Tentatively Looking at Titration

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Currently taking 5/8ths of a .5mg tablet split into four doses through the day:

1/4 tab at 9.00am

1/8th tab at 2.00pm

1/8th tab at 6.00pm

1/8th tab at 10.00pm

[[Th...]]

Currently taking 5/8ths of a .5mg tablet split into four doses through the day:

1/4 tab at 9.00am

1/8th tab at 2.00pm

1/8th tab at 6.00pm

1/8th tab at 10.00pm

 

Got it!! 

 

.125mg at 9:00am

.0625mg at 2:00pm

.0625mg at 6:00pm

.0625mg at 10:00pm

 

For a total of .3125mg!! 

[[Lo...]]

t2 your realy gooood with math wow!

[[Th...]]

t2 your realy gooood with math wow!

 

Thanks!! (as my trusty calculator takes a bow!) 

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.3125mg sounds better than 5/8ths of a tab.  I'll use that measurement in future.  Looking forward to getting to .25 and getting a titration plan in place.

LB

[[Co...]]

Hi LB,

 

I am not suggesting a taper rate for you, but wish to give you some perspective about your dose.

 

0.3125mg Klonopin is a low dose. I am not suggesting that you need be anything but cautious in your withdrawal schedule, but your should not expect that it will take many months to withdrawl from this dose. If you are reducing your dose by and eighth of a pill, most of our member would consider two weeks between each cut as slow. However, there is great variability in how we experience these size of cuts, so you do what works for you.

 

You should keep in mind that at a low dose (so long as you have followed a sensible taper plan), your GABA system will have largely recovered even when taking this low dose. So, the small dose of Klonopin is is just small part of your GABA picture. When taking a large dose, it the benzo that is dominant part of the picture, so we must be very careful to keep cuts small (in terms of percentage). What I'm trying to say is that you should be confident that these 0.0625mg cuts from your present dose of 0.3125 will be, in all probability, really quite manageable. Try to be positive about it.

 

As you dose continues to lower (and you are taking less than four individual doses per day), you might make up a small glass of milk with single (one-eighth) dose, and split the drink into two or three smaller doses over the day. This will help protect you against inter-dose withdrawal effects.

 

You will probably not require a schedule, but I can draw one up for you if you feel the need. Just let me know.

 

Take care, and good luck.

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Thanks for your info Colin.  I realise from the fact that I have no real physical "need" in terms of anxiety to take the K, ie when I wake up in the morning I am not hanging out to take the medication, in fact I sometimes forget to take it until up to an hour after my scheduled dose.  My therapist agrees with me that I should continue to reduce, but I have some disagreement with my support group counsellors who advocate a very slow withdrawal.  They know nothing about titration and if I tell them I have got advice from a web site in the US I worry what their reaction will be.  I am a little confused, but as I generally have the anxiety under control most of the time and although I do get some w/d symptoms I am in a good place mentally, quite positive and really feel that a lot of the anxiety I still have is about being on benzos.  I have a fantastic husband who gives me great support and takes a lot of the unnecessary pressures off me while I am in withdrawal - I am very lucky in that respect. I  am prepared for a continued battle which may or may not arise in getting off the remainder and therafter - it can't be as bad as when I was told by my GP to reduce half a tab every three weeks, can it!

Thanks again, great forum and great additional support.  Will look at the using milk in the initial stages and just keep going.

Lynn B

 

[[Co...]]

Hi LB,

 

Your doctor has a responsibility to look after your medical needs. Although many doctors appear to be very gung-ho about benzo withdrawal, websites such as BenzoBuddies cannot know better than your doctor. All we know about our members is what they report to us, we do not know their full medical history, and we are not doctors. Like us, real-world support groups need to understand their limitations. It is not for BenzoBuddies or any other support group to dictate to you at what rate you should taper off your benzos. I'd go further and suggest that is not for your doctor to tell you this either - your doctor should support you, save if you propose proceeding in manner that s/he feels is dangerous.

 

We can discuss the possible pitfalls of a particular proposed action, but the final decision is yours to take.

 

This is not a "web site in the US". We are an international support group. If you were to assign a nationality to this place, then I guess it is more British than anything else, since I am British and own the domain. But really, my nationality, or where site is physically located (the web server) is irrelevant.

 

Support groups should not be judgemental. I try my best to keep this place as unjudgemental as possible. I have some small amount of training in counselling, and non-judgementalism is a central tenet - this should extend to support groups.

 

Whatever you decide to do, we will try our best to help you.

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Thanks - sorry didn't mean to label your site like that.  I agree that the advice given through this site is excellent .  I was just preempting what my counsellors will say - they are quite insular in their opinions and because they probably won't agree with titration (because of their lack of knowledge of the titration process) I guess I fear what they will say if they know I going to take that path.  To them I suspect "advice from the internet" would not be something they would recommend  because they are being judgemental (I disagree with them of this one).  They follow the Ashton withdrawal methods, but for some reason favour a much slower withdrawal because of peoples' "fear" of being drug free.  To me the day when I can be benzo free will be a good day, even though I fully realise that the healing will still have to go on past that day.  Unfortunately there seems to be so little knowledge by the medical profession about benzo withdrawal here that I have to rely on my support group and BB for advice. To me titration of the last small dose seems logical and I am gathering all the equipment necessary so will be in touch for a schedule sometime soon.

