Please help me tapering off Clonazepam!

[[yy...]]

I am a 46 years old male. I have been suffering from anxiety disorders for several years. I take EFEXOR XR for this disease, 150mg/d. I also take Clonazepam 1.5~2.5mg per night for sleeping. I have been on it for one year. Seventy days ago I decided to wean off the Clonazepam. I planned to decrease the dose by 0.1mg every 10 days. Recently I decreased the dose to 0.9mg per night successfully. But I couldn't go further. If I try to take 0.8mg before sleep, I would wake up at 4am and feel tired and a little depressed the next day. I've ever considered using Mirtazapine to substitute Clonazepam in order to sleep longer. Is that a right way? Should I take some supplements such as Melatonin (10mg) or CBD oil to help?

[Guest [Ka...]]

Hello yyz1112 and welcome to BenzoBuddies,

 

We are so glad you've found us.  Good thing you've chosen to taper clonazepam instead of quitting it suddenly as you've likely become habituated to it.  But there is hope as many of our members have successfully let benzos go from their lives.

 

I've put a link below to the planning your taper forum.  A reduction of no more than 5-10% every 10-14 days is generally recommended but everyone is different and so any taper should be based on the individual and their symptoms.

 

Planning Your Withdrawal (Taper Plans)

 

I've also included a link to the alternative therapies forum where you may find useful information:

 

Alternative Therapies & Supplements

 

Have a look around and get familiar with BB as there is a wealth of information here.  Dealing with the sleep issue can be quite challenging.  Some of our members have used alternatives for sleep so you'll likely get some good replies to your questions.

 

Best and again, a warm welcome to you,

 

Kate

[[sh...]]

I am a 46 years old male. I have been suffering from anxiety disorders for several years. I take EFEXOR XR for this disease, 150mg/d. I also take Clonazepam 1.5~2.5mg per night for sleeping. I have been on it for one year. Seventy days ago I decided to wean off the Clonazepam. I planned to decrease the dose by 0.1mg every 10 days. Recently I decreased the dose to 0.9mg per night successfully. But I couldn't go further. If I try to take 0.8mg before sleep, I would wake up at 4am and feel tired and a little depressed the next day. I've ever considered using Mirtazapine to substitute Clonazepam in order to sleep longer. Is that a right way? Should I take some supplements such as Melatonin (10mg) or CBD oil to help?

Welcome to BenzoBuddies!

Great decision on getting off of your Clonazepam! Before you continue to drop please read The Ashton Manual which is essential to understand how benzodiazepines work and gives great guidelines how to wean yourself off. Generally no more than 5-10 percent of your previous those is recommended to cut about every 7-10 days (average) some people need more time between reducing the dosage as they might develop some symptoms as the body accommodate the changes. Ideally you want these drops to go as gradual as smooth as possible. Everyone reacts differently to the reduction some tolerate it better than others, the appearance of withdrawal symptoms are normal part not a sign of illness. If you are mentally and physically prepared and know what to expect the process can be relatively easy. The least drug you take to fend off withdrawal symptoms the better is for you as they might interfere with your healing and sorting out your symptoms. While psychiatrists might routinely prescribe Mirtazapine I recommend you to discuss the use of it with your BenzoBuddies, personally had negative experience with them.

[[He...]]

Hi yyz

 

Welcome!

 

You’re doing great!

 

Is waking up early and feeling low your only symptoms?  If these are manageable, then you’re doing very well. 

 

When tapering, follow your symptoms.  Decide if they are ok, see if they decrease over 10 days.  Then keep reducing 5-10% each reduction.

 

Clonazepam is impossible to cut that small.  You’ll need to compound it to a liquid to do that.  Pharmacy can do that, doctor prescribes the compound.  It’s a compounding pharmacy.  Much easier.  You can learn how to make your own.  I cannot do the math or trust my results.  And I don’t want to put that much attention on my benzos, to make a compound in the kitchen.

 

Your dose will take time to taper.  But time will pass either way, so may as well do it.  Allow the time.  Be patient.  Expect symptoms.  Be adaptable to changing your plan.  Try to not updose or rescue dose.  A good reason to make small reductions is it prevents this temptation, because you’ll keep the symptoms manageable.

 

Practice self calming techniques as you go, so you have them well established when you get benzo free.

 

You’ve got this!

[[yy...]]

I still took 0.8mg clonazepam yesterday. Unfortunately, I woke up at 2:40am and couldn't fall asleep again.  I'll need a rescue dose of 1.5mg tonight.

[[Pa...]]

Rather than planning on a rescue dose or even using this strategy, it would be better to find a dose you can stabilize on and stay there for a few days.  When you're able you can begin your taper again, slower if that will work better for you. Its not a good idea to get in the habit of up-dosing, it confuses your brain and sets a bad precedent when the goal is to taper off of the drug. 

