New - Tapering from 1mg with 7 month use

Hi, my name is Jen, I've been on and off meds for years. I've previously been diagnosed as bipolar 2. I have been on many different ssris, etc, and stopped taking them over 7 years ago.

 

Background:

Previously (about 8 years ago) I was on Xanax. I don't remember the dose. I ran out and didn't bother to refill. I went through a week or so of every most common/less common/rare withdrawal symptoms out there. Finally, I went to a psych and she prescribed Klonopin. I was on that at, I think .5 mg per day or so for about 1.5 years. I had weaned myself off the host of other things she prescribed (Effexor XR and another one she prescribed, I can't remember the name, it was supposed to counter the side effects of the Effexor) by myself. I also, somehow managed to quit the Klonopin by myself. I may have tapered a bit, but not much. I didn't suffer many withdrawal symptoms at that time.

 

Fast forward to 2+ years ago. I was given Traxene for anxiety but found I was pregnant relatively early into taking it, so I stopped taking that. It wasn't something I liked anyway as that stuff put me dead out.

 

Today:

Here I am, wanting to get off Klonopin because I want it all out of my system by August or so when we start trying for another kid. I'm pretty sure this is something I don't need except maybe in dire circumstances (which, in my opinion is how it should be taken, for instance, to get through going to the airport or flying or dealing with an ex.. of course, I also know I should learn coping abilities, but I digress.)

 

My first last dose was 1.5 weeks ago because I ran out. (I suck at keeping on top of my scrips) I experienced the same sort of withdrawal I had with Xanax but couldn't get to the doctor until the following Monday. I didn't start to feel the withdrawal symptoms until about 3 days after last dose, but they were doozies. I ended up taking left over Tranxene at 7.5mg over the course of 5 days (4 pills), my last dose being Monday morning. I'm pretty sure the dose ratio re: Klonopin is pretty high.

 

So here I am now. Today. I have a new scrip for Klonopin to start tapering from. 1mgx30 plus a refill. So far today I have taken .75 and have tremors with mild anxiety but at least the big bad things are at bay. I understand I should probably start my taper lower than .25 and am interested in the liquid klonopin you make yourself and will be looking into getting a medicine dropper/syringe and bottle soon. I found a recipe online but frankly, it's pretty confusing to me. Maybe it would help if I saw the syringe. (;

 

How long should I stay with a particular taper? Say I go 1/8th (I suck at math), is 1/8th ok? How long before I dummy it down another 1/8th?

 

Is liquid Klon more expensive (if you don't make it yourself) than pill form? (I have no insurance.)

 

I am used to taking that 1mg at one time at any point in the day (no set time). Should I take the dose at a lower rate at set times per day or do the one per day schedule?

 

I am taking b-12 (highest dose), Folic Acid (same) and am starting to take Omega-3 (fish oil) to help my body gear up. I have considered taking detox/blood cleansers, but I'm scared that will be counter productive.

 

I'm so sorry I'm rambly and spastic. I am a bit manic and have always been a bit of a scatterbrain. (; 

 

TIA! I'm glad this board is here!

Hello Jen,

 

I suggest the first thing to do is for you find what is the minimum daily dose you require to feel relatively OK. You should not be looking to find a dose where you feel great (quite frankly, that ain't likely to happen), but rather a level where the the worst of the withdrawal symptoms are under control, but hopefully you won't feel too zonked out at the same time. You will need to take your Klonopin at regular intervals and at a set dose. What you should be aiming for is stability. Once you have adjusted to your new regimen you can then look at tapering off.

 

Titration will allow you to make a steady decline in dosage at minimal cost. Even if you were to purchase liquid K, you'd probably still have to fiddle with it to achieve a steady reduction in dosage. You may as well do it yourself from the pills. It is pretty straightforward, but you are correct, the instructions tend to be overly complicated. We are working on some new instructions (with the minimum of equipment) at the moment and hope to have them up within the next few days.

 

I too am glad you found this forum; you will get through this with a little help.

 

Take care.

Hi, Mary,

 

Welcome to BenzoBuddies!

 

Regarding the detoxing...now is definitely not a good time. Detoxing might very well pull the benzo out of your system along with the other junk, causing a huge flare-up in withdrawal symptoms. I've been there (a couple of times!), and now I am very careful. Unfortunately, we have to wait until we're off benzos to do a really good detox.

