Jsince - may need to consider titration

[[...]]

Jim,

 

I am hanging in there, have a doctor appointment today.  I am not feeling as well as I would like to be feeling at this point post-benzos.  It's interesting we recieved nearly the same taper advice.  I think slowing down is a good idea, I honestly believe I tapered too quickly.  Slow and steady wins the race.  Hang in there, my friend.

 

Tim

[[Js...]]

Thanks Tim, let me know how the DR. appointment goes, send me a PM if that is preferable.

 

Jim

[[Js...]]

Colin, T@, TC, whomever....

 

I am now at 46ml/.46mg of K. That is split into 3 daily doses of .15 @ 7:00am, .05 at 2pm and then .26 at 9:30pm.

 

I am reducing in a rotating fashion, taking 1ml of morning, then 1ml off afternoon then 1ml off the night.

 

As I now get down in overall dosage the afternoon dose is starting to get small and soon will be nonexistent and then after that the morning dose will fall off leaving me with only a nightly dose.

 

Is that OK?  As the afternoon get less and less, should I try to hold out on the morning dose till 9:00 - 9:30 am to make it a more equal 24 hour distribution? and lastly, once I only have a nightly dose is that gonna cut it?

 

You comments on this would be greatly appreciated.

 

Also, now that I am at roughly still .50 of K, should I consider doing a cross over to Valium to make the peaks and valleys a little more manageable?

 

Thanks,

 

Jim

[[Co...]]

Hi,

 

In your shoes, I think I would be tempted to equalise the three doses, rather than tapering off the afternoon dose well before your morning and evening dose. Klonopin has an averagingly long half-life, and many people find that it is best for them to take it three times a day.

[[Th...]]

I thought we recommended in previous posts to leave them at 3 doses per day? I always made up the whole dose for the day, take out the appropriate amount for the day and then divide it into 3 doses per day.

[[Js...]]

How would I go about that Colin, do I stop cutting altogether and start to spread out the doses? How do I equalize them? all at once or in some form of stepped fashion?

 

what did you think about the Valium idea?

[[Js...]]

Colin, T2, any suggestions

[[Th...]]

That is split into 3 daily doses of .15 @ 7:00am, .05 at 2pm and then .26 at 9:30pm.

 

I would start by moving 1ml at a time over to the mid day dose from your night time dose until it is somewhat even with the others.

[[Js...]]

Hi Theresa, how did the LANAP go?

 

That sounds like a reasonable plan but again the insomnia doc said she wanted to try to keep the nighttime dose a little heavier, kinda what Prof. Ashton suggests too if you are having sleep issues.

 

Any comment on the idea of switching over to Valium for the last .5K (10mg V)? that way we could realistically get away from the midday without issue.

 

Thanks again and don't mean to be a pain, just trying to figure out the right plan.

 

Jim

[[Th...]]

Hi Theresa, how did the LANAP go?

 

That sounds like a reasonable plan but again the insomnia doc said she wanted to try to keep the nighttime dose a little heavier, kinda what Prof. Ashton suggests too if you are having sleep issues.

 

Any comment on the idea of switching over to Valium for the last .5K (10mg V)? that way we could realistically get away from the midday without issue.

 

Thanks again and don't mean to be a pain, just trying to figure out the right plan.

 

Jim

 

This time was worse than last week. He hurt me really bad with the numbing shots.  :'(  I just hate being that numb and on top of it I bit my tongue in the back after he asked me to close down and grate my teeth!    He should have helped me keep my tongue out of the way, dumb ass!!  When I got home both times, I took 3-200mg of Advils,  then two hours later, 2-325mg of Tylenol. Then 6 hours later I'd do that again, at least the Advils. By the next day I only really needed one or two Advils or Tylenols. So the pain of the actual surgery is not too bad. The biggest deal is not being able to eat too much as you've experience with your extraction. I'm still not allowed to eat on the side done two weeks ago other than soft foods. You might want to google LANAP and see the aftercare instructions.

 

If I was you, I would not consider crossing over to Valium. It can take quite a few weeks and many experience a lot of depression and nausea with Valium. If you want to leave the night dose a little heavy, go ahead but do not eliminate the day time dose, IMO.

[[Co...]]

Hi Jim,

 

I will look at your questions tomorrow. Feel free to send me a reminder PM.

[[Co...]]

Hi Jim,

 

If you are experiencing inter-dose withdrawal effects, then yes, switching to a three-times-a-day regimen would make sense. Try to space your doses eight hours apart, or as near as you can reasonably manage. I'd move just a fraction of your dose every few days (or a ml or two every day, as Theresa described), and if you are not reducing your overall daily dose, I would imagine you could do this within a week or two will no ill-effects.

[[Js...]]

Colin, that is the thing, I don't think I am experiencing inter dose withdrawal at this point, the midday has always been the smallest dose and it never really seemed like I needed it. This may help, right now my symptoms are worse in the morning then get better as the day progresses. I usually take my afternoon dose (.05 right now) at 2:00 but I never am craving it, sometime I forget to take it until 3:00 - 3:30 and even then it just because I remember it, not that I'm starting to jones for it. I will say I have never completely missed it so don't have that to compare too. So....I'm quite sure I don't have interdose withdrawals at least at this point, does that change anything in your recommendation?

