Need help to know what scale to use

[[El...]]

Hello. 

I am currently taking 12.5mg of diazepam which I'm not touching for now, only holding because I've been trying to stop Seroquel XR for more than a year, and am now at 2.8mg (I was given 25mg to sleep... Until it made everything a hell) 

The big problem is that I am unable in France to get an instant release form of the medication, so I have to compose with 50mg Seroquel XR (25 don't even exist in France...) and I've been crushing the pill in liquid to do a 50mg/50ml liquid solution. The problems started when the pill started refusing to disolve and I felt massive differences in the doses I took with my pipette. 

What I want to try and do :

Cut the lowest amount of pill (like 5mg) that would register on a digital scale, and do the same process but rather than keep the liquid with 50 mg, do it for 5mg and from that, just take a unique dose in the evening just like I've been doing. I think it might mean my dose would be a lot more accurate since I'd be handling a smaller amount of liquid and medication concentration. 

I do need assistance for scales, because I have no money to spend on crazy expensive scales. Would someone be willing to walk me through the best ones and if they think this technique would maybe be best, rather than what I've been doing which clearly is messing up my NS badly. 

 

Thank you for reading, I'm really out of options here so I'd rather go ahead and try that rather than stick with that technique that harms me. I'm almost there, 25 to 2.8mg is great but... I'm really exhausted of withdrawal and I want to move forward. I appreciate any help and tips you could give. 

Courage to everyone. 

[[Co...]]

Hello @[El...]. Welcome to BenzoBuddies.

Other members are probably better at directing you to specific products. But as it happens, there has been quite a lot of discussion at BB about scales of late. I would advocate for using inexpensive scales.

Rather than me repeating myself, and so that you read the comments from others, I will instead link to the relevant threads:

I made several posts to this thread; my first post is here:

Several posts to this thread:

And this post of mine includes some comments (from some who operates his own lab as part of his business) about what type of scales might be suitable:

I'm sure others too will be along to comment here.

[[El...]]

Hi @[Co...] and thank you for the reply.

I did have a look at these threads, I have ordered scales on the inexpensive side, even though I doubt I'd be able to figure out how to measure exactly fine cuts bellow 10mg for instance, every review I've read on the subject of medication tapering kind of trashes these scales. 

So hopefully what I'm trying to achieve by doing a combination of weighing the closest amount that'll be exact (probably 10mg), disolve into liquid (I'll have to have a look at these liquids to help dispersion, I have no clue where to find those) and then use this to measure a few doses out of it with syringe will be a good method. 

I've had such a horrible time stopping this medication, and I don't even know whether it'd be strategic to start a water titration taper of the diazepam BEFORE stopping Quetiapine altogether. At this point I'm honestly very tired, it's been years I've been on this warpath with medication (I know I'm not alone in this, but it feels very much like it, often, because there's a clear lack of physical help and structures to help). 

So for now, first things first, find a way to stability with the Quetiapine doses. I'll need to see about the rest afterwards. 

If there's any tips on how to use scales accurately, like adding weight to it maybe to measure rather than start out at zero (I've read some comments on some scales about the problem with weighing incredibly small quantities starting out at zero of digital scales) 

I'd appreciate any help, especially if there's anything like a physical structure / some kind of guide to help me find the support I need around me (I'm very isolated and would like that to stop :))

Merci beaucoup (thanks a million) 

El. 

[[Co...]]

Hi @[El...]

The thing to remember is that you are not measuring 10mg of benzodiazepine, you are measuring a powder created from crushing a pill, which contains excipient ingredients. You will see in the example in the post I link below, where I describe that the active benzodiazepine ingredient forms only one part in 343 of the pill. So, 10mg of benzodiazepine would equate to 3.43g of ground pill.

All things considered, weighing a ground pills and subdividing that using scales will be more accurate than creating a liquid. Even if you producing the liquid after first subdividing the pill using scales, you are likely to be introducing greater inaccuracies when creating a liquid.

Once you receive your scales, we will help you get the most out of it.

[[El...]]

Thanks again for this.

My apologies the first time I read it through it came out as the same usual nonsense math always feels in my brain and I'm very foggy today. So, if I understand correctly, from the pill itself that I'm crushing, the actual medication is a lot less than the total; so I'm virtually taking extremely small amounts presumably? 

