Tapper down Plan for Clonazepam - Seeking advise

[[Buddie]]

Hello [...],

Reading your posts I can tell that you have plenty of experience. Thanks for sharing it.

I am on 0,35 mg of Clonazepam. Currently in Mexico, and here I do have access to Roche Liquid Clonazepam. Reading the post of Salazar77 Roche is a reliable manufacturer, so I am happy to use that product in my taper. I was thinking to prepare my own brew as I was not sure in the quality and precision of the liquid clonazepam here.

I do have all the equipment and I understand the maths.

My question now is, which should be a safe plan to start the liquid taper? What would you recommend me? I have a good connection with my body and my main guidance will be symptom based. But I do not know what to do. I read the Ashton Manual but for some is a bit aggressive. I agree with Jelly Belly and I´d love to remain functional in my taper down. I don´t need or want to rush it. I am willing to do my best to have a smooth tapering and healing.

[[Buddie]]

Hi [...]

If you can get liquid Rivotril that would be awesome. I see you're done a lot of reading and researching. Great work!

With regard to my own taper, I mainly did DMT starting off with Bob7's method. At 0.4mg I switched to liquid. You are very observant as in December last year I decided to take a risk with my cuts to see what reductions I could handle. I was on holiday so I did cut and hold with my liquid and made a 10% reduction. It went quite well. Then after 2 weeks I did another 10% reduction. This time I was really struggling. The two consecutive cuts were just too big. But I recovered within an extra week. With this experiment I learned my best rate is probably the average of my cuts at 7.5%. That's where I was tapering before as well. I knew I could not speed it up. I prefer micro tapering but it's difficult to determine percentages because the effects are delayed. You can't say for certain. So I was happy to take a calculated risk and try out these percentages with cut and hold.

I generally recommend people start at 7.5% reductions because it's in the middle of our recommended taper range. You can decide whether you want to do cut and hold with your liquid or micro tapering.

[[Buddie]]

Thank you for the kind words, [...].

That’s wonderful you have access to the Rivotril drops from Roche.  Roche is the patent holder and brand manufacturer so you can be confident that the quality and consistency of your liquid will be high.  Even more importantly, this liquid is a solution (not a suspension) so dosing accuracy will also be high (i.e. a given volume of the liquid will contain exactly the same amount of drug).

Are you already using the liquid?  If not, then I suggest your first first step is to determine how you will respond to the liquid.  Some individuals notice a difference in solid versus liquid dosage forms whereas others do not.  The only way to know is to try. 

A common mistake I see members make is to switch to a liquid and make a reduction in dose at the same time.  Instead, switch to the liquid at your current dose, taken at your current dosing time.  Refrain from making any other changes (e.g. adding another medication or supplement).  Then wait a week or so to see how you react.  (Have I already mentioned the importance of keeping a daily taper journal?  If not, let me know and I will elaborate.)

If all goes well with the switch from solid to liquid dosage form, your next step will be to make a reduction in dose.  Given your history of taking/discontinuing the clonazepam, you might want to consider starting with a conservative trial reduction in the range of 5%.  If all goes well with that, you can cautiously increase your taper rate until you find your ‘sweet spot’ (i.e. your personal taper rate limit).  The only way to discover this is via systematic experimentation such as [...] has conducted.  Different individuals can tolerate different rates.  Also, many individuals find they need to ‘fine tune’ (adjust) their taper rate multiple times during the course of their taper.

In closing …

In case you haven’t already read it,  you might find this post from member BenThrottle of interest. He describes how he is tapering clonazepam using the Rivotril drops.

Re: Help with taper plan. Liquid Clonazepam.
http://www.benzobuddies.org/forum/index.php?topic=245494.msg3236429#msg3236429

[[Buddie]]

[...] and [...],

Thanks again to both. I feel a lot more confident now.

I am still cutting 2 mg pills with a razor blade and using a jeweler scale to get the 0.35 mg dose. I will move too liquid this week and wait as you recommended.

Yes, I already started a daily tapper journal with date, dose and notes regarding syptoms. It has been very helpful. I am planning to add percentages and keep all the formula calculations there. Should I add more information in the journal?

As I said I am in Mexico. I have a prescription for Liquid Clonazepam (Rivotril) from Roche but unfortunately I just found out that recentely it has been discontinued in this country. Tomorrow I will call Roche here in Mexico to check.

There are two alternative brands. Today I asked my local psychiatrist about them. He prefers Roche but he told me that the other two brands are also reliable and from reputable laboratories. He prefers one more than the other. So I will try the one that he advised me to use.

Thanks for sharing BenThrottle method. I will do the same.

I feel more confident and well informed to begin this healing journey now. Hope to have a smooth ride out.

[[Buddie]]

Oh no, I'm sorry about the Rivotril. I don't know if you've seen this thread discussing similar issues in Spain. I wonder if it has something do to with Roche? [...] will probably know more.

I am no expert but my logic tells me if you can get a generic it should be okay. It can't be worse than what I'm brewing in my kitchen right?

I can see you have done a lot of reading and educating yourself about this process, which is good. I did the same. Before I started tapering I read so much. It helps to empower yourself to make decisions because there is no "one way fits all". We can each give you input but in the end you have to decide what is best for you. And the more you read the more informed your decisions are.

[[Buddie]]

Hello Jelly Belly and [...],

First question.

