Tapering from .125mg Clonazepam twice a day

[[hi...]]

My husband recently tapered off Mirtazapine (stopped 4 weeks ago). To help with this process Dr prescribed .25mg Clonazepam twice a day.  He took that dose for 2 1/2 weeks then dropped down to .125 mg without too much problem.  He's been on that dose for 2 1/2 weeks.  Really want to get him off Clonazepam as quickly as possible to reduce the amount of time he's on the drug.  As he's still going through some issues from Mirtazapine withdrawal (nausea and increased anxiety) I want to minimize any further symptoms but I'm aware the sooner he can get off this drug the better.  Is it better to drop one dose at a time or both at the same time?

E.g. .125 mg in am & .062 mg in pm or .062 mg am & pm?

[[...]]

This is a great question.

 

It depends on the symptoms.

 

If his worst symptom is insomnia, then slowly taper off the morning dose first and save the benzo for PM so he can sleep.

 

If this worst symptom is panic attacks or anxiety, then taper off the PM dose first.

 

In any case, do not cut 0.062 mg in AM and PM at the same time - that is a drop of 0.125 for the day and seem high.

 

Remember, after each reduction, hold at that level for 10 days or until the symptoms are tolerable, whichever is longer.

 

[[hi...]]

Thanks for the advice. Fingers crossed all goes well.

 

[[...]]

PS - try never to go up in dose or start again on benzos.

 

I have noticed, the first time tapering off Benzos can be "ok" but when the user goes back on them, the second taper is MUCH harder.

[[hi...]]

I'm curious as to why it is better to adjust only one dose?  Doesn't this have the effect of being in withdrawal every day when the larger dose wears off rather than having an even amount in your system all day?

 

[[...]]

You are right.

But the number choices you gave did not offer that.

You said

E.g. .125 mg in am & .062 mg in pm or .062 mg am & pm?

 

If you can use a razor blade and eyeball it so you can get to 0.0935, then yes, make your reduction to 0.0935 AM and 0.0935 PM so it is smoother.

 

 

[[hi...]]

Ah!! thanks so much for your reply.  This makes much more sense to me. I had been looking for tapering information from the Ashton Manual.  Switching to diazepam is not an option so I just followed the method with what we have - .5mg Clonazepam pills.  The tapering method for all in the Ashton Manual gradually reduces and eventually eliminates one dose at a time. I had thought it best to drop each dose and suggested 0.62 am & pm but you're right that is too big a drop so, then I thought following the Ashton guidelines, to maintain his existing dose of .125mg at night and drop the am dose to 0.62mg.  He struggled yesterday and today with such a big drop from one dose to the other so I think .0935 am & pm is the way to go. It's the same daily dose so hopefully I'm not messing things up by switching to this schedule.