I will need to be helped to calculate the doses of crushed pills then yes, but that's good news to me if it's the case. It means I'd be likely far more down the line of tapering than I thought? 

 

I wouldn't rely on liquid if I could just crush the pill and take the right amount measured by the scale. I just doubt it'll calculate 2.8mg accurately, from everything I've read on them. They're not even sensitive enough to get me that . 8 so... 

I am very very sensitive to getting lower dose, jumping from 2.8 to.. 2mg would probably be too much at jumps at this stage. 

Thank you for saying that I would get some help to make the most out of the scales though. I truly appreciate it. 

 

 

Edited December 12, 2023 by [El...]

[[Co...]]

Hi @[El...]

Our aim is to divide the pill into smaller amounts than is practicable via usual pill-splitting. If we use a pill cutter, we can probably divide the pill (roughly) into quarters - in the majority of cases, this is good and accurate enough. But if we wish to divide the pill into smaller amounts, we need to get a bit creative.

The post of mine I linked exampled a 0.5mg Klonopin pill which weighed 171.5mg (0.1715g) in total. If we wish to divide the pill into 10 parts, each part would weigh (approximately) 17.2mg (0.017g) which is achievable, even with inexpensive jeweller-type digital scales).

Your scales are unlikely to measure to that many decimal places for 171.5mg (0.1715g). So we would round this up to 0.172g (and the weight of individual pills will vary anyway).

If we decide to reduce our dose 10% of the dose of the pill, this would equate to 0.0172g. So, if wished to take 40% of the pill, that's 4x0.0172g = 0.0688g (round this to 0.069g, which is probably the limit of accuracy for your scales).

But the approach I would take is this: since each pill weighs about 0.17g, we might decide to divide the pills into seventeen 0.01g parts. This approach removes the need to make any calculations. So, we would reduce the amount taken by 0.01g of the ground pill with each step. This means that it would take 17 steps to taper off the 0.5mg pill. We would just allow a reasonable number of days (which can adjusted according to how we react) between each step. For someone tapering off 0.5mg Klonopin utilising typical pill-splitting (into quarters), they might allow 1-2 weeks between each cut. So, it might take them 4-8 weeks to complete their taper. I example this to help inform your own rough guide for how many days to allow between each cut of 0.01g of a pill.

If we wished to make even smaller cuts (in this same example), we might make thirty four 0.005g cuts to our dose. (This is probably getting quite close to the accuracy of inexpensive scales - but I would argue that this is entirely good enough for our purposes.)

The above are just examples - it likely will be different for you. The key is to be able to make smaller cuts than what might be reasonably achieved using a pill cutter. That's all really.

When you receive your scales and have set it up (and possibly, calibrated it), the next thing to do will be to weigh individual pills. I expect we will be able to devise a system which will allow you to make very small cuts (as small as you wish within reasonable limits), and also remove the need for maths.

[[An...]]

Hi @[El...] and welcome to BB friend.

How long have you been on the seroquel? I looked at your profile. Says you have been on the valium for 6+ years. You are currently down to 12.5. How much were you taking before you started tapering? Did the seroquel help in the beginning with sleep? You said it made everything a living hell.

[[El...]]

22 hours ago, [[C...] said:

The above are just examples - it likely will be different for you. The key is to be able to make smaller cuts than what might be reasonably achieved using a pill cutter. That's all really.

When you receive your scales and have set it up (and possibly, calibrated it), the next thing to do will be to weigh individual pills. I expect we will be able to devise a system which will allow you to make very small cuts (as small as you wish within reasonable limits), and also remove the need for maths.

That'd be great really @[Co...] thank you. I obviously can't weigh the pills yet and I have two different kinds (one pharmacy had one brand, another one another) but it's great if we can figure out a way for me to be able to stabilise (I am not stable at the moment with the whole liquid system gone crazy the past week and before that it wasn't stable either I'd say, just a lot more manageable...) 
I am meant to receive within a week, which is a long wait considering how much I'm in need of stable dosing, but... I'll hang in there. 

Hi @[An...] and thank you for the welcome. 

