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Klonopin taper. Could somebody help?


[Sa...]

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Hi everyone, I am new here. I am searching for suggestions on how to get rid of klonopin. I am actually on 0.7mg per day divided in 0.1mg at 8a.m., 0.1mg at 2p.m. and 0.5mg at 8p.m. I am using a liquid formula so (sorry in advance if I use "drops" instead of mg or ml but it is easier for me) it is one drop at 8a.m., one at 2p.m. and 5 at 8p.m. I am not listening to doctors I asked help to who just said to take away one drop every week. I already done that in the recent past and it was awful. I was on 0.5mg three times per day and the doctor who was following me just told me to do that and I actually did it because I trusted him. So for a total of 15 drops per day I went down to 7 drops per day in just one month or so. It was really awful and I told him I was suffering badly. He was of little help and I am disappointed because he is very well known worldwide and I really hoped he could help. But I realised later that I was wrong because it was him who actually prescribed me klonopin because he said it could help me tackle my paws from paroxetine. I was on paroxetine for years but I wanted to be free and I kicked it during a 9 month taper that was brutal. I did it by myself because the previous doctor just told me to stop taking it in one month which was impossible for me. Even though I did it in 9 months I developed paws and, long story short, I searched for help and found this doctor who put me on klonopin. Too bad I just realised later that you can't stop withdrawal from an ssri using something that has nothing to do with serotonin.

Anyway now I have no doctors guiding me (I have also lost my faith in them because I just think they have no clue about withdrawal and stuff). I am planning a direct taper. I tried to switch to valium but it didn't work and I am scared to substitute to another benzo and having to adapt to a new substance.

I have purchased some syringes for insulin, the one featuring 0.5ml. If I am correct 0.2ml are equivalent to 0.5mg of klonopin. The syringes are divided in 50 parts so I guess that 4 parts are the equivalent of one drop.

The plan is to put 0.2ml of klonopin in one syringe (20 parts) and just take 19parts first one month, then 18parts for the next month and so on. This is referred to the evening dose. Then I have to figure out what to do with the morning and early afternoon doses. In the ashton manual it is clearly written that one should get rid of the afternoon dose first, then the morning one and the last one should be the evening one.

So I am stuck not knowing what to do in general. I have used delorazepam in the past and I know that one drop of klonopin is equivalent to 5 drops of delorazepam. I could switch to it in morning and afternoon and stay on klonopin in the evening. But that could be maybe wrong.

I am so scared that what I've being through with paroxetine withdrawal is nothing compared to what it will be with klonopin... in the end I have read "benzo hell" everywhere and I know that not everyone will make it. 

So yes... I am very scared.

Any suggestion would be appreciated. Thank you in advance and sorry for my English.

Regards from Italy

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It looks to me as if you're doing an excellent job of managing your taper on your own, I'm very impressed with your knowledge and determination.  I'm not sure what you need from us, it sounds like you have a great plan tailored to suit your needs.

 

I'm concerned about your intention to use Delorazepam, why would you introduce another benzo into your taper if your goal is to be benzo free, am I not understanding you correctly? 

 

 

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Hello Pamster, and thank you for your reply and your words of encouragement. They are very much appreciated as I feel validated in my plan(do you confirm that 0.2ml is equivalent to 0.5mg?). I was thinking about subsituting the klonopin I am using in the morning and in the afternoon (two drops total) with delorazepam because I ve read that one drop of klonopin is the same as 5 drops of delorazepam and maybe (but it is only an idea I have that could be wrong and infact I am here for suggestions) it could be more manageble to reduce delorazepam just taking one drop off every now and then. Am I wrong? Would it be a stupid thing to do?

Or should I use the syringe to taper the afternoon and morning klonopin (as suggested in the ashton manual: quit the afternoon,  then the morning, then the evening doses) ?

Or should I just skip the afternoon dose and see how it will proceed for a month? You guys suggest a 5/10% reduction so skipping the afternoon dose would be a lot more, am I right?

I would just need some instructions on where to start with my taper and if the calculation I made with the syringe are right.

Thank you again

P.S: I must admit I am scared because I ve read too much about the danger of benzodiazepines and I don't have proper support around (no family. I have lovely friends but I am mostly alone in this struggle). Plus I have read that even after stopping I could possibly still feel all the withdrawal for months or even years. All in all... I am scared, very scared 

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I would rush things up as I would want a benzo free life but I know that a cold turkey approach could be very dangerous and I am living prof after going from 1.5mg klonopin per day to 0.8mg per day in 30/40 days.

