How to micro taper 1mg clonazepam

[[Ky...]]

Hey all, I’m looking to quit clonazepam. I’ve been taking 1mg for about 11 years daily. Doctor knew I was taking it every night for years and never said anything about the dangers of long term or stopping. Or else I wouldn’t have taken it all these years no matter how much it helped my anxiety. I’m planning to get a scale and want to micro taper. I don’t understand how I should do this? Shave off small amount with a file? I want to do very small decreases over a long period of time since I’ve been on so long. How do I do the math on this? Please give me a few dosage drop math examples of how you get what I’d want to see on the scale? And what kind of numbers I should be aiming for? I herd keep drops about 5%. I’m terrible with math. Please help! I’ve also thought about the liquid taper? Any examples of that would be great too, and if it works good with water? 

[[Co...]]

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

Have you already attempted to quit? If so, what happened?

What dose pills do you use?

I generally suggest using scales over water. The problem with water is that you cannot be certain that the active ingredient is evenly distributed throughout the liquid. So any sample you take from it might be significantly over or under the intended dose.

I note that some advocate shaving the tablet. This seems unnecessarily fiddly and is probably less accurate (when we are shaving off an edge, for example, we are mostly removing coating). Further, tablets (except where they have score lines - they are then guaranteed to have half the dose on each side of the line) are not guaranteed to have the active ingredient evenly distributed throughout the tablet.

For these reasons, I think a much better approach is to obtain a small pestle and mortar (intended for pill crushing), as this will result in a powder where the active ingredient is much more evenly distributed.

As for percentages - yes, this can a bit confusing. First, just remember that a percentage is just 'parts per 100'. So, if you are reducing your dose by 5%, this means that if it was divided up into 100 parts, you would remove 5 of them (I am not suggesting that you actually divide up the powder into 100 parts).

One other consideration - at higher doses, a logarithmic taper might be more appropriate. This means that each reduction is relative to the previous dose. For example:

Linear taper (10% reductions):

100, 90, 80, 70, 60, 50, 40, 30, 20, 10, 0.

Logarithmic taper (10% reductions):

100, 90, 81, 72.9, 65.6, 59.5, 53.1 (and so on).

A logarithmic taper is much slower. And, actually, (mathematically) never reaches zero. It also draws out the taper at lower doses way beyond reason. We generally recommend a logarithmic taper at higher doses, and then switch to a linear taper at lower doses. I further suggest, at a dose of 1mg clonazepam, for the purposes of tapering, this is a lower dose and a linear taper is probably more appropriate. In any case, tapers should be adjusted to how you react. So it is probably best to avoid getting bogged down in a rigid plan.

Example (linear taper):

• P = Your pill: 1mg clonazepam
• W =Tablet weight: 0.8g (758mg) - (just an example/guess)
• Days to Complete Taper: Reduction (R) = 5%; frequency (F): every 7 days

(100/R) x F = (100/5) x 7 = 20 x 7 = 140 = DCT (this means it will take 140 days to complete the taper)

W/DCT = DR (reduction per day) 758/140 = 5.414mg (your scales will not measure fractions of a milligram)

The above just allows you to estimate how much you should reduce the amount of powder you consume each day. In this example, you would just choose either 5mg or 6mg as the size of the daily reduction. Choosing a taper rate is just a guess anyway, so choosing 5 or 6mg is not a problem and avoids you having to keep a tally of complicated numbers and make daily calculations.

In this example, if you chose 5mg as the daily reduction, it would take 152 (758/5) days to complete; and for 6mg, it would take 127 (758/6) days to complete. You would simply reduce the amount of powder consumed each by by 5 or 6mg.

If all of that seems complicated, it will become transparent when we have some real numbers (the weight of the pill and your desired taper rate). When you can tell us these, one of us will help you work out the numbers if you need help.

I have another mathematical approach which might be simpler to follow (but it would require a daily calculation). I'll post it soon.

[[Ma...]]

1 hour ago, [[C...] said:

I note that some advocate shaving the tablet. This seems unnecessarily fiddly and is probably less accurate (when we are shaving off an edge, for example, we are mostly removing coating).

I’m currently breaking my tablets in half and shaving a little off from the center.  Are you saying shaving off the edge of a whole tablet is inaccurate? That makes sense I suppose but if I’m splitting in half, shaving from the center, and weighing I would think that’s accurate.  I actually find it tedious to grind up the whole pill onto a tray and then get that onto a scale and then into my mouth without spilling some but maybe there’s an easier way.  Also, if you do it that way, you have to do it every night which in and of itself is pretty tedious.  Right now I can shave the pills to the correct weight for a week and not have to go through this process every night.  

Edited February 4 by [Ma...]

[[Co...]]

18 minutes ago, [[M...] said:

I’m currently breaking my tablets in half and shaving a little off from the center.  Are you saying shaving off the edge of a whole tablet is inaccurate? That makes sense I suppose but if I’m splitting in half, shaving from the center, and weighing I would think that’s accurate.  I actually find it tedious to grind up the whole pill onto a tray and then get that onto a scale and then into my mouth without spilling some but maybe there’s an easier way.  Also, if you do it that way, you have to do it every night which in and of itself is pretty tedious.  Right now I can shave the pills to the correct weight for a week and not have to go through this process every night.  

I think working from the centre out suffers from the same problem - as you reach the edge, it mostly will be coating. The greater potential problem is that the active ingredient might not be evenly distributed within the tablet.

How much this is an issue is anyone's guess - it will probably depend upon the brand. But if experience indicates no problem, then continue to work in the way which has been working for you.

I think the approach I would take is to grind up the pill into a fine powder and place this in small try onto the scales (be sure to use the 'tare' function). Using a very small scoop, gradually remove what's not needed. Then, when I'd reach the target weight, I'd poor the remaining powder into a glass of water, swill it, and drink it.