I've been taking Seroquel for more than a year and half, started around may/june 2022. It completely drugged me to sleep, and was for the short term (a few weeks) necessary to help me ease some insomnia but afterwards it became a hell because of the sheer horror of the nights themselves (terrible night terrors, interrupted sleep, constant grogginess, foggy brain, concussion feelings in my brain, I couldn't function basically and the terror/deep anxiety stayed during the day, so I made the decision to start cutting and have been doing so since last winter. So a year of taper so far...) 

Yes, I'm at 12.5 mg of Valium because I was beforehand taking 15mg at day, and before the Seroquel (and the other stuff given for help to sleep) I wanted to cut it entirely out, I almost succeeded, was almost at only 4mg or so but I had a major health related issue that sent me to hospital, and couldn't continue taper during this time. So... I'm tired  
very very very tired. I'm hanging on at the moment for the sake of my partner who'd do pretty much anything to help and give me love, which is awesome and more than I ever had, hanging on because I'm an artist and I've got things to say, to create, and that keeps me going, but I gotta be honest... this is the bane of my existence. As i'm sure is the case for everyone on here. Nothing new but still worth saying. 

Thank you for asking  

[[VI...]]

jewelry scale. can be had on amazon. I have one accurate down to the .001g.

[[Co...]]

17 hours ago, [[V...] said:

jewelry scale. can be had on amazon. I have one accurate down to the .001g.

Yep. Just look over the reviews for one that's reasonably reliable. But they can be had for a few tens of dollars, and are generally good enough for our purposes.

[[El...]]

 

Yes I've gotten one that should arrive by the 20th hopefully. I'll let you know once I've received it. 

I'm really having a hard time right now so I hope the more precise calculation of dose will make my life a lot easier. 

 

[[Co...]]

It will be OK. We we will come up with a method which makes it easy for you - no maths - just simple, very straightforward measurements.

[[An...]]

Just now, [[C...] said:

It will be OK. We we will come up with a method which makes it easy for you - no maths - just simple, very straightforward measurements.

👍 @[Co...]

[[Co...]]

Hello @[El...]

Are you still attempting to make a liquid from your Seroquel XR? It is my understanding that it is not suitable for the reasons you mentioned in your opening post.

[[VI...]]

Even with the scale, there could be problems with dosing. Ill explain: If you weigh the pill and say for example you have a 50mg pill that is 100mg -you know 50mg is active and 50mg is inactive. If the pill is scored in half, there is 25mg in each side guaranteed. Now here comes the issue/the problem: WHERE in that quarter would be the 25mg located? No one knows for sure because beyond any scoring, they're not required to make it precise. If you sliced the pill into 1/8ths you could get a 1/8th with all 25mg or 0. another example would be like 19 and 6....and so on Make sense? This is why for your purpose; the scale would probably not work as well in this situation, unless you were able to get ahold of 99% pure seroquel powder, which is unlikely for the 'normal person'. 

If you are using water as a solution, you're not doing it right with this specific medication.

Everyone just wants to "throw it in water and think it dissolves'. This is not how chemicals necessarily work. I don't know too much on seroquel, but have done a quick search for you, and found out why you might be having problems. Seroquel is poorly soluable in water. (source: National Institutes of Health .gov) You may need to do some research and find out what it is soluble in and use that as your solution. Then the method would work just fine, with easy math, and a 1ml or .5ml oral syringe. 

 

I'll also leave this here:

 

Quetiapine (hemifumarate) is soluble in organic solvents such as DMSO and dimethyl formamide. The solubility of quetiapine (hemifumarate) in these solvents is approximately 10 mg/ml. Quetiapine (hemifumarate) is sparingly soluble in aqueous buffers. 

 

source: Google, top of the page. 

[[Li...]]

Hello @[El...].  

Per Tips for Tapering off Seroquel (quetiapine) from Surviving Antidepressants: 

 

“Splitting an extended-release tablet appears possible (there are many reports on the Web of people doing this), but this compromises the extended-release quality, possibly resulting in immediate-release quetiapine.

If you are used to the extended-release form, you may be sensitive to the "dosage dumping" resulting from immediate release of the drug.

The extended-release quality of Seroquel XR is due to a "matrix" formulation, not the coating on the tablet.

You cannot make a liquid from quetiapine XR, the glue in the matrix formulation clumps into a gel.”

 

[[Co...]]