I have the liquid Clonazepam. It´s 2.5 mg / ml. It´s called Klodex. A generic brand recommended by my local psychiatrist.

Today I bought a set of syringes. From 0.3 ml, 0.5 ml, 1 ml, 3 ml, 5 ml and 10 ml.

The liquid is dense, it seems to be oily, probably propylene glycol?

I am able suck the liquid with the small syringes. From my view is better to use micro syringes vs the bottle dropper (It´s a small glass bottle with a plastic dropper attached to the tip) to ensure accuracy?

My current dose of 0.35 mg of Clonazepam which is the equivalent to 0.14 ml of liquid Clonazepam.

Which is be the best way to measure the liquid Clonazepam to prepare the solution?

I am getting familiar with all this procedures and equipment. All your ideas are welcome.

Second question:

How long it takes to notice  new syptoms after a reduction of the Clonazepam? I am aware that takes a few days to notice how a reduction went. One week? Two weeks? Is every body different? Could it be felt in two or three days?

A million thanks.

[[Buddie]]

Was a medication guide/pamphlet included with the Klodex?  Does it have a section that lists the ingredients?  If so, what are they?

If you didn’t get a guide, does the national agency that regulates medicines in your country have an online database with this information? 

For example, the brand liquid manufactured by Roche in Australia lists this ingredients for the 2.5mg/mL Rivotril drops:

Peach flavour PHL-014725, saccharin sodium, brilliant blue FCF, glacial acetic acid, propylene glycol

Source:
Rivotril - NPS MedicineWise
https://www.nps.org.au/medicine-finder/rivotril-tablets

[[Buddie]]

Hello [...],

Thanks for your answer.

There is no information about the ingredients anywhere online. None in its guide as well. I just called the laboratory and they said that will provide me the information later today.

How do you handle the Clonazepam liquid to get precise doses?

Here is my idea so far:

Using the 0.3 mL micro syringe I can remove 0.14 ml of liquid Clonazepam which is the equivalent to 0.35 Mg of Clonazepam (My current dose) . I did it last night and is easily doable. The micro syringe fits perfectly well in the dropper tip and it doesn´t leak. 

Poor the 0.14 ml of liquid Clonazepam in 99.86 Ml of filtered water, to have a 100 cc solution. Shake it well.  My local psychiatrist confirmed that I could mix the solution with water or juice.

Having that 100 ml solution prepared I could start to DMT the first 7% (for example) in one week, removing daily 1 ml of that 100 mL solution.

Using a micro syringe of 0.3 mL gives me confidence that I will use an accurate amount of liquid Clonazepam vs the bottle dropper.

All your ideas are welcome.

[[Buddie]]

You’re most welcome, [...].

The time, energy, and thought you have devoted to preparing for and planning your taper is an example to us all.

Please do let us know what you find out from the laboratory.  We are always on the lookout for liquid formulations of clonazepam.

The approach you’ve outlined is sound.  Your use of multiple strategies to maximize the likelihood of getting accurate doses is particularly impressive.  If you use those strategies consistently, you will also maximize the likelihood of getting precise doses.

Re: the question in your earlier post about how long it takes to notice a reduction …

This is difficult to answer, especially if you are microtapering on a daily basis. One of the disadvantages of daily microtapering (especially benzodiazepines with longer half-lives) is that it presents the possibility that withdrawal effects will accumulate (become superimposed on one another) and eventually reach a tipping point where they become intolerable.  If this happens, there’s no way to know which reduction (or series of reductions) was responsible.  One strategy you can use to minimize the likelihood of this ‘hitting a brick wall’ effect is to keep an eye on your taper rate (i.e. percent reduction over time).  Another is to build holds into your taper to give your body time to catch-up/process the reductions made up until that point.  I’ve included a link below to an approach developed by one of the moderators at Surviving Antidepressants that incorporates these strategies.

You’ve also identified another reason your question is difficult to answer — everyone is different.  We all have to discover our unique ‘withdrawal pattern’ for ourselves via experimentation.  Based on clonazepam’s half-life, I’ve read it can take from 1 to 2 weeks to fully ‘register’ a dose reduction if one is minitapering (i.e. making ‘small enough to be tolerable’ dose reductions and then holding until withdrawal effects emerge, peak, and stabilize).

Link:
The Brassmonkey Slide Method of Micro-tapering - Tapering - Surviving Antidepressants
https://www.survivingantidepressants.org/topic/17671-the-brassmonkey-slide-method-of-micro-tapering/

[[Buddie]]

[...] has given you a wealth of information. With regards to symptoms and micro tapering. When we do cut and hold most people feel symptoms within 3-5 days. I always feel my symptoms on day 5, hit me like a freight train. With micro tapering I don't think you'll feel anything in that usual time frame. I don't have scientific evidence to back it up, it's just from my experience. You kind of just wake up one day and start feeling it settling in like a fog.

Also the way you feel symptoms is different. When I do cut and hold I get an onslaught of symptoms from day 5-10 gradually easing over those days. Around day 10 I'll be back to my base line symptoms. With micro tapering I just feel meh all the time. My baseline is slightly more elevated but I don't get the onslaught of symptoms. I'm not sure if this makes any sense? I guess you'll have to experience it to understand it.

Anyway you're well prepared and ready for  this, so keeping my fingers crossed this is an uneventful taper!