[[Ma...]]

2 minutes ago, [[C...] said:

I think working from the centre out suffers from the same problem - as you reach the edge, it mostly will be coating. The greater potential problem is that the active ingredient might not be evenly distributed within the tablet.

 

The coating is thin.  There is definitely the problem of distribution, but this evens out over time.  Since these are long acting drugs people are tapering (Valium or Clonazepam typically) this day to day variation in someone’s body is pretty minimal.  We are talking about half lives of 50-200 hours.  If I chip off a piece with a little less ingredient in one piece of a pill then, like the flip of a coin, I will chip off a piece with a little more ingredient the next time. As long as the method is consistent, the overall taper is (relatively) smooth.  I’ve talked to plenty of people who have used the shaving method to taper off so I think it’s valid and should not be eschewed.  

[[Co...]]

Hi @[Ma...]

My post was more about generalities. I've written many times about how longer acting benzodiazepines mitigate against inaccuracies - the long half-life acts as buffer against small and moderate variations. But since we cannot know how much variability there is across the tablet, and the degree of variability will surely differ across brands, I feel I need to point out possible points which might affect individual experiences.

I actually agree with you. I've also written (many times) about how other factors affecting blood concentrations typically swamp any variations/inaccuracies from members attempting to titrate doses in the region of one one-hundredth of of a pill: variations of dose between pills; if the pills is taken with or without food; doses not being equidistant from each other; other medications taken with one dose but not all doses (affecting metabolisation); etc. For these reasons, and particularly for longer half-life benzodiazepines, there is typically little need to make such tiny reductions to dose. For example, for most, when using 2mg diazepam pills, they can successfully taper off by halving or quartering their pills.

Some years ago, there was another benzodiazepine withdrawal support forum which heavily promoted the idea of taking making a liquid using diazepam, and taper off at a rate of 100 days for each 1mg. And when below 5mg per day, it even suggested taking 200 days to taper off each milligram. Crazy stuff.

Have you changed from the cut and hold method to microtapering? - Page 3 - [Archive] Titration Taper Plans - Benzodiazepine Withdrawal Support (benzobuddies.org)

I wrote about 'buffering' here:

Have you changed from the cut and hold method to microtapering? - Page 7 - [Archive] Titration Taper Plans - Benzodiazepine Withdrawal Support (benzobuddies.org)

At the end of day, aiming for more accuracy than is reasonably achievable will cause no harm (unless the member becomes obsessive about it). Some might even find it provides them with a feeling of greater control. I like your more pragmatic approach, but it does not suit all.

[[Ma...]]

5 minutes ago, [[C...] said:

At the end of day, aiming for more accuracy than is reasonably achievable will cause no harm (unless the member becomes obsessive about it). Some might even find it provides them with a feeling of greater control. I like your more pragmatic approach, but it does not suit all.

Yes, agree; at the end of the day it has to be very individualized.  For me, I tried the water taper method and it was too tedious and led to me obsessing about messing up one of the many steps involved with that.  But for others it works wonders so I don’t question anyone having success using it.  I have OCD traits and that method was not for me; I imagine grinding pills every night would be the same.  Once a week I shave my 7 pills to whatever weight is needed and don’t think about it again. For me, that is best.

As a side note, I was holding at .5 Clonazepam for the last 6 weeks and simply cut my 1mg pill in half, without weighing afterwards.  Now that I’m cutting again, I notice how inaccurate pill cutters are.  I cut my .172g pills and I never end up with 2 pills weighing .086. Usually it’s like .091 and .081 (or sometimes even more off!). Yet I completely stabilized during this period without thinking about it.  It underscores that things even out over time.  As long as your method is consistent.  

[[Ky...]]

@[Co...] Thank you so much for your response. I’m ordering a scale ect. I’ll reach back out once I have them and weight the pill. I really really appreciate the feedback. @[Ma...] thank you also so much for the feedback. You both have me great insight on what way I may choose. I also stress too much about the liquid method. And I think shaving works, obviously that was the way I thought I’d go about it. but I am ocd and now I realize I would shave an overthink if I’m getting a good mixture then go into panic attacks and after taking the dose and assume to myself I’m going through withdrawals when it’s actually anxiety from ocd 😂 when Colin said some people need to feel in control, that’s me lol that what my ocd and anxiety runs off of when I feel like I don’t have control. I’ve struggled with my new knowledge after 11 years on a benzo- that it wasn’t something my Dr should have allowed me to take every day or often. Knowing that if I abruptly would have just stopped it could possible kill me or have very bad permanent damage. There was a time about two years ago I was going to taper down- I was only at .5 at the time an I was taking it every other day and eventually I was just going to stop. (Not knowing) and then my anxiety got bad an I went back to at night time daily then they’re was a “shortage” of .5 so my Dr bumped me to 1mg which I’ve been taking for probably a year or a little over a year. But luckily I stumbled across what could Happen an now I know. But finding out that information makes me feel like I’ve lost control an makes me just want to stop. So I know I have a very hard road ahead that I can’t just stop. So I hope you guys know how appreciative I am to have found this website and that you guys have taken time an reached out to help me. 

[[Co...]]

Just a note about the scales: they will need to measure increments of 0.001g (1mg). Remember, the weight of the pill (powder) is what we are interested in - this is far higher than the weight of the active ingredient. Your whole '1mg clonazepam' will likely weigh several hundred milligrams.

[[Ma...]]

Is there a brand or model scale that’s recommended??

Thank you

[[Co...]]

29 minutes ago, [[M...] said:

Is there a brand or model scale that’s recommended??

Thank you

I would recommend using Amazon and read the reviews. The best (available) brand might vary by country.