Klonopin Liquid Titration Advice: 1% per day or..?

Contemplating beginning a liquid titration using .5 mg clonazepam/day as the start point. Been on this dose for about a month; previously was at 1mg every other day for about 4 months, and spent 5 months on various dosages between 1 and 1.5 every two or three days, thinking I could avoid dependence that way, being ignorant about the half-life involved due to poor medical advice.

 

I have read that small increments over short duration are easier on the system than larger increments over longer duration. So I am wondering if doing 1% day or every other day would be easier than the generally used 5%-10% every one or two weeks? It is confusing because on the one hand, your body needs time to adjust to new dose, so it would seem that it having more time to do so would support the larger cuts over a longer period, but simultaneously the larger jumps are what seem to trigger the more sever symptoms as evidenced by so many reports and of course the major damage of cold-turkey withdrawals. Is there some consistent logic to guide one's approach in devising the best way to proceed? Is the best scenario simply short cuts over longer time frames, and in general, at 10 months is a protracted titration schedule actually making matters worse by potentially adding an addition 6-10 months to my overall benzo usage? Tough questions.

 

I am wondering if anyone has had luck just reducing 1% daily over a period of 4 months or so? I am experiencing some inter-dose withdrawal right now, and even when I take my current .5 mg dose some days it seems effective for a short while and other days it almost seems like I feel worse after taking it.

 

Finally, is liquid titration versus pulverizing and weighing pill dust on a .000 gram scale markedly more accurate?

 

Thanks so much for your input on this frightening topic.

K does not come in convenient pill sizes for scale use for daily taper as the cut sizes needed are too small for the scale.  But they are not too small if you make the K into liquid.

 

Your 1% a day cut you are thinking about would be too big for most people here, but ultimately the cut you use is determined by how fast you can recover.  Daily cutting does not really jibe with percents.  Instead there is a daily cut and we ride it until it is used up.  But if you were to figure the percent it usually works out to a fraction of a percent.

 

As for the logic of cutting, I think your answer may be in looking at benzo shortage.  As we taper we need a certain dose to feel good.  This required dose gets lower and lower as we taper.  But if we get out ahead of this "healing" point we feel it as increased symptoms.  Larger step cuts do this.  They remove too much benzo and we are left short and it takes time to recover.  In the meantime we get symptoms.  Daily cuts OTOH are able to "follow" this healing point down.  If done correctly there will be few and mild symptoms.

 

Another thing I'll add is that it is simply false to think that step cutting is somehow faster due to larger cuts.  IMO we heal as we heal and that is not affected by the way we taper, although I will say that daily cutting is probably more time-efficient and that step cutting may cause longer lasting symptoms.  It seems like something else happens when we are too short of benzo.

Thanks for your reply SG57. Seems like there is no real way to know except to try, and it is a long process. The recommendations one reads are so variable it is hard to really know. But I think I will go for something more gradual, as it seems like it would be gentler and also if one has an increase in symptoms it would be easier to make a thoughtful adjustment. One clarification: if one grinds the pills into a fine powder and uses a 1/1000 gram scale my calculations show you could measure 1% reductions. My only concern would be how well distributed the active ingredients would be in the powder, because there are other fillers mixed in. No one seems to have a definitive answer on this point. Simple pill splitting, for this reason, would seem to be less accurate as a rule, but I don't often see mention of this. Do you have any thoughts on this?

That's a valid question about pills.  Is there a coating?  Is the benzo spread evenly?  I've never seen a definitive answer, but I have to say reading the chatter from all the people filing and weighing pills here there does not seem to be a problem.  Of coarse, a way around the issue is to pulverize the pill, shake it thoroughly, and weigh the powder.

That would be my plan if I were to go with the weighing option. It seems criminal to me that manufacturers who make klonopin's generic equivalents, the medications affordable unless you have some Cadillac insurance plan that will cover the brand-name, are not required to produce it in all the smaller denominations so that people can have support in coming off the drugs without destroying themselves. I've priced the brand-name equivalents and they are cost-prohibitive. Maybe somehow I can convince my doctor to use the Ashton method, but he is so benzo ignorant he recommended a 50% cut for a couple of weeks and then just cessation. He is one of the types who simply knows better and if you ask him to do anything that exceeds your brief medication management appointment (such as actually learning something new) says he is simply too busy or just shrugs you off. It seems they don't even train psychiatrists on benzo withdrawal syndrome in med school. Quite astonishing.

