HELP with math pleaseeee?!

[[Je...]]

I’ve had an extremely long journey with benzos over 18 years many failed tapers and now here I am I was on 3 mg and now I’m down to a little less than 0.75 mg a day. My psychiatrist was wonderful. He let me taper at my own speed with no issue he passed away. I live in an extremely rural area where I cannot get another doctor besides my GP who has no idea what they’re doing so I’m doing my best. Currently my entire daily dose is 0.222 which is 0.25mg (weight is 0.084) in the morning, 0.25mg (0.084) in the afternoon and a little less than that at night (0.054)

if I reduce at 12 percent what would my schedule look like? I really need math help with this! I am going to get my night dose down to 0.125mg which I think I’m almost there so first I need to know what that weight would be and what percentage I’m reducing from my WHOLE Dose by going from my current night dose to 0.125. 

then I need a schedule for reducing my morning dose slowly to 0.125mg, then my afternoon.  Please any help!!! 
im making cuts every 10-14 days. 

[[Fa...]]

Hi, @[Je...].  If .25mg active ingredient weighs .084g on your scale, it's safe to assume your nighttime dose weight of .054g equates to roughly .161mg active ingredient.  So yes, you are getting close to a nighttime dose of .125mg active ingredient.

If you want to reduce your total daily dose by 12%, we need to multiply your current total daily dose weight of .222g by .88 (88%).  This 12% reduction equates to a new total daily dose weight of .195g.  If you left your morning and afternoon dose alone at .084g, your nighttime dose would now be .027g.

If you wanted to just reduce your nighttime dose of .161mg active ingredient (.054g dose weight) to .125mg active ingredient - you would just reduce the nighttime dose weight of .054g to .042g (half of the .084g scale weight and half of the .25mg active ingredient).  This would be a very reasonable total daily dose reduction of roughly 5.4%, and your new total daily dose weight would be .210g.  

Hopefully something in this is helpful.  FWIW, if it were me in your shoes I would take it one step at a time and not worry about future reductions.  Why don't we just reduce our evening dose to a new dose weight of .042g (.125mg active ingredient and a 5.4% reduction), hold for 2 weeks and re-evaluate from there?

[[Je...]]

I only have a few months to get off, only one doc is willing to write the script - I have driven 5 hours to see doctors that refused .. where I live there aren’t many options. 
would you maybe be able to help me make a schedule for now with the night time dose, and then for the AM dose? It’s very hard for me to figure out the numbers… and I really really don’t want to make a mistake 

[[Fa...]]

Hi again, @[Je...].  I would continue my search for a new provider and/or kindly ask your GP if he/she would so kindly prescribe your clonazepam until you reach 0.  I would calmly state to him/her that your desire is to safely discontinue your clonazepam.

Perhaps, you could provide the information from the boxed waring on the attached drug label to their attention - particularly bullet point number 3 (link attached).  I've also attached a published deprescribing guidance you may consider drawing to their attention.

I do not feel comfortable outlining a 3 month taper schedule as it is not practical.  If you are going to go that route, you could in essence make 9 separate cuts every 10 days.  This would be a linear taper.  You could reduce your total daily dose weight by .025g every 10 days until you reach 0.  This could be accomplished within 3 months.

Links attached:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ebc11109-e7bf-452d-b675-4b3236d54164

https://corxconsortium.org/wp-content/uploads/Benzo-Deprescribing.pdf

[[Je...]]

May I private message you I reduced my nighttime dose to 0.38 and it has worked out well. I am now reducing my afternoon dose from a weight from 0.084 to 0.066 I would like to continue until both of my morning and afternoon doses are at 0.125mg which is 0.042 in weight. I really like the idea of a linear taper but I absolutely will hold when necessary as I just had Covid and had to hold. Please let me know if you can help me with a paper plan even just for the next few doses I really have been working at this for a long time on my own and with the help of one member who is not able to help any longer, but I really would love the math help as I am very confident in this taper! 

[[Fa...]]

Hi again, @[Je...].  Can you please clarify your nighttime dose of .38?  Do you perhaps mean .038g dose weight?  If so, you made an exponential reduction of 7.2% (total daily dose weight rom .222g to .206g) which was a reasonable reduction, and I am glad it worked out well for you.

If you now reduce your afternoon dose from .084g to .066g, you will be making an exponential reduction of 8.7% (total daily dose weight from .206g to .188g) which still would be considered a reasonable reduction.

Were you able to find a new prescriber?  If not, is your current prescriber still 'forcing' you off the clonazepam within a couple months or is he/she going to allow you to taper off according to your symptoms and functionality?  This information is pertinent in regards to your 'next steps'.

In case you have not read, or come across, the platform guidelines for use of 'private messaging', I have quoted them below.  In your case, for example, it would be a disservice to you if I were to have made an error with my math and/or suggestions, and the larger community was unable to read/correct/critque my information.

Quote

You may not use the PM (Personal Message) system for withdrawal or taper advice. PMs are primarily intended for moral support, fun, and distraction. Please post your taper plan or withdrawal questions and concerns to the Community forums for wider discussion and feedback.

 

[[Je...]]

I’ve been tapering since last June I believe but yes I have no way to find another prescriber I live very far from anything and the nearest doctor is 2 hours which is who I see now, I’m doing well, I’m just trying to make sure I don’t go tooo fast lol staying positive and getting it done  I guess I need to know what my best cut would weigh so I can be prepared 

[[Fa...]]

@[Je...], it sounds as if you have just made a total daily dose reduction from .206g to .188g - which is an exponential reduction of 8.7%.  Why not hold for 2 weeks and re-evaluate?  If all goes well, you could reduce your total daily dose weight from .188g to .172g for example - which would be an exponential reduction of 8.5%.  

If it were me in your shoes, I would like to know how I handled the 8.7% reduction in dose before I made any further decisions.  Also, I would want to know that my prescriber was going to allow me to taper for as long as I needed in order to discontinue my benzodiazepine safely.

Also just to clarify, is this how you are currently dosing:

.084g morning + .066g afternoon + .038g evening?  If it were me, I would attempt to work towards getting my dosing schedule consistent (e.g., 3 doses of .042g).  From there, I would attempt to rid myself slowly of the afternoon dose to get to a daily dose of .25mg active ingredient clonazepam with a morning dose weight of .042g and an evening dose weight of .042g spread roughly 12 hours apart.