Tentatively Looking at Titration

Hi, having been doing some reading on titration off Clonazepam and really need some advice.  I am currently taken .75 of a 5mg tab spread through the day as follows:

.25 at 9.00am

.125 at 2.00pm

.125 at 6.00pm

.25 at 10.00pm

My last cut was two weeks ago when I cut the 2.00pm dose from from .25 to .125.  Prior to that I hadn't made a cut for six weeks, that cut being halving my 6.00pm cut to .125.  Some w/d symptoms - mostly palpitations but have found that regular walking seems to help eliminate them.  Also chest tightness which no longer frightens me as I have had cardio checks and all is ok.

Titration seems to be a possibility for me as I am now scared of making cuts as I don't know which one to cut next, but I am afraid because I have a lot of morning anxiety at present  (the original reason for my being prescribed c/pam in the first place in February 2008) but feel that a lot of my anxiety is about the drug and I just want off it.  My psychotherapist has suggested I continue making regular cuts as my dose is so small, but fear is setting in and I am starting to anticipate withdrawal symptoms.  Question - does titration make the journey any easier?  To me it seems logical that it would be better to do a titration taper than make .125 cuts every three weeks and then wait in anticipation of w/d symptoms.  Just confused now and needing some advice. 

Look forward to any help you can give.

Titration is a godsend. You are in control,not the nasty drug. Yes wd happens no matter what but its not even comparable to when I was dry cutting. You will get your life back a whole lot sooner with titration.good luck

Hi, having been doing some reading on titration off Clonazepam and really need some advice.  I am currently taken .75 of a 5mg tab spread through the day as follows:

.25 at 9.00am

.125 at 2.00pm

.125 at 6.00pm

.25 at 10.00pm

My last cut was two weeks ago when I cut the 2.00pm dose from from .25 to .125.  Prior to that I hadn't made a cut for six weeks, that cut being halving my 6.00pm cut to .125.  Some w/d symptoms - mostly palpitations but have found that regular walking seems to help eliminate them.  Also chest tightness which no longer frightens me as I have had cardio checks and all is ok.

Titration seems to be a possibility for me as I am now scared of making cuts as I don't know which one to cut next, but I am afraid because I have a lot of morning anxiety at present  (the original reason for my being prescribed c/pam in the first place in February 2008) but feel that a lot of my anxiety is about the drug and I just want off it.  My psychotherapist has suggested I continue making regular cuts as my dose is so small, but fear is setting in and I am starting to anticipate withdrawal symptoms.  Question - does titration make the journey any easier?  To me it seems logical that it would be better to do a titration taper than make .125 cuts every three weeks and then wait in anticipation of w/d symptoms.  Just confused now and needing some advice. 

Look forward to any help you can give.

 

Hi LB,

 

One thing is I think you are currently taking 1.0mg total based on your schedule?? Another thing I noticed is that you are taking your clono 4X/day. Most members take clono 2 or 3X/day. I took mine 8 hours apart 3X/day. How long have you been taking it this way? You may be able to eliminate one of the four doses (2:00pm or 6:00pm) and slowly move the other doses so they are 3X/day.

 

If you want to do titration, it is pretty much straight forward. It does minimize the withdrawal symptoms by reducing everyday instead of every couple of weeks.

 

Let us know what you decide to do. You will need to post your request here for Colin with all the information he needs. You can find that here.... http://www.benzobuddies.org/forum/index.php?topic=11093.msg150014#msg150014

 

 

T2

Hi, having been doing some reading on titration off Clonazepam and really need some advice.  I am currently taken .75 of a 5mg tab spread through the day as follows:

.25 at 9.00am

.125 at 2.00pm

.125 at 6.00pm

.25 at 10.00pm

My last cut was two weeks ago when I cut the 2.00pm dose from from .25 to .125.  Prior to that I hadn't made a cut for six weeks, that cut being halving my 6.00pm cut to .125.  Some w/d symptoms - mostly palpitations but have found that regular walking seems to help eliminate them.  Also chest tightness which no longer frightens me as I have had cardio checks and all is ok.

Titration seems to be a possibility for me as I am now scared of making cuts as I don't know which one to cut next, but I am afraid because I have a lot of morning anxiety at present  (the original reason for my being prescribed c/pam in the first place in February 2008) but feel that a lot of my anxiety is about the drug and I just want off it.  My psychotherapist has suggested I continue making regular cuts as my dose is so small, but fear is setting in and I am starting to anticipate withdrawal symptoms.  Question - does titration make the journey any easier?  To me it seems logical that it would be better to do a titration taper than make .125 cuts every three weeks and then wait in anticipation of w/d symptoms.  Just confused now and needing some advice. 

Look forward to any help you can give.

I'm a little confused about your dose, too.  If it is 3/4 of a 5mg tablet, then you are taking 3.75 mg/day which is quite a high dose.  Maybe your tablets are 0.5mg instead of 5 mg?

 

From what I've read, titration does make tapering easier.  You can continue to make the size bi-weekly cuts on your current schedule if you want to, you'll just be making teensy reductions every day or so rather than larger cuts every 2-3  weeks. Makes a lot of sense to me.  If you know what's involved in titration, you know you'd need some supplies and then post a request for a schedule with the info in the link Theresa provided. If you need more info about the process, there's a description and video here:

http://www.benzobuddies.org/forum/index.php?topic=6393.msg61329#msg61329

Sorry people - a real benzo moment.  I am currently taking .75 of a .5mg tablet, not 5mg as I stated in previous posts.  Have only ever been as high as 2mg in total, but have been cutting by about 1/8th every six weeks since November when I found a support group here in my hometown.  However the counsellor has no experience with titration (he is though a benzo survivor) and he is not keen on my trying titration.  I just want rid of this stuff and want to do it too quickly probably so may go down the cutting route.  Just a bit muddled at present and still having a lot of anxiety - is it better to put up with the crap for a short time or prolong the agony.  Don't know.  My psychotherapist feels I should keep cutting the dose but only every month or so. 