 

I don't know if this helps you but I found a generic Klonopin in .125 mg orally disintegrating tablets which are scored and can be carefully cut in half - or pulverized easily as they are chalky rather than smooth coated.  In fact, my doctor didn't even think they could be split but they can.  That said...you can only cut them in half and that gets you to .0625 which is already more than 10% of what you are on now.  The name of the generic is: Clonazepam Orally Disintegrating Tablets, USP manufactured by PAR Pharmaceutical. They would be very easy to liquefy I would think but I need to learn about liquid titration.  God...and I thought MY shrink was clueless.... 50%?!!!! you have my sympathy in that respect!

 

Thinking good thoughts for all of us on this journey 

mana

Sandover

 

You might want to consider the liquid titration method. It is much easier to do minute reductions.  I have been taking .50mg clonazepam for almost a year. Started becoming tolerant to that dose so I decided to start the taper to get off this drug instead of upping the dose per my Doc's recommendation. But I started my taper reductions way to aggressive the first couple of times.  1ml a day using the 50ml cylinder which was about 2% a day. Entered hell by the 4-5 days with severe wd symptoms. Had to go back to my original dose to stabilize for a few days. 2nd attempt tried 1 ml every 2 days. By day 8 I was back in hell. Stabilized again on my original dose and now on SG57's advice I started with .10ml cuts for a few days with no problems. I have increased the reduction to .15ml daily and will continue this for a while to see how my body reacts to this cut. If all goes well I plan to make my next increase to a .20ml reduction.

 

I have tried various methods of liquid titration including trying to dissolve the clonazepam with 1ml of 80 proof vodka or 151 proof Bacardi and add 49ml of water based on some of the posts I read about liquid titration for various benzos.  Neither one really dissolves the clonazepam. It still just stays suspended in the solution. I think the best way to go is grind the pill up and use the whole milk method. I have had the best results with milk.

 

My main problem with tapering is lack of sleep. I usually get less than 4 hours of sleep. Occasionally I am able to get 4 1/2. It is hard to continue working consistently with sleep deprivation. If anyone has had any luck getting a decent amount of sleep while tapering I would sure appreciate some advice on what you are taking that has worked. The constant lack of sleep slowly leads to anxiety issues among a host of other problems, (elevated heart rate, heart palps, muscle twitches etc.)

 

Good luck with your taper plan and definitely keep a daily schedule of what you do each day. It really helps if you get into trouble.

mnypit08

 

I know for myself, I have had to creep up in how much of the daily clonazepam milk solution at increments as little as .0001mg... .0001ml using 1mg K in 100ml of milk

I started with the usual recommended .001mg back in March (starting at 1mg a day divided into two does), got eager quickly and then within days was slammed and then scared. A special BB buddie slowly encouraged me to have the confidence that I could do this, and so I cut at the .0005mg for a long time, then tried .00075mg, within two days was again scared. And so have had to move at slow increments of .0001mg at a time, going form .0005mg a day cut to my current daily cut of .0012mg in about three or four months. I try to increase it by .0001mg every two to three weeks, depending on my stressors and menstrual cycle. So far, this seems to be working for me. My hope is to continue to do this until I get to the daily cut number that has too many symptoms, and  then dial down a bit. My hope is to do the same thing as I get past the .5mg mark and at some point as I go down, try to slow down, perhaps .0001mg at a time, reducing a little more of my cut rate every few weeks on the down side,as in a true bell curve. I just wish I had had the patience way back in the beginning to start this way right from the gate, but like most, if not all of us, I wanted off of it like yesterday.

For myself, if I did not do it this way, I am not sure I would be able to handle my full time job and my part time job, one of which is fairly intense and stressful.

