Clonazepam 0.5mg Taper Advice - Should I re-instate or Hold

[[Kl...]]

I wanted to post a question as I am feeling quite discouraged at the moment.  I started Clonzepam back in 2018 to help with some Panic Attacks that I was experiencing, likely related to job stress.  I was on it PRN from 2018 to about Jan 2022.  During that time, I used 0.25mg for stressful events (maybe a few times a month), but started using 0.25mg a bit for Insomnia in the latter part of 2021.  In Dec '21, I got a mild case of COVID.  It came and went quickly, but about 4 weeks later, I started getting more issues, especially a significant increase in panic attacks and generalized anxiety.  It escalated, and I started taking more Clonazepam.  2022 was a rough year, and I was typically taking either 0.25mg and 0.5mg a day.  I tried to stop and did for about 4 weeks, but the anxiety was awful, enough that I ended up taking time off from work.  After working through an Inpatient Program, I slowly got back to work.  Things were up and down, and my Prescriber wanted me to be on 1mg daily, but we settled on 0.5mg daily, and that is what I have been on since February 2023.  I tried a variety of other meds (Lexapro, Effexor, Buspar, and others), but always felt worse on them so was only using the Clonazepam.

On 13Aug23, I started on Prozac, 10mg, and decide to try and taper down the Clonazepam, because I really want to be off it.  I have had a variety of health issues since 2022, and I really deep down think that Clonazepam, as well as my own anxiety, has caused them.  So I started a 5-10%, every 2 week taper using an online calculator.  As of today, I am down from 0.170mg (dry weight) to 0.145mg and holding.  At first, things were going ok.  I had a couple good days and was feeling confident the Prozac was helping and the Clonazepam taper was small enough not to impact.  But after about 5 days, things have just gotten worse.  Left Sided Headaches, Dizziness, Brain Fog which is impacting my work, and extreme fatigue.  I was a super active person before 2022.  Marathon Runner, Hiker....I just ran 2.5 miles and felt so tired and weak.

So my question is given that I am still starting the Prozac, and feeling awful, should I reinstate back to the full 0.170mg, or should I hold.  Am I just going too fast?  I feel like the 0.5mg was not working like it previously had, which was the reason for starting the Prozac.  I would rather hold, but I don't know how long I can do so at this level of functionality.  I need to provide for the family, but could afford to take time off if needed.  I am just not sure what the right approach is at this point.  There is so much knowledge on this forum, I am hoping someone who has had a similar experience can help give me some guidance, because I am feeling very lost, hopeless, and even writing this message is about all the energy I can muster up.

I will also update my signature when I have a little more energy, but wanted to get this out.  Thanks in advance for any feedback.

Thanks,

Klonobye

 

 

[[Su...]]

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

Left Sided Headaches, Dizziness, Brain Fog

Interesting.  My clonazepam withdrawal symptoms all started left side as well. Tinnitus,  tongue pain and numbness,  and nerve pain in my shoulder and eventually in my left arm.

Of course at the time I had no idea what was happening and as symptoms progressed I thought I was dying.

I know this doesn't answer anything for you but you aren't alone in your specific experience. 

[[or...]]

I am having a lot more left-side headaches as well as Tinnitus, some brain-fog still, had it since my start but it's lessened.  I'm 5 months into my taper, but these all got worse after last taper so I am holding longer this time.  I'm only tapering 3% every 2 weeks basically, and rarely had any sxs to speak of.  Some of mine could be our weather/allergies from pollen, and now lots of smoke from wildfires 18 miles from here.

[[Kl...]]

Thanks for your replies so far. The left sided headaches started about a year and a half ago when I was using Clonazepam PRN. I always wonder now if I was having some withdrawal type symptoms from Kindling then, or if they were unrelated. I haven’t had tinnitus, but I would say generally my left side is always the problematic one.

I’m sorry for your symptoms as well. It is really difficult. It’s like an invisible disease. The fatigue has been the worst over the past several weeks. It’s like I can barely keep my body supported when I am sitting at my desk. I am just not sure if it is just the Prozac kicking in, or if it is because of the taper. I suppose nobody can really tell me that, just interested in thoughts on re-instating back to the full dose to see if it really is the taper causing this.