[[sh...]]

I still took 0.8mg clonazepam yesterday. Unfortunately, I woke up at 2:40am and couldn't fall asleep again.  I'll need a rescue dose of 1.5mg tonight.

Because of the reduction, symptoms (such as insomnia) are not unexpected and you need to learn to handle them without resorting back to your benzodiazepine. That is the point of benzodiazepine withdrawal to wean yourself off. So up-dosing to fend off symptoms defeats the purpose and there is a potential kindling effect when you do that.

I can only repeat what Pamster says "it would be better to find a dose you can stabilize on and stay there for a few days.  When you're able you can begin your taper again, slower if that will work better for you. Its not a good idea to get in the habit of up-dosing, it confuses your brain and sets a bad precedent when the goal is to taper off of the drug. " Wishing you the best!

[[He...]]

So, did you updose?  Lots of advice against that.  It comes from experience.  Lots of experiences have taught us this isn’t the best way.  One night of insomnia isn’t impossible to handle.  There will be more of those.  There will be symptoms.  There’s just no way around it.  If your symptoms are minimal, that’s good news.  One tough night isn’t enough time to say the taper isn’t working.  You need to let your brain catch up.  As well, your updose is almost double your tapered dose.  That’s going to confuse your brain.  This is the reason we advise small dose reductions.  The symptoms will be less and updosing is unlikely to be needed.  Up and down simply doesn’t work.  In fact, it can stop working altogether and symptoms can persist even with the updose.  All of this said with respect to the fact this is your taper.  It’s totally up to you.  I just don’t want to see you struggle more than necessary, and if it’s somewhat preventable.  So now, get stable and then resume tapering at 5-10 % if whatever your current dose is.  Wait 10 days before the next reduction.  I hope you can find a way to accept the symptoms and heal. 

[[yy...]]

Thank you for the replies. I am a programmer. I cannot work at daytime after just two sleepless nights. I am hesitating whether to cross over to mirtazapine, which I have been on for two months in 2015, at a dose of 7.5mg.

At that time, I've got social anxiety disorder (SAD). SAD attacked me when I encountered something that I was afraid of, such as an important meeting that would come on in a few days. After the meeting I recovered immediately.  From Jan. 2015 to May 2016, I took escitalopram to treat SAD, and took mirtazapine to treat the difficulty falling asleep for the first 2 months. I weaned off escitalopram without doctor's instruction.  I knew that I was not cured.

From Jan. 2017 to now, the disease has changed to generalized anxiety disorder (GAD), which has different symptoms from SAD.  I woke up too early.  I found another psychiatrist, who started to prescribe EFEXOR and benzos. Until August 2019, I weaned off all drugs under the doctor's instruction. BUT, the GAD recrudesced only one month later.  I had to take medicines again. 

[[sh...]]

Thank you for the replies. I am a programmer. I cannot work at daytime after just two sleepless nights. I am hesitating whether to cross over to mirtazapine, which I have been on for two months in 2015, at a dose of 7.5mg.

At that time, I've got social anxiety disorder (SAD). SAD attacked me when I encountered something that I was afraid of, such as an important meeting that would come on in a few days. After the meeting I recovered immediately.  From Jan. 2015 to May 2016, I took escitalopram to treat SAD, and took mirtazapine to treat the difficulty falling asleep for the first 2 months. I weaned off escitalopram without doctor's instruction.  I knew that I was not cured.

From Jan. 2017 to now, the disease has changed to generalized anxiety disorder (GAD), which has different symptoms from SAD.  I woke up too early.  I found another psychiatrist, who started to prescribe EFEXOR and benzos. Until August 2019, I weaned off all drugs under the doctor's instruction. BUT, the GAD recrudesced only one month later.  I had to take medicines again. 

Your story sound familiar to many benzodiazepine user as psychiatrists are trained to handle people with GAD or panic disorder exactly the way you describe. However, often they mistaken and interpret drug withdrawal symptoms as the return of the initial underlying problems such as anxiety and they end up treating withdrawal symptoms with adding more antidepressants and more benzodiazepines. The problem is that benzodiazepines as central nervous system depressants indiscriminately suppress every CNS function in your body from vision, hearing, taste, breathing, hormone production, muscle, function and so on. Benzodiazepines not only reduce your anxiety but mow down everything else which is very concerning especially because many users are unaware of the consequences down the road. The main point is that people need to know what is happening to them and to be prepared to handle should they develop tolerance withdrawal symptoms or should they need to get off of their benzodiazepines for reasons such as planned pregnancy or adverse effect on cognition just to mention a few. Of course they can be useful in cases when anxiety is disabling but unfortunately the long term use of them can lead to negative events. It seems that you had your previous weaning off under control and your doctor was helpful. That is great news, hopefully you can get off of your medication the same way when you are ready.