 

 

As for sleep, I try all kinds of things. Warm milk some nights, recently purchased several pairs of prescription glasses with Amber tint to wear in the evening, one for watching tv, the other up closer for the computer, some Amber colored light bulbs for at night, sometimes drinking Tart cherry juice, Magnesium glycinate to help with sleep, and ester C before bed as I feel, at least for myself, and at least for now, it has helped with the adrenaline rushes that I had been having last year when I think I was starting to have acute withdrawal. I try to mix it up a little so that my body does not get use to anything in particular. But I think for the most part is going slow, slow, slow, no matter how annoying or frustrating it is. I also try my best to get off of the computer sooner rather than latter. I also used f.lux program of dimming my computer screen as I saw recommended here on BB. Also no bright overhead lights after dinner, ever. My boyfriend is very sweet in saying he does not feel embarrassed if I go into the store with him at night in my amber shaded glasses. I also use a high quality SAD lamp in the morning or try to get as much natural light in the morning as I can.

 

For the most part I have had mild symptoms, though still annoying, so far with the worse being occasional inner vibration that wake me and the fear of not sleeping well, some slight muscle twitches and sometimes the area where I had a tooth extracted a year ago hurts, and anxiety about getting anxiety or fear of things going really bad again.

 

When I have increased my cut too quickly I get serious inner vibrations to the point where I can't even sleep, have fear that I will freak out, increased anxiety both mentally and physically, get migraines and a feeling that my skull feels it is on fire. To me that was too much. Also, some days, even at this slow rate I feel the all too common apathy, and feel oversensitive to stress and have lowered self esteem. I am always try to creep up my daily cut rate, but slow as to not get into trouble. Another wise BB buddie said to live your life while you taper, and that is why I am doing it slowly.

 

And lastly for me, read what you can to get information, get the support you need here on BB but don't dwell too long when you are feeling anxious and scared, be picky about the stories you read when you are feeling vulnerable. Some days I can read them, and some days they make me feel even more frightened.

 

Wishing everyone all the best in this journey.

 

mnypit08

 

I know for myself, I have had to creep up in how much of the daily clonazepam milk solution at increments as little as .0001mg... .0001ml using 1mg K in 100ml of milk

I started with the usual recommended .001mg back in March (starting at 1mg a day divided into two does), got eager quickly and then within days was slammed and then scared. A special BB buddie slowly encouraged me to have the confidence that I could do this, and so I cut at the .0005mg for a long time, then tried .00075mg, within two days was again scared. And so have had to move at slow increments of .0001mg at a time, going form .0005mg a day cut to my current daily cut of .0012mg in about three or four months. I try to increase it by .0001mg every two to three weeks, depending on my stressors and menstrual cycle. So far, this seems to be working for me. My hope is to continue to do this until I get to the daily cut number that has too many symptoms, and  then dial down a bit. My hope is to do the same thing as I get past the .5mg mark and at some point as I go down, try to slow down, perhaps .0001mg at a time, reducing a little more of my cut rate every few weeks on the down side,as in a true bell curve. I just wish I had had the patience way back in the beginning to start this way right from the gate, but like most, if not all of us, I wanted off of it like yesterday.

For myself, if I did not do it this way, I am not sure I would be able to handle my full time job and my part time job, one of which is fairly intense and stressful.

 

 

As for sleep, I try all kinds of things. Warm milk some nights, recently purchased several pairs of prescription glasses with Amber tint to wear in the evening, one for watching tv, the other up closer for the computer, some Amber colored light bulbs for at night, sometimes drinking Tart cherry juice, Magnesium glycinate to help with sleep, and ester C before bed as I feel, at least for myself, and at least for now, it has helped with the adrenaline rushes that I had been having last year when I think I was starting to have acute withdrawal. I try to mix it up a little so that my body does not get use to anything in particular. But I think for the most part is going slow, slow, slow, no matter how annoying or frustrating it is. I also try my best to get off of the computer sooner rather than latter. I also used f.lux program of dimming my computer screen as I saw recommended here on BB. Also no bright overhead lights after dinner, ever. My boyfriend is very sweet in saying he does not feel embarrassed if I go into the store with him at night in my amber shaded glasses. I also use a high quality SAD lamp in the morning or try to get as much natural light in the morning as I can.

 

For the most part I have had mild symptoms, though still annoying, so far with the worse being occasional inner vibration that wake me and the fear of not sleeping well, some slight muscle twitches and sometimes the area where I had a tooth extracted a year ago hurts, and anxiety about getting anxiety or fear of things going really bad again.

