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Help with withdrawal (starting soon)


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My story: Back in 2018 I was having really bad chest pains and thought I was having a heart attack. It was later determined that I had an anxiety breakdown because all the health tests I undertook in 2018 came up good including my heart. So the psych doctor I had at the time started me off with various medications but I eventually wound up on a 1mg Ativan/30 mg Prozac during the day, and 2 mg Klonopin at night.

My previous doctor was very liberal with benzo prescriptions. He once offered me Valium when I told him I was sleeping ok with the Klonopin, but I declined. He retired at the end of 2021. About 6 months later I got a new doctor who so far I can't say I really care for, but that's another matter.

 

So I have a doctor appointment Thursday afternoon via video. I am scared out of my mind. The first appointment we had she noticed I was on both Ativan and Klonopin/Clonazepam. July 14 was my first visit with her and she took me off Ativan cold turkey as she only wants me on one benzo. Since July 14 I have been freaking out about the idea of withdrawal so much so I'm having physical manifestations of anxiety such as sensitivity to heat, feelings of depression and not very high moods to enjoy myself. The most important thing that I keep going is my sleep. I work a high pressure high intensity job at a casino where I have to focus a lot and meet quotas. I feel like nighttime is not a good time and that's when my mind tends to run wild the most.

I am an excessive worrier and have needed medications to sleep for as long as I can remember. I used to be on Trazodone before I got switched to Klonopin. What should I tell my doctor? I will also need something for sleep eventually how did some of you get sleep while going through withdrawal?  Please help me. My wife and my job are everything to me especially my health insurance which my wife especially needs as she is diabetic.

For the record my doctor wants to start at a 25% withdrawal to 1.5 mgs.

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I'm so sorry I didn't see your post until now, what happened with your doctor?  I hope you'll come back and report how it went, I'll be here.
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Hi Pamster,

Well there's not really much to tell. I was so off put by our first visit that I called and asked to switch to another doctor because of the impressive that I got and the CT of Ativan without so much as an ok.

As a result of that, I was given the option prior to the appointed as to whether or not to proceed with the appointment so I did. I understood her a little bit better this time around.

However because of my request to transfer my care to another doctor she didn't want to put any new treatment plans in place until I get a chance to speak with the new doctor. I almost considered retaining her but I think I still want a new doctor. My wife says yes and I'd like your opinion too.

As of now, she will oversee any prescription needs but I won't be doing any tapering until the new doctor has spoken to me.

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I'm so glad you came back because I have a question. 

 

You say she cut you off of your 1 mg of Ativan, did you actually do this or were the symptoms you were having a result of the stress of knowing she was going to take you off cold turkey?

 

I'm glad you decided to see her so you could better understand her position but it does sound like you need someone who is less ridged and willing to let you, the person who is actually going to do this have some say in your care.  It's so difficult to advocate for ourselves when we feel like this, the vulnerability and fear has us acting in ways not typical to our personalities but you're right to keep looking until you find someone who will consider you a partner, not a second class citizen.

 

I know you've probably seen this but this document is written with prescribers in mind, its short, sweet and well sourced.  Colorado Consortium Benzodiazepine Deprescribing Guidelines

 

 

 

 

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Good morning Pamster,

So when my anxiety goes into overdrive I start to have physical symptoms. Chest pains, sensitivity to heat, and my mind going 100 mph it seems. After the first appointment I was getting so excessively worried I couldn't put it aside and calm myself down.

Up until I met her I was taking 0.5 mg Ativan during the day along with 30 mg Prozac. When we met in July she saw that I was on both Ativan and Klonopin and she took the Ativan off my medication list right then. She then said at the next appointment which was Thursday afternoon that she would want me to start thinking about tapering Klonopin. Not that I would be forced to do it.

When I told her I feel functional with Klonopin on July 14 she kinda dismissed that and was like "well you're going to have to get off of it eventually." So between then and yesterday's meeting I was just having anxiety overdrive pretty much daily.

Yesterday's appointment almost made me want to keep her, but my wife watched the appointment and said the vibe wasn't really there between myself and the doctor. Although the doctor did say it would be unethical to cold turkey someone off of a benzo and that slow taper is recommended but I'm not sure how slow she would go. My wife says to have and keep faith in the new doctor.