 

Therese

I could have sworn I answered before. :/

 

I'm pretty sure I'm at either 1mg or 1.25. I went to .5 this morning because .25 just does nothing for me. Hopefully I can start at 1mg per day and the tranxene didn't mess me up.

 

Therese, thanks! That makes a lot of sense. I'm glad I decided to hold off on that.

 

Colin, Thanks for the chat yesterday. I'm trying to figure out what that "relatively ok" is. I think I'm at it. I'm not sure where to draw the line. Trembling sucks, but I can live with it. The anxiety is a little high, but I think I can live with that too. Where do you draw the line? And you're right, I think I will be ok w/o doing a liquid dose thingie. Ugh, I've got a birthday party to go to this weekend and it would be nice not to be so shaky. Par for the course, I imagine.

 

I'm going for .50 11am and .50 towards 8ish pm. And taper from there. Should I taper the morning or the night dose or both?

 

Thanks again!

If you can "live with" the symptoms, that's a sign that they're in the bearable range ("relatively OK"). When they start to become unbearable, and you start saying things like "I will NOT be able to handle it if it gets any worse than this," then that's a sign you are tapering too fast.

 

I think Colin was envisioning that you make your own liquid Klonopin from milk (we're working on instructions for that right now) so that you don't have to pay for a compounding pharmacy to make a special solution, which would cost you more than the pills. Once you get your liquid made up, you will in essence be tapering both the morning and the night doses. Tapering Klonopin is almost impossible without going to some kind of liquid solution. That drug is just too potent.

Thanks so much Therese. I've been going back and forth on whether to do the liquid taper, but I'm thinking as the dose gets smaller it's the most logical solution. Why the milk, though, instead of hot water?

 

I'll be glad when that's put together!

 

I'm not feeling *great* but it is bearable where I'm at right now. (which is crazy because I was at 1mg a day and am still there, but I think that's because I split my dose into two.)

I'm not surprised you feel better on two doses a day instead of one. Klonopin has a relatively short half-life compared to Valium, so the drug levels in your bloodstream can fluctuate quite a bit during the day. I would recommend staying with two doses a day throughout your taper.

 

We use milk because benzos are fat soluble, not water soluble. So the benzo can dissolve in the milk because the fat is dispersed evenly throughout the milk. I hadn't heard of the hot-water method before I saw your link (I'd heard of water titration, but not with *hot* water). Curious!

I need to clarify. I was on 1mg once a day and fine. I didn't take it at set times or anything, just whenever. Sometimes it would be around 11am or so, and others around 5-7pm. Just whenever I started to stress out. My prescription actually said for "nerves". My "mother's little helpers", so I called them.

 

Anyway, First day splitting my dose into two doses wasn't so great, but better now. The reason I was feeling better was because I was four days off of it when I split my dose. (;

 

The link I read said it was water soluble, but it could definitely be incorrect. I put some instructions in my blog that I'll try to concentrate on when I can actually concentrate on something. I need to get to the pharmacy (maybe this weekend) and pick up some supplies for the liquid. What's cool is I already have a pestle thingie magig.

 

I think I'm a tiny bit ocd, so a liquid taper actually intrigues me from just that standpoint alone. XD

Hi Jen,

 

It will help no-end if you take your benzos at set times, and at equla distances apart. If you take them twice a day, then the doses should be 12 hours apart. Three times a day - 8 hours apart. Four or more - you should take your first dose when you rise, and you last when going to bed - the rest should distributed evenly throughout the day.

 

---

 

Sorry, it has been longer than I had hoped for. I won't publish a full instruction manual here, as we are still ironing out some details. We have ripped apart all the ideas and assumptions people make about titration. What it boils down to is that there is no point in making the liquids to very exacting strengths for minuscule reductions because there is no way we can measure that accurately in the home. Even if we could, we would expect the actual dose within individual tablets to vary somewhat - these inaccuracies swamp any attempt to make up exacting benzo liquids. What we have decided is that there is no real point in trying to make cuts smaller then 1% of dose per day (1ml from 100ml of liquid, for example). Once we accept this to be true, it frees up the method considerably - it becomes quite straight forward. If taper rates of 1% or more per day are too great for you, then you simply instead make the cuts every two or three days to suit. We will give you all the information you need.

