Dry Taper to Water Taper?

[[Ga...]]

I’m about to restart my taper. I have the option of doing the cut and hold dry taper method or the DMT with water. 
 

Which should I choose? And if I start with one can I transition to the other if I’m having a real hard time?

For context: I’ve been on .5mg daily of Klonopin for 16 yrs. 

[[El...]]

@[Ga...] I am not sure there is any definitive answer to your question.  It would seem that the most successful method for tapering is the one you feel most comfortable using. 

If you feel confident cutting, shaving, weighing tablets and holding for 1-2 ( or more) weeks between reductions to stabilize, the cut and hold dry taper method is probably a successful method for you.

Or, if you feel more confident dispersing your tablet in water or milk and removing a small quantity with a syringe daily, the DMT is probably a successful method for you.  Two notes of caution:  1) If you are currently using tablets, you will probably need a period of time holding your dose constant (no reductions) to make sure you are stable and fully adjusted to the "liquid".  Some people experience a period of instability when starting a new formulation.  And if you decide to start with the liquid and then go back to tablets, you might also need a period of readjustment.  2)  When using the DMT, it is often recommended to regularly schedule short holds so the cuts do not " pile up".  This might be, as an example, holding for approximately 5 days after every 5% overall reduction.

Wishing you well.  Let us know if we can help.

[[...]]

15 hours ago, [[G...] said:

I’m about to restart my taper. I have the option of doing the cut and hold dry taper method or the DMT with water. 
 

Which should I choose? And if I start with one can I transition to the other if I’m having a real hard time?

For context: I’ve been on .5mg daily of Klonopin for 16 yrs. 

I'm really wishing you the best! I am sitting right here facing this same choice as well. I will look forward to seeing what you choose and I hope you continue to post through it and get support and let us all know how your doing. 🌹

[[Ga...]]

13 hours ago, [[E...] said:

@[Ga...] I am not sure there is any definitive answer to your question.  It would seem that the most successful method for tapering is the one you feel most comfortable using. 

If you feel confident cutting, shaving, weighing tablets and holding for 1-2 ( or more) weeks between reductions to stabilize, the cut and hold dry taper method is probably a successful method for you.

Or, if you feel more confident dispersing your tablet in water or milk and removing a small quantity with a syringe daily, the DMT is probably a successful method for you.  Two notes of caution:  1) If you are currently using tablets, you will probably need a period of time holding your dose constant (no reductions) to make sure you are stable and fully adjusted to the "liquid".  Some people experience a period of instability when starting a new formulation.  And if you decide to start with the liquid and then go back to tablets, you might also need a period of readjustment.  2)  When using the DMT, it is often recommended to regularly schedule short holds so the cuts do not " pile up".  This might be, as an example, holding for approximately 5 days after every 5% overall reduction.

Wishing you well.  Let us know if we can help.

I'm committed to doing either one - I have both the syringes and the scale.

 My question is this; has the forum found one method more effective than the other?

Re: the water titration...to be clear, I'm contemplating just letting a pill dissolve in water and pulling ml as I go. I do not have a liquid prescription or liquid form of Klonopin. In this case, do I still need to hold/transition for a week?

[[El...]]

@[Ga...] I could be wrong, but I do not believe there is consenus that one method will work better than another.  I am sure there are many factors (your sensitivity to reductions, the half-life of the benzo being tapered, your age, your general health, your body chemistry, other use of medications or supplements...) that determine an individual's success using one method versus another.  The only thing we can do, really, is try a method to see if you are "comfortable".  Many have used several methods during their taper.  I originally used cut and hold.  That worked for a few months until it was taking me too long to recover between reductions.  Then I briefly trialed a water taper but had trouble with accuracy probably due to the insolubility of lorazepam.  Then for several months I did a daily microtaper using the tablets with a laboratory-grade scale.  That worked well until my doses got too small to weigh accurately.  Now, I am doing a daily microtaper with pharmaceutical liquid lorezapam.

I do think it is advisable to only make one change at a time.  For example, say you begin the DMT with water and you begin your reductions at the same time.  If you begin to experience uncomfortable withdrawal symptoms...you won't know if the uncomfortable symptoms are a result of the Clonazepam being dissolved water or if you are making your reductions too quickly, or the reductions are " piling up" on each other...  So, a period of holding may help to determine if the method is working for you, before attempting reductions.