18 hours ago, [[V...] said:

Even with the scale, there could be problems with dosing. Ill explain: If you weigh the pill and say for example you have a 50mg pill that is 100mg -you know 50mg is active and 50mg is inactive. If the pill is scored in half, there is 25mg in each side guaranteed. Now here comes the issue/the problem: WHERE in that quarter would be the 25mg located? No one knows for sure because beyond any scoring, they're not required to make it precise. If you sliced the pill into 1/8ths you could get a 1/8th with all 25mg or 0. another example would be like 19 and 6....and so on Make sense? This is why for your purpose; the scale would probably not work as well in this situation, unless you were able to get ahold of 99% pure seroquel powder, which is unlikely for the 'normal person'.

Yes, we know there is no guarantee about how the active ingredient is distributed throughout the pill. In fact, I was recently reading a paper about this matter, and even in scored pills, it is not very reliable.

Having said this, the anecdotal experiences from members is that it generally works well enough.

As for using a balance (scales) - I only advocate for the pill being ground into a fine powder and mixed. The active ingredient should be reasonably even distributed within the powder.

Even with pure active ingredient, most home situations would require the use of bulking agents so that volume (mass, really) of the combined (and mixed) active ingredient and bulking agent is enough to allow for reasonable divisions using an inexpensive balance in the home.

18 hours ago, [[V...] said:

If you are using water as a solution, you're not doing it right with this specific medication.

Everyone just wants to "throw it in water and think it dissolves'. This is not how chemicals necessarily work. I don't know too much on seroquel, but have done a quick search for you, and found out why you might be having problems. Seroquel is poorly soluable in water. (source: National Institutes of Health .gov) You may need to do some research and find out what it is soluble in and use that as your solution. Then the method would work just fine, with easy math, and a 1ml or .5ml oral syringe.

Yep. Different medications require different solvents. For this reason, I tend to suggest using a suspension medium (or something which can act as a suspension medium).

18 hours ago, [[V...] said:

I'll also leave this here:

Quetiapine (hemifumarate) is soluble in organic solvents such as DMSO and dimethyl formamide. The solubility of quetiapine (hemifumarate) in these solvents is approximately 10 mg/ml. Quetiapine (hemifumarate) is sparingly soluble in aqueous buffers. 

source: Google, top of the page. 

That would be for pure ingredients. If there are excipient ingredients (fillers), these are highly likely to affect solubility. We have had problems in the past with some (using information from other support sites) claiming (with certainty) they can produce benzodiazepine-solutions in the home using tap water, vodka and various crushed benzodiazepine pills. Creating 'solutions' in the home is tricky, even when using propriety products meant for this purpose. Totally winging it is not sensible (even if some do manage to make it work for them.)

[[Co...]]

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

Hello @[El...].  

Per Tips for Tapering off Seroquel (quetiapine) from Surviving Antidepressants: 

“Splitting an extended-release tablet appears possible (there are many reports on the Web of people doing this), but this compromises the extended-release quality, possibly resulting in immediate-release quetiapine.

If you are used to the extended-release form, you may be sensitive to the "dosage dumping" resulting from immediate release of the drug.

The extended-release quality of Seroquel XR is due to a "matrix" formulation, not the coating on the tablet.

You cannot make a liquid from quetiapine XR, the glue in the matrix formulation clumps into a gel.”

Thanks, @[Li...].

[[El...]]

On 14/12/2023 at 23:45, [[C...] said:

Are you still attempting to make a liquid from your Seroquel XR? It is my understanding that it is not suitable for the reasons you mentioned in your opening post.

Hi @[Co...] I've received the scales just now. 

Yes I was relying on liquid which has been honestly hell to manage a steady dose because it's just... Too complex and I'm not into chemistry or even basic maths are a bit tricky to me. I'm a lot more of a literate person than sciencey (sadly in this case...) 

So anyway, if it is possible to see what can be done with the scales and the pills (like I said I've got two different kinds in two different boxes, but they're both XR 50mg pills) 

I don't know how to proceed from there so any help would be tremendous!! 

I've been holding on the past week but it's been a bit of a storm on the side effects/withdrawal effects/ping pong brain side of things. 

Thanks for your help 🙏🤟

Edited December 19, 2023 by [El...]

[[El...]]

On 17/12/2023 at 14:21, [[L...] said:

Hello @[El...].  

