General Taper Question

[[be...]]

Been taking .5 mg sometimes 1 mg klonopin nightly since 2003.  Reached tolerance back in 2006 and gradually developed symptoms of withdrawal (didnt realize it until Dec 2011 what was actually wrong).  Decided to go off of klonopin in the Spring of 2011 because the klonopin had lost its effects years earlier...did it all wrong and went back on within a month....

 

Started new taper in december 2011 with cuts at 50 percent and now down to just below an apprx. Amount of .125 mg at night.....feeling really bad.....symptoms are ten times worse....tinnitus, insomnia, vertigo, cognitive, gut, anxiety, fear, etc

 

Must admit i was also having a mixed drink each night, too.

 

Need to get stable....feeling so shaky and not sure if it is caused by lack of sleep or my taper method or both. 

 

I need to get sleep desperately.

 

 

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I'm sorry you're suffering. 

Looks like you made very large cuts.

The suggested rate of taper is 5% to 10% every 2 weeks and holding until stable before making the next cut.

How long have you been at .125 mg?

Once you've stabilized you may wish to consider titration which would allow you to make much smaller cuts.

[[be...]]

I have been at the .125 mg for 3 weeks.....tried switching to the brand from generic but couldnt handle the symptoms in that plus it is not covered by insurance...went back to genric after 3 days on brand amd then tried to go from .125 mg to half of that....

 

My mind is mush...dont really understand how to do the titration.....how would i jump from the .125 mg to an equivalent valium from here?

 

[[...]]

If you are considering a crossover to valium you may wish to take this table of benzodiazepine equivalencies to your doctor. http://www.benzo.org.uk/bzequiv.htm

Also, you may wish to take a look at the sample crossover and taper schedules in the Ashton Manual.  Here is a link to that section of the manual. http://www.benzo.org.uk/manual/bzsched.htm  You may wish to print some of this and take it to your doctor to ensure a proper crossover to valium.

 

If you have questions about titration you may wish to post on the titration board.  There are many knowledgeable member there to help you.

 

Alternatively, you could have a compounding pharmacy prepare a liquid suspension of klonopin.  Check first if this is covered by your insurance.

 

I would suggest not to lower your dose below .125 mg until you feel stable and to slow down your rate of taper once you're ready to  continue.

[[pd...]]

I would up-dose (the least amount possible), stabilize, and then slowly start back down without a rush. Most importantly…I’d quit drinking at night (or move that drink to earlier in the day?) b/c alcohol is going to screw with the quality of your sleep BIG TIME.

 

I cut down last week to .03-.04 +/-, I had my first decent sleep last night in about a week...today, I feel the best I have in a long time and feel very happy; which is weird b/c i have a lot of stressful things going on right now in my life, aside from Klonopin issues. It is all about sleep...eliminate things that will harm your sleep i.e. alcohol.

[Guest [wi...]]

Sorry, but maybe you shouldn't be drinking at all when on benzos. I used to do that. It's just not the greatest idea as they interact with one another. Just a thought, not a doctor.

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Here's some information regarding alcohol during benzodiazepine withdrawal from benzo.org.uk.

 

Alcohol consumption, even in relatively small amounts, is not advised during benzodiazepine withdrawal. Many people report that alcohol, a sedative that should cause a reduction in anxiety, actually heightens withdrawal symptoms, particularly those of derealisation and depersonalisation.

 

Even if you find that alcohol has a calming effect on withdrawal symptoms, regular alcohol use creates a toxicity that will almost certainly prolong your recovery process. And even if you are able to withdraw successfully from benzodiazepines while consuming alcohol on a regular basis, which is unlikely, you will have probably substituted one addiction for another.

[[be...]]

Thanks to all....actually the drinks were prior to thrpe taper.....have now cut back to one drink of wine here and there and it is earlier in the eve.  I will def look at all of the links for sure....

 

Have decided to stabilize on the .125 mg until i can speak with doc.  Unfortunately, she is not familiar with benzos and the problems they cause....i have provided the links to her for Dr. ashtons taper....

 

Our insurance is terrible....more than likely wont cover it but will check....we dont have many compounding pharmacies in the states.

 

What do people think about working with a psychiatrist to wean off....i have never been to one and am afraid he will want to prescribe more drugs for the klonopin withdrawal......any thoughts?

