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Liquid Taper 0.5mg clonazepam 3ml/day


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After watching an easy-to-follow video on youtube on how to liquid taper off of benzodiazepine, I created the excel model in the screenshot below that I used to see how far along my wife could taper (if all goes as planned) using a liquid taper strategy.  It would cut 13% every 2 weeks gradually each day.

 

Is this the general idea of a liquid taper and what are your thoughts on the cadence?  Is it too aggressive a plan?  She is coming on 3 months of taking 0.5mg of clonazepam daily.

 

Liquid Taper of 0.5mg clonazepam 3ml / day

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Personally I think 13% every two weeks is too much. It's also important to remember that cuts have an accumulation effect so she might be okay with the first two or three but I'm mindful that it will likely catch up with her.

 

Also if I look at your sheet and if my understanding is correct,  her cuts are linear reductions i.e. she's making the same reduction each day. This means the percentages keep increasing over time. That is not ideal. The way I do my liquid taper is calculating my percentage on a two week basis to avoid linear reductions.

 

I don't plan my taper ahead of time. I have a journal where I keep a daily record of my symptoms and the intensity of my symptoms. I rate my symptoms on a scale of 1-10. I also note any other circumstances or meds/supplements that might contribute to symptoms. Based on this, I then decide every 2-4 weeks how I'll proceed with my taper and at what percentage I'll taper. Whether I'm slowing down or keeping it the same. I hope this helps. Please keep asking if you have more questions.

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I agree with jelly baby. 

 

Given what you’ve shared in your other posts, it sounds like your wife has become physically dependent on — not addicted to — clonazepam (see link below to learn more about physical dependence vs addiction). Although you both want to get her off the drug as quickly as possible, you also want to do so in a way that keeps her withdrawal symptoms tolerable. The only way to determine what taper rate (percent reduction over time) she can tolerate is via a series of experiments in which she is both the experimenter and the subject.

 

In case you are not already aware of this …

 

In the US, clonazepam is available in 0.125mg and 0.25mg Orally Disintegrating Tablets. A stability-tested formulation for a professionally compounded 0.1mg/mL oral suspension is also available (see link below).

 

My apologies if you’ve already shared this elsewhere, but what is your wife’s daily dosing schedule?  How many milligrams of clonazepam does she take at what times?  Is she experiencing any signs of interdose withdrawal (i.e. withdrawal symptoms are emerging in between scheduled doses)?

 

Links:

 

Addiction vs Physical Dependence - Benzodiazepine Information Coalition

https://www.benzoinfo.com/addiction-vs-physical-dependence/

 

0.1mg/mL Clonazepam Oral Suspension from Nationwide Children’s Hospital

https://www.nationwidechildrens.org/-/media/nch/specialties/pharmacy/compounding-formulas/clonazepam-oral.ashx

 

Interdose Withdrawal - Benzodiazepine Information Coalition

https://www.benzoinfo.com/interdose-withdrawal/

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I see a request from Libertas for additional information of your wife's situation, filling out your signature with the pertinent information would insure other members will provide suggestions based on the current situation and the best part is you won't have to repeat yourself.  Here are the instructions. Add your history/signature
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Thank you all. I just updated the signature with more details.  She was originally prescribed 1mg of Clonazepam each night before she goes to bed.  She decided to only take 0.5mg which addressed the issue and has kept it there since with the exception of two nights where she had a bad withdrawal during attempts to ween off and she then bumped up the dose to 1mg. 

 

One concern we have is she feels as if the Clonazepam is currently trying to coax her into taking more. Last night she woke up at 5am and told me she had some slight jerking.  Has this happened to anyone else?  If so how to you address the dose when this happens?

 

I hope this information helps and any feedback you can give us we appreciate.

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If the jerking was a pre-existing condition it is likely to return when discontinuing benzo's. I'm sorry to be the bearer of bad news. I was prescribed Clonazepam for spasms in my jaw and ever since I started tapering it is back with a vengeance. The problem with benzo's is, it gives symptomatic relief it does not address the underlying problem. When you grow tolerant to the dose the condition will resurface again. You'll have to take increasingly more to treat it.
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Thank you for adding your signature.  It looks like you and I will have to agree to disagree on whether your wife is addicted to versus dependent on the clonazepam. ;)

 

I have the same understanding as jelly baby.  If the myoclonus was a pre-existing condition, it will likely reoccur when the clonazepam is discontinued.  If you have not already done so, you and your wife might want to investigate other treatment options (see link below).

 

Is the return of the myoclonus the only symptom your wife is experiencing?  Or is she also experiencing other symptoms commonly associated with benzodiazepine withdrawal (e.g. increased anxiety, insomnia, irritability, appetite/weight change, GI distress, sensitivity to sounds/light/temperature/touch, balance issues).

 

I ask because I’m now wondering if your wife has become tolerant to the clonazepam.  Tolerance means that the drug stops working effectively at the current dose.  In some cases, tolerance can occur within just a few weeks.  The ‘solution’ to tolerance is to increase the dose, but it’s likely the individual will eventually become tolerant to the higher dose. 

