Help with taper plan. Liquid Clonazepam.

Hi Ben!

 

Did you already begin the daily liquid micro taper?  If so, on what date?  I'd like to put it on my calendar for easy reference. 

 

Sounds like you perfectly understand the process.  Remember--if your WD effects get too bad, you can hold anywhere along the line by repeating the previous day's dose.  Take notes to keep track of where you are in your dosing.

 

Please keep us posted on how your taper is going.  In a different thread, someone recently opined that a cut-and-hold is not much different from a daily liquid micro taper.  In a way, that's true--however, since the DLMT is more gradual, the effects should be a little less jarring.  I'll be interested in your assessment. 

 

Thanks, and good luck!

Koko Lee

Glad to see we're on the same page. For a moment I got worried thinking the liquid reduction I did in the morning was not equivalent to the goal of the water suspension taper of phase 2 (which is focused on the nighttime dose:) Explaining it to you helped me realized it was correct, and gave me piece of mind.

 

I started tapering using the aqueous solution method on Sunday 10/18/2020. I do hope the effects are less jarring, that's one of the reasons I'm doing it this way. I'll let you know about it.

 

In any case, there's another reason for me: psychologically speaking, I feel it's more exciting to see everyday I make a little progress as opposed to cut and hold for weeks. My impatience to leave the benzos are in a whole new level. So reducing everyday makes me feel less stressed. Is not the same being waiting at the Airport to catch a flight than being already in the Airplane flying towards the destination, at least that's the way I see it (I almost forgot we're in the middle of a pandemic were flying is not that common anymore...

 

Anyways, I'll keep you posted, talk to you soon!

 

Hello Koko Lee,

 

Regarding your previous comment (that the water diluted method is not very different from the taper and hold method), I'm concerned that I'd had to postpone my tapering too much every time I feel unpleasant withdrawal symptoms/Tinnitus, but on the other hand, I don't want to mess up the taper in a way that I feel so bad that I have to end up updosing....

 

So my question is: do you know someone/or if it's feasible to keep tapering with the water/liquid solution method, constantly as the withdrawal symptoms would be in waves (come and go), or I should immediately stop when I feel bad for the symptoms will only get worse and worse?

 

If that's the case (withdrawal symptoms would keep getting worse and worse), for how long do you advice holding the taper: 3 days? a week?

 

I was also thinking about enduring the symptoms and stop for a few days every time I reach a new phase (say, 5 days?).

 

I'd like to know your input about that, and well as anyone in this forum. If possible the benzo buddy who feels the effects of the methods are not really different from each other.

 

Today I'm having brain zaps, my T sounds like a loud hissing, and for some reason, today I'm extremely pessimistic/negative. Is like if I'm not the same person for a while...then, become rational again. I hope it has to do with the weather, and I can continue tapering at least until reaching phase 3.

 

Then I'd probably stop for a few days (especially since I'm changing the tapering method in the morning dose).

 

Anyways, thank you and everyone in this forum for your advice.

 

Best,

Ben

 

 

Hi Ben!

 

Did you already begin the daily liquid micro taper?  If so, on what date?  I'd like to put it on my calendar for easy reference. 

 

Sounds like you perfectly understand the process.  Remember--if your WD effects get too bad, you can hold anywhere along the line by repeating the previous day's dose.  Take notes to keep track of where you are in your dosing.

 

Please keep us posted on how your taper is going.  In a different thread, someone recently opined that a cut-and-hold is not much different from a daily liquid micro taper.  In a way, that's true--however, since the DLMT is more gradual, the effects should be a little less jarring.  I'll be interested in your assessment. 

 

Thanks, and good luck!

Koko Lee

Hello Koko Lee,

 

Regarding your previous comment (that the water diluted method is not very different from the taper and hold method), I'm concerned that I'd had to postpone my tapering too much every time I feel unpleasant withdrawal symptoms/Tinnitus, but on the other hand, I don't want to mess up the taper in a way that I feel so bad that I have to end up updosing....

 

So my question is: do you know someone/or if it's feasible to keep tapering with the water/liquid solution method, constantly as the withdrawal symptoms would be in waves (come and go), or I should immediately stop when I feel bad for the symptoms will only get worse and worse?

The symptoms reflect the rate at which your body is processing the cumulative cuts.

 

You started the DLMT on Oct 18, and assuming you decrease by another mL this evening, you will have made 8 days' worth of cuts to your dose.

8 x 0.00125 mg = 0.01 mg

That's 40% of the total Phase 2 dose reduction.

 

At this point, you're still adjusting to your very first DLMT cut.  Meanwhile, your body has not fully recognized the cuts you've made for the past 2-3 days.  So your symptoms are beginning to pile up. 

If that's the case (withdrawal symptoms would keep getting worse and worse), for how long do you advice holding the taper: 3 days? a week?

 

I was also thinking about enduring the symptoms and stop for a few days every time I reach a new phase (say, 5 days?).

 

I'd like to know your input about that, and well as anyone in this forum. If possible the benzo buddy who feels the effects of the methods are not really different from each other.