 

 

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It really depends on the psychiatrist.  Some are helpful, some are not.  Just keep in mind that you have the right to ask for drug free treatment.  You do not have to take any other medications if you choose not to.

[[su...]]

Hello benzobetty,

 

You got some really wonderful information from mmgc. She is very knowledgeable and helpful. I wanted to let know that if it were me, I would not see a psychiatrist to taper from a benzo. I am working with my internist (primary care physician). I showed him some research about why to do a slow taper. I will post that to you on this thread. I have his support and I do my own tapering at home. I am dry cutting Klonopin. I put together some information that may be helpful about how to directly get off Klonopin buy dry cutting. There are many options of becoming benzo free. I'm just going to show you some things I have learned over the years that work for me.

 

Summer

 

[[su...]]

Hello benzobetty,

 

I have researched this information prior to stating my taper. I found the information in Ashton and Peter Breggin M.D. (a Psychiatrist) to be very supportive of a slow taper.

 

Below: I will share some of the research that led me to the path I am on, regarding a slow taper. I shared this with my doctor and was able to get his support on doing a slow taper. I am the type of person who seeks to know what is happening and why, it brings comfort to me. I hope it does the same for you.

 

 

"Your Drug May Be Your Problem, How and Why to Stop Taking Psychiatric Medications" 2007 fully revised and updated edition, by Peter Breggin, M.D. (a Psychiatrist)

 

 

Peter Breggin, MD. “Again, keep in mind that these withdrawal methods are only guidelines and not absolute rules. Applying them depends on how fast you feel comfortable to proceed and on how much discomfort you experience and can bear between dose reductions.”

 

Peter Breggin, MD." The most important rule is to respect your own feelings and to avoid tapering faster than you find bearable. Stay within you own comfort zone when pacing your withdrawal. Keep in mind that the longer you were taking the drug, and the higher the dose, the more gradual your taper should be."

 

Peter Breggin, MD. "Clinical experience with benzodiazepines also suggests that extension of the withdrawal period is not harmful, especially after the initial dose has been decreased by 50 percent. In ordinary circumstances, however, patients should be allowed to share in controlling the process, especially in regard to slowing it down."

 

 

 

“The Ashton Manual” by Heather Ashton, 2002

Professor Ashton." It is sometimes claimed that very slow withdrawal from benzodiazepines "merely prolongs the agony" and it is better to get it over with as quickly as possible. However, the experience of most patients is that slow withdrawal is greatly preferable, especially when the subject dictates the pace. Those who have been on high doses of potent benzodiazepines such as Xanax and Klonopin are likely to need more time."

 

Professor Ashton.  "It cannot be too strongly stressed that withdrawal symptoms can be minimized and largely avoided by slow tapering."

 

Professor Ashton. “There is no need to hurry withdrawal. Your body (and brain) may need time to readjust after years of being on benzodiazepines. Many people have taken a year or more to complete the withdrawal."

 

Professor Ashton. "Slow withdrawal in your own environment allows time for physical and psychological adjustments, permits you to continue with your normal life, to tailor your withdrawal to your own lifestyle, and to build up alternative strategies for living without benzodiazepines."

 

Professor Ashton. "Actually, the rate of withdrawal, as long as it is slow enough, is not critical. Whether it takes 6 months, 12 months or 18 months is of little significance if you have taken benzodiazepines for a matter of years."

 

I hope this is helpful,

 

Summer

 

[[su...]]

Hello benzobetty,

 

 

I saw your question about reducing your dose from .125mg. I put together 3 options depending on what you think your body can handle for the next dose reduction. When you feel ready.

 

Ashton recommends going to 0.5mg of Valium that would be the equivalent of 0.025 mg of Klonopin. So, 0.3125mg or maybe 0.015625mg should be low enough to step off and become benzo free. Here is the reference below:

 

The Ashton Manual

 

http://www.benzo.org.uk/manual/

 

 

Chapter II

 

Getting off the last tablet: Stopping the last few milligrams is often viewed as particularly difficult. This is mainly due to fear of how you will cope without any drug at all. In fact, the final parting is surprisingly easy. People are usually delighted by the new sense of freedom gained. In any case the 1mg or 0.5mg diazepam per day which you are taking at the end of your schedule is having little effect apart from keeping the dependence going. Do not be tempted to spin out the withdrawal to a ridiculously slow rate towards the end (such as 0.25mg each month). Take the plunge when you reach 0.5mg daily; full recovery cannot begin until you have got off your tablets completely. Some people after completing withdrawal like to carry around a few tablets with them for security "just in case", but find that they rarely if ever use them.

