2.8%. As the difference is small it can work. In this case 3 x 0.5 mg and 1 x 0.25 mg tablets would suffice for 4 days.

 

As I have a doubt on how many Auden 0.5 mg tablets are still available, I'm not sure what I have proposed above makes any sense at all.

 

 

 

[[Me...]]

Thanks so much Jim.

 

As the strips have different quantities, I am able to make 5 days worth of 0.45mg. I’ll try this method and see how we go. I’m feeling really down to be honest as I’m not really sure how to proceed from here onwards and I need to present a plan to my psychiatrist on Wednesday. I had hoped we could have gone with liquid titration. I’m also sad that I may well be a case for protracted withdrawal since I’ve been polydrugged and now facing what looks like a hard taper off clonazepam. I’m so afraid that I won’t be abelt to get off this stuff and will be stuck in withdrawal for years. I hate being pessimistic but it saddens me so much as all I want to do is to be able to enjoy my little family.

 

Thank you so very much for all your help and support, it gives me great comfort to know that you and others understand.

 

 

 

 

 

[[Ji...]]

Hi Mermaid

 

I’m feeling really down to be honest as I’m not really sure how to proceed from here onwards

I understand. The way I feel is that you are amongst the lucky people who are still functional with this poison. Many buddies actually suffer unimaginable symptoms (permanent head pressure, tinnitus, blurry vision, nausea, hair loss, akathisia, jerking movements, nerve pain, skin pins and needles, derealisation and depersonalisation...), are bedridden with 15, 20 years of benzo and other drugs as luggage and don't know if and when they will see a light at the end of the tunnel.

 

I may well be a case for protracted withdrawal since I’ve been polydrugged

To have protracted withdrawal certain conditions have to be met:

1. A taper pace way too fast when not abruptly discontinued (cold turkey).

2. Frequent doses stops/restarts with up-doses

3. Benzo is used in combination with other beta-blockers, antidepressants, sleep meds, pain meds, opioids drugs, antipsychotics drugs... with patient poly-drugged on multiple centrally active pharmaceuticals

You don't seem to be concerned with point 1 and 2. I therefore would not give more attention to this and would concentrate my effort to find the way to smoothly taper with manageable symptoms.

 

I need to present a plan to my psychiatrist on Wednesday

What if you print out the schedule report in PDF and show the doctor the way you will be tapering (slow and gentle) the timing and the required quantity of tablets?

 

 

[[Me...]]

Thank you so much Jim. Yes, I know that for the moment at least I am functional and am appreciative of that.

 

Shall I print the daily microtaper for  dry cut taper method off in that case? I have the pill and liquid one to hand already but we are unsure if that one is going to work...

 

Thank you again for helping me!

 

[[Me...]]

Could I just ask also Jim - do you happen to know what the weight would be for 10 0.5mg clonazepam tablets since I am trying to input in to your Direct Taper Plan?

 

Many thanks

 

[[Ji...]]

Hi Mermaid2

 

It varies in function of brand but Teva brand clonazepam 0.5 mg tablet weighs 0.166 g ( http://www.benzobuddies.org/forum/index.php?topic=194816.msg2544667#msg2544667 ). So the answer is 1.66 g for 10 tablets.

 

[[Me...]]

Thank you so much for all your time, Jim.

 

[[Ly...]]

Hello Jim,

 

I switched over half of my dose of clonazepam early in Sept [see signature] to liquid, reserving the other half in pill form for evenings [to help with insomnia, etc.].

 

Did somewhat ok for a while, but reduced to10%.  I started feeling bad through the day, so I divided my dosages to 4--preparing 4 doses for the day in little bottles--all equivalent [NOT a good idea on retrospect since my insomnia was made worse by this tactic].

 

When I switched my nighttime dose to liquid, too, I started to immediately feel worse.  It has gotten really bad now.  3 days and extremely symptomatic--progressively!  But am not taking it with food.  Lack of sleep and intense panic attacks during the night are making me extremely weak and sick.

 

I saw you mentioned in one of your posts about metabolism being involved in liquid or pills.

 

If I take my liquid dose with food, won't that be the same as though I took a pill and water with my food?  I wasn't taking the p.m. liquid dose with food [could this be my problem??]

 

I want to take the dose in liquid form because I know eventually I will have to start it or try the scales again to weigh such small amounts.  But our scales [we tried 2--one cheap, the other expensive] were not accurate and really frustrated us since I am so sensitive to any small deviations.

 

Why would taking a pill with water at a meal with food be any different than taking the liquid dosage at a meal with food?  Both are taken in the stomach with food and digested together.

 

I need to understand the metabolism issue.  Does it have anything to do with food in the stomach/digestion process or is it entirely a liver issue and the drug going through an entirely different modality that is making this difference?  Is my body NOT metabolizing it properly and it is too strong or too weak? 