The person who said that was badsocref, if you want to ask him to clarify.  He's right that cutting, say, 0.025 mg and holding for 25 days accomplishes the same goal as cutting 0.00125 mg daily for 20 days with a 5-day hold at the end.  However, with the latter scenario, your body has already processed the earliest few cuts before it even notices the final cuts--so your body's reactions are spread out over the full 25 days instead of affecting you all at once. 

 

With that said, remember that, whether you cut-and-hold or DLMT, Phase 2 is a cut of 

(0.025 mg/0.225 mg) x 100 = 11.1%

and, without any hold times, your taper rate is

11.1% / 20 days = 0.55% per day

 

The tinnitus mitigation web page I sent you a couple of months ago recommends a taper rate of no more than 0.33% per day.  In other words, to the extent that you stick with cutting 0.025 mg every 20 days, your pace is much faster than recommended by that audiologist.  (And in fact, tapering at 11.1% even every 30 days is faster than recommended by Ashton). 

 

Remember that, when I suggested this plan, I pointed out that it was a fast taper and remarked that you will need to take breaks based on your symptoms.  Consequently, you should not feel bad about doing exactly that.  The plan was designed only as a starting place--not to be rigidly followed as day-to-day prescription.   

 

I understand that you are concerned about tolerance and are in a hurry to get done with this process, but the point of tapering slowly is to minimize protracted post-WD symptoms.  So please take whatever breaks are necessary so as to optimize your well-being, both in the short-run and long-term.           

Today I'm having brain zaps, my T sounds like a loud hissing, and for some reason, today I'm extremely pessimistic/negative. Is like if I'm not the same person for a while...then, become rational again. I hope it has to do with the weather, and I can continue tapering at least until reaching phase 3.

Based on those symptoms, I would allow myself a hold.  You will have to determine the length of the hold according to, not only how you feel, but how you expect to feel, considering your personal past experience. 

 

I think you said it took you 4 or 5 days to really begin feeling the abrupt 0.025 mg cut you made as the first step of your taper.     

 

Assuming that a 4-day delay is typical for you,  I would suggest trying a 4-day hold and consider resuming on the 30th.  By then, your system should have begun recovering from the first few days' worth of Phase 2 cuts and will have just begun to react to the cuts made on the 24th and 25th.  You will still not feel good, of course.  But remember that, once you resume, you will undergo the usual ~4 day delay before your body recognizes that your taper has picked up again. 

 

If you choose to continue DLMT (as opposed to cut-and-hold), you'll get a better feel for when to take breaks and for how long to hold them.   

 

I hope this helps.

 

Koko Lee

Hello Koko Lee,

 

Thank you for your prompt response/advice. Hope everything is fine with you.

 

I decided to stop, not only because of my symptoms (louder T), brain zaps, brain shrinking feeling, but because yesterday was the end of Daylight Saving Time here in Spain.

 

It's just one hour, but now my schedule is set off balance, so that's another reason to stop, I need to stabilize things before moving forward.

 

Forgive my asking you again to send me the Tinnitus Web Page. I don't remember receiving that link (if you still have it handy).

 

I don't remember getting it either. I was probably too anxious to pay enough attention or simply missed it (I always try to do my best to pay close attention to your messages or any benzo buddy message for that matter, but for some reason, I don't know where it is)

 

I will continue with your method. Even though is more laborious, I believe it gives me more control, besides I feel it's more motivating.

 

Should I see that down the road is not the right one, then I'll consider Badsocref's (he was very kind and offered me to show me a method using micropipettes), but I don't want to be changing from one method to another.

 

I'm grateful you gave me that plan, I'll stick to it the best I can and stop when things become unbearable. I know there's a lot of suffering ahead, and there's nothing I can do to avoid it. I might minimize it, but months of torture are granted for me.

 

Talk to you soon.

 

 

Hello Koko Lee,

 

Regarding your previous comment (that the water diluted method is not very different from the taper and hold method), I'm concerned that I'd had to postpone my tapering too much every time I feel unpleasant withdrawal symptoms/Tinnitus, but on the other hand, I don't want to mess up the taper in a way that I feel so bad that I have to end up updosing....

 

So my question is: do you know someone/or if it's feasible to keep tapering with the water/liquid solution method, constantly as the withdrawal symptoms would be in waves (come and go), or I should immediately stop when I feel bad for the symptoms will only get worse and worse?

The symptoms reflect the rate at which your body is processing the cumulative cuts.

 

You started the DLMT on Oct 18, and assuming you decrease by another mL this evening, you will have made 8 days' worth of cuts to your dose.

8 x 0.00125 mg = 0.01 mg

That's 40% of the total Phase 2 dose reduction.

 

At this point, you're still adjusting to your very first DLMT cut.  Meanwhile, your body has not fully recognized the cuts you've made for the past 2-3 days.  So your symptoms are beginning to pile up. 

If that's the case (withdrawal symptoms would keep getting worse and worse), for how long do you advice holding the taper: 3 days? a week?

