Feedback Requested on Proposed Titration Taper

Hello All:

 

I would appreciate feedback on my proposed titration taper schedule.

 

I have been taking 30 mg. temazepam in capsule form (powder enclosed in a capsule) for approximately 6 weeks. I spoke to a Kaiser pharmacist today who thought it was OK to open the capsule, mix it with water, and titrate the amount down.

 

Since I have been on temazepam for only 6 weeks, I would like to try a 3 month taper schedule. I have a graduated cylinder so I can titrate the daily amount by 1 milligram.

 

Any feedback is welcome. Thank you!

 

Kristin

Hi Kristen,

 

I will need to know the following:

 

The size of the cylinder (how many ml will it hold);

 

The intervals (the size of graduations marked on the cylinder);

 

Your dose (30mg, I believe);

 

The number of capsules you use per day (two, I believe);

 

The taper rate;

 

The start date (the table will give you dates for all the redcutions, as well as the size of reductions in dose).

 

 

The system is set up to work from a taper rate (10% cut every 14 days, for example), but I should be able to work it backwards from the total time to complete the taper instead. With the additional information, I can set up the table tomorrow, to start the next day, if you wish.

Hi Colin:

 

Following are the answers to your questions ~ Kristin:

 

The size of the cylinder (how many ml will it hold): 100 ML

 

The intervals (the size of graduations marked on the cylinder): 1 ML

 

Your dose (30mg, I believe): YES, 30 MG. DAILY

 

The number of capsules you use per day (two, I believe): TWO 15 MG. CAPSULES AT BEDTIME

 

The taper rate: 90 DAYS

 

The start date (the table will give you dates for all the reductions, as well as the size of reductions in dose): NOV. 1

Hi Kristin,

 

I've done as you requested. However, this is a much faster taper plan than I would recommend. Most people taper at about 10% of their dose every 7-14 days. Titration, because it is much smoother than splitting pills, may offer a little boost to the speed at which you can taper, but not this much. Let me know if you think you would like to go a little slower.

 

Your taper schedule: http://www.benzobuddies.org/spreadsheets/bbo-kristinh-2007-10-31.html

 

You can add it to you signature with following code:

 

This is my [url=http://www.benzobuddies.org/spreadsheets/bbo-kristinh-2007-10-31.html]titration schedule[/url].

 

The above will display like this:

 

This is my titration schedule.

 

You can change the displayed and clickable text to whatever you wish.

Thanks, Colin. If you recommend a slower schedule, I would be interested in seeing it.

 

Also, I have managed to  reduce my daily dose from 30 mg. to 26.75 mg. Temazepam so 26.75 would be my new starting point.

 

Thanks for all your help.

 

Also, do you recommend mixing the medication with water or milk or

 

Kristin

I'll recalculate the taper plan later tonight, for you to start on 2nd, if that's OK? I'll use taper rate of 10% every 7 days. That may still be too fast, but you can try it and see how you progress. We can always rework the schedule to suit, after you have tried it for a little while.

There is a website called "The Road Back" that suggests taper rates of 2% to not go through any withdrawal at all.  What I can't figure out is how you could possibly do a 2% taper and how long it would take.

There is a website called "The Road Back" that suggests taper rates of 2% to not go through any withdrawal at all.  What I can't figure out is how you could possibly do a 2% taper and how long it would take.

 

2% over what period of time?

2% every 14 days.

2% every 14 days.

 

That's plain stupid. A few unfortunate people may need to taper that slowly, but as general advice, that makes little sense. Even if the amount cut does not reduce as the dose diminishes, that taper plan would still take two years. If the size of the cuts do diminish as the dose shrinks (which is the usual way in benzo circles), then it would take very much longer than two years!

OK, thanks, Colin. I'll look forward to receiving the revised plan.

 

Yes, I really don't want to take 2 years to get off a six week habit!!

