Advice needed on Taper

[[Le...]]

Good day everyone, I have been taking rivotril 2mg for 1 year before tapering. I had reached down to .5mg in 2022 and wass not able to move very far as my sleep and ability to function would be affected. I recently started to try tapering off the .5mg in December 2023. Now I'm at .44mg/ .43mg as the scale would indicate. A psychiatrist recommended that I either :

1. take the .44mg every other night for 2-3 weeks and then stop. Or he said I could

2.Take sertraline 50mg along with the rivotril and continue to cut as this would be more successful for my anxiety disorder.

 

I feel uncomfortable adding another pill to my complicated experiences. What advice can I get?

 

[[Re...]]

@[Le...] Hello, Welcome to BenzoBuddies!

I an sorry you are having difficulties. The dosage you are at is usually a more difficult one regarding symptom severity. 

Your Doctor said : "take the .44mg every other night for 2-3 weeks and then stop."

The tapering method with skipping a day is not recommended in general, it would only possibly make your job a bit more difficult. 0,4 mg range is not a small dose, it is very much effective. Don't stop suddenly this high, please. 

Continue to taper with reducing the previous dosage 5-10% every two, three weeks, or even slower depending on your symptoms. 

People have different experiences with antidepressants during the tapering period. Many have benefitted them, others claim it makes their symptoms way worse. I, personally, would not add a medication to my already sensitized, injured system. 

Regarding clonazepam I would advise you to go even slower, but first, wait until you stabilize. 

• You may try cutting smaller from your tablet with a more precise scale.
• It would really be worth considering a clonazepam oral liquid if available in your region. 
• Switching to a longer acting benzodiazepine is also a possibility.

Please don't rush, take your time. When switching to a liquid, don't do cuts simultaneously. Your dose, when switching, may require an alignment, but don't get scared of this. 

Switching to diazepam might be a bit more complicated. I would only do this myself the methods above really don't work. 

These are my ideas only. Please discuss every step with your doctor, especially that you wish to go slow and have symptoms. He/She seems to be well cooperating with you, you're lucky there:)

Edited February 29 by [Re...]

[[Re...]]

@[Le...] The recommended jumping dose is 1-0,5 mg Diazepam equivalent, that is around 0,025 mg clonazepam. 

https://www.benzoinfo.com/ashtonmanual/chapter2b/

 

[[Le...]]

Thank you for the information and advice!! I m located in the Caribbean and we don't have .5mg of rivotril nor a klonopin oral liquid.

If I did want to access .5mg rivotril/klonopin how can that be done by the medical personnel above me?

If I made a trip to the US would a doctor be readily willing to prescribe .5mg?

 

Thank you again!!

 

[[Re...]]

I am located in Europe @[Le...], so I sadly can not answer this question. I am not sure how a doctor in the US could prescribe medication to you, you need a social security number for that. 

Have you specifically asked your provider about clonopin oral liquid, was this their answer? 

If so, you may continue cutting your medication or preparing your own liquid for tapering.

Do you have a reliable scale at home? 

 

[[Le...]]

I have 2 scales and I'm not sure how reliable they are. Their measurements fluctuate so now I'm concerned.

Our pharmacies do not have the oral liquid. Once I asked my pharmacy to make a rivotril solution for me but it did not work, kept me up all night and  worsened my symptoms so I'm skeptical about locals making the liquid.

We also do not bring in the.5mg which I queried. I suppose I have found myself in a strange situation where I have to continue to cut from tiny 1/4 pills.

 

Thanks!

[[Re...]]

 

I am sorry you have negative experiences with compounded liquid @[Le...]. I am not sure if you have access to amazon in the Caribbean, I have doubts about that. Please forgive my ignorance. 

I just checked some recent posts and found this scale, this one goes down to 0,001g.

https://www.amazon.com.au/Precision-Milligram-Tweezers-Calibration-Weighing/dp/B011J88S8M

I am sure that even if you don't have the service above you can find a reliable scale, similar to the one above. 

[[Le...]]

Yes we do have amazon access. I will try to look at the scale.

 

Thank you! Much appreciated! 

[[Le...]]

Yes we do have amazon access. I will try to look at the scale.

 

Thank you! Much appreciated! 

[[Le...]]

So I'm now reading about linear taper vs exponential taper schedule. Is the latter better as in resulting in less withdrawal symptoms? Secondly, when do you stop pushing yourself to go to work and stay home and rest and recover?

 

Thank you for any advice.