Stressing about next dose reduction and related symptoms

[[Ma...]]

 

I'm feeling pretty overwhelmed right now. Scared to make the next cut because of how severe my symptoms were last time. Trying not to focus on it, but I can't seem to keep my mind from going there. My next reduction won't be until after March 3rd when I see my doctor. I'm thinking about trying the liquid titration method so I can reduce my dose more slowly. I can't miss two days of work every time I reduce. I don't think I can take the severe headache and vomiting either. In some ways I'm glad I had the super severe symptoms off the top, but it's also turning into dose obsessive anxiety.

[[ja...]]

Hi Magna... Looks like you are just at the start.  Congratulations! 

It sounds like your first cut was awful. 

I am wondering if you should consider a Valium crossover or liquid tapering.  I failed my first two Clonazepam tapers.  I succeeded this time by crossing over to Valium equivalent and then taking it slow.  I had fewer really awful taper symptoms until after I got down to 10 mgs.  Which is 1/4 of your current dose. 

I know we are all so different, but I pray that you have a savvy doctor, or you will lean into all the knowledge here, so that you can gain some confidence - especially at the beginning! 

Now that I am down at the bottom end of my taper, the cuts are awful, (my choice to do a dry taper - 1/2 mg cuts) but they get better in a roller coaster way usually by 3 weeks.  At this stage, I have developed some healthy denial about how bad it gets.  On Valium - for me - I don't feel the brunt of the cut for 4 or 5 days.... so there is a cushioned effect.....

Hey love - good luck...... hope you can find an easier starting road.

[[Li...]]

Hello, Magna. My apologies. I missed this post but have responded in your other thread.  Here’s a link:

 

http://www.benzobuddies.org/forum/index.php?topic=236950.msg3041267#msg3041267

[[Ma...]]

Hi janiceh,

 

This was my first cut and it was pretty bad. I expected some extra difficulties due to my poor ability to metabolise meds, but nothing like this. My doc and I have discussed doing a crossover, but question if it will make things worse since my medication metabolism is so slow and varies greatly based on the inert ingredients. Right now I can only use one specific generic brand of clonazepam. If the pharmacy switches brands I have immediate withdrawal symptoms taking the same prescribed dose. Just changing me over to Valium will be a battle in itself. Because my doc wants to minimize the battles she wants to try everything else first. I'm with her on that. I suspect that the reason it took eight days for more than a full constant headache to appear is because drugs have a much longer than indicated half life in my body. This isn't the first time I've had such severe side effects from coming off or starting on a med. No picnic either way and I don't expect this to be any different (other than being a very long process with lots of ups and downs). Thankfully my doc has been using this protocol for many, many years and is quite adept at it and at treating odd drug metabolizers like me. The unfortunate part is that she is moving about 5 hours away and to a different state in June. I hope to be in a better place with managing my taper by then.

 

It's nice to hear from someone who has been where I am and is now closer to the end. I think denial in this situation is a good coping mechanism. Wishing you success as you continue toward being off the benzos for good.

[[Ma...]]

Greetings, Magna. I’m glad to learn that the symptoms from your reduction have settled down some, but sorry you are fearing your next reduction.  Am I understanding correctly that this was your first reduction?  If so, is it possible that “fear of the unknown” (i.e. not knowing what to expect) might be contributing to your fear?  If so, you may feel less fearful after you discover more about how you react to reductions (e.g. what your typical withdrawal symptoms are, how long they last before you feel ready to reduce again, etc.). 

 

Hats off for thinking ahead about talking to your doctor about a prescription compounded suspension! We have past and current members who have used/are using this approach successfully to taper clonazepam. I’m one of them. 

 

You are wise to reach out to a pharmacist friend for advice, especially given that s/he works at a children’s hospital.  The pharmacies at children’s hospitals are great sources of information about compounding b/c children often need special formulations of drugs. For example, in the U.S., a stability-tested formulation for a 0.1mg/mL clonazepam suspension is available online from Nationwide Children’s Hospital.

 

FYI -  many of our members (myself included) have found it helpful to use a combination of tablets and liquid to taper.  If you are in the U.S., the strengths of clonazepam tablets available are 0.125mg, 0.25mg, 0.5mg, 1mg, and 2mg.  (Another advantage of this approach is that it reduces the amount of liquid you need to have compounded.)