[[je...]]

Hi @[Kl...]

I'm just checking a couple of things with you so we know we're on the same page. When you say you're on 0.145mg dry weight - are you talking about the actual weight of the pill itself or are you talking about active ingredient? If it is pill weight then it should weigh 0.145 grams right not mg? 

Could you please complete your history? If you click on my avatar you'll see my history as an example. It's very difficult to know if you've tapered too fast without knowing when  you made reductions and how much those reductions were. 

[[Tr...]]

Hey 👋🏼 

I came off of K using a dry cut method for the first 2/3rds of the dose. I was able to do about 5% reductions per month and stay somewhat functional. I worked full time and still was fairly active. It was hard, but I made it work.  
There were some months I had to drop to 2% reduction because it was just too much. 
I was a runner before all of this and tolerance (the unknowns of what was making me feel so dizzy and awful) and tapering really knocked that out unfortunately. 
Personally, I wouldn’t go all the way back to 0.170 - maybe do about half-way back to full dose? If I calculated right you went down by like ~14% ?

My withdrawal pattern was- I felt ok first day or 2 after a drop, then days 3-5 it all hit. Then it would resolve a bit by 10-14days. I would have all the weird physical stuff, and anxiety, and just feel awful. You may be different, it may let up sooner. But day 5 was always rough after a cut. 

I had mostly right side of head stuff - jaw pain, tingling, blah blah blah. Try to ride it out, it was definitely the K for me. So much of that is better now that I’ve been off a while. 

You'll learn what your cut offs are for tapering too fast. Establish that and stay in your zone. 👍🏻 

slow and steady friend!

 

[[Kl...]]

@[je...] Thanks for your reply.  Yes, I made a mistake in my previous message.  0.145g dry weight of the pill is what I am currently holding at.  My reductions were

12Aug23 - 0.170g

13Aug23 - 0.168g

14Aug23 - 0.166g

15Aug23 - 0.162g

16Aug23 - 0.160g

17Aug23 - 0.156g

18Aug23 - 0.153g

19Aug23 - 0.150g

20Aug23 - 0.148g

21Aug23 - 0.145g

Holding at 0.145g since 21Aug23.

I added all my history to my profile, so you can also take a look there for a more complete picture.  Hopefully that helps.

[[Kl...]]

@[Tr...] Thanks for your thoughtful message.  Glad to meet a fellow runner, even if you had to stop after hitting tolerance.  If I could ask, how did you know that you hit tolerance and that it was the Klonopin?  You said the unknowns of what was making your feel dizzy and awful, and yes, that, along with neck pain, stomach issues, waking up in the mornings in a panic state, and also with the morning headaches for me.  I have anxiety issues, but I have said time and time again that I know my body (after having run 10+ marathons over 10+ years, I have a pretty good tolerance for discomfort) and something just doesn't seem right.  But any doctor I see says that it is too low a dose to cause problems, it is a baby dose, that it is all just baseline anxiety or Psychosomatic.  And hey, some of it probably is to be fair, but I can't believe that all of it is anxiety and not something else.  After coming to this site, I feel like there is a huge community of folks that are experiencing the same things I am, so I am hopeful that I can get off this medication and try to go back to my real baseline anxiety, which didn't include all the physical symptoms I now deal with daily.

Thank you for sharing your tapering experience.  I obviously want to get off this, but will slow the taper if needed like you did...Like training for a marathon in reverse.

Also, Congrats on your taper and glad you are feeling better.  How long have you been off?

[[je...]]

Thanks for providing the information @[Kl...]. You have made a 14.7% reduction in 9 days. That is quite steep and my guess would be that this reduction is causing your symptoms. I'm not sure which online calculator you've used and if there's a problem with the calculator or if you've accidentally done your calculations incorrectly? The other issue is you also started another drug at the same time when you made a reduction. This could contribute to symptoms as people react differently to meds. Usually we recommend only making one change at a time.  The fact that you've stopped benzo's in the past could also make withdrawal symptoms worse for you. I do think holding for a couple of weeks would be the best course of action. Can you explain how you are doing your micro tapering?