The "funny" thing is that I don't feel any benefit from klonopin. I am not relaxed and I can't rest. And also, sometimes, when I take it I feel some paradoxical increase of anxiety.

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Hi Salazar77,

 

I understand that you no longer expect useful tapering advice from your doctor.  But is your relationship solid enough that he will continue to refill your liquid clonazepam prescription, or are you limited to what you now have in your possession?

 

 

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Hello Koko Lee.

My general practitioner is refilling me. It was always him who did that as the previous doctor lives in another city. My general practitioner knows exactly the situation and he is very helping and caring

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And am I understanding you to say that the smallest volume you can accurately deliver is one drop, which is equal to 0.1 mg?

 

 

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Yes, it is. It is the smallest. And even if there is a pharmacy in my city that could provide compound doses I already asked them and they told me that it would cost a lot to have smallest doses. So the only way for me is to skip one drop each time (which would be top much, according to what everyone says in various forums) or to use the syringe method I explained.  Any wafer option would be appreciated. Any tipa and suggestions on how to do that. I am too scared of what the benzos are doing and have done to me. If they were not harmfull I could have Stayed with klonopin but I don't think this is an option.
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I was going to ask if the literature accompanying the medication states that it can be added to a glass of water, to be taken immediately.

 

It sounds like you have already investigated the possibility of diluting/compounding clonazepam.    :-\

 

     

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Yes I asked to a friend who works in the chimica field and he said that liquid klonopin is a suspension and not a solution so it would be difficult to dissolve it exactly in water and have a precise dose.
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In the US, there's a method to compound a suspension from powdered klonapin tablets using a suspension vehicle called Ora-Blend. 

 

If your klonapin is already a suspension, maybe it could simply be diluted with Ora-Blend? 

 

(I realize "maybes" are unhelpful in the context of benzo tapering.) 

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I should check out of this is available here and if it is I should figure out how to do that.

Aren't you supporting my previous idea of the syringe ? I thought it could be a good idea in order to make smaller reductions.

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I hadn't really formed an opinion of the syringe approach until you mentioned that your klonapin is a suspension. 

 

My understanding is that suspensions must be agitated immediately before dosing so that drug particles that settle will be re-suspended.  Using pre-filled syringes, I'm not sure how the contents can be mixed well enough to ensure a uniform suspension. 

 

Forgive me if I missed part of your explanation--but why not leave the medicine in the bottle, shake before dosing, and then draw up however many "parts" you need when you need them using your insulin syringe?

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I re-read what you wrote about dosing with the insulin syringe.  I misinterpreted you.  We're basically saying the same thing, and what you suggest should work, assuming your calculations are correct.  The only potential problem  is that, depending on the viscosity and particulate content of your suspension, the syringe needle may be so fine it could clog up.  If that's not a problem, then someone here or your chemist friend should be able to verify your calculations and you're on your way. 

 

If the insulin syringe doesn't work out and you want to try diluting your suspension with what's used for clonazepam suspensions in the US, here's the amazon link to that product.

https://www.amazon.com/Ora-Blend-Flavoring-473-ml-bottle/dp/B011JFZR8O

 

And here's a link to the compounded clonazepam suspension method we use here (so you can verify for yourself the stability of klonapin in Ora-Blend and the expiration of the suspension). 

https://www.nationwidechildrens.org/-/media/nch/specialties/pharmacy/compounding-formulas/clonazepam-oral.ashx

 

Good luck to you!

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Wow! Thanks for the tips. Not sure i would be able to do that proprio as it seems difficult. It seems my syringe is good enough for the paurose. But I will read carefully what you sent me. Thank you very much.
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I'm so grateful Koko Lee dropped in to help you sort things out Salazar, I lack the knowledge needed to address your concerns.

 

I'm still wondering however about your thoughts on using Delorazepam, I'm hoping it's been taken off the table since I was having difficulty seeing the benefits.

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I trust what you say and your concern. It was just an idea in order to simplify the process but I guess it is just not worth it. I will use my syringe. I removed tfe needle and I tried to put 0.2ml in it. Then I just put 5 drops in a glass. I emptied the syringe in another glass and it seems the amount was the same. Of course i cant compare it properly but it seems it will work hopefully.. In your opinion and experience how long would it take to heal? I mean, once the klonopin will be out of my system how long would it take to feel normal? And even when I reduce the amount could I feel some healing process?
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I'm glad to see you've done a bit of experimentation, I often say this is what we do, we experiment on ourselves in an effort to rid ourselves of these drugs, it's unfortunate but this is all we have.