 

What time does your wife take her evening dose?  The fact that she woke up at 5am with myoclonus raises the possibility that she may be experiencing interdose withdrawal.

 

Link:

Myoclonus - Diagnosis and treatment - Mayo Clinic

https://www.mayoclinic.org/diseases-conditions/myoclonus/diagnosis-treatment/drc-20350462

 

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Thank you everyone for the feedback I really appreciate it. Please don't take anything I write as disagreement.  I'm acting as a conduit for my wife though she is fully on board with everything I write here. She just has a lot of anxiety with health-related issues caused by watching her mother being significantly ill throughout her childhood.  If she reads some of the feedback here it may trigger her, otherwise, she'd be logged into the thread.  In fact, I asked her if she wanted to just for the moral support she'd get from all of you and she told me she'd rather I work as a conduit

 

We also wonder if what she has is physical dependence or if it is the underlying symptoms she had earlier, though there is no way to tell and she has symptoms of physical dependence.

 

With regards to her underlying condition..... After having an MRI, cardiac ultrasound, a stress test, stress test with an ultrasound, and a cat scan, from the Cardiologist, they diagnosed she has a racing heart and prescribed her beta blockers.  2 months after she began having the hypnic/myoclonic jerks at night that kept her up for 4 days straight. That is when she was prescribed Clonazepam which helped with the jerks. 

 

We then got an appointment with a Neurologist who performed a cranial MRI (twice) an in-office EEG (1 hour), a 48 hour at-home EEG, and an ultrasound of her brain, along with some functional tests in the office.  The Neurologist responded that she does not have any manor neurological issues or disorders that would be caught through these tests..... so now my poor wife, who already health-related anxieties from her upbringing is left not knowing what is causing her symptoms. One Cardiologist suggested it could be an autonomic disorder similar to POTS that he's seen in patients with Long COVID and may go away after 12 months, but the symptoms began 6 months after we contracted COVID.

 

With regards to the Clonazepam, Now that my wife knows what it is she doesn't want to take it and wants to ween off of it and transition to another treatment for the jerking symptom once she tapers off of the clonazepam. Her Neurologist is suggesting Neurontin as a non-addictive alternative, we are hearing others suggesting CBD as an anti-convulsant and we were directed to the story of Charlotte's Webb.

 

She does have many symptoms of physical dependence on clonazepam.  Most notable,

- nausea/dry heaving

- Loss in appetite, resulting in weight loss (she's 5'4" and typically weighs 103, she's down to 98.9) and I'm pushing her to eat.

- She does have sensitivity to sound now.

- Brain Fog and she's often distant.

- pins/needles in her legs (she experiences them as bubbles.... she says it feels like bubbles rolling up her legs).

- Out-of-body experiences (she feels like jumping out of her skin)

- Thoughts of death.

 

All of this is scaring the crap out of her and me. She wants off immediately but realizes the pain involved in it and I am highlighting to her what I'm reading in this thread and what I've read in the Ashton manual. 

 

I hope this helps give some color and thank you all for the help and guidance you've offered me so far in this journey, though I know I've been here very shortly..

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Thank you for checking in, we really appreciate the concern and support.  Her neurologist suggested a tapering plan that weens her off in this manner:

 

Week1/Week2: 0.5, 0.5, 0.25, 0.5, 0.5, 0.25, 0.5

Week3/Week4: 0.5,0.25, 0.25, 0.5, 0.25, 0.25, 0.5

Week5/Week6: 0.25,0.25,0.25,0.25,0.25,0.25,0.25

 

Then we'll continue from there. He suggests Neurontin as a replacement for the night convulsions which we are going to keep on hand. If this plan fails, my wife agreed to try the microtaper which I have prepared in the event this plan doesn't work. 

 

We got her a medicinal marijuana card and went to the dispensary and got 5mg indicol thc mints to use as a sleep aid as well as a cbd/thc blend to help with anxiety and nausea intraday.  This has really helped her so far.  She's taken the 5mg indicol mint a half hour before she intends on going to sleep then takes her portion of clonazepam based on schedule above right before she goes to bed.  Her sleep has improved significantly and the cbd/thc has helped ease her nausea and her jerks. 

 

In addition, each week we've started off with a Sodium Chloride IV (standard saline solution) which also has B12, Magnesium, and Glutathione.  This has helped give her energy to get through the week. 

 

 

We will keep you updated on how this coming week goes. We're currently at the Neurologist office hoping we get another refill of the clonazepam.  My wife got into a heated argument with the practitioner who prescribed her this medicine originally because she was upset she's been prescribed it so we now need the Neurologist who gave her the detox plan above to partner with her to give us enough medication to draw down safely.  She only has 14 days of this forsaken medication left. Please pray for her.

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I'm thankful your wife has found some relief and I hope you get the medication she needs to find her way off of the Clonazepam, thank you for keeping us informed. 
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