 

 

 

 

You get the % by taking the dose reduction and dividing it by the dose you are currently at. For example; a 0.03125mg dose reduction from 0.5mg is a 6.25% dose reduction.  0.03125 divided by 0.5 = 6.25% reduction.

 

I have been dry-cutting. I have learned some important things about this process for me:

 

 

1) Each dose reduction I am able to get to a point where my body gets used to the dose and my withdrawal symptoms are lower. I usually get a couple of days where I have lower withdrawal symptom days. I have found that those several days enough for me to feel ready to take on another cut.

2) I have found that I need to hold for no shorter than 2 weeks.

3) I listen to my body and hold until it feels like it has adjusted to the new lower dose.

4) My average holds have been 2 to 4 weeks

5) In order to keep the symptoms at a tolerable level, I keep my cuts around 10% or lower.

6) I have been able to keep my cuts to .03125mg when I hit .5mg of Klonopin.

 

 

 

In case you are interested in how I am able to dry cut the lower doses:

 

Cutting .25mg:

 

Here is how I am able to get the .25mg pieces. I break the .5mg tablet in half.  The brand Klonopin is scored and breaks in half easily.

 

 

Cutting .125mg

 

Take the .25mg and cut that in half. That is a .125mg piece. . I use an angle razor like a box cutter. And cut on hard surface like glass or a mirror.

 

Cutting .0625mg

 

I have the 0.5mg Klonopin.

 

I break the 0.5mg tablet in half then, I cut 1/4th off of that. I use an angle razor like a box cutter. I have found that the razor is thinner and sharper than the pill splitters I have worked with. Yet, I have read that some have no problem using pill splitters.

 

I cut the 1/4 off of the tablet on a glass surface. I have found the glass surface to be hard enough to get a clean cut. I press down firm and fairly fast. The 1/4 breaks away (from the .25mg). Now I have 0.0625mg.

 

NOTE: If you are unable to get a chip that is .0625 mg then you could crush it into powder. That would work as well. You would take a .25 mg piece and separate it into 4 piles.

 

Cutting .03125mg (Powder)

 

The way I get the .03125mg is I crush a .25mg piece and separate the powder into 8 piles. I happen to have a window scraper so that is what I use or you could use a razor. I crush the .25mg on a dinner plate with the top part of a pill crusher. Then use the window scraper or razor to separate the pile into 8. Each pile is .03125mg.

 

Note: (What I do is crush the portion of the tablet. Then I put it in one pile. I do my best with the razor to separate the pile into two. Then I take the two piles and separate them into two. That makes four piles. Then I take those and separate them into two more piles. That makes eight.)

 

 

 

Cutting .0156mg (Powder)

 

The way I would get a .0156mg cut is by crushing .125mg piece (to get the .125mg, cut the .25mg in half). Then crush the .125mg on a dinner plate, into powder with the top of a pill crusher. I happen to have a window scraper so that is what I use or you could use a razor. Then separate the piles into 8. Each pile is .0156mg.

 

NOTE: With the powder, here is how I take it. I lick my finger, press it on the powder, then I put the powder in my mouth. Then I drink some water after.

 

 

 

Here is an example of reducing the dose from .125mg by .0078mg:

0.0625mg (Chip or Powder)                 

0.03125mg (Powder)

0.015625 (Powder)

0.0078mg (1/2 of the 0.015625 powder)

--------------------------

0.1172mg Total

That is a 6.2% dose reduction

 

Here is an example of reducing the dose from .125mg by .015625mg:

0.0625mg (Chip or Powder)

0.03125mg (Powder)

---------------------------------

0.109375mg Total

That is a 12.2% dose reduction

 

Here is an example of reducing the dose from .125mg doing a .03225mg dose reduction:

0.0625mg (Chip or Powder)

0.03125mg (Powder)

---------------------

0.09375mg Total

That is a 25% reduction

 

Take Care,

Summer

 

[[be...]]

Wow!!  That is a bit intimidating......fearful that i will not be measuring properly and create worse symptoms than i already have....does it need to be dragged out so long?  Really appreciate you taking time to provide all of this information and will discuss with doc.....

 

Thanks and pleasant healing....