Please keep us up-dated with your progress!

[[Li...]]

5 hours ago, [[G...] said:

Re: the water titration...to be clear, I'm contemplating just letting a pill dissolve in water and pulling ml as I go.

Hello @[Ga...].  I just want to make sure you understand that clonazepam is insoluble in water.  When you add water to a tablet, the clonazepam in the tablet does not dissolve (as in go into solution).  Instead, it disperses.  The resulting mixture of clonazepam particles and water is a temporary suspension not a solution. 

 

[[Ga...]]

@[Li...] yes, I understand it is a suspension vs. a dissolution. And I understand that is a difference. 
 

Do you think this is material difference in the sense that I should do the dry cut vs. water taper?

[[Li...]]

Thank you for letting us know you are aware of the difference between a suspension and a solution, @[Ga...].  

What do you mean by ‘material difference’?  Are you referring to the likelihood of obtaining accurate and consistent doses using the ‘shave and weigh’ technique versus the water taper?  If so, I am unaware of any credible evidence on this topic.  As @[El...] commented, each of us has to experiment to find a technique that works for us (plus be prepared to switch to a different technique if needed).

Assuming you do not reside in a country where a manufacturer’s oral clonazepam solution is available, is obtaining a prescription for a professionally compounded oral solution or suspension an option?

Also, are you aware of the option of using whole fat, homogenized milk to make a do-it-yourself emulsion?

[[Ga...]]

@[Li...]  @[El...] @[...] Thank you for taking the time to respond. 
 

Yes, you nailed it…. by material difference I mean will I have a hard time getting accurate doses. Yes, I’m aware of the whole milk option. Do you think thats a better option?

I’m leaning towards the water/milk plan, but I’m concerned when I travel for work (by air /TSA) how I will adapt. 
 

I’m open to the liquid compound if you think that is superior. 
 

Thanks again for the attention. 

[[...]]

20 hours ago, [[G...] said:

@[Li...] yes, I understand it is a suspension vs. a dissolution. And I understand that is a difference. 
 

Do you think this is material difference in the sense that I should do the dry cut vs. water taper?

I am unclear on this difference.. is this the difference between doing a water or compounded vs the pharmaceutical prescription liquid of diazepam ? I am asking for myself cuz I'm tapering valium and I'm trying to understand the liquid micro taper as I think that's probably the best solution for me as I'm stuck at the end and any reduction at this point from 2 mg is intolerable the cut and hold method gives me dread to even consider due to my entire taper being over rapid and every cut being being brutal so I could probably Google this but any personal experience with the differences here would be appreciated ☺️

[[Li...]]

6 hours ago, [[G...] said:

Yes, I’m aware of the whole milk option. Do you think thats a better option?

Are you asking if it’s a better option than water?  If so, my personal opinion is yes.  

Here’s what the Maudsley Deprescribing Guidelines (Horowitz & Taylor, 2024) has say about using milk as an off-label option for patients who require smaller doses:

“Benzodiazepines are more soluble in oil or fat than in water (Macheras et al 1990).  When mixed with full-fat homogenized milk, some or all of the drug will dissolve in the milk fat.  This should form an evenly dispersed emulsion when shaken vigorously ….” (Horowitz & Taylor, 2024, p. 341)

However, having written the above, I have read here and elsewhere about people who do just fine with water tapers.

6 hours ago, [[G...] said:

I’m leaning towards the water/milk plan, but I’m concerned when I travel for work (by air /TSA) how I will adapt. 

Traveling with a controlled substance is a legitimate concern, especially one in modified, off-label form.  However, you impress me as having good problem solving skills so should be able to figure something out.  Plus, you can always seek input from members here. 

7 hours ago, [[G...] said:

I’m open to the liquid compound if you think that is superior. 

My personal rank ordering of clonazepam liquids is:

1. Manufacturer’s oral solution
2. Professionally compounded, stability-tested compounded oral suspension (some members have also found compounding pharmacists who have access to formulations for an oral solution)
3. Do-it-yourself liquids:
   • milk
   • water

If you are in the US, something else to consider is that clonazepam is available in Orally Disintegrating Tablets in several strenghts (e.g. 0.125mg, 0.25mg, 0.5mg).