 

I was also thinking about enduring the symptoms and stop for a few days every time I reach a new phase (say, 5 days?).

 

I'd like to know your input about that, and well as anyone in this forum. If possible the benzo buddy who feels the effects of the methods are not really different from each other.

The person who said that was badsocref, if you want to ask him to clarify.  He's right that cutting, say, 0.025 mg and holding for 25 days accomplishes the same goal as cutting 0.00125 mg daily for 20 days with a 5-day hold at the end.  However, with the latter scenario, your body has already processed the earliest few cuts before it even notices the final cuts--so your body's reactions are spread out over the full 25 days instead of affecting you all at once. 

 

With that said, remember that, whether you cut-and-hold or DLMT, Phase 2 is a cut of 

(0.025 mg/0.225 mg) x 100 = 11.1%

and, without any hold times, your taper rate is

11.1% / 20 days = 0.55% per day

 

The tinnitus mitigation web page I sent you a couple of months ago recommends a taper rate of no more than 0.33% per day.  In other words, to the extent that you stick with cutting 0.025 mg every 20 days, your pace is much faster than recommended by that audiologist.  (And in fact, tapering at 11.1% even every 30 days is faster than recommended by Ashton). 

 

Remember that, when I suggested this plan, I pointed out that it was a fast taper and remarked that you will need to take breaks based on your symptoms.  Consequently, you should not feel bad about doing exactly that.  The plan was designed only as a starting place--not to be rigidly followed as day-to-day prescription.   

 

I understand that you are concerned about tolerance and are in a hurry to get done with this process, but the point of tapering slowly is to minimize protracted post-WD symptoms.  So please take whatever breaks are necessary so as to optimize your well-being, both in the short-run and long-term.           

Today I'm having brain zaps, my T sounds like a loud hissing, and for some reason, today I'm extremely pessimistic/negative. Is like if I'm not the same person for a while...then, become rational again. I hope it has to do with the weather, and I can continue tapering at least until reaching phase 3.

Based on those symptoms, I would allow myself a hold.  You will have to determine the length of the hold according to, not only how you feel, but how you expect to feel, considering your personal past experience. 

 

I think you said it took you 4 or 5 days to really begin feeling the abrupt 0.025 mg cut you made as the first step of your taper.     

 

Assuming that a 4-day delay is typical for you,  I would suggest trying a 4-day hold and consider resuming on the 30th.  By then, your system should have begun recovering from the first few days' worth of Phase 2 cuts and will have just begun to react to the cuts made on the 24th and 25th.  You will still not feel good, of course.  But remember that, once you resume, you will undergo the usual ~4 day delay before your body recognizes that your taper has picked up again. 

 

If you choose to continue DLMT (as opposed to cut-and-hold), you'll get a better feel for when to take breaks and for how long to hold them.   

 

I hope this helps.

 

Koko Lee

fwiw - I sold my half of the analytical lab last week (ch-ching).  I can still get in there to do a video, but not for too much longer.

I decided to stop, not only because of my symptoms (louder T), brain zaps, brain shrinking feeling, but because yesterday was the end of Daylight Saving Time here in Spain.

Of course, Ben--I'm relieved to hear you're easing off the accelerator for a few days.     

Forgive my asking you again to send me the Tinnitus Web Page. I don't remember receiving that link (if you still have it handy).

 

I don't remember getting it either. I was probably too anxious to pay enough attention or simply missed it (I always try to do my best to pay close attention to your messages or any benzo buddy message for that matter, but for some reason, I don't know where it is)

Here you go.  While this was written with SSRIs in mind, you'll see in the comment section that the author refers to SSRIs and benzos more or less interchangeably.  Pharmaceutically imprecise as that may be, he nevertheless does a good job of presenting the generally-accepted harm-reduction tapering guidelines, which are the same for both drug classes:  10% per month, 5% every two weeks, and 1% every 3 days.  Each of these, when divided out, yields the ~0.33% reduction per day that I alluded to previously.   

https://hearinglosshelp.com/blog/tapering-off-citalopram-safely-without-side-effects/

I will continue with your method. Even though is more laborious, I believe it gives me more control, besides I feel it's more motivating.

 

Should I see that down the road is not the right one, then I'll consider Badsocref's (he was very kind and offered me to show me a method using micropipettes), but I don't want to be changing from one method to another.

Certainly each taper method has it's strengths and weaknesses.  However you choose to taper, we'll all be pulling for you.  As always, keep us posted as to how you're doing.   

 

Best of luck to you,

Koko Lee

Hello everyone!,

 

I'm doing so far with the Clonazepam liquid taper suggested by Koko Lee.

 

Just to be extra safe I holding 3 days (maintaining the dose from the day before) every time I reach the amount of 7ml reduced, and then every time I reach the amount of 20 ml reduced, hold it for 5 days, regardless of how I feel.

 

I might not feel any really bad symptoms at that moment, but in any case, I'll just hold the same dose for a few days every time I reach a milestone, just for precaution.