 

OK, before I start, I need you to again restate your position. I think you take a total of 1mg or 1.25mg Klonopin per day - is that correct? How much with each dose? What cuts have you carried out in the past that you felt were successful? How much of a cut from what dose, and for how long you felt you needed to stay at the new dose. Once you have replied to these enquiries, I'll post the figures you need, and a simple method. You will need a 100ml measuring cylinder marked with 1ml increments.

Originally I was taking 1mg per day once per day. I did the 1.25 on that one day because of the withdrawal of not having it for 4 days.

 

Right now I'm at .875 per day with a planned taper next week of another .125

I'm taking .375 morning (11am) dose and .50 for my night (8pm) dose. So far these times seem fine for me and I haven't had any problems with this taper.

 

If I were to change my dosing schedule, should I do it gradual or just do it? 12 hours apart would probably give me 9-10am and 9-10pm.

 

In the very distant past I pretty much cut .25 at a time w/o much problem.

Hi,

 

Yes, as our dose decreases, we need to make smaller and small cuts. How much of cut we can take seems to relate our total dose. So, we might manage a 4mg cut from a 40mg dose (10%) without any real problems, but by the time we get down to 20mg, that 4mg cut would count for a 20% cut - most people would find that pretty tough, and some, impossible. We would probably be cutting by about 2mg at a dose of 20mg.

 

What size are your tablets (what strength)?

Oh, and how long have you found you needed to stay at your new dose before you feel up to cutting again? I'm looking for examples of cuts that worked well for you.

I tablets are 1mg (I wanted .5's but didn't push the issue, should have, much easier to cut from .5's)

 

I feel like I could cut again right now if I wanted to, but I am holding out a few more days. I don't really have past experience or rather, remember it. It's been several years and I didn't really pay attention. All I know is I got off Klonopin before w/o much of a hassle after at least 1-1.5 years of use. I don't remember if I was at 1mg or .5's then or my dosing. I've always pretty much took them when I felt crazy.

 

thanks!

Oh, and I plan to be off them by August, so a super slow (or maybe even slow) taper isn't going to work for me. 

Well,

 

I've done a quick calculation based upon you most recent cut: 1mg down to 0.875mg, and assuming that you stick at this level for 14 days. The following will deliver the same overall taper rate, but will remove those big jumps every two weeks. This schedule would take 14 weeks - too long perhaps?

 

Crush one 1mg tablet into a fine powder with back of a spoon in a cup. Add a little homogenised milk and allow the powder to fully dissolve. Pour the milk to the measuring cylinder. Pour a little more milk to the cup, swirl around, and add this to the cylinder (this will ensure you have transferred all the benzo to the cylinder). Top up the milk in the cylinder to 56ml. Mix well. You know have 1 tablet in 56ml of milk. Initially you should discard 7ml of milk; the remaining 49ml will contain a dose equivalent to the 0.875mg of benzo you take now. You will cut 1ml of liquid every two days. You always make up the liquid to the 56ml, but after the 49ml dose for two days, you will take 48ml for two days. Then 47ml for two days, etc., etc.

 

A faster option, which would be equivalent you continuing to reduse by 0.125mg every 10 days:

 

Follow the same instructions for making up the liquid. This time make up the liquid to 80ml. Your first cut should be to 70ml so that you end up with milk containing 0.875mg of Klonopin (what you take now). Each day you will reduce the amount milk you consume by 1ml. You always make up 80ml of liquid; day one will be 70ml; day two 69ml; day three 68ml; etc., etc. This will take 10 weeks to complete.

 

Both of the above examples gives you your daily benzo dose. You will need to split this into your separate doses throughout the day. If after you completed all the above steps, you find you have an awkward amount of liquid to split into two, three, or more doses, then simply add more milk to an easy to split amount. If, for example, you only have 4ml of milk after your deductions, you will struggle to spilt this into three doses. However, if you top up this 4ml to 60ml, and mix well, you could split this into three 20ml doses.

 

Edited for typo in a figure.

Thanks so much, Colin! I'll get into that if it starts to look like I'm going to have issues with the dry taper.. er, probably when I get to .25? We'll see how my will and physical/mental holds out.

 

This is much appreciated. (:

 

Jen

Well, it's pretty easy to do this at any stage. If you do reach a stage where you need it, just ask and one of us will make the calculation for you.

Don't laugh, but my main reason for not going ahead with the liquid yet is because I already quartered (cut my pills into 4 pieces) my doses and am not sure if I'm actually going to get a mg by er, trying to piece them all back together. I was a bit over-eager there starting out.