My doctor  also feels that if I want to try titration that is ok with him but again his knowledge of the w/d effects of benzos seems limited so I have to decide really what is best for me.

[[Co...]]

Hi LB,

 

I didn't take any offense (I'm sorry I gave you this impression) - I was just trying to make clear our position to anyone reading this thread.

 

I've talked with Prof. Ashton about various withdrawal methods, and e-mailed her for comments on my overview of Direct, Substitution and Titration methods. She replied:

 

Dear Colin,

 

I think that is very good and very balanced. I have no criticisms. Thank you for asking my opinion.

 

Best wishes,

 

Heather

 

The overview:

 

Direct Taper

 

Advantages: simple; wide support from doctors; probably all that's required by the majority of people in the general community looking to quit benzos.

 

Disadvantages: many benzos are too potent to allow a smooth taper for some people (or the pills prescribed are too large in dose for successful pill-splitting); many benzos have too short a half-life to allow a smooth taper (interdose withdrawal is often a problem); can be tricky to split pills accurately.

 

We suggest that unless past experience of attempted tapering indicates otherwise, members should initially try cutting their dose by no more than about 10%, and will probably make new cuts (about 10% of their dose at the time of the new cut) every 7-14 days. These figures are intended as ballpark estimates - mileage will vary.

 

 

Substitution Taper

 

Advantages: switching to an equivalent dose of Valium from a short half-life benzo (this must be carried out gradually) virtually guarantees that you will experience no interdose withdrawal effects; switching from a very potent benzo to Valium allows for much smaller cuts to your dose (more frequent small cuts are better tolerated than less frequent large cuts); if you have had problems sleeping, you may benefit from the sedating effects of Valium.

 

Disadvantages: some planning is required with a switch to Valium (but we will help you with this); an equivalent dose must be calculated and tweaked where necessary to suit the individual; many doctors (particularly in the USA) do not support a switch to Valium; switching will likely add to the overall time taken to withdraw; a small number of people appear to not tolerate the switch to Valium very well (this sometimes might be due to the wrong equivalent dose being prescribed or a failure to tweak the dose for the individual concerned according to how they react).

 

Prof. Ashton achieved very good results in her clinic by switching patients to Valium. Usually, her patients had already failed to quit benzos via the Direct route. If your doctor is supportive, and willing to adjust the equivalent dose as required, you are more likely to benefit from substitution.

 

 

Titration Taper

 

Advantages: allows for a very smooth taper, even when tapering from a large dose pill and/or potent pills; does not require a sympathetic doctor.

 

Disadvantages: ties you down to the kitchen, as a fresh batch must be prepared each day, and refrigeration is required too; your doctor might be unsupportive if you explain that you are 'titrating your benzos'; interdose withdrawal effects still might be a problem if you are taking a benzo with a short half-life; it is more complicated, and requires the purchase of some equipment.

 

We will work up a titration schedule for you, and post it to this website - just print it off. It will include the exact dose to be taken and the dates of changes to your dose. It might appear a little complicated at first sight, but once you have gone through the preparation once, you will find it is pretty straightforward.

 

I'm sorry, and I do not mean to put you off your counsellors, but I understand enough about counselling to know that you should not be judged in this way. As for Prof. Ashton's protocols, even Prof. Ashton understands and appreciates that different approaches other than hers are valid and are sometimes warrented and more appropriate. If Prof. Ashton understands this, so should her devotees.

 

I am singularly impressed by Prof. Ashton, not because I think she is always right, but because she does not think she is always right! She is a proper scientist.

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To0 true about Professor Ashton - she is a wise lady, but no doubt along the way she has ruffled a few feathers and she is only human.  But she is a true advocate for not using benzos in circumstances such as mine, and in fact I didn't necessarily want long term medication, I really wanted talking therapies.  Unfortunately I now realise that in my city there is a very long wait to get into our only Anxiety Clinic so medication seems to be used quite widely to allow people to function normally (for a short time at least).  Just wish someone had told me it was addictive so quickly!

I am reassured that you have been in contact with Heather Ashton for advice from time to time and I have definitely decided to titrate.  The counsellors I speak of are benzo survivors, but they tend to put us all in the same boat in terms of our initial need for benzos and for how long we have been on the drugs.  I do feel they need to be a little more open-minded and if I am successful with titration maybe I can educate them too that this is another method of getting off this poison.

As I said I am gathering my equipment together for my "drug lab" and will be in contact again when my 100ml cylinder arrives - I order through the internet.

Thank you again for your replies and for all the good work you do.  I am glad to have found this site and will continue to post and support others as they go through bad patches and alternatively seek support should I have rough times also.

 

[[Lo...]]

hey lb i wasnt around to congratulate you on your being free of benzos .. sorry. but id like to say now congrats and knew you could do it!

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Thanks LIB - yep now nearly seven weeks benzo free and it keeps on getting better and better.  Thanks for your good wishes.

 

I wasn't around on BB during your taper from the dreaded poison but hope that your benzo free life is going fine - you certainly had it together during the final stages.