 

This is of course, an idea, and it can be flexible, and I may adjust along the way. The plan structure regarding the morning dose and nightime dose is intact, the only thing I'm adding are mandatory holds every time I reach a certain amount of lines reduced from the graduated cylinder, that's all.

 

I have Tinnitus as a withdrawal symptom, so based on an article written by Dr. Neil Bauman, he recommends going even slower for those having this withdrawal symptom (a daily average of 0.33% reduction). So with the 3 days hold every 7 ml reduction would be something like this:

 

0.5% of daily reduction x 7 days getting 1ml off equals: 3.5%/10 days (10 comes from 7 days reduction+3 days hold)=0.35% reduction, pretty close to what Dr. Baumann recommended.

 

So far, my symptoms are Ok, my T is still there, but starting to have a few moments of silence. I'm trying to be consistent as possible and I know there will be bad days along the way. I just hope with these cautionary holds every few lines of suspension reduction so the withdrawal symptoms (including my T) are under control.

 

Hope this can be useful for anyone going through the same situation.

 

 

Thank you for the update BenThrottle, I've never heard the suggestion to go slower if tinnitus is a problem, I'm glad you found that.  Your symptoms sound tolerable, I'm sure the information you've provided will benefit another person, we have many members and non members who read these pages looking for the story that best reflects their situation, every post helps someone else.

 

 

Thank you for the update BenThrottle, I've never heard the suggestion to go slower if tinnitus is a problem, I'm glad you found that.  Your symptoms sound tolerable, I'm sure the information you've provided will benefit another person, we have many members and non members who read these pages looking for the story that best reflects their situation, every post helps someone else.

 

You're very welcome Pamster, and thank you so much for your support, input, and reassurance that going slower is never a bad idea.

 

At present I'm entering phase 3 of the aqueous solution taper.

 

The goal now is to bring down the daily dosage of liquid  Clonazepam from 0.20 mg to 0.175 mg (that's minus 40 ml in the graduated cylinder in the morning dosage described in the plan suggested by Koko Lee while keeping minus 20 ml in the graduated cylinder during this phase).

 

I have not been so active in the forum lately, as some symptoms have started to kick in. Anxiety, hopelessness, worsened tinnitus, some eye flashes, and a little bit of stomach discomfort. I will hold on the dose for about 5 days to allow stabilizing again. I was starting to feel great, and I hope to get back on track soon.

 

I'm going to post the link of liquid Clonazepam taper in here so people don't get lost/confused as I understand there are many posts and it might be difficult to follow/find the initial conversation, hope it helps others trying to reduce their liquid clonazepam dosage.

 

My initial dosage was the equivalent of 0.25 mg of Clonazepam: 0.10 ml. The goal: to taper safely to minimize my symptoms, mainly loud tinnitus, eye flashes, extreme anxiety, and depression.

 

Here's the plan, suggested by Koko Lee

 

http://www.benzobuddies.org/forum/index.php?topic=245494.msg3128853#msg3128853

 

 

 

 

 

 

Koko and Ben,

I read that article by Dr. Bauman in which Koko provided a link.  Long ago I came off an antidepressant, so based on the article I can clearly see how withdrawing from Benzo and Effexor are very similar. 

 

Along with tinnitus, he also mentions sensations such as "prickling" and "electric". My current situation is that when the tinnitus is high, so are  the "pins and needles" and it was becoming a real challenge to move forward. 

 

I've been looking for a a plan which incorporates a .1 mg/ml liquid reduction (coupled with holding) and Bauman articulates this method extremely well.  I'll be printing off Bauman's article and giving it to my doc.  Side note...she's also helping other patients taper off antidepressants and will most likely understand the benzo/antidepressant link. 

 

 

Thank You !

Breck

Hello Breck,

 

Hope this message finds you well.

 

I'm sorry about your withdrawal symptoms. Yes, for what I understand, Venlafaxine and Benzos may induce tinnitus after the treatment is discontinued or tolerance is built. For what I understand, the Venlafaxine tinnitus should subside after 7 days or so.

 

So my question is: are you coming off benzos or Venlafaxine? In any case, as you mention, Dr. Bauman's method may apply for either of those. As a general rule I'd suggest to keep into consideration to keep an average of 0.33% daily reduction of whatever you're taking (AD or Benzo).

 

As you know I'm coming off liquid Clonazepam. Whenever I my tinnitus gets too loud (like today!), brain zaps too bothersome, as well as general anxiety, I stop the taper.

 

I've actually included mandatory 3 day holding period on my taper every  7 ml reduced.

 

Good luck with your Dr. I believe having a compassionate Doctor who really understands how to taper from benzos is like finding a treasure.

 

Keep in touch,

Ben

 

 

 

 

 

Koko and Ben,

I read that article by Dr. Bauman in which you provided a link.  Long ago I came off an antidepressant, so based on the article I can clearly see how withdrawing from Benzos and Effexor are very similar. 

 

Along with tinnitus, he also mentions sensations such as "prickling" and "electric". My current situation is that when the tinnitus is high, so are  the "pins and needles" and it was becoming a real challenge to move forward. 