Per Tips for Tapering off Seroquel (quetiapine) from Surviving Antidepressants: 

“Splitting an extended-release tablet appears possible (there are many reports on the Web of people doing this), but this compromises the extended-release quality, possibly resulting in immediate-release quetiapine.

If you are used to the extended-release form, you may be sensitive to the "dosage dumping" resulting from immediate release of the drug.

The extended-release quality of Seroquel XR is due to a "matrix" formulation, not the coating on the tablet.

You cannot make a liquid from quetiapine XR, the glue in the matrix formulation clumps into a gel.”

Hi @[Li...] yes I've read this before and sadly there was nothing I could do about it. Like I said : no doctor understands the need for an instant release medication in France and they dont even make them lower dosage than 50 (I had 25mg pills in the UK)

So as much as I was troubled by it, there was nothing to do... 

I have been used probably when I was taking the 25mg to the XR effect but it's long gone I believe because I've been cutting the pills for over a year. 

 

But thank you for all the research! And to @[VI...] as well. I appreciate all the info I can get, although I am well aware that it is far more complex than "chuck into water and stir and that's all" but like I said: I had no other choice, no resources (before getting onto this forum) no help from anyone knowledgeable about not just chemistry but who understands that medication is a big issue and who has that knowledge to share with me to support the taper I still bravely go through despite the fact that no, I didn't have the knowledge to make it work and felt shit about it. So it'd be appreciated if these facts were acknowledged rather than just throwing info I already knew I hadn't and it's time I'll never get to go back to anyway. So moving on and finding a good solution now

But thank you regardless for the research and help. 💕

Edited December 19, 2023 by [El...]

[[Li...]]

Are you are still planning to use a combination of dry and liquid titration for the Seroquel XR?  If so, here are two formulations for quetiapine suspensions that might be of interest:

Quetiapine Oral Suspension 10mg/mL

 

Quetiapine Rosemont 20mg/ml Oral Suspension

The first uses quetiapine tablets as the drug source, the second uses bulk power (aka Active Pharmaceutical Ingredient). 

 

[[El...]]

Thank you @[Li...] for this! The first one seems very similar to what I've been doing with the 50mg pills I have but I did it with water 

So yeah I'll probably go for this, a mix of dry cut (to get the pills to the smallest amount I can get them to, to have less to manage in one solution at a time) and then make a liquid with that. 

But it might be too complicated to do this like this, if just the dry cutting is enough I can do that, but I've no idea how to manage that one. So if @[Co...] can help me out with calculation that'd be lovely 👍👍👍

And thank you for helping. That's really awesome to finally have some advice. 

 

 

[[Co...]]

Hi @[El...]

As it happens, I wrote up a post yesterday explaining the approach I had previously mentioned to you. Of course I will help modify it to your specific needs. But, hopefully, this will provide you with an outline.

My intention with this approach is to remove mathematics from the process.

[[El...]]

Hi @[Co...]

Thanks for this guide but I do not understand it, and I have no idea how much of a pill to grind, or how much for that matter my dose should even be at that point, since I've been taking "2.8mg/ml" of liquid but it's feeling all up and down every dose. 

I'm looking for a way to measure the amount I'm taking, to find a dose that'll be similar to what I'm currently taking and I have no idea of how to do any of that. 
Math is not at all something I'm comfortable with and I do understand that a pill in itself has more than the active medication but how the heck do I figure this out, I have no idea. 

The scales work fine, but I have no clue what to do with the pills I've got, if I should weigh how much one pill is and just cut at random... 
I really need some assistance that's specific to this case I'm afraid. I'll refer to the guide post you linked though for later. 
Thank you for your assistance, I can weigh the pills and we can maybe discuss this so I can figure something out? (My brain is in a deep fog/frustration and anger driven today and I'm feeling desperate at the moment)

Have a good evening.

[[Co...]]

Hi @[El...]

I will respond more fully tomorrow. I need to go back over your posts to gain a better understanding of your situation. I will help you put this together.

I assume you purchased the balance (scales) because you wish to make cuts using using a powder. You would grind a whole pill and use the scales to make small reductions to your dose.

These are regular pills (not capsules) - yes? If your balance need calibrating, do this first (there should be instructions for this). Then weigh a few random pills and note their weights. Report the weights here. From this, we can begin to out together the steps for you to take. You will need to decide on an initial taper rate, but we can address that a little later. It should be a simple method for you to follow.