Help Planning dry taper Clonazepam

Hi,

I've spent this month attempting to stabilize as you can see from my signature.  A lot of false starts.  I am going to stick and hold with .5mg 3x a day.  I will be seeing my Dr. on October 3rd.  She will be a new Dr. for me as my original prescribing Dr. recently retired and she is his replacement.  I do know that she authorized a refill based on my chart and the upcoming appointment.  I have hopes maybe she will bring a fresh set of eyes and be willing to help if I can present her a reasonable taper plan.  I would like to avoid crossover.

I have a brand new GEM scale, microcrystalline powder, gel caps, pill splitter, a medicine organizer (bob7 style).  I'm not sure whether the daily method is for me at first, or the 5-10% every 10-14 days is better to start from 1.5 mg/day.  Ideas on what mg tablets to request before having to get into the weights and measures? 

I am here for suggestions to present to my Dr on Oct. 3rd and your experienced advice is greatly appreciated.

Sincerely,

Rae

What are you looking for in this taper plan Rae? Do you know what your doctor is expecting? I'm not a big fan of taper plans. People (and very often doctors) get stuck on a plan and dates and then get themselves in serious trouble.

I don't have a taper plan either. I have an idea of what I'll do the next 2-4 weeks but I'm basing everything on my symptoms. If my symptoms are not cooperating with my plan I change it up.

My doctor is very supportive and just prescribes what I need. As long as I'm reducing she's okay with it, it doesn't matter how long it takes. So I just report my dose each time and she's also okay if I need to hold.

We could look into a method of tapering for you, I just want to make sure we're answering your question and meeting your needs.

Hi Jelly,

I don't know what to expect from the Dr. as she is new to me.  I would like to be able to do a 10% reduction and hold for        days.    I've heard 10-14 days.  From my brief experience it seems what I did 4-7 days ago is what I'm dealing with now. 

Well for the next couple of weeks you need to hold your 3x 0.5mg to stabilize. You can certainly try 10% reductions but just letting you know I wasn't able to sustain it.

I recommend you taper at you percentage over a two week period. Because of the long half-life of Clonazepam it's really important to give your body enough time to recover from the cut. I don't think the cut has fully materialised in 10 days.

Then you need to decide how you want to do it. I have tried 3 different methods and I can only share my experience of each which will be biased. But at least it will give you some insight.

I tried shaving and weighing. Lots of people do it and most start out this way. I must be the village idiot because for the life of me I just couldn't do it. I struggled my butt off. You could try this before your next appointment to see how it goes and if you can manage. As a test run, weigh your pill, then deduct 10% of the weight of the pill in grams and see if you can shave it off.

With Bob's method there are 2 things you need to consider, first you need to figure out the maths. You can't reduce by 0.001mg/day as it's too little at your dose. My husband took Bob's spreadsheet and he made me an Excel sheet to calculate percentages for 2 week intervals.

The next thing to consider relates to micro tapering. When you micro taper it's difficult to know when your cuts are becoming too big. If you do cut and hold you know fairly quickly. With micro tapering they build slowly. By the time you realize you've cut too much you're already into the next cut or the next two cuts. It's really important to stay on top of your symptoms. If you make these capsules 2 weeks in advance and on day 3 you decide to hold then you need to make a whole new batch. Sometimes you decide half an hour before your dose is due but then you don't have the correct pill. It takes at least an hour to make 2 weeks of pills. So this is one drawback of this method.

I'm now on liquid. For me liquid is the easiest. I do cut and hold with liquid and micro tapering with liquid. (You can do cut and hold with Bob's method as well, someone just needs to figure out the maths).

So that's the quick version of what I've tried and my experience. Like I said it's biased. It will probably help if you read a bit more on the tapering threads.  I also think it will be a good starting point if you try shaving and see how you go with that.

Let me know if you have more questions.

Hi jelly,

For its ease, and just as a simple starting point, what do you think about a simple water suspension? Have two of the daily doses in tablet form, and then split the 3rd tablet dose in half, dose half in tablet form and make a water suspension from the other 0.25, removing 1 or 2ml each day depending on the amount of water you want in the suspension and the time you want to taper that 0.25 over. The upside is that you can hold on any dose at any time because you don’t have to pre-prepare weekly doses? I would still use scales to split the tablet and make sure the two halves were equal before making the suspension from one half. Do you see this as an option?

Hi jelly,

 

For its ease, and just as a simple starting point, what do you think about a simple water suspension? Have two of the daily doses in tablet form, and then split the 3rd tablet dose in half, dose half in tablet form and make a water suspension from the other 0.25, removing 1 or 2ml each day depending on the amount of water you want in the suspension and the time you want to taper that 0.25 over. The upside is that you can hold on any dose at any time because you don’t have to pre-prepare weekly doses? I would still use scales to split the tablet and make sure the two halves were equal before making the suspension from one half. Do you see this as an option?

Yes, this is almost what I did/am doing. I used a combination of pill and liquid to taper. I did however use percentages to taper the liquid portion rather than picking a random time and linear reductions. My pills are scored so I didn't need a scale I only used a pill cutter to cut my pill into 0.125mg quarters and I liquid tapered the 0.125mg sections. But if you don't have scored pills, you may have a clever solution. I do think this is the easiest method of all I have used. However I also think it's more reliable if you can get a liquid compound from the pharmacy rather than making a homebrew mix. A compounding mixture can stay in the refrigerator for 60 days if I'm correct, so that's also very handy. Good question, thanks for asking.