 

I've been looking for a a plan which incorporates a .1 mg/ml liquid reduction (coupled with holding) and Bauman's article articulates this method extremely well.  I'll be printing off Bauman's method and giving it to my doc.  Side note...she's also helping other patients taper off antidepressants and should understand the benzo/antidepressant link as well.

 

 

Thank You !

Breck

Dear Koko Lee,

 

Thanks for letting me know how to adjust my taper plan when traveling from Europe to the U.S.

 

I'm going to repost it here so other benzobuddies have access to it in case they are soon relocating to another country that has a different time zone and don´t want to exacerbate their withdrawal symptoms due to messing up their dose schedule.

 

This was a matter of concern to me as I didn't want to mess up my schedule. The plan suggested by Koko Lee to help me cope with the new time zone is below:

 

I quote:

 

"Your plan of a transition period during which you'll incrementally either lengthen or shorten the time between some doses. To avoid interdose withdrawal, it's probably better to decrease the time between certain doses.

 

For example:

Starting point (Florida time):  2 am and 2 pm

Step 1:  1 am and 1 pm

Step 2:  midnight and noon

Step 3:  11 pm and 11 am

Step 4:  10 pm and 10 am

Step 5:  9 pm and 9 am

Step 6:  8 pm and 8 am

 

According to this plan, you'd alternately wait 11 hrs and 12 hrs between doses until you reach your preferred dosing routine.  This alternating schedule would, in effect, allow you to "back up" by one hour per "Step"."

 

End of quote.

 

Please notice I was not able to follow Koko Lee´s plan, since I read her message too late. However, I followed my own plan, apparently it has worked well so far. It has been very simple.

 

I was flying from Europe (Madrid) to North America (Eastern Time)-6 hour difference-so basically what I did was the following:

 

1. The day of the flight I took my morning dose 3 hours later than usual (did so at the airport), and that night (during the flight) 3 hours later than usual (keeping my time zone from Madrid).

 

2. To alleviate the change of schedule, the following Week I held my dose one day for each time zone (a total of 6 days).

 

3. At present I´m still in phase 4, because besides the extra holding time, (Please notice I do have the usual holding times for every amount of dose reduction). 

 

4. My new dose schedule was somewhat modified upon arriving to North America so is not as far apart from the time I took from Europe: I take my morning dose 3 hours earlier, and my nightime dose 3 hours earlier than I did in Europe.

 

It´s been 11 days, and so far so good. My withdrawal effects haven´t worsened, and I hope they continue like that.

 

Once again,  thank you Koko Lee for your help! Hope this info is helpful for whoever is following a taper and is planning to move to travel to a place that has a different time zone. I think both plans Koko Lee´s or mine can be helpful.

 

 

Hello everyone,

 

I wanted to keep you updated regarding my tapering so far.

 

Now I'm entering phase 6. So far, with the taper plan kindly suggested by Koko Lee, the symptoms have been manageable. Of course, I had to add extra days to minimize my loud tinnitus, and anxiety. So far, up to phase 5, and following the liquid taper plan proposed by Koko Lee, I was reducing 7 ml, holding 3 days, upon reaching the final phase. Then I would hold the dose for 5 days.

 

Now I'm in a more complicated situation. The dose reductions as I approach lower quantities are greater, and thus, the possibility of exacerbating my withdrawal symptoms is real. It's a matter of fact, I feel it's been happening already.

 

For that I have two options:

 

A) Striving to adhere fairly closely to Dr. Neil Bauman's harm reduction guideline of reducing by roughly 0.333% per day.  For Phase 6 (going from 0.125 mg to 0.100 mg), I plan to reduce by 0.00125 mg every 3 days. For Phase 7 (going from 0.100 mg to 0.75 mg), I plan to reduce by 0.00125 mg every 4 days,"

and so on. 

 

The disadvantage of this plan is that it takes too long, and it creates more anxiety. The liquid taper limits your life a lot, and this plan lasts way more than a year...but then again...so does the withdrawal symptoms:(

 

The other option would be the following:

 

B)

 

Phase 6 (0.125 to 0.100)

Taper 1 mL/day for 3 days

Hold 1 day

Taper 1 mL/day for 3 days

Hold 3 days

Taper 1 mL/day for 3 days

Hold 1 day

Taper 1 mL/day for 3 days

Hold 3 days

Taper 1 mL/day for 3 days

Hold 1 day

Taper 1 mL/day for 3 days

Hold 3 days

Taper 1 mL/day for 2 days

Hold for 5 days

37 days total

 

Phase 7 (0.100 to 0.075)

Taper 1 mL/day for 3 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 3 days

Taper 1 mL/day for 3 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 3 days

Taper 1 mL/day for 3 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 3 days

Taper 1 mL/day for 3 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 5 days

38 days total

 

Phase 8 (0.075 to 0.050)

Taper 1 mL/day for 2 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 3 days

Taper 1 mL/day for 2 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 3 days

Taper 1 mL/day for 2 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 3 days

Taper 1 mL/day for 2 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 3 days

Taper 1 mL/day for 2 days

Hold 1 day

Taper 1 mL/day for 2 days

Hold 5 days

42 days total

 

Phase 9 (0.050 to 0.025)

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 5 days

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 5 days

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 5 days

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 5 days

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 5 days

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 5 days

Taper 1 mL/day for 1 day

Hold 1 day

Taper 1 mL/day for 1 day

Hold 5 days

68 days total

 

As you can see, the latter taper is somewhat more aggressive, but shorter. I don't want to postpone so much my taper, but at the same time, I don't want to risk ruining everything.

