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Water, milk, baby food or ice cream (!) for titrating


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Thank you, Colin, for your excellent review of suspensions.  This is my first post, and already some of my questions are answered!  (By the way, I took quite a bit of chemistry in college and I can't "call you out."  Good job!)
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I don't know if this is the right thread to post this on--I'm new here.  Anyway, I'm starting my titration tomorrow, and today I experimented with various ways of crushing pills.  The pill crusher I got at the pharmacy was far too large for my 0.5 mg lorazepam.  I also tried crushing in a small plastic bag with a meat hammer (smooth side) but that wouldn't have been very accurate, either.  I finally made my own mortar and pestle out of a 30-ml dosing glass (made of glass) and the bottom end of a screwdriver.  This crushed the test pill to a very fine powder, and both the glass and the end of the screwdriver can be rinsed with milk, and then I will top this up to 100 ml. (I had a regular mortar and pestle but again, it was too big for the job.)
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Thank you, Colin, for your excellent review of suspensions.  This is my first post, and already some of my questions are answered!  (By the way, I took quite a bit of chemistry in college and I can't "call you out."  Good job!)

 

I might write up a new sticky about suspension mediums based on the various post regarding this topic. I'd welcome more input!

 

I don't know if this is the right thread to post this on--I'm new here.  Anyway, I'm starting my titration tomorrow, and today I experimented with various ways of crushing pills.  The pill crusher I got at the pharmacy was far too large for my 0.5 mg lorazepam.  I also tried crushing in a small plastic bag with a meat hammer (smooth side) but that wouldn't have been very accurate, either.  I finally made my own mortar and pestle out of a 30-ml dosing glass (made of glass) and the bottom end of a screwdriver.  This crushed the test pill to a very fine powder, and both the glass and the end of the screwdriver can be rinsed with milk, and then I will top this up to 100 ml. (I had a regular mortar and pestle but again, it was too big for the job.)

 

I have seen tiny mortar and pestles for grinding pills. Might be worth a look.

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Hey Colin...seems like you've been around the block a few times...I don't mean to corrupt this thread, but hey--can you tell me where to find a thread or blog for people just starting out?  There is so much info here (that's wonderful) that I don't know where to look.

 

Thanks in advance,  ANewOne

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I might write up a new sticky about suspension mediums based on the various post regarding this topic. I'd welcome more input!

 

Not many people use this method, but I've found Ora-plus a very good suspension liquid for tapering.

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Has anyone tried Enfamil or Ensure for titrating?  I've started out with 4% milk as has been suggested, but I am wondering if the lorazepam is dispersing properly since the milk is so cold.  These others wouldn't be cold to start with.  But I am also worried that  there might be enzymes in these which would break down the drug, or whether the vitamins and minerals would interact with it.
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I tried tepid water today.  The powder didn't cake up in my (supposed) mortar as it did with the milk, and as someone else mentioned, I could see what was happening.  I used to put the pills under my tongue, and they would take about 10 minutes to disperse.  That's at body temperature, and I don't think my water was that warm, so I let it stand for about 1/2 hour.  Seemed to work well.
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I am planning on using orally disintigrating tablets. I've read that another had good luck with those. How do you feel it will affect things?
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  • 1 month later...

prhiannon, thanks for your post, I agree with so many of you points.

 

Sorry I don't know how to quote on here so just had to copy and paste your comments and make them blue.

 

Aside from the fact that I don't like milk, I feel more comfortable being able to see the suspended particles and their consistency before drawing out with my syringe. I only started my water taper yesterday. Today I thought I would try almond milk (due to all I have read about people saying how much better milk is than water) but felt totally lost and uncomfortable without being able to see the contents. I will definitely carry on with water as originally planned.

 

I don't grind or blend, I just allow the pill to dissolve in the water, and then stir it up well.  I keep stirring it as I measure it out so that it stays in suspension.  (I have done the same, as I agree with your comment below)

Personally I think the less you manipulate the pill and the fewer surfaces you expose it to, the more consistent your measurements are going to be from one day to the next, because microscopic amounts of the drug are going to stick to any surface it's exposed to.  That's why I avoid the whole grinding and blending business.

 

A question, have you been titrating different meds concurrently? I have started tapering both Ativan and Alprazolam yesterday. How has it been going?

 

Thanks a million. I feel so relieved after reading your post...after all the complicated titration methods i have read about...and the general fear involved in tapering!