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Kudo's to your wife for being there and for giving you her impression of the visit, I can see you have a strong ally!  :thumbsup:

 

I want to talk to you about what you're feeling, the symptoms you're dealing with while still taking the Klonopin.  When we become dependent on the drug, it begins to cause the very issues we went on it to fix, insomnia, anxiety, panic, tinnitus and hundreds of others maladies.  The reason I'm telling you this is because the extreme reactions you're having could be a result of the drug, not your normal condition and once you get off of it and recover from your use, you may find life much easier to manage. 

 

As we age we develop skills and even though you've been on the drug, you've matured and gained some powerful life lessons and some members have found that they're able to deal with their anxiety so much better after going through this.  I just wanted you to have hope that once free from Klonopin you may find life to be manageable.

 

I'm thankful your current doctor will still prescribe to you while you're looking for a new doctor, in the meantime, would you like help with a possible taper plan?

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Good evening Pamster,

I would very much appreciate help with a possible taper plan. I can use all the help I can get. Also, what are some withdrawal symptoms I can expect even with a slow taper?

I've read some of your posts about the more people know, the less they'll fear. So if you or anyone could educate me a little on what withdrawal symptoms to expect I would love the information. That's why I'm here for information and for support, and to support others.

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From reading your posts it seems like your current dose is 1.5mg of Klonopin right? I think the next step would be to determine what method you'd like to use to reduce your dose. What size pills do you have?

 

It's difficult to tell you what symptoms you'll experience because everyone reacts differently in withdrawal. I think the most valuable information is if you taper slowly and according to your symptoms you should be able to function. It doesn't mean you'll feal great, but withdrawal will be tolerable. Oh, and not to stick to a plan or a date. People who get fixated on getting off by a certain date seem to get into trouble as they ignore their symptoms and rush their taper.

 

Initially all of this seems very overwhelming - the methods to taper, the maths, the symptoms - but once you get the hang of it, it becomes part of your life. You learn to live with it. A lot also depends on your attitude and mental state. Those who allow negativity to dictate their lives seem to struggle very much. But if you have an attitude of "oh well, this totally sucks and I hate what I'm going through, but I'm gonna do my darn best to get to the other side" you'll do pretty well.  :thumbsup:

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My current and present dose is 2 mgs, taken via 2 - 1 mg tablets orally each night roughly 90 minutes before bedtime. At this point I believe I would like to start off with a direct simple taper. I am wondering what are the most common withdraw symptoms with tapering? Any other info you have is much appreciated.
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Chapter 3 of the Ashton manual lists our symptoms and possible reasons why we feel them, I actually found it comforting because it helped me know what I was feeling was normal.  https://www.benzo.org.uk/manual/bzcha03.htm

 

Something to know, we can experience symptoms when we become dependent on, tolerant to, withdraw from or recovering from benzodiazepines.  We can feel all of the symptoms listed in that chapter no matter where are in the process.  There isn't one set of symptoms for each phase of our journey, we can feel them all in varying degrees of intensity.  Its impossible to know who will get hit with what and how hard but we find out pretty fast.  I wish I could prepare you but this process is all about nasty surprises and the best way to handle it is by understanding these are just symptoms and while they can make us miserable, for the most part, they can't hurt you, they're signs of recovery. 

 

Would your doctor be willing to prescribe a smaller dose pill to aid you in making smaller reductions?

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Good evening Pam,

I'm pretty sure they would be willing to do that. I will have more information once my new doctor is chosen. In the meantime do you have any taper recommendations?

Also Pam were you still able to work at a job throughout your recovery? That is one of my biggest concerns.

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I was able to work my full time job all but the first three weeks after my cold turkey, it was difficult but I'm so grateful I was able to because it was a good distraction.  I was miserable but sitting home with only my symptoms to think about would have been horrible.  I found myself dreading weekends, that's how much working helped me so I hope you'll be able to work too.

 

Is it your intention to start your taper before you get the lower dose pills?  We may need to look at shaving them with a razor blade to achieve decent dose accuracy. 

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Morning Pam,

So you took 3 weeks off after your CT, then continued working? If I read correctly then working will probably be beneficial for me.

