Gratefully seeking titration schedule for clonazepam (klonopin)

[[co...]]

Start date: March 17th

    Dose: .75 mg/day

    Tablet dose: .5 mg

    Number of tablets: 1.5 tablets

    Taper rate: 1% per day

    Cylinder details: 100ml cylinder with 2ml increments

 

I have been on this medicine at this dose for nearly two decades and would like to slowly come off. I made it off once before using the dry cutting method but wasn't able to sustain it for more than a year. I'm feeling hopeful that a slow withdrawal will be successful. I am also taking Luvox but will tackle that afterwards.

 

Thank you, in advance!

[[Be...]]

Countrymouse,

 

A popular way to taper is just to remove 1 ml until your symptoms start to show signs of worsening and then stabilize. After stabilization, you continue with 1 ml withdrawals until you again start to show signs of symptom spike. You just keep doing this until you are off. That's not the way I am doing it and based upon your years of use, I suspect you may have some problems. I am using the 10% of previous dose method and am having a lot of success with that. Some need to go down to 5% because they have too many symptoms with a 10% reduction. This will lead to a very slow taper, but that seems like something you might want and, in my personal opinion, is the best way to do this.

 

With the percentage taper method, you just need a calculator and maybe a calendar in addition to what you use for any titration. Essentially, you just figure out how many mls you need to cut in order to reach your percentage decrease. You then reduce this amount over a set period (like a week to 10 days) and then stabilize for another week or two. At some point, when you reach low concentrations, you can start making your cuts more linear, with a set ml decrease instead of the percentage. I am tapering from clonazepam and am currently using 0.5 mg PAR brand orally disintegrating tablets to titrate. When I reach 0.5 mg, I will move to 0.25 mg and eventually 0.125 mg.

 

Some tips: Don't immediately start your taper when you titrate, give yourself time to adjust because the switch from dry to water titration or other titration is like a cut. Also, whenever you switch anything, including medicine brands, give yourself time to adjust. Last, be sure you ingest the appropriate rinsate and that you rinse at least a couple of times.

 

Hope this helps, though you may have to familiarize yourself with titration if terms and process are unfamiliar.

 

 

[[Be...]]

You may want to check out other information I posted here:

 

http://www.benzobuddies.org/forum/index.php?topic=49474.0

[[co...]]

**** Please note that I will be using a 100 ml cylinder with 1 ml gradations and will also have a 10 ml syringe.******

 

 

I am in Canada and am unable to get the PAR brand orally dissolvable tablets. Does anyone know if the regular tablets will work?

 

Also, I usually take .5 mg in the morning and .25mg in the evening. How does that work with a titration schedule?

 

Thanks so much!

 

[[Be...]]

Regular pills will work. I've never used them, but most others do. I hear mixed things about pill crushing versus just letting them dissolve. Your unequal doses are a challenge for me. I don't really know the answer there. Most people try to get as an even a dose in their system as possible, so you might try to cut down your morning dose until you get to 0.25 mg. Also, this may help combat insomnia some, but no guarantee. Hopefully some of the more experienced titrators will weigh in on your challenge. Have you watched Kian's video on titration? It's a good tutorial.

[[co...]]

Thank you so much! Yes, I'm not sure what to do with my uneven doses either....I'd be very grateful for someone to weigh in. All of this is very new to me!

 

 

[[Ho...]]

Because clonazepam has such a long half life, the differing dose during the day shouldn't be a problem. You can crush up your total dose of the day, mix it with milk or water; take out 1 ml, then drink half of what you have left in the morning; store the other half in the fridge and drink it at your usual time.

[[co...]]

Thank you for your helpful reply.

 

Just to get it straight:

 

- I can mix up 100 ml with my full daily dose of .75mg and take half in the morning and half in the evening.

- Do you think it would be a good idea for me to begin doing this for three or four days just to allow my body to get used to the change in dosage?

 

So the first option I have is to start at 100 ml and then to reduce it by 1ml per day until I feel symptoms, at which point I will hold for a few days until they subside and then resume my 1 ml cuts.

 

The second option is the 5% reduction method. Does that mean that if my starting dose is .75mg then I should reduce it by .0375mg in order to have a daily dose of .7125mg? My second cut would be a 5% reduction of .7125 and so on...I get this, but I don't understand how I can measure .7125mg using the titration method.