 

Thanks.

[[Ji...]]

Hi LynnM

 

I did write something about that topic in here: http://www.benzobuddies.org/forum/index.php?topic=204001.msg2643631#msg2643631

 

But I think it may be something else here. It could be that your body just can't tolerate alcohol-dissolved benzo. To make sure I'm not completely wrong, I would like to propose you to make a change to the way you are tapering. This time we will take strictly MINIMUM amount of liquid and when possible we will take MAXIMUM amount in DRY TABLETS.

 

Example:

A man takes 0.5 mg of benzo each day. He has 0.5 mg tablets and he decides for Liquid Taper. By dissolving a tablet of 0.5 mg in 1 ml of Vodka then diluted with 4 ml of water he has a solution of 5 ml, 0.1 mg/ml. His planned taper pace is to reduce 0.025 mg/14 days. The taper schedule is the following:

 

 

At day 2 for instance, instead of taking 0.4964 mg benzo in ALL liquid, he just takes 1.21 ml in solution and the rest in 3/4 of a tablet. By doing so the impact of the liquid, in tiny volume, is minimized.

 

Could we please try that? If yes then generate again the schedule starting from your CURRENT DOSES and set the parameter "Combine with tablets" to Yes. The night dose must be kept as TABLET-ONLY (is it still 1 mg?) to not compromise your sleep.

 

[[Ly...]]

Jim, since I will be using only a small amount of liquid instead of so much, I will need to change the information.

 

Could you please get  me started with the formulation since I am making such a big change?  I also have had a lot of trouble getting the schedule to work for me.  I need help a.s.a.p.

 

Here is my information:

1.    I will round this up to 1.70 mg. Clonazepam at .5 mg. each pill [the pharmacy kindly ordered me a year's worth at .5 mg. to avoid generic changes, so I have to stay with that size pill].

2.    I would like to take 3 times a day.  Morning/Noon/Bedtime [there will be pills for bedtime for sure and a pill for the afternoon.  I can start reducing the morning one easiest with liquid]

3.    I will only need a small amount of liquid, but do not want to make it every day.  Perhaps once every week or so.  [i was using 20 tablets before, so this will change drastically.]

        I don't know the number of pills or the volume of liquid, etc. that is required on the taper plan schedule

4.    I would like to hold for a time until I stabilize and then drop, at this point in time, only 5% every 14 days since I am  so symptomatic.  If I improve and can move up later, I will do so.

5.    I would like the attenuated Quantity reduction, please at 5%

6.    You suggested "with tablet"

7.    I don't know how to set up the "Daily doses in taper order"

 

So sorry to bother you with this.  Right now I am very "scared" and having a hard time and don't want to mess up anything.

 

Thank you.

 

[[Ly...]]

Builder or Jim, I tried the schedule online and it worked this time!  So, you do not have to generate it for me.

 

I have a question:

 

Since I am using less liquid, I settled for 5 tablets [.5 mg. each] in 25 ml of liquid.  I do not know how to proportion this with the vodka and water.  When I was doing the 20 tablets [.5 mg. each tablet], I used 100 ml liquid [20 ml. vodka/80 ml. water].  Not sure what ml of vodka and water to use if I am doing only 5 tablets [.5 mg. each]. 

 

If I find I need more liquid, I can do 10 tablets [.5 mg. each] in 50 ml of liquid.  But I still can't figure out the ratio of vodka to water for a .1 mg/ml solution.

 

Any help would be greatly appreciated.

 

Thanks.

 

 

[[bu...]]

Builder or Jim, I tried the schedule online and it worked this time!  So, you do not have to generate it for me.

 

I have a question:

 

Since I am using less liquid, I settled for 5 tablets [.5 mg. each] in 25 ml of liquid.  I do not know how to proportion this with the vodka and water.  When I was doing the 20 tablets [.5 mg. each tablet], I used 100 ml liquid [20 ml. vodka/80 ml. water].  Not sure what ml of vodka and water to use if I am doing only 5 tablets [.5 mg. each]. 

 

If I find I need more liquid, I can do 10 tablets [.5 mg. each] in 50 ml of liquid.  But I still can't figure out the ratio of vodka to water for a .1 mg/ml solution.

 

Any help would be greatly appreciated.

 

Thanks.

 

Your previous solution (20X .5mg = 10mg) in 100ml liquid was .1mg per ml.

 

Your new solution should be ...

 

5X .5mg (2.5mg) + 5ml vodka + 20ml water.  That will still be .1mg per ml.

[[Ly...]]

Thanks, much!

[[Ly...]]

