Clonazepam vs Trileptal. Which should I taper off of first?

[[St...]]

Hi I’m Steve. 48 year old male. I been taking between 1.0mg up to 2.0mg of klonopin for the last 18 years. I have been taken 1500mg of trileptal for the last three years.

My concern is which medication should I taper off of first? I hate the side effects of the trileptal and have started tapering from 1500mg to where I’m currently at which is 1200mg. I’m in a four week holding pattern and at that time the plan is to reduce to 1050mg assuming everything is ok at 1200mg. 
Is it better to taper from the klonopin first? Or continue coming off of the trileptal and then between a slow tapering process off the benzo?

I have read documentation that the trileptal can cause the klonopin to lose some of its effectiveness. Has anyone had experience coming off of a mood stabilizer and a benzo? What would you recommended? I have already weaned myself off of my SSRI and topamax. I’m fully committed to living my life psych med free after being hooked on this junk 18 years ago. 
Any advice or words of your experience would be greatly appreciated. I look forward (well I scared to death of benzo withdrawal symptoms) to eventually reclaiming my life even if it takes a couple of years to get there. Looking forward to sharing experiences with everyone who suffers from benzo dependency and getting clean and helping others recover the way I hope to for the rest of my life. 
Thank for reading this! 
Steve 

 

[[Br...]]

Hello @[St...] - welcome to BenzoBuddies!  I'm glad you understand the importance of tapering one drug at a time, as well as tapering gradually, and that this process can take some time.  The focus of BB of course is benzos but my understanding is that mood stabilizers like trileptal need to be carefully and slowly tapered.

In making your decision about whether to taper off Klonopin or trileptal first I would start by checking drug interactions using this link: 

http://www.drugs.com/drug_interactions.html.

I have a few questions because sometimes more information helps us get a better idea how to help you. What are the side effects of the trileptal that are bothering you.  You mention you have held the trileptal dose at 1200mg for the pasts four weeks.  What is the reason you're holding? Is it because of withdrawal symptoms?  Are you having any bothersome issues with the Klonopin?

 

 

[[St...]]

Hi Brighterday,

               I have actually looked at the interaction guide and the concern is that taking trileptal can cause the Clonazepam to metabolize faster causing withdrawal from the Clonazepam to occur.
                 Trileptal seems to have so many side effects. I spent nine days inpatient last November because of suicidal ideation. I have suffered massive weight gain, developed acid reflux, abdominal pain, ED, numbness in hands and feet. 
                    I’m actually only 8 days into the four week hold. My new psychiatrist and I agreed I would hold to see how I react to the reduction in Trileptal before reducing dosage again. I actually just met this doctor last week and he is the first doctor willing to work with me to taper off of my prescription meds. That is a minor miracle in itself. 

                       I’m not aware of any issues  with the klonopin. I have been on it for so long I only seem to notice it if I miss dosages, which I never do. 
                        I have also recently tapered off of SSRI and quit Topamax cold turkey (which was stupid) and I’m sure I may be feeling some withdrawals from the SSRI (Vybriid) still. 
                         Right now I have mild to moderate withdrawal symptoms nothing too severe. My plan currently is to taper off of trileptal and when I am free of that begin the hellish withdrawal from Clonazepam slowly and safely. 

[[Br...]]

@[St...] - I'm so glad you have a psych doc who will work with you collaboratively. I agree that's a minor miracle in itself!  It sounds like you have made your decision to taper trileptal first.  Your reasons seem very sensible. 

Survivingantidepressants.org suggests tapering at a rate of 10% per month, based on the last dosage you took.  If you experience withdrawal symptoms they suggest making smaller cuts.   

As far as tapering Klonopin when you get to that point, we typically suggest tapering with cuts of no more than 5-10% of your most recent dose every 14 days or so depending on your symptoms.  We find it is best to let your taper be guided by your symptoms as opposed to adhering to a rigid schedule.

 

[[St...]]

I definitely didn’t want to do this without a trusted doctor. Somebody has to keep filling the prescriptions while I’m tapering off and I need someone to work with me because I know there will be unexpected symptoms coming off of this stuff. I have faith that my new doctor will allow me to lead (he doesn’t have a choice lol) and hopefully he will be there to provide needed guidance and assistance. 

My first dosage reduction for the trileptal was a 20% reduction and I am going to reduce closer to 10% from my current dosage (it is planned to be 12.5% reduction) each time I reduce the dosage for the trileptal. 

when I start to taper off of the klonopin it will never be more than 10% of whatever the current dosage is and more realistically it maybe be 5% reduction or even 2.5% reduction hopefully at evenly spaced intervals. Ultimately my brain, body and central nervous system will let me know what it can and cannot handle. 

im still planning on getting off the trileptal first. I’m concerned about how the trileptal might reduce the effectiveness of the klonopin. I am thinking the less trileptal I have in my system, the less effect it would have on the klonopin so I am planning to stay the course I am currently on. Of course, plans can always be changed! 
 

I am very familiar with surviving antidepressants.org website. It has great info on how to taper slowly and safely. I’m planning a dry micro taper off of the klonopin using the Ashton manual as my main reference for getting off benzo forever. The doctor can hopefully help with things like liquid dosing or other ways of coming off the drug that I’m not familiar with. 
 
im sure im not in the minority saying I wish I could just get this over and done with but I know I am just beginning the longest and most difficult journey I have ever taken. Im grateful for your responses Brighterday and I’m grateful there are communities like this that can help and save people from this awful benzo epidemic. 

[[Br...]]

Sounds like a great plan @[St...].  Please reach out for support, input or to bounce ideas around whenever you'd like.  I hope you'll keep us posted on how things are going.  Wishing you all the best.

[[St...]]

Thanks Brighterday! I just read your success story. 2mg of klonopin in 5 weeks. Holy hell. I’m on 1.5mg of klonopin and I’m thinking it will take me anywhere from 12-24 months to complete a slow taper. And I’m still terrified what that will feel like. 
 

I will definitely be very active in this community. I’m not shy about sharing my life experiences and I want to get well and help support others as they try to do the same.