 

If you still suggest balancing out the doses, instead of "moving" the amounts to become more equal, could I just start reductions more often from the nighttime dose instead of the morning and afternoon. For instance take 2 consecutive reductions from my nighttime dose, then a single reduction from my morning dose and leave the afternoon dose alone for now until they become more equal. Or, does that lead to the  possibility of having further complications.

 

Thanks again, I'm not trying to be difficult, just want to consider all the options,

 

Jim

Jim

[[Co...]]

Hi,

 

I misread your signature. I thought you were taking 0.48ml twice a day. Perhaps you could clarify your daily regimen for me.

[[Th...]]

Hi,

 

I misread your signature. I thought you were taking 0.48ml twice a day. Perhaps you could clarify your daily regimen for me.

 

This is what he's taking now...    .15 @ 7:00am, .05 at 2pm and then .26 at 9:30pm.  That is in mls but also equals the mgs.

[[Co...]]

Thanks, Theresa.

 

Jim,

 

Your overall dose is low, you seem to progressing without too many problems, so I would not worry too much about any of this. I'd adjust your doses according whet you feel is the most appropriate. If you feel there are no real problems, I guess, in your shoes, I'd tend towards equalising your doses simply by concentrating your reductions on your morning and evening doses until they equal your afternoon dose. These things are best left to the person following the taper - there are few (if any) hard and fast rules.

 

If you feel your morning anxiety is in need of extra medication, then perhaps leave the morning dose alone, and concentrate your upcoming cuts towards your evening dose. Honestly though, you will know better than any of us what you should do.

[[Js...]]

Thanks T2 and Colin, thanks for reminding me that I am at a low dose, even at .44 ml/mg the end seems so far away.

 

I will just start to whittle away at the morning and night dose and see if all stays relatively OK. I'm not sure about the morning anxiety, sometimes (actually alot of the time) it feels that the anxiety is worse after taking the dose than better. Who know.....

 

I'll keep ya updated and pray for the best.

 

Jim

[[Js...]]

Colin, sorry to keep second guessing everything but I'm kind of caught between recommendations. As I mentioned I am working with the Director of a local insomnia clinic in town, they use Klonopin at times in their practice and is very familiar with bringing people of benzo's while trying to minimize impact on sleep. Her typical recommendation to her patients are .125 reductions every 3 weeks so she is definitely in tune with a slow taper. I spoke to her this morning and she is pretty adamant about keeping the nightime dose higher than the rest. She feels that since my midday dose is already quite low (.05) and that I feel OK in the afternoons that I should continue on my stepped reduction and let that dose fall off the map as the time comes. I know it is a personal decision based on my situation, I do see others on the board doing 2 doses a day and in some cases a single nighttime dose. Also, if I were just doing the .125 dry cuts that midday dose would eventually fall off too before the others. So....with all that said would I be making a grave mistake in following her recommendation? she also suggests holding off on taking the morning dose will roughly 10am so we can get a 12hour spread between doses.

 

what do ya think,

 

Jim

[[Th...]]

Jim,

 

No one can predict what is the best way for you, that is why we always recommend to "let your body be your guide". If you are not feeling bad in the afternoon, then go ahead dump that dose and do what the sleep clinic director said, see how things go.

 

T2

[[Js...]]

Hi T2, thanks. I think I may go that route, things have been going OK for me in this taper compared some and I'm down so low in the afternoon that you would think if I were gonna have problems that they would start to show up by now, maybe that is a stupid assumption but seems valid.

 

hey, question for ya. As I get lower we have to admit things can get tougher. My dilemma is that I have to be able to work, what does one do if they find them getting into a withdrawal situation that is impacting/preventing that from happening. I am in sales and love my job but sometimes it can be a bit stressful, I used to actually like that part of it but now that isn't quite as enjoyable. I really don't want to go back on the benzo but I also can't retire yet (only 48) and I get become unemployed, that is just not an option. If I have too I will be forced into taking this stuff, and words of wisdom?

[[Th...]]

I would tend to think that if you keep things slow and steady, you should be fine. Not everyone has a problem the lower they go, some do better the lower they get (ST). There's just no way to know how you will do so try and be optimistic that you will also be fine.

[[Js...]]

Thanks for the optimistic words T2, I know that there is no real answer till you are there. I have spoken w/ ST a couple of times, I know his depression go better but he will also admit it maybe the AD's he started to take. I guess I will just have to keep my fingers crossed, continue to slowly taper and see where I end up. My considering an AD is always an option too, just rather not go their. Not sure how I would react to them given my current state of affairs.

 

Thanks again Theresa,

 

Jim

[[so...]]

jsince, still moving down the titration ladder.  gonna hit the bottom sooner than you think

st

[[st...]]

How are you doing, Jim?  Hope all is OK.

 

Patty  xo

[[Js...]]

Hi Patty, after a tough Sunday the past couple of days have not been to bad at all.

 

And you?