Taper help

[[fo...]]

Hello. I am wanting to initiate a taper from 1 mg clonazepam and I am currently suffering long Covid and not doing well. The damage that Covid does to the brain is immense and I knew I could handle a scale and to cut and file etc. if someone could review this plan and see how this looks I would be so appreciative. I am starting with 300 ml and going from 1 mg to 0.75 mg in 75 days with 15 day golds at each incremental decrease. Decreases are 5%, 5.3%, 5.5%, 5.9% and 6.25%.

 

Then I decrease from 0.75 mg to 0.5 mg over 100 days with 15 day holds. These vary from 5% to 6.7%.

 

Next I decrease from 0.5 to 0.25 over 150 days. Holding 15 days and percentages are 5, 5.3, 5.5, 5.9, 6.25, 6.7, 7.14, 7.7, 8.3, and 9.

 

I don’t have a plan yet for the 0.25 and below. This is 325 days to go from 1 to 0.25 which seems a good pace. The last few cuts may be a bit high. I planned to just water taper knowing I would have to agitate the jar. 

 

Can someone see if this looks reasonable? I don’t have a Compounding pharmacy near but know the one 80 miles away can ship to me. This method seems simpler and my husband will help. I really appreciate any help.

 

If using 300 ml and just decreasing 1 ml daily is better please let me know but in my view I really like the holds and trying to keep some kind of a percentage that wasn’t over 10.

 

Thank you

[[fo...]]

Oops that should say could NOT handle a scale etc.

[[fo...]]

Anyone?? Really would love some help here. Thanks

[[fo...]]

Going to try one more time. Anyone able to look this over for me? Does this water taper seem safe? Any admin free to help me here? Thanks

[[Lo...]]

I found this video helpful.

 

Seems like it could suit you pretty well. Granted I have no experience I've only been on clonazepam for 3 months and am starting to taper now but it seems like a pretty simple method to follow. I hope you make out alright.

[[fo...]]

Thank you. Yes, I’ve viewed this multiple times and she is very helpful. I really was hoping an Admin could look over the plan as far as numbers etc and give me reassurance that it looks like a decent plan moving forward. I thank you for replying. I’m really needing the help to go forward.

[[...]]

formy4kids,

 

You are making a very common mistake.  You are getting stress and anxiety from trying to make a taper plan to cover the future days.  You have all kinds of changing (like every 15 days).  Your mistake is, no one can predict how a taper is going to go.  You put all that work and planning into a taper with so much detail and then when you try it, things will change and all that math must change.

 

You must learn to not worry about the future and every detail of your taper.  It will create anxiety about being perfect and anxiety makes the withdrawal much worst.

 

Instead, pick a simple taper and tell yourself, this is good for a few weeks but I am ok to change it if I need to.  Keep a journal of your dose and symptoms so your can detect when things are going well or poorly and make adjustments.

 

Also remember, all tapers will have withdrawal.  There is no perfect taper. Searching for it will exhaust you. 

 

In my opinion, a daily tiny taper is smoother than a cut and hold.  So yes, I think the water method of 300 ml and just decreasing 1 ml daily is better. 

[[fo...]]

I appreciate your knowledge. I have paid attention through watching others and seeing feedback.  I have attempted to start a taper multiple times but life has been very difficult lately. I had some great input months ago, then lost my father. I then came to the forum again and was diagnosed with long Covid and was far too sick to begin a taper. The one resounding point was that I want to stick around a 5% decrease because of the length of time I’ve been on the K. I also heard a lot about the importance of holding because it was stated that symptoms won’t appear until that time and it gives my brain the opportunity to heal a bit at each stage and I’ll know if the pace is right for me. In the signature of other members taper plans I see holds more often than not at each decrease so I thought I was helping myself. I am not attempting perfection, but I’m trying to decrease at a rate that has the best chance to keep me as functional as possible and let my brain adjust along the way.

Peace in the plan decreases my anxiety. I felt less anxiety having this plan that kept percentage drops at a reasonable amount and had some holds but if it’s less likely to be smoothe and gentle that’s definitely something I need to consider. I see people holding their dry taper and compound taper amounts 10-14 days regularly and saw this encouraged. I guess I’m confused. I thought I had s good plan here thank you for your input. Can you tell me this? With the 300 ml microtaper going down one ml each day from 1 ml K …….at what point am I at approx 0.5 mg K? I guess I have some thinking to do. I feel defeated.

[[...]]

You want to know when you will be at 0.5mg if you do the 300 mL water method?

 

Well, since you are at 1 mg right now, then it would be at day 150.

 

Do not feel defeated.  This is a process.  You will have good days and bad days.  When the bad days happen, remind yourself a good day is coming.  Bad days cannot last forever.

 

[[fo...]]