 

Thank you in advance! Everyone's kindness here is already getting me excited to begin rather than filling me with dread...

 

 

Thanks!

 

 

[[Be...]]

Mouse,

 

I would look into getting a 100 ml cylinder with 1 ml graduations. They are pretty cheap. Using the percentage method you just have to go to a certain ml based upon the cut and round up or down. With 5% I might be tempted to round up so I cut a bit more. With 10%, I'd round down. Since you will be using a 10 ml syringe with graduations of .1 ml (assuming that), you can actually be pretty accurate with the cuts in between if you desire. However, you can also just elect to space out the 1 ml reductions.

 

This is based upon percentage reduction. Others may propose the straight 1 ml method to remove the calculator and calendar and just rely on monitoring of symptoms. I tried that but it didn't work for me.

[[co...]]

I've ordered a 100 ml cylinder with 1 ml graduations and will have that to work with. I will also have the 10 ml syringe.

 

What do you mean by "Using the percentage method you just have to go to a certain ml based upon the cut and round up or down" -- can you give me an example of that, using my numbers from my last post?

 

Thanks,

Mouse

[[Be...]]

So the first cut is pretty easy, right? You just remove 5 ml because you are starting with 100 ml and 5 ml is 5%. Beyond that it can get tricky but nothing too complicated. For example, after your 5% cut you would be at 0.7125 mg. 5% of that value is 0.035625 mg. If you subtract the latter from the former you get  0.676875 mg. Forgiving all the significant figure stuff for this you then take 0.676875 and devide it by your dose .75. When you do that, you get 0.9025. You then multiply that by 100 to get the ml equivalent of the 5% reduction, or 90.25 ml. So, you could, if you wish, get down to 90.25 ml by decanting 9.75 ml using your 10 ml syringe, or you could choose to simplify by rounding up to 91 ml or rounding down to 90 ml. If you go to 90 ml, you are actually cutting slightly more than 5% from your previous dose. I was thinking about the amount you take out in my last discussion, not the amount remaining, so my "up" and "down" are reversed here. Sorry for that confusion and whatever confusion this causes in general. In any case, I hope this helps.

[[Ho...]]

- I can mix up 100 ml with my full daily dose of .75mg and take half in the morning and half in the evening.

- Do you think it would be a good idea for me to begin doing this for three or four days just to allow my body to get used to the change in dosage?

 

Yes to the first statement. You can mix up the 100 mls, and take half in the morning and half at night. The amount of each dose doesn't need to be exact with clonazepam...because of the long half like you have a lot of wiggle room.

 

I would stay on your current dose for 5 -8 days. If you're going to have problems, that when they will show up. Some people have a problem when they first titrate. It seems, generally things do eventually settle down.

[[co...]]

Thanks you two!!! Benzo 3, that's the first explanation that has made sense to me. How long do you wait between 5 percent cuts?

[[Be...]]

I'm doing ten percent and waiting a week, but sometimes I feel that may not be enough. I won't go forward though unless I feel reasonably stable or more than 2 weeks have passed. With a five percent cut, one week may be fine, try it out and see how you feel.

 

At some point realize that you will have to just make incremental cuts and abandon the percent method. However, I'd recommend that a very low dose.

[[Be...]]

I think you know this, but you wouldn't normally titrate the entire 5% on the first day, you space it out over a week or so. Also, if you change anything, give yourself a chance to stabilize, this includes crossover to titration and switching medicine, which I probably already mentioned.

[[Bi...]]

You would make a cut, stabilize, make another.

 

I wouldn't toss big amounts at a time.

 

Billy.~

[[co...]]

When you say that you wouldn't normally titrate the full 5 percent and that you would do so over a week, what do you mean? That part has me confused. Do you mean that you introduce the five percent cuts gradually over the week?

Thanks!

[[Be...]]

It means that at the end point of your "cut", you've reduced a total of, in this case, 5% from your previous dose in mg. So the idea is to gradually and incrementally get to the 5% by the end of your cut period. I use one week to cut and one week to stabilize. It's worked so far. If I need to stabilize for longer, I will.