 

You're asking the million dollar question and unfortunately I can't give you an answer about how long it takes for us to heal. We know that healing takes place as we taper, this is evident in the pain we feel and once we're rid of the drug, the healing will continue which of course means more pain.  Our bodies don't work like the pill, it can't repair itself in an instant like the pill took away our anxiety.

 

I've seen threads on the forum asking for feedback about this question, some say average healing time is around 14 to 18 months after the drug is gone from your body but this is anecdotal with some taking less time and others taking more.  There are so many variables, time on the drug, amount taken, genetics, general health, there's just too many to be able to offer an accurate timeline.

 

Please understand, withdrawal symptoms will change as will the intensity so I hope I'm not discouraging you, this is survivable, it's not pleasant but the end result is wonderful.

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[c5...]

A LOT of people make these suspensions and feel they work pretty well.  Many liquified benzo preps are meant to be diluted prior to ingestion.

 

I understand your reasoning for considering delorazepam, but think that diluting your liquid klonopin formulation should accomplish the same goal without introducing a new benzo into the equation.

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Hello, Salazar77.  Just double-checking ...

 

Given that you are in Italy and have a prescription, I wonder if the liquid you are using is in fact an oral solution?  Can you tell us the manufacturer?  Is it Roche perchance? 

 

Also can you tell us the concentration of the drops?  The oral solution manufactured by Roche contains 2.5 mg/mL clonazepam (one drop contains 0.1 mg clonazepam). 

 

 

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Hello Libertas. Yes, it is 2.5mg/ml manifactured by Roche and 0.1mg is 1 drop. I use that with water but I see it cant dissolve there.

Hello Badsocref, I definitely won't use delorazepam to substitute my morning and afternoon dose after Reading you guys are not suggesting it and, given the fact that trying to use diazepam as suggested in the ashton manual didnt work for me I guess it is sister to opt for a direct taper.

Hello Pamster, thank you for your answer. You are not discouraging me. I know it will be tough but I hope it won't be as tough as it was when I went down from 1.5mg daily to 0.7mg daily in 40 days because I thought I was going to die or killer myself.

The withdrawal was so bad I can't even describe it. It was a neverending nightmare. Hopefully, doing it slowly it would be manageble.

So in the end you are suggesting to prepare a solution? You don't think my idea of using the syringe will work?

If I will do a solution I guess I should study it carefully because I don't think I understood it properly. I should need a guidance. Or maybe I will try with the syringe for a couple of weeks and I will see how it will be. And I guess I should start tackling the afternoon dose first.

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Hello again, Salazar77.  That’s great news that you have the oral solution from Roche.  Did your liquid come with a drug information pamphlet?  If so, does it have a section that describes proper use of this particular formulation?  I’ve included an example below of the “Proper Use” section for one of the Intensols available in the US.  Like your solution, Intensols are concentrated.

 

As you’ll read, the manufacturer recommends mixing the Intensol with liquid (or semi-solid food) to make it more palatable. However, the manufacturer also clearly states that the resulting mixture should be consumed immediately—not stored for future use.

 

If your liquid has similar instructions, Koko Lee and I have an idea for a workaround.  We would be happy to share it with you if you are interested. 

 

Moving forward, what do you have in mind for your total daily dose of clonazepam expressed in drops?  How many times a day do you plan to dose?  How many drops will you take each dose?  (Most/many members find it helpful to take a consistent dose at consistent times every day.)

 

What percent reduction in dose do you want to try to begin?  (e.g. 5%? 10%?) 

 

 

Proper Use of an Intensol™

 

An Intensol is a concentrated oral solution as compared to standard oral liquid medications. It is recommended that an Intensol be mixed with liquid or semi-solid food such as water, juices, soda or soda-like beverages, applesauce and puddings.

 

Use only the calibrated oral syringe provided with this product. Draw into the syringe the amount prescribed for a single dose. Then push the plunger on the syringe to add the contents into a liquid or semi-solid food. Stir the liquid or food gently for a few seconds. The Intensol formulation blends quickly and completely. The entire amount of the mixture, of drug and liquid or drug and food, should be consumed immediately. Do not store for future use.