Thank you very much. And if I’m struggling, the answer would be to increase the volume of water a bit to decrease the amount coming out, correct? Say I’m having withdrawals that feel undoable, I could increase to say….450 ml…..and continue? (Didn’t choose 600 because that’s just in my mind a long time to taper without it taking a very mental toll). Would that be correct that I could increase the water volume and stay with 1 ml and that would just slow the taper some? Yes I’m looking at the future but for me, it really helps the anxiety.

[[or...]]

In my opinion, a daily tiny taper is smoother than a cut and hold.  So yes, I think the water method of 300 ml and just decreasing 1 ml daily is better.

 

 

I did something similar and had a pretty smooth taper from 3 mgs. I had to make adjustments as I went along, but it was sure better than cut and suffer, er hold.

 

Best wishes,

 

Katz

[[...]]

Yes, that would slow down you taper.

 

You can also hold.  For example, assume you started with 1 mg of your benzo in 300 mL of water. 

 

Also assume you just finished your first 7 days like this:

Day 1 you removed 1mL and drank 299 mL

Day 2 you removed 2mL and drank 298 mL

Day 3 you removed 3mL and drank 297 mL

Day 4 you removed 4mL and drank 296 mL

Day 5 you removed 5mL and drank 295 mL

Day 6 you removed 6mL and drank 294 mL

Day 7 you removed 7mL and drank 293 mL

 

BUT THEN you felt sick.  You could hold, removing 7mL and drinking 293mL, until the symptoms were tolerable enough to continue.

[[Li...]]

One of the disadvantages of making fixed-amount reductions in dose is that the monthly taper rate (percent reduction over 30 days) increases over time.

 

For example, here are the monthly percent reductions from 300mL to 0mL:

 

300 -> 270 = 10% reduction

270 -> 240 = 11.11% reduction

240 -> 210 = 12.5% reduction

210 -> 180 = 14.29% reduction

180 -> 150 = 16.67% reduction

150 -> 120 = 20% reduction

120 ->  90 = 25% reduction

90  ->  60 = 33.33% reduction

60  ->  30 = 50% reduction

30  ->    0 = 100% reduction

 

Given your stated goal of trialing a taper rate of 5%, you might want to evaluate your response to that rate by holding your dose constant for a ‘processing period’* when your reach 285mL (Day 15).

 

*Clonazepam has a relatively long half-life, so it can take a while (e.g. 6-12 days) for the blood serum concentration of the drug to return to steady state after a dose reduction (or series of reductions).

[[fo...]]

Thank you Libertas. I had posted a plan but I now don’t see it here. It was given to me by a friend that recently water tapered. It is broken down in to phases. 1 mg down to 0.75, 0.75 to 5, 5 to 2.5 then 2.5 to 0. Each amount drawn is held for 15 days. The amt of fluid is altered in each phase to keep a percentage between 5-7.9. The holds seemed like a good idea for brain healing along the way and it kept the percentage of change between doses more consistent.

Im not a wealth of knowledge for sure. I only know I want to get it right the first time, and I know I’ll have symptoms but I have to remain functionable. My dad just passed and im taking care of my mom.

 

So you feel going from 300 ml to 0 drawing out 1 ml daily is a better plan, Libertas? Or is what I was speaking of reasonable? Bob has been great help. Im just very full of anxiety because long Covid has my brain locked in fight or flight so my CNS is already very unstable. The autonomic nervous system not functioning gives all the same symptoms that tolerance w/d would and im trying to figure out what’s causing what? Thank you

[[fo...]]

Bump. Libertas, can you share any thoughts on a straight microtaper versus instituting holds at each decreases and trying to keep a percentage more steady by breaking this down into phases? Thank you

[[Li...]]

Hello, formy4kids.  I’m sorry you are struggling with long COVID.

 

I am not a proponent of fixed amount reductions in dose for the reason I explained in my previous post (i.e., the taper rate increases over time).

 

I also am not a proponent of planning an entire taper from start to finish. IMO it encourages risky behavior (i.e. the individual follows the plan blindly instead of monitoring their symptoms/functionality and adjusting their taper as needed).  It’s also a waste of time — I have yet to encounter a member who has been able to successfully discontinue their benzodiazepine by following a taper plan from start to finish. Indeed, one could argue that making adjustments based on symptoms/functionality is one of the keys to a successful taper.

 

You have told us you wish to try a taper rate of 5%.  I suggest you do this and see how it goes. 

 

I also suggest you consider finding, vetting, and working with a compounding pharmacist who (1) has expertise in preparing stability-tested liquid formulations of clonazepam and (2) is willing to help you with the practical aspects of tapering (e.g. how your doctor should write the prescription, how to make adjustments in your taper rate, how to calculate your doses). Member Boges11 has found such a pharmacist in Arlington, TX (Nick at Pharmacy Solutions) — although he may not be able to work with you directly due to rules/regulations regarding shipping of controlled substances across state lines, he may be willing to consult with you or a suitably qualified compounding pharmacist in your state.

[[...]]

I want to support Libertas statement - do not try to plan a taper from start to finish. 