 

Kristin

Hey, Kristin,

 

Sorry - I'm a bit snowed under at the moment - I forgot that your use was for only six weeks. You should probably aim to use pill-splitting instead, go at whatever rate you can manage, and use titration (if needed) later. At six weeks, you stand a good chance of not yet being dependent. Can you again post your situation, and brief history. Why do you feel you need to titrate? Unless you have good reason to think you have become dependent, you could probably aim to taper off in 1-2 months. Ideally, you want off before becoming dependent. You need to test the water, and if you feel OK, be ambitious, and push ahead. No cold turkey though!

 

Keep cuts as small as possible, but make them as frequently as you can manage without too many ill-effects. Even if not yet dependent, a very accelerated taper should be avoided. I'm sorry I am not being exact with numbers, but it is an inexact business, as individuals vary so much.

Colin:

 

As I explained before, I cannot split the doses very well because they are in capsule form.

 

I think I will just proceed with my own titration plan. Thanks for your help.

 

Kristin

Hi,

 

Yes, I remember now.

 

Mostly, titration is used where people need to make much smaller cuts to their dose. Because your benzos are in capsule forum, it makes cuts of any kind difficult. I think you should be able to follow your own plan, and I recommend the use of milk. You can use the table I produced, or I could produce another that lasts about six-weeks, if need be. I guess you should be a little cautious at first though, so using the existing table would be a safer starting point - I can always adjust things later for you. Also, make the cut to one of the capsules, then add the contents of the second capsule. You understand, make up the liquid using one capsule, make the reduction to volume of benzo-milk liquid, then add the contents of the second capsule. Also, make sure that the contents of the capsules are a very fine powder. If they are not, first grind the contents down before using them.

 

Take care, and good luck.

That's exactly what I thought.  Thanks for confirming.

OK, Colin and Summer, let me run this by you because I have never done this before:

 

For the first cut in your titration table, I measure out 100 ml. of milk, add the contents of one 15 mg. capsule of temazepam (the powder is very fine), subtract 5 ml. from the mixture, and then add the contents of the second 15 mg. capsule of temazepam. Is that correct?

 

I know you are swamped but if you could come up with a two month tapering plan, I think I would feel more comfortable with that than a three month plan.

 

Thanks for all you do -- this is a great service.

 

Kristin

Hi,

 

That's correct. You are making the redcition to one pill only. The reason for this is that increases accuracy to titrate just one of the pills, and also allows for smaller reductions from you total dose. It may well be overkill (for many or most), but it does no harm, and some will benefit from this level accuracy. Some will, no doubt, think it is rather anal retentive and unnecessary to use such a level of accuracy. Even if true, it can be rather powerful to think that you have this level of control over your withdrawal.

 

I'll work up tomorrow a table for a two month taper, to start on the 2nd November. If it does prove too much, you can slow it down very easily. can you supply me with the starting dose, or will be the same as the one you supplied earlier?

Thanks, Colin. I'm known for being anal retentive so I have no problem with titration.

 

My starting dose is 26.75 mg. Temazepam daily.

 

Kristin

Hey Colin:

 

Let me know what you think of the following two month titration plan. I took your three month plan and just sped up the last 30 days a little. I am currently taking 30 m.g. temazepam daily in capsule form (two 15 mg. capsules) so I can easily mix the contents with milk in my 100 ml. cylinder. Thanks!

 

