Help with tapering 0,5 mg klonopin

[[ob...]]

Hello

thanks for accepting me. I have taken 0,5mg klonopin for my hyperacusis since 6 months and I would like to stop it. Unfortunately my ENT and psychiatrist provided me very bad advice and after 2 months i tried for one week to cut the dose in two and since I had an aggravation of my hyperacusis I went back to 0,5 mg.

Now I want to taper properly and I looked at the Ashton guide and the suggestion to switch very progessively to diazepam during 5 (or even more) weeks and then taper with diazepam. I am kind of inclined to follow that avenue because diazepam has always helped for my hyperacusis. 
Am I taking any risks ?

for the moment I use Rivotril with drops (not tablets any more)

many thanks for your advice 

kind regards 

[[ma...]]

 

 

Hello Obi Wan  Welcome to Benzobuddies

I’m glad you’re here with us, I am sorry about your hyperacusis diagnosis that must be tough for you.  I am sure you will get plenty of tapering advice on this board.  I am sorry about the bad advice you received, 50% reduction is way too much (ouch). Many choose to crossover to a longing acting benzodiazepine for a smoother taper.  Some find diazepam  too sedating but you seem to be fine with it.  I tapered off diazepam,  slow is the way to go. 

The general rule of thumb is reducing between 5/10% every 10/14 days.  This is too quick for some of us, its  always important to listen to your body and adjust the reduction accordingly.  You will get some symptoms, that’s normal, just keep in mind they are temporary. You’ve joined a wonderful supportive community, who will support and encourage you along the way. Please check out the forum and keep posting any questions for members to respond.

I am glad you are familiar with The Ashton Manual,  It is a great resource for understanding the effect benzo’s have on our body, Chapter III reassured me that symptoms I had were temporary.

https://www.benzo.org.uk/manual/bzcha03.htm

Here is a link to the Ashton manual

https://www.benzo.org.uk/manual/bzsched.htm

Withdrawal support board

https://benzobuddies.org/forum/121-withdrawal-recovery-support/

 

Magrita

[[he...]]

You should be able to go as slowly as you want with the Rivotril drops. That's wonderful that you're already using that form of the drug. I would agree with magrita in how fast you should start. If it were me, I would go conservatively and try 5% over 14 days. If that works well, go a bit faster. If not, slow down a bit. You can do this!

[[ob...]]

Many thanks for your very comprehensive and quick replies. Just to be sure I do understand well. If I follow the Ashton manual, (there is table for tapering 1,5mg), then for 0,5mg clonazepam I would replace each week 0,1 mg clonazepam by 2mg of diazepam. Would that seem correct to you ? And then when I am at 10 mg diazepam after 5 weeks I start to taper diazepam (she says 1 mg every 2 weeks but I guess I could go slower).

But cutting 20 per cent clonazepam even if replaced by the equivalent in diazepam that would not be too much right ?

you also mention that with clonazepam drops I could easily make smaller doses how would you do that ? 
many thanks and sorry to bother with additional questions (but I am still traumatized by the bad advice I got from doctors)

many thanks 

kind regards

Dominique

 

 

 

 

 

[[Pa...]]

Hi obi wan, you mentioned you're interested in crossing to Valium because it's worked well for your hyperacusis in the past, can you tell us a little more about your history with Valium?  All benzodiazepine use and length of time on the drug as well as how long it was taken are pertinent to this discussion.  We'll address your concerns once we know a little bit more about your past use. 

Sorry its taken so long to get a reply to your question, we've recently moved to new software and we'll still getting learning how to find our way around. 

[[ob...]]

Many thanks for replying to me. I used Valium / diazepam from time to time but very infrequently like max 2/3 days in a row (5mg). But it helped me with my hyperacusis because it is a muscle relaxant so for example before taking a plane of a train….so I do not think I have any addiction to it (but you know better than me). Recently since I am homebound and got very bad with my hyperacusis i took it more often but maybe one or two pills per month. I hope this answers your question ? Happy to complement if needed. And many thanks so grateful for your insights and advices.

many thanks 

kind regards 

[[Pa...]]