I will probably taper before getting lower dose pills

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Yes, I only took 3 weeks off but I was working a job I'd had for years and I had a good team, in fact, I let two of my team members know my plight and they looked out for me.  It was tough, I had to keep lists, take notes and post reminders for myself but I made it through.  I also had to take walks to get away from people because it was so painful to be around them all day, I even hid out in a bathroom stall from time to time but I made it and I hope you will too.

 

Only having 1 mg pills is challenging, with a scored pill you can be sure there is an equal amount of medication in both halves but that accuracy isn't there when you cut them into smaller pieces.  However, you're on such a high dose I feel you can make some initial reductions without causing too many problems for yourself by just eyeballing your dose.  Many members are comfortable cutting their pills all the way to freedom, some prefer a little more accuracy so they invest in a jewelers scale to weigh their dose, still others will use liquid titration.

 

Would you be comfortable shaving your pill to achieve a first dose reduction of 10% that would take you to approximately 1.8 mgs? 

 

Oh and one more question, you mentioned this in your post: "Since July 14 I have been freaking out about the idea of withdrawal so much so I'm having physical manifestations of anxiety such as sensitivity to heat, feelings of depression and not very high moods to enjoy myself."

I don't believe you were freaking out about the idea of withdrawal, I think you are experiencing it.  Being ripped of 1 mg of Ativan is cruel and unusual punishment so we need to make sure you've stabilized from that before proceeding with the Clonazepam taper.

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Oh and one more question, you mentioned this in your post: "Since July 14 I have been freaking out about the idea of withdrawal so much so I'm having physical manifestations of anxiety such as sensitivity to heat, feelings of depression and not very high moods to enjoy myself."

I don't believe you were freaking out about the idea of withdrawal, I think you are experiencing it.  Being ripped of 1 mg of Ativan is cruel and unusual punishment so we need to make sure you've stabilized from that before proceeding with the Clonazepam taper.

 

I wasn't sure if withdrawal began until all benzos someone is on were stopped or tapered. You definitely have something there.

 

I would definitely be willing to start at 10%  I'm going to share this with my new doctor.

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Anytime you reduce you will most likely feel symptoms, you can also feel them when you change the time of day you dose, or if you decide to split your doses to avoid interdose withdrawal.  These are powerful drugs and minute changes can produce severe symptoms.

 

Let us know how it goes with your doctor and please, do ask for smaller tablets, it will make your life so much easier.

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  • 1 month later...

Hi Pam I just wanted to give you and everyone here an update. I have not yet begun to taper just yet. I meet my new doctor via Zoom on Friday morning. I already have ideas on what I want to say and where I would like to start. I just need to feel him out first to see if he'll be compatible for my care.

I have also noticed since I've been off the Ativan daily my sleep is different. I still sleep but work is hard and very draining still. Hopefully a new sleep medication once I've tapered down enough will work.

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I'm glad you can sleep and glad you can still work but I know its difficult.

 

Its good to hear you're preparing yourself for your appointment, many of our members say that speaking without emotion and just stating your case helps.  Please let us know how it goes. 

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Well hopefully once I begin tapering the Klonopin it won't affect my sleep too much or affect my work. I'm more concerned with the Klonopin taper and what that will affect. It's the Klonopin that's been helping me sleep for the last 3 almost 4 years.
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You're pretty much guaranteed to have insomnia but even if you are, its possible to recover from this and for sleep to return.  I took the drug for sleep and mine has returned. 
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I noticed in your signature you tried Ambien but stopped. Did you ever try anything else to combat the insomnia? I've read that post about that one guy who went through insomnia for 10 months. Do/did you get some sleep each night or did you just not get any sleep?
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I reached for Ambien a few months into my recovery and it made things so much worse, I hope you won't do what I did.  I think I tried a few non-addictive drugs and supplements but they didn't do much, time seems to be the only thing that works without causing more problems.  I sleep great now.
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Good afternoon Pam,

I just met my new doctor, and I love him. My goodness it's like noght and day between the previous doctor and my new one. Anyway I was talking with the new one and he's agreed to my tapering plan which is to reduce the dose by 10% every 3 weeks. And he let me decide that. He's also going to work with me very closely on any insomnia issues but he did advise the taper would take at least 6 months to complete. I'm actually a little less scared now than i was before.

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