 

Smiley :)

 

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I am glad to hear that water works for titration as I am allergic to milk.  BUT what I don't understand is when you start and how to measure doses??? I suck big time at math!!  I am still in my c/o stage from cl to v.  Have a tapering date set of April 21st.  Trying to figure this all out once I get down to small doses is driving me bonkers and adding more stress to my already stressing about the taper itself. My psych will not prescribe liguid valium for reasons she failed to make clear to me, even stated I could find someone else to help me if I was not happy with her decision but that she will not change her mind. . .  As we all know finding a doc with benzo tapering experience is very difficult.  I am soooo disappointed!!!  She wants me to follow the Ashton method, which I have no probem with, although I will probably take it even slower that that, but as most know Ashton starts to reduce at 1 mg every one to two weeks once you hit 10 mg of valiun- and then jump at 1 mg!  I don't think my body could handle that. I have already had a failed taper, three week taper plan from the same doctor who first started to prescribe benzos to me without ever explaining what they were, that you get addicted and how to get off them properly. Tthat attempt landed me in the psych ward for 5 days, then 5 days of outpatient care. I am very sensative.  Anyone use a pill slicer?  Would it be reasonable to cut a 2mg v tab into 4ths? or even smaller when I get down to that point?  I am so mad at my psych for not letting me use the liquid and I just don't understand how to titrate even though I have read a lot about it here and even watched the video.  Can anyone help me to understand this better?
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Hi Angelluv!

 

Colin put up a really good post about titration on page 1 of this thread.  It helped me figure out how I wanted to do it.  I will be happy to help you with the math, if you tell me how much and how often you want to cut.  Hope it goes well for you

 

ANewOne

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ANewOne- I dont't know yet.  Plannimg on starting at the Ashton recommended 2mg cut for the first two weeks and see how I feel. I have the option using 5 and 2 mg pills to go even slower if I want.  I think I can cut a 2 mil pill into 4th with a pill cutter?  Does anyone once know if you can cut a quarter of a 2 mg valium pill in half?  Say I want to start titrationg when I get down to 7 mg.  How would I go about that?  And would I have use for that if I can cut the 2mg pills into 4ths?  Is that considered a "low dose"?  If I can cut that amount into 1/8th I may not have to titrate?  Any thoughts? 
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Personally I think the less you manipulate the pill and the fewer surfaces you expose it to, the more consistent your measurements are going to be from one day to the next, because microscopic amounts of the drug are going to stick to any surface it's exposed to.  That's why I avoid the whole grinding and blending business. 

 

Well, this is kind of an old post. But just wondering (op) if you shake the fluid before syringing?  According to your theory this would also leave sediments in the top portion of the jar.

Thanks (if your happen to read this)

 

edit..Sorry, I just reread your post. You stated that you stir rather then shake? So you've had no problem with a vortex forming (due to the circular motion of stirring) that leads to uneven distribution?

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ANewOne- I dont't know yet.  Plannimg on starting at the Ashton recommended 2mg cut for the first two weeks and see how I feel. I have the option using 5 and 2 mg pills to go even slower if I want.  I think I can cut a 2 mil pill into 4th with a pill cutter?  Does anyone once know if you can cut a quarter of a 2 mg valium pill in half?  Say I want to start titrationg when I get down to 7 mg.  How would I go about that?  And would I have use for that if I can cut the 2mg pills into 4ths?  Is that considered a "low dose"?  If I can cut that amount into 1/8th I may not have to titrate?  Any thoughts? 

 

Hey Angel,

I cut my valium 2 mlg into 4ths. I'm always skeptical of the dose, but it's what I've got. I use a pill cutter. It's the only one I've ever had but I wipe the blade part with a tissue each time so I think that helps with some level of "accuracy". I actually was able to get liquid valium and I use that for any dose portion under .5. For instance I'm on 2.2 now, so I just take the 2 mlg pill and .2 liq (which is really nice, no cutting for a couple weeks)

 

I was on another forum that had a vide for titrating in babyfood that seemed to make sense, I wasn't ready for it yet and didn't save it, figured I would be able to find it. I haven't needed it but so many people ask, I wish I could find it!

 

Anyway, just thought I would chime in since I am cutting the pills. Hang in there!

:)

Sarah~

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Thank you Sarah, I think with Valium I won't have to titrate.  I am gonna take it slow.  I experimented cutting with some extra pills I have and I actually was successful on the 1/8th cut.
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  • 2 months later...

Just wondering about the vortex thing. In microbio we always vortexed the liquids when we were doing dilutions. Medium was generally a nutrient broth the consistency of milk roughly iirc. We would inoculate a tube, vortex, pipette to next tube, vortex, and so on. That was how we counted the bacteria in a solution. Now it's been a while, and maybe this worked because of the error margin, which I assume wouldn't be desired in a medication solution?

 

 

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Just wondering about the vortex thing. In microbio we always vortexed the liquids when we were doing dilutions. Medium was generally a nutrient broth the consistency of milk roughly iirc. We would inoculate a tube, vortex, pipette to next tube, vortex, and so on. That was how we counted the bacteria in a solution. Now it's been a while, and maybe this worked because of the error margin, which I assume wouldn't be desired in a medication solution?

 

 

 

I think that's right pi. The medication would stick to the sides of the container. You would lose a lot of it. Having said that, what's more important is consistency. If you regularly stir your solution, then you'll lose approximately the same amount every time you do so.