More questions I'm afraid, can you tell us how long you were taking Valium before you started on the Klonopin?  The reason I ask is because even intermittent use of benzodiazepines can result in the body's dependence, and it can set up the perfect storm for difficulty in future tapering efforts.  Its my belief that given your previous experience with Valium, it's imperative you taper very slowly.

Did you experience any other symptoms besides increased hyperacusis?

We don't typically recommend crossing over to Valium for members currently taking Klonopin since it so long acting and because crossing can be unpleasant but if you and your doctor feel this is the best option then we'll definitely support you.  Speaking of support, will your doctor prescribe enough to allow you to taper as slowly as you need to?

 

[[ob...]]

Many thanks for your answers. I understand it is complicated. I took valium from time to time since 1 year (so 6 months before i started klonopin). 
When I tapered klonopin too fast (as recommended by the doctor…) I experienced I think after like 3-4 days indeed increased hyperacusis and I think light insomnia. But then I went back to the initial dose after 6 days I think. 
if you say that crossing to Valium is not the best way maybe I won’t do it I mean my neurologist wanted me initially to start 5 mg of Valium and then decrease 0,1mg of klonopin every 5 days which appears to me very fast…her idea was that Valium could help me…that’s why I heard of the Ashton manual and though her method was better….

what do you mean by crossing can be unpleasant ? Like I could experience withdrawal from clonazepam ? 

otherwise yes I think I will have the support of my neurologist to get the medicine…I have a box with tablets of 2mg diazepam that I could cut in two or more I guess. I have also clonazepam drops (although I do not know how to divide one drop maybe you could help me with that ?).

I hope his helps and thank you so much for your time.

kind regards 

 

 

 

 

 

 

 

 

 

 

[[ob...]]

Hello 

sorry to bother you do you have maybe an update after my replies let me know of course if you need more elements ? I’d like to stick if possible to the Ashton manual but of course your advice is highly appreciated !

many thanks

kind regards

Dominique 

 

[[Pa...]]

Hello again, I'm sorry, I've been a bit under the weather and missed your notification.  

Let me clarify, we don't typically recommend crossing over to Valium unless the member is struggling with intense interdose withdrawal from a short acting drug like Xanax.  Crossing can be challenging, some members notice sedation and depression which will typically leave once they get used to it but others can't do it and they have to switch back and as you know, any change can increase our discomfort.

Your situation feels different, if you believe Valium is more suitable for you and your doctor agrees, and if you're familiar with its side effects, then it might be the way to go. 

Can you explain your doctors plan in more detail, does your doctor agree with Professor Ashton that .5 mg Klonopin is equivalent to 10 mgs Valium, there are tables which suggest differently but I believe she opted for the higher end because she worked directly with her patients in her clinic and saw the need.  Does he plan to slowly build up the Valium while slowly withdrawing the Klonopin as she recommends?

As for the drops, I've read from members that you can dilute your drops with water, but I don't have taper experience so hopefully others will jump in to help.

[[ob...]]

Many thanks for your quick answer and your time !

Actually I submitted the withdrawal plan of dr Ashton to my doctor and she agreed to it. My starting dose is 0,5mg K. The idea would be to replace every week 0,1mg of K with 2 mg of Valium. And then after 5 weeks I start to decrease Valium. To be safer I could even replace like 0,05 mg K with 1mg Valium I guess, the substitution would then 10 weeks. And then decrease from there. Looks like a lengthy process but I want to avoid aggravating severe hyperacusis it is already a nightmare…

any advice on how to dilute drops would be much appreciated? I mean can I dilute like 1 drop in a glass and basically drink half of it to count that I had a half drop? (I guess I could use the glasses which indicate quantities ?).

another question I have as well is on the decrease of Valium. Ashton indicates a decrease of 1 mg (so 10 per cent of initial dose every two weeks). So this is not 10 per cent if the last dose but of the initial dose - would you do the same because I understand from the posts that would recommend 10 per cent of the lash dose (but then at the end I guess it might try indefinitely no?) ? 

many thanks again for your time 

kind regards 

 

 

[[ob...]]