DAY 1: 95 ml., 2 capsules

DAY 2: 90 ml., 2 capsules

DAY 3: 85 ml., 2 capsules

DAY 4: 80 ml., 2 capsules

DAY 5: 75 ml., 2 capsules

DAY 6: 71 ml., 2 capsules

DAY 7: 66 ml., 2 capsules

DAY 8: 62 ml., 2 capsules

DAY 9: 58 ml., 2 capsules

DAY 10: 54 ml., 2 capsules

DAY 11: 50 ml., 2 capsules

DAY 12: 46 ml., 2 capsules

DAY 13: 42 ml., 2 capsules

DAY 14: 38 ml., 2 capsules

DAY 15: 35 ml., 2 capsules

DAY 16: 31 ml., 2 capsules

DAY 17: 28 ml., 2 capsules

DAY 18: 24 ml., 2 capsules

DAY 19: 21 ml., 2 capsules

DAY 20: 18 ml., 2 capsules

DAY 21: 15 ml., 2 capsules

DAY 22: 12 ml., 2 capsules

DAY 23: 9 ml., 2 capsules

DAY 24: 6 ml., 2 capsules

DAY 25: 4 ml., 2 capsules

DAY 26: 1 ml., 2 capsules

DAY 27: 96 ml., 1 capsule

DAY 28: 93 ml., 1 capsule

DAY 29: 90 ml.,1 capsule

DAY 30: 87 ml.,1 capsule

DAY 31: 84 ml.,1 capsule

DAY 32: 81 ml.,1 capsule

DAY 33: 78 ml.,1 capsule

DAY 34: 75 ml.,1 capsule

DAY 35: 72 ml., 1 capsule

DAY 36: 69 ml.,1 capsule

DAY 37: 66 ml.,1 capsule

DAY 38: 63 ml.,1 capsule

DAY 39: 60 ml.,1 capsule

DAY 40: 57 ml.,1 capsule

DAY 41: 54 ml.,1 capsule

DAY 42: 51 ml.,1 capsule

DAY 43: 48 ml.,1 capsule

DAY 44: 45 ml.,1 capsule

DAY 45: 42 ml.,1 capsule

DAY 46: 39 ml.,1 capsule

DAY 47: 36 ml.,1 capsule

DAY 48: 33 ml.,1 capsule

DAY 49: 30 ml.,1 capsule

DAY 50: 27 ml.,1 capsule

DAY 51: 24 ml.,1 capsule

DAY 52: 21 ml.,1 capsule

DAY 53: 18 ml.,1 capsule

DAY 54: 15 ml.,1 capsule

DAY 55: 12 ml.,1 capsule

DAY 56: 9 ml.,1 capsule

DAY 57: 6 ml.,1 capsule

DAY 57: 3 ml.,1 capsule

DAY 58: 0 ml., 1 capsule

Hi,

 

Sorry, I've not out together the two month table for you. Since you are unsure of what rate to taper at, Perhaps your way will be best at first. After a while, you will have a better idea of what you can mange, and I can create a table based what has been successful for you.

 

You label up your table differently to me. I list the amount taken from the titrated tablet/capsule, and the number of additional tablets taken. I'm just pinting this out, just in case there are crossed wires anywhere.

 

You are starting the table from 95ml from your 100ml liquid, but your daily dose is 26.75mgs (do you mean 26.25mgs?).

 

Can you confirm the following:

 

You take one whole 15mg tablet, and three-quarters of another 15mg tablet (11.25mg).

 

11.25mg from 15mg would be 75ml from your 100ml liquid.

 

So, you should start at about 71ml (from your 100ml liquid) as your first dose, PLUS the other 15mg capsule.

 

---

 

I've assumed the above to be correct, and altered the existing table to start on 3rd Nov. You start from 74ml.

 

Now, this taper is very fast, but given your relatively short time on benzos, it is worth a shot. If you begin to feel ill, stop making new cuts, and I'll work up a slower schedule for you.

 

http://www.benzobuddies.org/spreadsheets/bbo-kristinh-2007-10-31.html

 

You may have to refresh your browser, as it may display the old table instead.

OK, Colin -- I think I get it. I add one 15 mg. capsule to 100 ml. of milk and subtract 29 ml. of liquid.

 

Question for you -- do I take the other 15 mg. capsule whole or do I add it to the 71 ml. of liquid or does it matter?

 

Kristin

 

 

Hi,

 

You can do it either way, but if you add the second pill after reducing the liquid to 71ml (or whatever the amount should be at that stage), you will have a very convenient liquid for splitting up your daily dose as you wish. When the volume of liquid becomes too low for convenient splitting of the daily dose, simply top it up with more milk, as will have already made the reduction to the volume at that stage.