 

The plan followed so far has worked (including the holding times), the trouble begins now that, for the lower the dosage, the higher the reduction, and thus the withdrawal symptoms.

 

Looking forward to hear your feedback and hopefully this can be useful for you as well.

 

 

 

I'm concerned about your plan BenThrottle.  I didn't taper but I've learned in my time here that its not a good idea to make elaborate plans for your taper because they really need to be based on your symptoms not spreadsheets or arbitrary time lines.  We like to see smaller reductions at the lower doses since many members find their symptoms can get more intense the lower they get. 

 

I'm also wondering about the holds you've programmed into your taper plan, it feels like you're overthinking this.

 

It would be better to look at your taper in terms of a month to month process so you won't get overwhelmed by the length.  When you think of how many years it took to get you to this point its worth considering that it will take awhile to get free.  I use this same thought when I think about going on a diet, it took me many years to gain these 14 pounds and I can't expect it to come off in a couple of weeks, it takes what it takes. 

 

 

 

 

Dear Pamster,

 

Thank you for your reply. Makes sense your example about your diet, same with working out.

 

I have been following a taper plan proposed by Koko Lee:

 

http://www.benzobuddies.org/forum/index.php?topic=245494.msg3129243#msg3129243

 

The reason I mention predetermined plans is because so far it has worked pretty well. It's a plan that has allowed me to add hold days while still following a sensitive taper process.

 

However, just as you mentioned, I have started to experience a worsening of my withdrawal symptoms: louder scarier tinnitus, anxiety, and feelings of sadness.

 

I'm already experiencing worsening of withdrawal symptoms, so I’m definitely increasing my holding times. At present I'm starting phase 6 (based on Koko Lee's Plan: http://www.benzobuddies.org/forum/index.php?topic=245494.msg3129243#msg3129243)

 

For Phase 6 (going from 0.125 mg to 0.100 mg of Clonazepam), I plan to reduce by 0.00125 mg every 3 days (holding times will be added as needed if symptoms get unbearable). This is just a reference, as I understand my taper needs to be based on my symptoms. The former plan, way more aggressive of holding 1 day every 3 days will be discarded.

 

I wanted to know if this plan (0.00125 mg every 3 days) seems reasonable. I want to taper slowly, but I don't want to taper for years and years. I wasn't taking benzos for so long, but it seems that I'm quite sensitive to them.

 

In conclusion (and I'm sorry to ramble so much), I'm experiencing sheer anxiety, and loud tinnitus, and I just wanted to have a reference regarding of how should I slow down.

 

I'm also confused regarding my symptoms because I'm having a flu, plus going through a difficult personal situation, and I'm not sure if this spike is due to the fact, I'm approaching lower dosages, or because of the flu and stress. In any case, I wanted to keep you all posted and let you know that I will slow down, following for this phase this taper plan. Since I already have bad symptoms, I'm hoping my tinnitus eases up as I stabilize.

 

As always, thank you so much for your input.

 

I wonder if your uptick in symptoms might be because you’ve reached a tipping point in terms of percent reduction in dose per month and need to decrease it?

 

Might I suggest you calculate the percent reduction you have made each month for the last 3 months or so? I’ve included a link to a online calculator you can use below. Enter the dose you were taking at the beginning of the month and the dose you were taking at the end of the month then click the Calculate button.

 

Can you tell us more about the rationale for holding 3 days?  Clonazepam has a relatively long-half life of 30-40 hours.  This means it can take from 150-200 hours (about 6 to 8 days) for reductions (or increases) in the drug to reach steady state. 

 

Percentage Change Calculator

https://www.calculatorsoup.com/calculators/algebra/percent-change-calculator.php

Hello Libertas,

 

Thank you so much for your input and the link.

 

At the beginning of the liquid taper (phase 1) my daily reduction was 0.5%. At the end of phase 5, my daily reduction was 1% a day. I'm entering phase 6, at the end of this phase my daily reduction will be around 1.23%.

 

So far, I've been reducing every 7 days and holding for 3 days. Once I reached the mark of 20 reductions, I would hold for 5 days. This has worked out fairly well so far.

 

However, at the end of phase 5, my symptoms (extremely loud tinnitus, and anxiety) have ramped up. So yes, I do believe my symptoms can be due to the higher percentage of reduction and reaching a lower dose.

 

However, at present I'm going through a difficult personal situation and a flu, so I'm not sure about the cause, but definitely the dose reduction is first on the list.