Jim Hawk,

 

When I switched over to the pills from the liquid, I noticed an immediate improvement and last night I slept better and when I did my early awakening, I did not have the panic attacks, etc. and went back to sleep.  This morning I felt better.

 

I am apprehensive to take any liquid now since obviously there is a reaction in my body to this modality--either in metabolism or something else.  I have given it several weeks to work and I only got progressively worse.  When I went full liquid then, it got increasingly severe over a 3 day period of time and I could not even function and definitely felt like I was dying.  Horrible!  Getting back on the pills made an immediate difference.

 

I guess I have no choice.  I will need to crush the pills and use the gram scale and hope for the best with accuracy for that little bit that I would have taken as liquid.

 

When I went to your taper schedule, it would not allow me to do the direct taper.  I could not enter the fields.  The dosing part had a blue disclaimer written across the page and I could not enter any information.

 

Should I just use the schedule I have now and instead of using the liquid in ml, substitute it with powder on the gram scale? 

 

This is how the page for my taper plan printed up.  Is the information correct for a 5% reduction for reduction quantity? [see below]

 

Benzodiazepine Liquid Taper Plan

Daily Plan

Summary Medication: Name: Clonazepam - Tablet size: .5 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 10 - Volume of liquid: 50 ml - Concentration: 0.10 mg/ml

Daily doses: Dose 1: .5 mg - Dose 2: .5 mg - Dose 3: 1.0 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 08.10.2018 - Reduction percent: (N/A) % - Reduction quantity: 0.100 mg - Period: 14 days - Reduction order: First doses first - Combine with tablets: Yes - Attenuated ending: Yes

 

 

Day Date Dose 1 Dose 2 Dose 3 Total dose

#       /      /    mg = ml + tablet mg = ml + tablet mg = ml + tablet mg/day

1       /      /    0.4929 1.18 ¾ T 0.5000 1 T 1.0000 2 T 1.9929

2       /      /    0.4857 1.11 ¾ T 0.5000 1 T 1.0000 2 T 1.9857

3       /      /    0.4786 1.04 ¾ T 0.5000 1 T 1.0000 2 T 1.9786

4       /      /    0.4714 0.96 ¾ T 0.5000 1 T 1.0000 2 T 1.9714

 

 

 

[[Me...]]

LynnM, May I asknif you made the liquid yourself or was it a compound pharmacy? I’m wondering if there would be a difference in using the pharmacy solution over making it yourself.

[[Ly...]]

When I wanted to taper from valium, I had the pharmacy order me the liquid valium.  When I tried it, I had a bad reaction.  Only took it twice, but it was bad.  I always wondered later that if I had continued with it for a while, my symptoms would have settled down, but now that I've tried the vodka and clonazepam liquid plus tablets and had such a reaction over several weeks and then a severe reaction once I changed over to just the liquid for 3 days, I know that there must be something in my system that does not agree with this modality.  Metabolism?  Not sure. 

 

I'm not well-versed in body chemistry and it's reactions to different compounds.  I know each one of us is an individual and we all respond differently for different reasons and that a lot of other things can come into play that will decide our response, so I just need to accept that this is one modality that does not agree with me.  Not even the dry works well and hasn't since my surgery 3 years ago.  I've always been symptomatic.  I just don't do well on drugs.  They've tried me on many things to help with the symptoms, but I could never tolerate them for more than a week or two and had to stop or else they didn't work at all.  I was always a specimen of health and strength before the accident, surgery and all the powerful drugs they pumped into me.  One very prominent doctor told me, "they really socked it to you!"  Then they put me on the benzo and the rest is history. 

 

Struggling to this day and not a day without nausea and pain.  Just thankful that there are some days that are more tolerable than others.  Hoping someday it will end.

[[Ji...]]

Hi LynnM

 

Should I just use the schedule I have now and instead of using the liquid in ml, substitute it with powder on the gram scale?

You can not. The weight you see in the Liquid Taper is the benzo weight. The weight used in Direct Taper is the tablet weight. They are related but remain two different things.

 

The best solution to overcome the application error and in the same time be autonomous for next schedules generation would be to change to a different computer and try again. Or, ask someone to install Chrome or Firefox as internet browser. They are free and can likely fix that issue.

 

Waiting for it, here is the PDF report for tonight. https://drive.google.com/file/d/1dXWtrmYPtqqHviFVPRM2OXaeCO3nK6Ou/view?usp=sharing . I have used the same tablet weight as the last time. If it has changed meanwhile you will NEED to change it before generating again the schedule. Also I'm not sure if you wanted "Attenuated ending" set. You can eventually change it later on with no impact to the current doses.

 

Resume from where you are now by looking at the column Benzo (mg) in Total per day at the very right. The quantity to resume from must be as close as possible to the yesterday dose and possibly lower.

