Need help with a crossover plan.

I have been on Klonopin since May 09 at 2mgs. per night. I have made my way down to .75mgs. at night. I was wondering what the best way to crossover would be and how to taper. I have been having alot of trouble and maybe this way would work smoother. A reduction plan would be very helpful. It would be to Valium.

Thanks!!

David.

Hi David,

What dose pills do you use? If you do not have them already, I suggest you talk to your doctor about using 0.5mg Klonopin tablets. These will allow you to make smaller substitutions.

First of all, you will need to agree a substitution dose for your Klonopin. Professor Ashton suggests 15mg Valium in substitution for 0.75mg Klonopin, but in the States, doctors usually will usually substitute 7.5mg Valium for 0.75 Klonopin. The truth is that there is individual variability in what constitutes a suitable substitution dose, so if your doctor is willing to be flexible according to how you react, this will help.

In any case, if you substitute gradually, this will help offset any inaccuracies in what would be a true substitution dose for you.

Assuming you have 0.5mg tablets, and you can quarter these tablets, this would mean that a dose of 0.75mg Klonopin would be equal to six quarter tablet doses. All you need to do is substitute a quarter tablet for the agreed (with your doctor) equivalent dose of Valium. Because of the way these tablets divide (a quarter of a 0.5mg Klonopin tablet equal 0.125mg), and if your doctor prescribes x10 Valium in substitution (1.25mg Valium), and because 1.25mg Valium is not easily achievable using 2mg Valium tablets), I suggest that you take 1.5mg Valium in substitution to 0.125mg Klonopin. If you doctor prescribes more, this might be even better (but take account of my earlier comments). Assuming a total substitution of 7.5mg Valium for 0.75mg Klonopin (but rounding up to 9mg for simplicity of dividing 2mg Valium tablets), your substitution schedule might look like this:

Edit

Assuming you have 0.5mg Klonopin tablets, and you can quarter these tablets, this would mean that a dose of 0.75mg Klonopin would be equal to six quarter-pill doses. All you need to do is substitute a quarter tablet of Klonopin for the agreed (with your doctor) equivalent dose of Valium. Because of the way these tablets divide (a quarter of a 0.5mg Klonopin tablet equals 0.125mg), and if your doctor prescribes Valium at a rate of x10 in substitution for Klonopin (1.25mg Valium in substitution for 0.125mg Klonopin), and because 1.25mg Valium is not easily achievable by dividing 2mg Valium tablets, I suggest that you take 1.5mg Valium in substitution to 0.125mg Klonopin. If your doctor prescribes more, this might be even better (but take account of my earlier comments). Assuming a total substitution of 7.5mg Valium for 0.75mg Klonopin (but rounding up to a total of 9mg because of the awkwardness of achieving 1.25mg doses of Valium by dividing 2mg Valium tablets), your substitution schedule might look like this:

/Edit

Start: 0.75mg Klonopin;

Step 1: 0.625 Klonopin (one and a quarter tablets) & 1.5mg Valium (three quarters of a 2mg tablet);

Step 2: 0.5mg Klonopin (one tablet) & 3mg Valium (one and a half 2mg tablets);

Step 3: 0.375mg Klonopin (three quarters of a tablet) & 4.5mg Valium (two and a quarter tablets);

Step 4: 0.25mg Klonopin (half a tablet) & 6mg Valium (three tablets);

Step 5: 0.125mg Klonopin (a quarter tablet) & 7.5mg Valium (three and three-quarter tablets);

Step 6: 0mg Klonopin & 9mg Valium (four and half 2mg tablets).

You might allow up to two weeks between each step, but many people make each change every week or even less. It partly depends upon how suitable is the amount taken in substitution. Obviously, if it is too small, you should allow more time between each step. Don't let this unduly worry you. If this is the case that amount taken in substitution is short, but you allow more time between each substitution, you will be, in effect, starting your taper while substituting.

I noticed this post and I couldn't help but want to add some food for thought.

First let me say Colin that I admire your ability to be able to take the time and explain these details!! You truly have a scientific mind, and perhaps someday I can explain these things like you can!

What I want to say is that I kept a journal through my process of Ashton's substitution/tapering. Every day I recorded the dosages I'd taken, that way I wouldn't become lost, or not remember this information later. This was also important to my doctor, as I was regularly in contact with him to let him know where I was in my progress. Fortunately, my doctor was very supportive in providing me with what I needed at the time to get through...

I am looking at my journal (which I am keeping for posterity) and I can see that there were some adjustments that I had to make to the recommended substitution amounts in Ashton's manual once I had completely crossed over. My problem was that after being on 6.25mg Valium for 4 days, I felt awfully depressed and sluggish. To alleviate this, I simply reduced the dosage down over the next week or so until I felt comfortable again. Once I found this dosage (4mg), I then continued regularly with the taper. Initially, every 2 weeks was standard for me, although later on, I had some difficulties and had to hold out longer. My last dose of Valium was Feb 16, so this plan really did work!!

Hope this reply doesn't complicate things for you David. I just thought I'd share my experience as an example of how the Ashton plan can work in practice.

pangelingua

Hello Pangelingua,

Thank you for your kind words, but when I read through my post again, I realised that the middle section of my post was confused and contained some errors. Hopefully it is a little more understandable to both you and Brian now that I've edited the paragraph.

I agree that keeping a withdrawal diary is a good idea - I highly recommend it!