 

As to my rationale of holding for 3 days, I tried to average the percentage reduction every 10 days to get a harmless number (0.35%, but this was of course based on the reductions of phase 1).

 

My symptoms have been manageable in the past, with ups and downs, and now I feel terrible. I'm planning to follow a suggestion of a Benzo Buddy (Koko Lee, who has helped me tremendously), which consists in holding 3 days and reducing 1 day, to stay around the 0.44% dose reduction (I'm doing this for phase 6).

 

However, one thing that troubles me is the fact that I feel that this taper is prolonging to another year, which makes me so depressed. I wasn’t taking benzos for so long, and I never took such a high dose (0.25 mg of Clonazepam) for a few months.

On the other hand, I don't want to mess up everything by rushing up things. I'm desperately trying to find a balance, so any suggestions are welcome.

 

Your input about how long clonazepam takes to stabilize is extremely useful. So, do think if I hold about 6 days my withdrawal symptoms ease up?

 

Thank you so much Libertas for your input.

Ben

 

 

 

 

I wonder if your uptick in symptoms might be because you’ve reached a tipping point in terms of percent reduction in dose per month and need to decrease it?

 

Might I suggest you calculate the percent reduction you have made each month for the last 3 months or so? I’ve included a link to a online calculator you can use below. Enter the dose you were taking at the beginning of the month and the dose you were taking at the end of the month then click the Calculate button.

 

Can you tell us more about the rationale for holding 3 days?  Clonazepam has a relatively long-half life of 30-40 hours.  This means it can take from 150-200 hours (about 6 to 8 days) for reductions (or increases) in the drug to reach steady state. 

 

Percentage Change Calculator

https://www.calculatorsoup.com/calculators/algebra/percent-change-calculator.php

Hello Everyone (and Koko Lee!),

 

Just to let you know how I'm doing with the taper. I'm still in phase 6 (-60 ml in the morning, and -46 ml in the evening: goal, to reach -60 ml in the evening as well).

 

I've been trying to follow Dr. Baumann's recommendation of reducing approx 0.33% per day (even a stricter approach) since I've been holding for 4 days. In the last few days, I've been trying to speed up the process to reducing every 3 days (of course, taking into consideration my symptoms), and still close to Dr. Baumann's recommendations.

 

So far, so good. Still have tinnitus, but not nearly as bad as a month ago.

 

My tinnitus is changing from one ear to another in times. I also have some insomnia, but it could be also the spring season. My goal in this phase is reaching 0.100 mg of liquid rivotril (going from 0.125 mg to 0.100 mg).

 

I will be monitoring my symptoms every 4 days to see how it goes, to see if I should increase my holdings (so far, I'm holding 2 days, reducing 1).

 

One concern that I have, hopefully someone could help me out is about the time to take the medicine. I'm still in a phase that I take 2 doses (to keep more less constant levels). In the latest phases, hopefully I'll be taking  a single dose a day. But for now, I prepare and take my suspension, twice a day. Which is time consuming (but necessary).

 

So far, I've been taking the medicine in the morning (at 9:00 AM, and the second dose at 8:00 pm). It has been working well. My question is: do you take your benzos on rigid schedules (meaning sharp times) or in approximately times? (can go an hour or so around the hour you were supposed to take it?).

 

Anyways, hope my update can be useful. I'm looking forward for any advice or experience regarding the flexibility of schedules taking the medicine. I'm a little bit concerned not for being able to comply always in time.

 

Thank you for any input. Have a great week.

Ben

 

I didn't taper but I've noticed members are fairly ridged in their dosing times, the only time I see them deviate is when they're actively trying to move the time they take it by doing it gradually. 

 

I've noticed members will make up batches of their medicine and keep it around for a few days, are you interested in doing that?

Thanks for your input Pamster. The thing is that I'm taking Liquid Rivotril. I mix it with water and the suspension is supposed to be taken immediately.

 

If I go on a trip or whatever I guess I'll have to take with me all the stuff (The cylinder tube, some bottled water, the syringes, and the rivotril).

 

Hopefully I don't to camping trips with strangers everyday .

 

I will be more strict in my schedule just to be on the safe side.

 

 

Having to take your chemistry set on the road sounds like a hassle, being tied down to preparing it every day sounds labor intensive, no wonder people celebrate so heartily when they become benzo free.  Even though they may still have symptoms, to be free of the process is wonderful.

Having to take your chemistry set on the road sounds like a hassle, being tied down to preparing it every day sounds labor intensive, no wonder people celebrate so heartily when they become benzo free.  Even though they may still have symptoms, to be free of the process is wonderful.

 

That is correct Sir:)

Hello Everyone,

 

I'm concluding phase 6 from my liquid taper (Rivotril) in about 8 days. I'm now discarding -57 ml of aqueous solution at night, while keep discarding -60 ml in the morning every day.

