Re: Clonazepam Tapering

[[SS...]]

Hello,

I have been on .5 mg of Clonazepam since mid fall. I want to get off and am unsure the best method. I had a horrible experience last year weaning off just .10 mg of Paxil (I obviously am very sensitive to all meds).

Should I start by cutting the .5 in 1/2?

Thanks for all help.

 

Edit: New separate topic split from other members thread.

[[su...]]

Hello SSGirl,

 

I see you are interested in tapering off of Klonopin. I put together some information that may be helpful. I have been dry cutting Klonopin and here are some of the things I have learned. I also added an example at the bottom of how to do the first dose reduction.

 

 

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. . That is because Klonopin has a half-life of 30 to 40 hours and the generic clonazepam has a half-life of 18 to 50 hours. It takes five half-lives to get a dose reduction out of our system.

 

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 below 10% by going 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, when at 0.5mg doing a 0.03125mg dose reduction:

0.25mg

0.125mg

0.0625mg (chip or powder)

0 .03125mg (powder)

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

.46875mg total

 

This is a 5.9% cut.

 

I hope this is helpful,

Summer

 

[[su...]]

Hello SSGirl,

 

I also wanted to add that it's important to go slowly as we taper and also to go as low as possible so that when we take her last dose it is more like a step instead of a jump. I hope this is helpful.

 

Getting off the last tablet:

 

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.

 

Summer

[[SS...]]

I apologize for being a little confused but could you clarify? I just want to confirm that basically the 1st step is to take 3/4 of a .5 pill; a half & a quarter? Also, I am confused as far as how long you stay at that point. It sounded as if you meant a few days in part of the response and then a couple of weeks in another. Argg...I am done with any drugs after this.

Thanks again for your help!

[[su...]]

Hello SSGirl,

 

You're welcome. I'm more than happy to help you in any way I can. Please feel free to ask as many questions as you need. We are here to help you succeed in becoming benzo free.

 

Reference to Tablet sizing:

 

0.5mg of Klonopin Tablets

0.25mg is ½ of a 0.5mg

0.125mg is ½ of a 0.25mg (or 1/4th of a 0.5mg)

0.0625mg is ½ of a 0.125mg (or 1/8th of a 0.5mg)

 

I have found it is important to hold no shorter than two weeks. My average holds have been 2 to 4 weeks depending on how long it takes for my body to get use to the new lower dose.

 

So, the first reduction would look like taking:

 

Here is an example, when at 0.5mg doing a 0.03125mg dose reduction:

 

0.25mg (0.25mg is ½ of a 0.5mg)

0.125mg (0.125mg is ½ of a 0.25mg (or 1/4th of a 0.5mg)

0.0625mg (chip or powder) (0.0625mg is ½ of a 0.125mg (or 1/8th of a 0.5mg)

0 .03125mg (powder) ( .03125mg is 1/2 of a 0.0625mg (or 1/16th of a 0.5mg)

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

.46875mg total

 

This is a 5.9% cut.

 

It sounds a little complicated yet, you will get a used to it before long. It will take a combination of all four of these for one dose reduction.

 

The other thing I find helpful is having pill containers:

 

PILL ORGANIZERS:

I would get some pill organizers. You can get them at the drug store. I would get the ones that have 4 compartments. They come in one week's supply, one sleeve per day. I would get two weeks supply of these. I put together two weeks supply of my dose reductions together at one time. I take one sleeve out in the morning and put it on my table and take my daily doses from there. That way it is all organized and planned ahead.

 

It may be worth even getting more than that so that you can use one of the sleeves to collect all the different sizes of Klonopin. For instance; one container for the .25 mg, then one for the .125, then one for the .0625. Over time they will become useful and help reduce the time it takes to prepare for the next dose reduction.

 

Have I put this in a way that is understandable?

 

Summer

 

 

[[SS...]]

Summer,

Just to clarify, the 1st cut would be 1/2 pill; .25 correct? (For 2-4 weeks).

Thanks again.

 

[[su...]]

Hello SSGirl,

 

Yes, you hold for 2 to 4 weeks.

 

The first dose reduction would be taking ALL of those 4 different sizes so that you have a total of 0.46875mg. That way you stay under the 10% that Ashton recommends.

 

Love to you,

 

Summer

[[SS...]]

Good AM,

I am currently at .25 of Klonopin & think I am ready to go to the next jump but am nervous because I am still EXTREMELY anxious ( I am also going thru a divorce, which does not help the situation). However, I just want to get off this drug and have read the longer you are on it, the harder it is to get off.

Should I go to the 1/4 pill at this point or is that too big a jump?

Thanks again for your help.

CC

[[su...]]

Hello SSGirl,

 

I am so sorry to hear you are going through a divorce. Any added stress can make the symptoms more intense. Do your best to remain as calm as possible. Your body is going through alot with getting free from Klonopin. It is best to do a slow taper at a pace that is manageable for you. I have found that keeping my dose reductions below 10% and now they are around 6%. Your body adjusts to each new lower dose and the GABA receptors are healing along the way. There is no need to rush this due to the drug still being in your system. It is important to become benzo free to heal completely. You are right about that. Slow taper is the best approach to becoming benzo free. Here is something that may be helpful.

 

I saw your question and put together some information that may be helpful. 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."

 

 

 

Here is a copy of the Ashton Manual. You can print it out for free. Just print one section and chapter at a time. There are about 3 or 4 chapters.

 

The Ashton Manual

 

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

 

 

 

I am sending you my love,

Summer

 

 

[[su...]]

Hello SSGirl,

 

Congratulations on getting down to .25mg of Klonopin. That is wonderful. You are getting there. I am so happy for you.

 

 

Here are 2 example of dose reductions from .25mg. One is a 6.2% decrease and the other is a 12.5% decrease. If you go down by .125mg (1/4th of the pill) that will be a 50% dose reduction.

 

 

Here is an example of reducing the dose from .25 mg by .015625mg:

To keep dose reduction below 10% it would be best to do a .0156 mg. It would look like this:

0.125mg

0.0625mg (Chip or Powder)

0.03125mg (Powder)

0.0156mg (Powder)

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

0.2344mg Total

That is a 6.2% reduction.

 

 

Here is an example of reducing the dose from .25 mg by .03125mg

0.125mg

0.0625mg (Chip)

0.03125mg (Powder)

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

0.21875mg Total

That is a 12.5% decrease.

 

 

 

Love to you,

Summer

 

[[Ve...]]

I was on 3 mg of clonazepam for six years  (at least - that is as far back as my pharma records go).  I self-tapered off 1 mg without too much trouble, but could go no further.  Highly recommended Dr. took me off remaining two mg in four weeks.  I thought I must have some other problem symptoms were so horrible and, hey, I was benzo-free, right?  GP verified benzo withdrawal.  Same  highly recommended Dr. took me from 2 mg clonazepam to 5 mg Valium in one week.  Wound up in emergency room and given huge dose of  Ativan.  I went back up on Valium myself.  No relief.  Now all is totally messed up. Pain is unbearable.  Have read Breggin, Ashton, and others.  Question is where do I go now?  Back to 3mg clonazepam? Start again on Valium?  I am scared of Dr.  Where else can I go?

[[bu...]]

I just started my klonopin taper from .5mgs  6 days ago. I went down to .33 mgs. Not sure how long before I make my next cut. Going through hell right now as this is my second taper as well. Reinstated about 2 months ago