I also want to chat to you about micro tapering and cut and hold. I have used both methods and both have their pro's and cons. Personally I do think when you're at the start of your taper it's better to do cut and hold. At the start you want to determine what percentage taper your body can manage. It's really difficult to do that with micro tapering because you don't necessarily feel the cuts. The cuts are just building. With cut and hold you will usually feel the cut on a specific day and you will feel symptoms lift after a specific time. I think it's easier to determine the percentage that works for you when you use cut and hold than when you do micro tapering. Once you know which percentage you can tolerate, it's easier to be more confident proceeding with micro tapering.

I hope some of this is helpful. 

 

 

[[Li...]]

Tip of the hat for adding your medication History to your profile @[Kl...].  The outline format you’ve used is very easy to read and understand (many of our members struggle with processing large blocks of text; this is one reason why very long posts in narrative format do not always garner many responses).  

Might I make one minor suggestion regarding your History?  To avoid confusion on the part of future readers, you might want to add a note that you are making reductions based on tablet weight not tablet strength.  In your case, you are using tablets containing 0.5mg of the active pharmaceutical ingredient or API (in this case clonazepam) but the weight of each tablet is 170mg (0.170g) because tablets contain multiple other ingredients in addition to the API.

I agree with @[je...] about the importance of getting a read of what taper rate you can tolerate as well as your withdrawal pattern (i.e. how many days it takes for withdrawal symptoms to emerge, peak, and stabilize).  One way to accomplish this is via cut and hold.  Another way to accomplish this is to make a series of small reductions equivalent to the target taper rate followed by a hold.  

[[Zi...]]

On 24/08/2023 at 10:42, [[K...] said:

I wanted to post a question as I am feeling quite discouraged at the moment.  I started Clonzepam back in 2018 to help with some Panic Attacks that I was experiencing, likely related to job stress.  I was on it PRN from 2018 to about Jan 2022.  During that time, I used 0.25mg for stressful events (maybe a few times a month), but started using 0.25mg a bit for Insomnia in the latter part of 2021.  In Dec '21, I got a mild case of COVID.  It came and went quickly, but about 4 weeks later, I started getting more issues, especially a significant increase in panic attacks and generalized anxiety.  It escalated, and I started taking more Clonazepam.  2022 was a rough year, and I was typically taking either 0.25mg and 0.5mg a day.  I tried to stop and did for about 4 weeks, but the anxiety was awful, enough that I ended up taking time off from work.  After working through an Inpatient Program, I slowly got back to work.  Things were up and down, and my Prescriber wanted me to be on 1mg daily, but we settled on 0.5mg daily, and that is what I have been on since February 2023.  I tried a variety of other meds (Lexapro, Effexor, Buspar, and others), but always felt worse on them so was only using the Clonazepam.

On 13Aug23, I started on Prozac, 10mg, and decide to try and taper down the Clonazepam, because I really want to be off it.  I have had a variety of health issues since 2022, and I really deep down think that Clonazepam, as well as my own anxiety, has caused them.  So I started a 5-10%, every 2 week taper using an online calculator.  As of today, I am down from 0.170mg (dry weight) to 0.145mg and holding.  At first, things were going ok.  I had a couple good days and was feeling confident the Prozac was helping and the Clonazepam taper was small enough not to impact.  But after about 5 days, things have just gotten worse.  Left Sided Headaches, Dizziness, Brain Fog which is impacting my work, and extreme fatigue.  I was a super active person before 2022.  Marathon Runner, Hiker....I just ran 2.5 miles and felt so tired and weak.

So my question is given that I am still starting the Prozac, and feeling awful, should I reinstate back to the full 0.170mg, or should I hold.  Am I just going too fast?  I feel like the 0.5mg was not working like it previously had, which was the reason for starting the Prozac.  I would rather hold, but I don't know how long I can do so at this level of functionality.  I need to provide for the family, but could afford to take time off if needed.  I am just not sure what the right approach is at this point.  There is so much knowledge on this forum, I am hoping someone who has had a similar experience can help give me some guidance, because I am feeling very lost, hopeless, and even writing this message is about all the energy I can muster up.