 

I've been using an small syringe to get the Rivotril  out of the bottle. However for next phase I will be using now the dropper that comes attached to the bottle (I think it's more convenient that way, and it allows a more consistent delivery of the medicine). Since each drop from the dropper provides 0.100 mg of Rivotril instead of 0.125 mg, I'll adjust phase 7 as it follows:

 

IMPORTANT: Holding times are just a reference, as they might be modified according to my symptoms. The goal would be going from the equivalent of 0.100 mg to 0.75 mg of Rivotril.

 

Below are the instructions for Phase 7, in which daily dosage tapers from 0.100 mg to 0.075 mg.  Instead of the insulin syringe, a dropper provided with the Rivotril concentrate will be used, where 1 drop = 0.100 mg Rivotril.

 

The tapering liquid, which will be made fresh every morning and evening, will consist of 1 drop Rivotril mixed with 100 mL water.  The concentration of this aqueous tapering liquid will be 0.001 mg/mL.  So, for example, 50 mL = 0.050 mg

 

Begin Phase 7 by taking equal morning and evening doses, as shown for Days 1-4, as follows:

 

Days 1-4 (daily dose = 0.100 mg)

 

Morning (0.050 mg)

 

Mix 1 drop Rivotril with 100 mL water in a glass.  Discard 50 mL.  Drink remaining 50 mL.  Rinse glass with water and drink the rinse water.

 

Evening (0.050 mg)

 

Mix 1 drop Rivotril with 100 mL water in a glass.  Discard 50 mL.  Drink remaining 50 mL.  Rinse glass with water and drink the rinse water.

 

Days 5-8 (daily dose = 0.099 mg)

 

Morning (0.049 mg)

 

Mix 1 drop Rivotril with 100 mL water in a glass.  Discard 51 mL.  Drink remaining 49 mL.  Rinse glass with water and drink the rinse water.

 

Evening (0.050 mg)

 

Mix 1 drop Rivotril with 100 mL water in a glass.  Discard 50 mL.  Drink remaining 50 mL.  Rinse glass with water and drink the rinse water.

 

Days 9-12 (daily dose = 0.098 mg)

 

Morning (0.048 mg)

 

Mix 1 drop Rivotril with 100 mL water in a glass.  Discard 52 mL.  Drink remaining 48 mL.  Rinse glass with water and drink the rinse water.

 

Evening (0.050 mg)

 

Mix 1 drop Rivotril with 100 mL water in a glass.  Discard 50 mL.  Drink remaining 50 mL.  Rinse glass with water and drink the rinse water.

 

Continue this pattern of 4-day cycles, reducing the morning dose by 1 additional mL each 4-day cycle while holding the evening dose constant at 50 mL (0.050 mg).

 

On the morning that 75 mL are discarded and the remaining 25 mL (0.025 mg) are consumed (while the evening dose is held constant at 50 mL = 0.050 mg), the daily dose will be 0.075 mg.  Maintain that daily dose for a full 4-day cycle to complete Phase 7.

 

I will hold the Rivotril bottle upside down vertically (not at an angle), in order to deliver a consistent drop size every time. A benzo buddy found a research that it's better to be done this way to avoid inconsistencies.

 

Should I feel that my anxiety and tinnitus gets worse, I will hold for more days until my symptoms subside.

 

 

 

 

Hello Everyone (and Koko Lee!),

 

Just to let you know how I'm doing with the taper. I'm still in phase 6 (-60 ml in the morning, and -46 ml in the evening: goal, to reach -60 ml in the evening as well).

 

I've been trying to follow Dr. Baumann's recommendation of reducing approx 0.33% per day (even a stricter approach) since I've been holding for 4 days. In the last few days, I've been trying to speed up the process to reducing every 3 days (of course, taking into consideration my symptoms), and still close to Dr. Baumann's recommendations.

 

So far, so good. Still have tinnitus, but not nearly as bad as a month ago.

 

My tinnitus is changing from one ear to another in times. I also have some insomnia, but it could be also the spring season. My goal in this phase is reaching 0.100 mg of liquid rivotril (going from 0.125 mg to 0.100 mg).

 

I will be monitoring my symptoms every 4 days to see how it goes, to see if I should increase my holdings (so far, I'm holding 2 days, reducing 1).

 

One concern that I have, hopefully someone could help me out is about the time to take the medicine. I'm still in a phase that I take 2 doses (to keep more less constant levels). In the latest phases, hopefully I'll be taking  a single dose a day. But for now, I prepare and take my suspension, twice a day. Which is time consuming (but necessary).

 

So far, I've been taking the medicine in the morning (at 9:00 AM, and the second dose at 8:00 pm). It has been working well. My question is: do you take your benzos on rigid schedules (meaning sharp times) or in approximately times? (can go an hour or so around the hour you were supposed to take it?).

 

Anyways, hope my update can be useful. I'm looking forward for any advice or experience regarding the flexibility of schedules taking the medicine. I'm a little bit concerned not for being able to comply always in time.

 

Thank you for any input. Have a great week.

Ben

It sounds like your two worst symptom are anxiety and tinnitus?  Are you dealing with any others?  It looks like a good plan and I like the fact that you've budgeted holding if symptoms become intolerable.