 

When I have increased my cut too quickly I get serious inner vibrations to the point where I can't even sleep, have fear that I will freak out, increased anxiety both mentally and physically, get migraines and a feeling that my skull feels it is on fire. To me that was too much. Also, some days, even at this slow rate I feel the all too common apathy, and feel oversensitive to stress and have lowered self esteem. I am always try to creep up my daily cut rate, but slow as to not get into trouble. Another wise BB buddie said to live your life while you taper, and that is why I am doing it slowly.

 

And lastly for me, read what you can to get information, get the support you need here on BB but don't dwell too long when you are feeling anxious and scared, be picky about the stories you read when you are feeling vulnerable. Some days I can read them, and some days they make me feel even more frightened.

 

Wishing everyone all the best in this journey.

 

Thanks Calicogirl:

 

I am confused. Do you really mean .0001 mg cuts? That's 1/10000 of a mg isn't it? I don't know of anyway to measure cuts at that level, either using pill powder and a scale or liquid. Please forgive if I am confused. I have to assume you mean 1/1000 of a mg? So does this mean, using milk titration, you are grinding up a pill, dissolving it in 100ml of milk, and then extracting 1/10th of a ml of milk? I am so confused. I tried to dissolve a pill in hot water tonight as a test and the pill wouldn't entirely dissolve. There remained a residue in the jar no matter how much I shook the jar. I have heard water won't work, then I have seen videos using water specifically. Milk seems so mysterious--you can't actually see what is going on inside the milk...how can one know for sure it is evenly dissolved? OK, that freaks me out, but assuming it has dissolved, how many milliliters are you cutting each time, and are you grinding the pill with a mortar and pestle?

Sandover

 

You might want to consider the liquid titration method. It is much easier to do minute reductions.  I have been taking .50mg clonazepam for almost a year. Started becoming tolerant to that dose so I decided to start the taper to get off this drug instead of upping the dose per my Doc's recommendation. But I started my taper reductions way to aggressive the first couple of times.  1ml a day using the 50ml cylinder which was about 2% a day. Entered hell by the 4-5 days with severe wd symptoms. Had to go back to my original dose to stabilize for a few days. 2nd attempt tried 1 ml every 2 days. By day 8 I was back in hell. Stabilized again on my original dose and now on SG57's advice I started with .10ml cuts for a few days with no problems. I have increased the reduction to .15ml daily and will continue this for a while to see how my body reacts to this cut. If all goes well I plan to make my next increase to a .20ml reduction.

 

I have tried various methods of liquid titration including trying to dissolve the clonazepam with 1ml of 80 proof vodka or 151 proof Bacardi and add 49ml of water based on some of the posts I read about liquid titration for various benzos.  Neither one really dissolves the clonazepam. It still just stays suspended in the solution. I think the best way to go is grind the pill up and use the whole milk method. I have had the best results with milk.

 

My main problem with tapering is lack of sleep. I usually get less than 4 hours of sleep. Occasionally I am able to get 4 1/2. It is hard to continue working consistently with sleep deprivation. If anyone has had any luck getting a decent amount of sleep while tapering I would sure appreciate some advice on what you are taking that has worked. The constant lack of sleep slowly leads to anxiety issues among a host of other problems, (elevated heart rate, heart palps, muscle twitches etc.)

 

Good luck with your taper plan and definitely keep a daily schedule of what you do each day. It really helps if you get into trouble.

 

Thanks Mynypit08. So you are talking about cuts of 1/10 of 1%, 1.5/10 of 1% and 2/10 of 1%? Even doing that daily, doesn't that mean your taper will take about 1.5 years, if you have to slow down toward the end? My math skills are weak, but am I close?

 

I don't know if this helps you but I found a generic Klonopin in .125 mg orally disintegrating tablets which are scored and can be carefully cut in half - or pulverized easily as they are chalky rather than smooth coated.  In fact, my doctor didn't even think they could be split but they can.  That said...you can only cut them in half and that gets you to .0625 which is already more than 10% of what you are on now.  The name of the generic is: Clonazepam Orally Disintegrating Tablets, USP manufactured by PAR Pharmaceutical. They would be very easy to liquefy I would think but I need to learn about liquid titration.  God...and I thought MY shrink was clueless.... 50%?!!!! you have my sympathy in that respect!