 

I don't think it matters how you mix it, it matters that you use the same procedure each and every time so that you're losing the same amount each and every time. This is also a good reason to consider your cross over to titration as a cut. Members often feel symptoms after they cross over because of a loss of some of the medication. I would imagine your first dose after crossing over, if you stir it, would be a considerable cut depending on how much medication stuck to the sides of the container.

 

I've tried titration. I preferred to place a cap on the container and shake it. I felt this would more evenly distribute the medication.

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  • 1 month later...

The best medium to dissolve your benzo in depends on what benzo you are taking.

Each benzo is soluble and in-soluble in different liquids.

For instance, klonopin and valium are soluble in milk.

Other benzos water, and other benzos need solvents not found in the home.

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Titration Wise Pilgrims

 

Can you please help put some myths to bed around the titration taper method.

 

1. A combo of liquid and dry is indeed common, and many buddies use this method. Benzo Support Org, has a ready formulated spreadsheet, ready made for this very purpose.

 

2. There is no dose level at which titration many be adopted, it's just an alternative to the cut and hold method. Whilst allowing for very small cuts as you near the end of your taper.

 

3. There is more than one way to put your pants on, there are at least half a dozen step by step guides out there. But they ultimately all achieve the same result, the important thing is follow the same process each and every time.

 

4. We are all different, and as such need to find our ideal cut rate. A very good place to start is at the same level as your dry cuts. This assumes you have found a level that suits you. If not start low and see how you go.

 

5. It's good practice to allow a week to get used to titration before making any cuts. But this is just a guide, and the final decision is down to the individual. 

 

Your Responses and input would be greatly appreciated, to kill some of this smoke and mirrors surrounding the process.

 

FX

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1. A combo of liquid and dry is indeed common, and many buddies use this method. Benzo Support Org, has a ready formulated spreadsheet, ready made for this very purpose.

 

Hello FX. I took a look at the spreadsheet you mentioned at http://www.benzosupport.org/the_spreadsheet.htm

 

Is this spreadsheet esssentially what Jana at Benzo Detox Recovery uses?

 

-Zoner

 

 

 

 

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Some pharmacists use a thick syrup to make suspensions, some have their own suspension kits. Have known some people who use jello, baby food, applesauce, syrup and so on. Ativan will never dissolve in water so it will be hardest to make an even dose suspension in water, and that could cause inter-dose WDs.

Chanetta

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Pilgrims

 

Day 10 of my MT, I'm half way to dropping ,5mg now and can report that instead of gelling hit and slammed. You tend to get what I would describe as touched and nudged. You don't spend 2/3/4 days fighting the drop, you rather gently push against it and that's about it.

 

So for those about to embark on it, here's my top tips.

 

1. Start at the same rate you can tolerate dry cutting.

 

2. Try it out for a few days around 5 before making any cuts, you can take this time to get yourself familiar with the process

 

3. Make sure you download the spreadsheet and set it up to match your current dry cut rate.

 

4. Make sure you tick of everyday as soon as done, don't leave it till later it's so easy to loose track

 

5. What ever method you choose to MT with, either ready made or cook your own. Stick with exactly the same method each and every time.

 

6. Be prepared to adjust your spreadsheet for each third of your taper.

 

7. If wd becomes very uncomfortable hold until you settle, be prepared for this. We are not machines and it will happen, but as long as you keep sliding down the dose ladder, that's the main thing.

 

8. If you are going away from home for a while, either bring your kit and carry on. But where that is not possible, factor in a clean break in your plan, where you can hold with dry. Obviously below 1mg will have be managed on an individual basis.

 

9. Only use full fat 4% mill, as this is ideal for Diazepam, so make sure you have a constant fresh supply.

 

10. Make your dose the night before and leave it in the fridge.

 

11. Make sure you use water or any clear drink to swill, and drink all of the residue after you have drank the milk.

 

12. Make sure you have a constant supply of syringes, as those numbers wear off very quickly. They are extremely cheap, so keep a reasonable supply.

 

13. Always have 2 graduated cylinders, they are so easily broken, so a spare at all times is an absolute must.

 

14. I like to add a little sugar to the milk,  I think it adds to the viscosity, and tastes a little better. If you do this add the sugar after you have removed your millilitres. Do not add before.

 

15. There is absolutely no problem with mixing dry doses with liquid. It all adds up to the same volume consumed.

 

16. Don't split pills, as long as you have a constant supply of all available pill sizes. There is no need to split them, this will give you a greater degree of daily accuracy. Than any dry cutting could.

 

17. Try and work towards dosing twice a day if you can, this will just make it easier, as you get lower and lower.

 

18. Be prepared to slow right down when you hit the 3mg mark. This seems a point to crop up time and time again.

 

19. If you feel after your first cycle that you could go a little faster, adjust your spreadsheet. This will probably only apply for the first third of your MT.

 

20. MT  has a greater success rate, than the small cut & hold method.

 

That's my top 20, that I've learned so far, so good luck, and don't forget to post when and how you are starting MT.

 

I as well as many others would be very interested to read your comments.

 

Take Care Pilgrims

John

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