I will also update my signature when I have a little more energy, but wanted to get this out.  Thanks in advance for any feedback.

Thanks,

Klonobye

@[Kl...] are you still taking Prozac? How is that working for you? I just started taking Fluoxetine (Prozac) 3 days ago to try and help with my depression during my taper off diazepam. I have been struggling lately and probably due to my taper. I am hoping the Prozac will help. I have noticed a bit more anxiety in since starting it. I am also very fatigued and struggle with insomnia! I hope you are doing ok. 

[[Kl...]]

@[Zi...] I am still taking the Prozac (since August 13). I am really not sure if it has helped or not. I have had some really good days, like yesterday, and some really bad days, like Saturday. There does not seems to be any particular pattern I can determine. I did a cut from 0.145g to 0.140g (dry weight of pill) last week, so that might also be partially responsible. But I have had days where I will get extremely fatigued, and also have not been sleeping as well since I started Prozac, but since I have made cuts to the Clonazepam at the same time, I am not sure which, if either is causing it. I wish the response was more help, but I am just not sure. Always trying to understand it all myself. I hope things are going ok for you as well. 

[[Zi...]]

@[Kl...]thanks for the reply. Yeah I think maybe your clonazepam cuts could be causing bad days. I am not sure on that. I am holding on my current diazepam taper until I can get more stabile. I just feel so anxious and out of it plus fatigued and depressed. I hope the Fluoxetine (Prozac) will help me. I am on day 4 of taking 10mg. I started September 4. 

What dosage of Prozac do you take and what time of day do you take it? I started in the morning but switched to around noon now. Not sure if it will make much difference. 

Hoping we all get better soon! This is a tough battle. 

[[Kl...]]

@[Zi...] Yes, I am the same. Anxious, fatigued, and I wouldn’t say depressed, but worn down from this battle. 
 

I was taking the Prozac (10mg) in the morning at basically the same time as the Klonopin, but by the mid morning/afternoon I was so tired that I was falling asleep at my computer. So I switched to taking the Prozac at 3pm. I think this helped with the fatigue. Not completely, but I have had some good days. It is honestly hard to tell anymore what is causing what, but for now I’ll stick with those times.

We will all get better. There are many success stories here that keep me inspired. Let me know how the change to 12 goes. Hope you get some relief soon.

[[or...]]

On 24/08/2023 at 20:18, [[T...] said:

Hey 👋🏼 

I came off of K using a dry cut method for the first 2/3rds of the dose. I was able to do about 5% reductions per month and stay somewhat functional. I worked full time and still was fairly active. It was hard, but I made it work.  
There were some months I had to drop to 2% reduction because it was just too much. 
I was a runner before all of this and tolerance (the unknowns of what was making me feel so dizzy and awful) and tapering really knocked that out unfortunately. 
Personally, I wouldn’t go all the way back to 0.170 - maybe do about half-way back to full dose? If I calculated right you went down by like ~14% ?

My withdrawal pattern was- I felt ok first day or 2 after a drop, then days 3-5 it all hit. Then it would resolve a bit by 10-14days. I would have all the weird physical stuff, and anxiety, and just feel awful. You may be different, it may let up sooner. But day 5 was always rough after a cut. 

I had mostly right side of head stuff - jaw pain, tingling, blah blah blah. Try to ride it out, it was definitely the K for me. So much of that is better now that I’ve been off a while. 

You'll learn what your cut offs are for tapering too fast. Establish that and stay in your zone. 👍🏻 

slow and steady friend!

This is the best post I've seen in awhile because it is how I am doing my taper and feel pretty good, able to function in my normal daily routines.  It's good to know someone that has done it this way, and then got to take their last dose, and you are better now.

Thanks much for sharing it as it made my morning for sure.  I'm usually holding about 14 days which I think I can cut a bit more often, now that I am seeing how things are going, but maybe I will and maybe I won't just depends on how I feel.  Anxiety seems to be my worst sx, and it causes me to shake uncontrollably which is very hard when other people are around me.  But I'm dealing with that, learning I just need to get home, and chill out Denise