 

You will spend too much time trying to "control the future" and that gives anxiety and anxiety makes withdrawal symptoms worse.

 

It is best to just drop a little, monitor your symptoms (you will ALWAYS have symptoms), and adjust your reductions so the symptoms are tolerable.

[[fo...]]

Hi Libertas. Thank you for your reply. Yes, I too have had issues with the water taper because while on this site and learning from others, I’ve heard it stressed so strongly to try to stay at an even percentage of reduction and that holding helps the CNS heal along the path. I of course was going to ask questions about this and be proactive because I really want to get it right the first time. I know subsequent tapers are more complicated.

Libertas my husband is willing to dry cut and measure for me and that way I would stay at 5%. I don’t know how you feel about dry taper/weighing/filing?

The nearest Compunding pharmacy is 80 miles away. I had really planned to taper without my primary care being aware because I’m uncertain she wouldn’t give me 90 days to get off. So keeping tablets sounded like the best plan.

For me, having an entire plan alleviates my anxiety. That in no way means I won’t be flexible as I proceed or won’t be aware I may have to change.

I just want a slow, stable taper and to remain able to function. If that means 3 years to taper so be it.

[[Li...]]

Regrettably, I have zippo experience with dry tapering/titration.  However, I do know we have members (past and current) who have used this approach successfully with clonazepam.

[[fo...]]

Thank you. I believe maybe buddie did? I do appreciate your thoughts and will keep working on the mental aspect. Long Covid really did a number on my CNS so this has all been really overwhelming. I’ll get there

[[Li...]]

You’re welcome, formy4kids.  If memory serves, the following members are dry tapering/titrating clonazepam: jillybean, hereforhelp, Rocknroll, and Agenthall.  I’m sure there are others.

 

Tip of the hat for recognizing that ‘feeding’ your mind (nervous system) healthy (calming) thoughts and behaviors is just as important as feeding your body healthy food during benzodiazepine withdrawal. 

 

For example, you’ve indicated you need a taper plan (or, more accurately, a taper calendar/schedule) to ease your anxiety.  I wonder if it would help you to consider that you already have a taper plan?  That is, you’ve identified a dose reduction technique (dry cutting) and a taper rate (5% every 2 to 4 weeks) you wish to trial.  You have created (or soon will create) a daily taper journal to record the date, doses, and global ratings of your symptoms and functionality.  You will review the data in your journal on a regular basis to determine if you need to make adjustments in either your technique, your rate, or your reduction interval.  If so, you’ll make the adjustment(s) and repeat the process. 

[[or...]]

I know what it's like to be new and excited about feeling like myself again, my long lost self.  I've taken Clonazepam for 35 years at 1 mg. and info on whether or not it dissolves in water alone has been essential for me to learn.  I should say it is just my opinion and I'm no professional, but I do believe it does not dissolve in water alone, enough for me to trust it as giving me the dose I would plan.  And no, nothing is perfect, or simple, in the taper, but people are doing it, and we can too

 

I also watch out for reckless information and have to do as much homework/research before I decide anything.  If something sounds too good to be true, that's a good sign for me to avoid it.

 

I have a lot of hope though and faith as well that I now stand a chance to be rid of the drug, and get back to some real quality of life 

[[fo...]]

Thank you Oregonlady. Those were my concerns as well, yet I do read many successful tapers with water so it must be working in some way. I was more concerned about the lack of stability in the decrease as far as holding a percentage and had originally learned how important that is. I also felt like holds were something that helped the CNS heal along the way. Dry cut allows me to stay at 5% and hold but I’m not excited about the weight, file, etc piece or the math.  I am concerned about the dosing in water as well but like I say, people do it.  Do you mind sharing what has worked for you?

[[or...]]

Well, I'm very new but I did dry-cut my first taper which I feel was just ok for me, but not with future cuts as I get lower doses.  I dry-cut .75 just using my thumbnails to break the 1 mg C and then the half I break into halves and just take .75 mg.  I doubt that is accurate but I've survived.  When I did that, I hadn't found BB and now I'm learning a lot, although it's hard for me to retain info, and short-term memory isn't the best.

 

I had a plan to water taper but I have a pretty bad tremor and slopped water when I tried the "jar" method in that video someone sent you.  I also am concerned about the suspension of my home-made liquid with the C.  I'm looking at a video on Pamster's Dry cutting using a scale.  I just feel more secure to be honest, taking the dry powder, or chunks rather than putting them in water.

 

It is true, I see some folks doing it and doing it successfully, it really does depend on the individual.  I have that tremor so even working with powder or teenie chunks will be stressful at some point but maybe once I'm used to it, things will mellow out   I want to dry-taper with very small amounts and .03% sounds good for a start. I wouldn't do a taper of another .25 tablet again even though I've survived it so far with few major wd sxs Denise

[[fo...]]

Hi OregonLady. I’m curious how you are doing? Which taper method did you choose and how is that going for you? I hope well. Give me an update when you can, and I’m crossing my fingers for you!