 

Thinking good thoughts for all of us on this journey 

mana

 

Thanks My Mana, that is useful info. I have to say the hard coated clonazepams are not too liquid friendly, I fear trusting they have equally dissolved in milk. Those might come in handy.

Thanks Calicogirl:

 

I am confused. Do you really mean .0001 mg cuts? That's 1/10000 of a mg isn't it? I don't know of anyway to measure cuts at that level, either using pill powder and a scale or liquid. Please forgive if I am confused. I have to assume you mean 1/1000 of a mg? So does this mean, using milk titration, you are grinding up a pill, dissolving it in 100ml of milk, and then extracting 1/10th of a ml of milk? I am so confused. I tried to dissolve a pill in hot water tonight as a test and the pill wouldn't entirely dissolve. There remained a residue in the jar no matter how much I shook the jar. I have heard water won't work, then I have seen videos using water specifically. Milk seems so mysterious--you can't actually see what is going on inside the milk...how can one know for sure it is evenly dissolved? OK, that freaks me out, but assuming it has dissolved, how many milliliters are you cutting each time, and are you grinding the pill with a mortar and pestle?

 

That is a tiny tiny cut, but liquids can do it.  1mg into 100ml makes a .01mg/ml solution.  Each ml contains .01mg K, each 1/10th ml contains .001mg, and each individual tick is .0001mg.  So it just squeezes in at the limit of a 1ml syringe.  But if more liquid was used it could go even finer.

 

Many pills just break up nicely on there own when put in liquid, but some need help with grinding.

 

The pill is over 99% inert filler and the K is just a tiny fraction.  So what you see is not the K.  Don't worry about milk.  It works.  Once you get going with it you'll learn to trust it.  Just be sure to use full fat whole milk.  The fat is the key.  And give it time to dissolve and mix it.  Dissolving is not an instant process.

 

Water will dissolve only .03mg/ml of K so you would need 34ml just to fit 1mg.  That is very poor solubility and I'd think it would take a long time to occur.

Sorry if my long post was confusing. Because Klonopin is such a strong pill, it easy to get confused with the decimal points.

 

I have been fortunate in that the generic K I use, Two .5mg tabs of Qualitest Clonazepam do seem to dissolve/break down in the full fat milk fully by my just putting them in my milk in canning jars and shaking them a few times over the next 12 to 24 hours.

While I can only speak for myself, I feel this method has to be working, otherwise, due to my high sensitivity, I would not be at just below .83mg per day. Sure it has taken me a long, long time, but it does seem to be working, again, at least for myself.

When I had gotten scared last Spring, I did a lot of holding and so on, then I steadied myself by withdrawing a tiny amount more each day, at that point, .0005mg a day, did that for a long time, at that point was generally only experiencing the pain of having to do the solution each day. And of course the usual anxiety of will I ever be free of this, I then tried to moved to a daily increase of .00075mg, within two days was scared of the symptoms and back down to .0005mg. It was then that I decided since I did not want this to take years and years and years, that I would move up in increasing increments of .0001mg, so moved to .0006mg for a few weeks, then .0007mg for a few weeks, then .008mg, .0009mg, then finally after about two and a half months of increasing got to the usual recommended jump in rate of .001mg. I have continued to do increases every few weeks, varying between 2 and 3 weeks, and am now currently removing .0012mg more each day, and plan to try .0013mg soon.

For me it has been learning to trust that doing a daily milk taper will work.

Oh how I wish it was done already or could take only 4 to 6 months, but I know for myself it can not. While with tapering I think one has to toss out time frames, I of course have goals/dates that I hope to meet, such as being off by 20 percent by New Year's and at a certain point by my birthday. But I know these are just goals, I know I will not push myself into an uncomfortable zone as the fear is too great and I have to be able to function thru this taper.

I know this does not really address the original question of the 1 percent off per day, oh how I wish that could be true for all of us, I guess I was more responding that this can be done, just at different speeds, and it is building the confidence to do it, trust it. While I am far, far from off/done with my taper, I now do trust that the milk taper does work.

I hope to someday get my daily cut rate up to .002mg a day, one .0001mg at a time, here's hoping.