 

Might I ask how you determined that your insurance won’t cover compounding? Some don’t, but others do cover all or part of the cost.  So, I just want to double-check.  Even if yours doesn’t cover compounding, the cost for a one-month supply (especially when used in combination with tablets) is “reasonable.”  Based on data I’ve gathered, the costs range from a low of $15 a month to a high of $60 a month for a compounded suspension made with brand Klonopin (brand is quite pricey compared to generic).  Also, some compounding pharmacies have “value plans” (discount programs) for customers who are going to be using their services on a regular basis.

 

Hi Libertas,

  Thank you for allowing me to respond here by including the link to my other post.

 

This was my first reduction and it was quite bad. I don't think I'm fearing the unknown so much as I'm fearing what I know already and was hoping wouldn't be. I'm a very poor metabolizer of meds and struggle with every medication I try from OTC meds to every prescription I've ever taken. Any med adjustment, start or stop is rough and I don't expect any different here. Looking at the long term is understandably daunting in light of what I know.

 

I guess I looked to compounded liquid quickly because I've been down this road before with other meds. That's how I know my insurance won't cover compounded liquid. And I called last week to verify. The pharmacist they have on staff to help get things pushed through insurance couldn't find a way to code it where my insurance would cover any part. I called a couple of compounding pharmacies that I know to be low cost last week as well and the cost was $30 and up for 100ml of 0.1 mg/ml. It just became more expensive as the volume increased making 30ml the most cost effective quantity and that's outside what I can afford long term based on quantity needed even mixing tablets and liquid to obtain dosage.

 

I did text my pharmacist friends last night.. she works at children's and he oversees a buying group for independent pharmacies so I'm hoping one way or the other I can find a cost effective solution. Just knowing my body's track record with meds I feel like my best hope of getting off the clonazepam is being able to accurately and precisely control my taper and slow it down more than generally recommended.

 

I'm not looking for this to be easy, but I do need to be able to go to work and be productive while I'm there.

[[Li...]]

It sounds like you know how to go about finding a solution, Magna.  I don’t gamble, but if I did, I would wager you will be successful!

[[Ma...]]

Thanks.

[[Pa...]]

Hi Magna,

 

I saw you popped into another thread and offered your expertise with scales, it's so nice to have subject matter experts on the forum who are willing to share it. 

 

I read you progress log today, it looks like things are getting difficult, I can't imagine tapering from benzo's given your situation, the intensity of the stimulation must be very uncomfortable to say the least.

 

Let us know if you need to talk, we're here for you.

 

Pamster

[[ho...]]

Magna - Since you're trying to work, it seems it would be wise to try and soften the blow anyway possible. You've gotten very good suggestions in the previous posts on managing the medication.  I offer what has helped me, and might help you- supplements. I stick to a few mainstream items and they've consistently helped through two different tapers from two different drugs. I am the canary in the coal mine for adverse drug reactions so I had to do something.

 

Vitamin C and Niacin ( I use non-flush) greatly help the anxiety symptoms. They both have numerous benefits scavenging drug metabolites, decreasing cortisol, and restoring nerve chemical balance.  Taurine works wonders for teeth grinding, ataxia, and muscle tremors. Natural anti-seizure. *Take with food as lowers blood sugar. Trace mineral Molybdenum specifically reduces acetylaldehyde by helping the enzyme. It's a nasty chemical by-product that is thought to be the cause of alcohol withdrawal symptoms. For garden variety tension, Ashwaganda or the proprietary blend Relora help calm. Take enough, and it helps sleep.

 

Consider a modified keto-diet as it has been scientifically demonstrated to lower excess glutamate. Too much glutamate causes blood sugar swings, brain excitability, and akasthesia, etc.

 

These are just suggestions that help the physiological struggles brought on by withdrawal.  Good luck and please contact the forum with questions. There are many people who've gone through this before you. Use their knowledge.

[[Ma...]]

Hohhot-

Thank you for the suggestions. I've been intending to look into this, but haven't been able to yet. I really, really appreciate you sharing your experience. We Canarys have to stick together!