 

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Hello again Libertas. I have read the pamphlet and it just says to mix the drops in water,tea or any juice and to drink it. It states not to put the drops directly in the mouth and that Kinda confused me because I did it often that way thinking that putting it under my tongue would have been better. I am wondering why they say not to do that. I will put it in water from now on.

Answering your question: I don't really have an idea on when to take all the drops. As I wrote before I am using it three times per day as prescribed and I never changed that even after Reading the ashton manual (the part explaining the crossing from clonazepam to diazepam which talks about three daily doses). I would have preferred to just have a one dose daily but I don't know if i could make it and if it would be safe to move the drop in the morning and the one in the afternoon and adding that to the bigger evening dose. Any modification scares me. So, very naively I was thinking, also taking the ashton manual as a guide, ti dismantle the afternoon drop, then tackle the morning one and then starting with the evening dose.

If changing the time per day of this and moving the doses won't cause problems I would do that.

You are asking what kind of reduction I was thinking to apply. Well, given the fact that I felt so bad when I followed my doctor's instructions when I went from 15 drops to 7 in 40 days and I don't want to experience anything like that anymore (I was in a really dangerous place and I was Kinda losing control... thinking back it still scares me and I am trying to forget what happened because I could cry... i guess this could be a ptsd) I would want to do it smoothly.  If I will use my syringe of 0.5ml divided in 50 parts and , referring to the evening dose (it is just an example) I would have to fill 0.2ml (20 parts where 4 parts correspond to one drop) I would start taking 19 parts for a couple of weeks or one month and so on... basically I was planning to take away one quarter of a drop every 2 weeks or month. Maybe this is a "coward" approach but as I don't have a family network to encourage me or to keep me safe and I have to do that all by myself I don't need to rush things up. Of course I would gladly do it faster but I know there could be bad consequences.

Just for the record, I wrote to a medical forum asking for suggestions and some doctors replied. They all said to take one drop away every week or two and when I replied asking if that could be dangerous they said "it won't because you are taking a little dose and there is nothing to be scared of". They implied that there is a "psychological factor" that prevent me from doing like they say. It makes me mad how doctors treat this sort of things not knowing how dangerous it is. The same as my old one who got disappointed when I was the mess I was in May. That is a shame.

Anyway I am here curious about your plan of attack to my problem. I really don't know if I would be able to purchase all the tools needed to make a solution and how to work things out that way. I hoped my idea of the syringe would have been enough and you would have considered it a good idea. I tried again this morning and it really seems that 5 drops in a glass and the amount of the 0.2ml syringe are equivalent.

But I am here to listen to suggestions ( if my limited knowledge on how to proceed will allow me to understand and apply)

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I know you are scared, but you will feel much better once you get your initial taper plan figured out.

 

As a first step, please give yourself a pat on the back for correctly calculating that 0.2mL of a 2.5mg/mL solution equals 0.5mg of clonazepam!

 

As a second step, we need to understand your current daily dosing schedule. Can you reply with a simple table that tells us the time you take each dose and the amount of each dose?  For example:

 

7 am - X drops

3 pm - X drops

1 pm - X drops

 

We also need to know:

 

(1) How many days have you been following this dosing schedule?

 

(2) How you are you feeling on this dosing schedule?

 

Are you experiencing withdrawal symptoms?

 

Within a day, do your withdrawal symptoms change (increase or decrease) as you get closer to the time of your next dose? 

 

From day to day, are your withdrawal symptoms getting better, worse, or staying about the same? 

 

Are your withdrawal symptoms tolerable?

 

 

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8 a.m. 1 drop

2 p.m. 1 drop

8 p.m. 5 drops

 

I ve being on this since june and the withdrawal symptoms I was experiencing in May are better in the sense that they are not as intense as they were before. The major one is the muscle spasms i experience mostly when i wake up but i am not sure it is relatable ti the klonopin because i had it since tha taper of paroxetine. I did some medical cracking to investigate if i had something neurological going on  but everything was fine. But yes the burning feelings, the vomit and all the intense despair have being pretty much mitigated. My symptoms don't have a clear pattern through the day but first sure the mornings are the worst. Walking up is difficult like if I am carrying a ton of bricks on my back and the feeling of loneliness and despair are there biting me. When I am approaching the evening I usually feel better. But the nights are not so good. I usually sleep 4 hours and I know this aspect will get worse as I will power the dose

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