Hello

after watching a video on U tube on mictro tapering I am actually also thinking about micro tapering directly from clonazepam (as you also mention it could be easier). I could for example use a 300 ml jar and remove 1ml per day - that would take 150 days which is quite long but my main aim is to avoid withdrawal effects….what do you think about this ?

many thanks 

kind regards 

Dominique 

[[Pa...]]

Hi obi wan,

Again, I'm so sorry I haven't been around, I've dealing with a nasty stomach virus that is taking its sweet time leaving, plus I didn't get a notification of your post so I lost you for awhile there.  Could you use @[Pa...] next time you post so I can be sure to see it? 

I'm so glad you've been educating yourself about your options, what have you decided to do?

[[ob...]]

@[Pa...]

many thanks hope you feel better now. Still reflecting on my options.

what about if I use a 200ml jar and I remove 1ml per day (first day 1ml, 2nd day 2m etc) - then it takes me 200 days which is quite a lot (I have been on clonazepam since 8 months now almost at 0,5mg). I could also do it with a 300 ml jar but that would be like 300 days and it seems a lot to me. 
 

would that be ok not too slow or too quick ?

 

many thanks again,

kind regards

 

[[Pa...]]

I think this sounds good and using a 200 ml jar is a good place to start.  The beauty of doing it this way is you can hold for a couple of days here and there if the daily reductions get to be too much.  Being flexible and allowing your body to determine the speed of your taper will ensure your success. 

I'm feeling much better, thanks obi wan. 

[[ob...]]

Many thanks for your quick reply !

[[Pa...]]

Are you comfortable with the mechanics of your chosen taper, you do know you'll need to agitate the suspension before pulling out the dose, right?  Then after you drink it, add more water to get the particles clinging to the sides of the container. 

[[ob...]]

@[Pa...]

Many thanks for this precision. I will do that. I just need to check also with my neurologist who wants to prescribe carmabazepine for my trigeminal neuralgia that apparently can lower the concentration of clonazepam in the blood. I am concerned about potential withdrawal issues but I am in heavy pain so….

many thanks

kind regards 

 

[[Pa...]]

2 hours ago, [[o...] said:

@[Pa...]

Many thanks for this precision. I will do that. I just need to check also with my neurologist who wants to prescribe carmabazepine for my trigeminal neuralgia that apparently can lower the concentration of clonazepam in the blood. I am concerned about potential withdrawal issues but I am in heavy pain so….

many thanks

kind regards 

Excellent decision, I wasn't aware of this but thank you for bringing it up, what you write here will help someone else facing the same situation.  

I'm sorry to hear about your pain.

[[he...]]

It's my understanding that you can dilute Rivotril drops with water to the desired concentration. I know this is often done with Valium liquid.

[[ob...]]

@[he...]thanks yes indeed this is the idea. Using a 200 ml jar and removing 1 additional ml per day. 
 

the other solution is to transition to Valium but I understand that I général people do not favour cross over 

kind regards 

 

[[ob...]]

@[he...] @[Pa...]

hello sorry an additional question but during my 200 day taper I plan to also taper Zoloft that I take since 3 months and a half at a low dose.

would that be an issue ?

many tanks 

kind regards 

[[Pa...]]

Please don't apologize, this is what we're here for. 

We don't typically recommend tapering more than one medication at a time, it can be too difficult to know what is causing what.  Tapers are all about paying attention to your reactions then making adjustments to correct.  I understand you may not want to be on the Zoloft for longer than necessary but tapering it can come with its own set of symptoms which might be too much to handle in combination.

As for crossing to Valium, we don't usually recommend that unless you're suffering from interdose withdrawal as it can come with its own side effects and adjustment period.  However, I've read it can be very helpful for those who have accomplished it.