 

The reduction of 0.100 mg/14 days corresponds to 5% of 2 mg (0.5 + 0.5 + 1) every 14 days. It is excellent in my opinion.

 

[[Ly...]]

Jim, we already have Firefox.

[[Ly...]]

Jim, I like the liquid w/pill schedule you have.  It lists the cutting of the tablet, as needed, as well as the amount of liquid needed for each day's dose cut.

 

I like when it lists the 1 T. or the 1/2 T. or the 1/4 T. or the 3/4 T., and then instead of listing the remaining amount I will need each day as liquid, could it list the amount in powder to be weighed on the gram scale.  This would be so much easier for me.  For example, see #36 [below].  It would be so much easier for me to take my 1/4 T in the morning along with 1.18 mg. in weight of dry powder on the gram scale and then move on to my next dose for the day of 1 T followed by the evening dose of 2 T.  Then day #37, I would take the 1/4 T along with the 1.11 mg. dry powder on the gram scale and continue each day like this.  I do not trust the accuracy of these scales, as I've had trouble in the past.  Right now, I'd like to dry cut the tablets and weigh out as little as possible so that if there is any inconsistency with the weights, it won't be as critical as it would be if I were to try to weigh out the larger size doses.  I'd rather keep them as whole as possible.  It is obvious that I cannot do any liquids for whatever reason at this time, so I will need to do whatever I have to even if I don't like the gram scale.  To scrape away at the tablets would drive me crazy and I hear too much about inconsistency in the whole pills and doing it this way.

 

Is this possible to figure out?  Can I figure it out on my own or can it be generated somehow on one of your schedules?  The one you sent me looked confusing and doesn't list the tablets to be cut as indicated below.  Any suggestions?  I am holding currently until I hear back from you and I stabilize more.

 

Thank you.

 

Day Date Dose 1 Dose 2 Dose 3 Total dose

#       /      /    mg = ml + tablet mg = ml + tablet mg = ml + tablet mg/day

36       /      /    0.2429 1.18 ¼ T 0.5000 1 T 1.0000 2 T 1.7429

37       /      /    0.2357 1.11 ¼ T 0.5000 1 T 1.0000 2 T 1.7357

38       /      /    0.2286 1.04 ¼ T 0.5000 1 T 1.0000 2 T 1.7286

39       /      /    0.2214 0.96 ¼ T 0.5000 1 T 1.0000 2 T 1.7214

 

 

 

 

[[Ly...]]

And, yes, Jim, I'd like it 5%, as you say, and attenuated.

[[Ji...]]

Hi LynnM

 

can it be generated somehow on one of your schedules?

Actually the schedule for Dry taper by design does not take into consideration any quarter or half or 3 quarters of a pill. The reason is that by doing so the already difficult weighing operation for normal quantity of powder will further worsen due to now lower quantity to weigh.

 

Can I figure it out on my own

You can.

 

The one you sent me looked confusing

As for the today Direct Taper schedule , here is the explanation:

 

 

[[Ly...]]

Thanks, Jim.

 

I have been feeling much better on the pills, but have had nothing but trouble with the 2 gram scales we purchased.  So, it was more anxiety than anything trying to get it to work right.

When I was finished after 14 days the first time around, I found that I had actually run out of the crushed pill, which meant that I had taken MORE than the amount I was supposed to REDUCE!  That was when I realized that this process was NOT going to work for us.

 

Since the liquid obviously does not work or works against me, I dislike taking any.  It would be as though I wasn't taking any of it or that it would actually hurt me to take it.  This is too scary for me.

 

We weighed the crushed pills and got different readings every time!  Unbelieveable!  We did not get a cheap model either.  We tried one that was moderately priced and one that was more expensive.  When we compared the two, they differed, as well!  But the having run out of the crushed pill at the end meant that we were taking more than the pills we started with and that meant an updose.  NOT good! 

 

I can understand why you say that dividing up the small amount of liquid converted to crushed pill would be too difficult to weigh such small amounts over the 14 days, such as 5% or 10%.  But what if we tried to figure out a reduction over a shorter course of time??? 

 

I feel overwhelmed, frustrated with my body's response and hopeless.

 

What can I do?

 

 

[[Ly...]]

Wait---I noticed the message you wrote in blue above the chart for the taper schedule.  Are you saying that I CAN convert liquid to dry if I follow the calculations you wrote out and still use the tablets? 

 

I see what you mean about the very low amounts to reduce.  Very difficult!

 

What to do???

[[Ji...]]

Hi LynnM

 

Are you saying that I CAN convert liquid to dry if I follow the calculations you wrote out and still use the tablets? 

Yes you can. Provided your gram scale allows it too.