Klonopin and doctor's advice

[[hy...]]

Hi everyone.  My heart goes out to all enduring the the symptoms and pain induced by prescribed benzo drugs.  I have been on clonazepam for 12 years at 1 mg. and have drank through most of that time usually heavily.  I quit drinking Jan 1st and began tapering K Feb 1st.  I started out by reducing as per doctors order at .25 mg per week but I took it much slower.  I am now at .5 mg daily and suffering.  I am doing .25 reduction every 2 weeks now though I started out more slowly.  I have extreme inner tension that has me cowering at home and doing as little as possible besides working.  I know I need exercise but it is tough to motivate and I am not as young as I used to be.  I quit coffee as well and am due to go to alternating days tomorrow of .5&.25 then in two weeks to .25 daily , then 2 weeks .25 every other day, then  2 weeks and stop.  I am very worried that if I feel like this now how will I feel mid May when I am on nothing.  Will this pain last forever?  Right now I am thinking of drinking but know I must not.  Guess I am just looking for a way out of this pain.  Any advice at all appreciated, thanks and good luck and health to all going down this road. 

[[pi...]]

Hi hyper1,

 

I do think that you are tapering too quickly from this strong medication.  I know it is per doctors orders but perhaps you can tell him about your symptoms and slow the taper or even consider titration.  Slow and steady wins the race as far as withdrawal goes.

 

Please do not take a drink.  Alcohol targets the same receptors as benzos so it is like updosing which can really mess with your withdrawal and recovery.

 

I tapered from .5 clonazpam with a crossover to valium.  That process took me 9 months. Perhaps you should stay on this dose for a while until you stablize.

 

Others will be along to offer their help and suggestionss.  This is a tough battle and my heart goes out to you as well. The one certain is that you will heal, time will allow balance to return to your system.

 

pianogirl

 

[[...]]

I'm not sure alternating doses daily is a good thing since this is essentially updosing every other day.  A taper generally means slow and steady reduction of a dose.

You may wish to discuss a slower rate of taper and smaller reductions for your remaining .5 mg.  Here is a link to the Ashton Manual http://www.benzo.org.uk/manual/.  The suggested rate of taper is 5% to 10% every 10 to 14 days.  Many people find they need to go slower than that or make smaller cuts especially at the lower doses.

 

[[Ha...]]

I can't imagine tapering off 1 mg of K in 4 weeks after 12 years of daily use.  I thought I could do it in 6 months but when I reached .25 I had to slow down because the symptoms were too severe.  I would suggest that you not put a target date on completing your taper, just listen to your body and go at a rate that you can handle without too much suffering.  I also would not recommend varying your doses day to day.  The purpose of tapering is to slowly reduce the concentration of benzos in your system in order to minimize the w/d effects and allow you to continue living your life.  If your concentration is varying day to day it's going to be tougher for your body to stabilize.  If you can cut your pills into smaller pieces, it is probably better to split your doses into 2 or 3 per day, and don't drop by 50% at a time when you get to the smaller doses.  This is just my advice, as I'm going through the same thing you will be going through.  I think getting off Clonazepam is a good decision.  Best of  luck.

[[hy...]]

Thanks Pianogirl ~ Half-life ~ & mmgc for your quick and sensible responses.  I feel better already just listening to people who know what they are talking about.  I know the booze is a bad idea but the mind plays tricks so thanks for reinforcing that Pianogirl.  Also Half-life and mmgc for your responses.  I will read and re read these as I am sure there is a way out of this.  I plan on doing as you guys suggest and remaining at .5 mg until I feel confident of a further cut.  Also the alternating between .5mg and .25mg I will change to just cutting down a little each day when I am comfortable and stable on the .5mg dose & my body adjusts to it. Look forward to being free one day.  I think I was panicking about my upcoming cut and the three of you made me feel much better so I thank you for helping ease my apprehension.  I am committed to getting benzo free and tell myself it will not be easy but is doable.  I am sure I will be around looking for more advice so until then, thanks ~hyper1

[[li...]]

My point of view is that it's definitely possible to taper too slowly.

 

A slower taper doesn't guarantee less agony.

 

As I see it, if you can handle the taper your doctor suggested you should probably/mostly stick to it.

 

Most likely there is no easy way to get off. The longer you are tapering the more opportunity for things to go wrong. Also I have serious doubts about almost continuously adjusting doses, it might be very destabilizing.

[[su...]]

Hello hyper1,

 

I see you are at 0.5mg of Klonopin. I am almost to 0.5mg of Klonopin as well. I put together some information that may be helpful, along with an example of a dose reduction from 0.5mg.

 

 

 

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) 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.

2) I listen to my body and hold until it feels like it has adjusted to the new lower dose. I usually get a few lower symptom days before I do another dose reduction.

3) My average holds have been 2 to 4 weeks

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

5) 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 0.25mg:

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 0.125mg

 

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 0.0625mg

 

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 0.03125mg (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 0.0156mg (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.

 

Cutting 0.0078mg (Powder)

 

Crush a 0.625mg into powder and separate into 8 piles.

 

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 hyper1,

 

 

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."

 

 

 

Take Care,

Summer

 

[[su...]]

Hello hyper1,

 

 

I was re-reading Peter Breggins” book and found something that might 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)

 

"Stay in Charge of the Withdrawal. This is not to say you should let your doctor control the withdrawal. Even if you have been given every possible reason to believe that he or she understands the withdrawal process, it has to feel like a collaboration. And since physicians often withdraw patients too abruptly from psychiatric drugs, above all else you must feel free to slow the process down. “

 

“Sometimes, as we discussed in Chapter 9, doctors cut the dose by half from one day to the next, while still calling this a “gradual” withdrawal. Such an abrupt reduction is an imprudent strategy in most cases. Because of ignorance, lack of experience in patient-centered withdrawal, or even an unacknowledged wish to sabotage your effort, your doctor may rush ahead and create unnecessary complications. The unfortunate outcome will then be used to prove to you that withdrawal was a bad decision to begin with.”

 

“Some of the steps discussed in later chapters of this book, such as seeking replacement solutions and mastering techniques to cope with various manifestations of your problem, will help you to show your doctor that you are motivated, responsible, and capable of withdrawing successfully.”

 

“If attempts to enlist your doctor’s cooperation or assistance fail, you should be neither surprised nor discouraged. Remember that you, and no one else, will do the actual “work” of coming off drugs. You will feel the pain, you will experience the rewards. You will have to deal with the objections and fears of those around you who resist the idea that at least some of your current problems are actually drug-induced. You must therefore try to be in charge of the entire process from the very beginning, from the very first moment you decide for yourself that coming off drugs is your goal.”

 

 

 

I am thinking of you and wishing you well,

Summer