Yes if I never increased my taper. But this is just a starting point to see how my body will react starting off at a low reduction and increasing when I feel comfortable. Just trying to avoid the wd hell as much as possible.

By the way now that I have done this for a few days I prefer crushing the pill with a mortar and pestle then adding 1ml of 80 proof tequila and 49ml water. It is much easier than dealing with the milk mess and the bubbles that form when you mix the milk. 3 days using this method and I am now on a .4ml reduction. I actually slept 7 1/12 hours last night. It has been over a year since I had more than 4 hours of solid sleep. I am also drinking 8 oz. of Traditional Medicinal Nighty Night without Valerian. I tried their Nighty Night with valerian but I wound up with the internal vibrations that Calicogirl also experienced. Also tried Yogi Kava Tea but the internal vibrations were even more intense. Cutting another .15ml so will be at .55ml tonight. We will see how it goes.

CalicoGirl

 

Thanks for your reply. The more feedback I get the better I feel about this taper plan. I hope you are able to increase your reduction in the future without fear of the dreaded wd hell. I too have felt the inner vibrations when I added certain herbal sleep aids. I thought I was loosing it. But I also was having the severe WD's because I was tapering way to fast. I am so greatful to have found the support on BenzoBuddies to help guide me through this awful drug withdrawal. Good luck with your plan. Mnypit08

Thanks Calicogirl:

 

I am confused. Do you really mean .0001 mg cuts? That's 1/10000 of a mg isn't it? I don't know of anyway to measure cuts at that level, either using pill powder and a scale or liquid. Please forgive if I am confused. I have to assume you mean 1/1000 of a mg? So does this mean, using milk titration, you are grinding up a pill, dissolving it in 100ml of milk, and then extracting 1/10th of a ml of milk? I am so confused. I tried to dissolve a pill in hot water tonight as a test and the pill wouldn't entirely dissolve. There remained a residue in the jar no matter how much I shook the jar. I have heard water won't work, then I have seen videos using water specifically. Milk seems so mysterious--you can't actually see what is going on inside the milk...how can one know for sure it is evenly dissolved? OK, that freaks me out, but assuming it has dissolved, how many milliliters are you cutting each time, and are you grinding the pill with a mortar and pestle?

 

That is a tiny tiny cut, but liquids can do it.  1mg into 100ml makes a .01mg/ml solution.  Each ml contains .01mg K, each 1/10th ml contains .001mg, and each individual tick is .0001mg.  So it just squeezes in at the limit of a 1ml syringe.  But if more liquid was used it could go even finer.

 

Many pills just break up nicely on there own when put in liquid, but some need help with grinding.

 

The pill is over 99% inert filler and the K is just a tiny fraction.  So what you see is not the K.  Don't worry about milk.  It works.  Once you get going with it you'll learn to trust it.  Just be sure to use full fat whole milk.  The fat is the key.  And give it time to dissolve and mix it.  Dissolving is not an instant process.

 

Water will dissolve only .03mg/ml of K so you would need 34ml just to fit 1mg.  That is very poor solubility and I'd think it would take a long time to occur.

 

SG57:

 

Are you grinding your pills or just leaving them in milk to dissolve? If so, how long do they need to dissolve? I am pretty sure my pills would need grinding. What happens if you need to travel. Do you carry a mortar and pestle everywhere you go?

SG57:

 

Are you grinding your pills or just leaving them in milk to dissolve? If so, how long do they need to dissolve? I am pretty sure my pills would need grinding. What happens if you need to travel. Do you carry a mortar and pestle everywhere you go?

 

Many brands will totally disintegrate, but some need help.  Why not test your pills to see what happens?

SG57:

 

Are you grinding your pills or just leaving them in milk to dissolve? If so, how long do they need to dissolve? I am pretty sure my pills would need grinding. What happens if you need to travel. Do you carry a mortar and pestle everywhere you go?

 

Many brands will totally disintegrate, but some need help.  Why not test your pills to see what happens?

 

How can you see clearly if they have dissolved when they are in whole milk? It is opaque.

How can you see clearly if they have dissolved when they are in whole milk? It is opaque.

 

True.  How about put it in a small amount in a spoon to see if it breaks apart or not?  You could also try water and "assume" it does the same thing in milk.  But if you are concerned then just crush it for peace of mind.