Sorry people - a real benzo moment.  I am currently taking .75 of a .5mg tablet, not 5mg as I stated in previous posts.  Have only ever been as high as 2mg in total, but have been cutting by about 1/8th every six weeks since November when I found a support group here in my hometown.  However the counsellor has no experience with titration (he is though a benzo survivor) and he is not keen on my trying titration.  I just want rid of this stuff and want to do it too quickly probably so may go down the cutting route.  Just a bit muddled at present and still having a lot of anxiety - is it better to put up with the crap for a short time or prolong the agony.  Don't know.   My psychotherapist feels I should keep cutting the dose but only every month or so. 

 

Hi LB,

 

Sorry for the confusion, but you say you are taking 3/4 of a .50mg tablet, that would equal .375mg. Your schedule indicates....

 

.25 at 9.00am

.125 at 2.00pm

.125 at 6.00pm

.25 at 10.00pm

 

These amounts equal 1.0mg per day total?? There is a big difference between 1.0mg and .375mg. Have you decided on titration?

Sorry people - a real benzo moment.  I am currently taking .75 of a .5mg tablet, not 5mg as I stated in previous posts.  Have only ever been as high as 2mg in total, but have been cutting by about 1/8th every six weeks since November when I found a support group here in my hometown.  However the counsellor has no experience with titration (he is though a benzo survivor) and he is not keen on my trying titration.  I just want rid of this stuff and want to do it too quickly probably so may go down the cutting route.  Just a bit muddled at present and still having a lot of anxiety - is it better to put up with the crap for a short time or prolong the agony.  Don't know.   My psychotherapist feels I should keep cutting the dose but only every month or so. 

 

Hi LB,

 

Sorry for the confusion, but you say you are taking 3/4 of a .50mg tablet, that would equal .375mg. Your schedule indicates....

 

.25 at 9.00am

.125 at 2.00pm

.125 at 6.00pm

.25 at 10.00pm

 

These amounts equal 1.0mg per day total?? There is a big difference between 1.0mg and .375mg. Have you decided on titration?

 

Hi Theresa,

 

They equal 0.75! However, Just to check, this 0.75 (three-quarters) of a 0.5mg tablet - yes? So, LB, you total dose is 0.375mg, not 0.75mg? Please state the number of pills (or fractions of pills) you take per day, AND the total dose.

Yes, I take the following:

.25 at 9.00am

.125 at 2.00pm

.125 at 6.00pm

.25 at 10.00pm

This equals three quarters of a .5mg tablet per day spread into the four doses as above.  Hope this clarifies the situation.

Still to decide on titration, not sure.  Would it be better to just work at cutting small pieces off the various doses over a period of weeks to reduce down to nothing eventually in a few months.  Am a little afraid of making larger cuts as have had some bad experiences and would like to make the process as easy as possible.  The worst thing has been palpitations, although now that I am able to exercise they seem to be abating.  Maybe I might just be able to carry on making the cuts.  Still confused but as I said the support group I go to do not use titration and I don't want to alienate myself from them as their support has been vital through this nightmare. 

Yes, I take the following:

.25 at 9.00am

.125 at 2.00pm

.125 at 6.00pm

.25 at 10.00pm

This equals three quarters of a .5mg tablet per day spread into the four doses as above.  Hope this clarifies the situation.

Still to decide on titration, not sure.  Would it be better to just work at cutting small pieces off the various doses over a period of weeks to reduce down to nothing eventually in a few months.  Am a little afraid of making larger cuts as have had some bad experiences and would like to make the process as easy as possible.  The worst thing has been palpitations, although now that I am able to exercise they seem to be abating.  Maybe I might just be able to carry on making the cuts.  Still confused but as I said the support group I go to do not use titration and I don't want to alienate myself from them as their support has been vital through this nightmare. 

 

Your current dosing as posted above totals .75mg which is one whole .50mg tablet plus .25mg (1/2 of .50mg tablet). If you are comfortable cutting .125mg every couple weeks, then you can try to proceed that way. If things become too uncomfortable, you can switch to titration. You may want to educate your support group to the titration method which can make tapering much smoother than "cut and recover".

Thanks Theresa2.  I am actually taking three quarters of a .5mg tablet.  The measurements quoted are actually the size of the piece of the tablet, not the milligrams.  Sorry about the confusion maybe I should have used imperial measurements.  Will continue along the slow cut method and see how things go.  Thank you for your help.

My correct dose is:

One quarter of a .5mg tablet at 9.00am

One eighth of a .5mg tablet at 2.00pm

One eighth of a .5mg tablet at 6.00pm

One quarter of a .5mg tablet at 10.00pm.

This equals three quarters of one .5mg tablet, that is approx .375 mg per day.

Thanks Theresa2.  I am actually taking three quarters of a .5mg tablet.  The measurements quoted are actually the size of the piece of the tablet, not the milligrams.  Sorry about the confusion maybe I should have used imperial measurements.  Will continue along the slow cut method and see how things go.  Thank you for your help.

My correct dose is:

One quarter of a .5mg tablet at 9.00am

One eighth of a .5mg tablet at 2.00pm

One eighth of a .5mg tablet at 6.00pm

One quarter of a .5mg tablet at 10.00pm.

This equals three quarters of one .5mg tablet, that is approx .375 mg per day.

 

That is a big difference from .75mg!!    You are getting so close to being done!!  Just let us know if you decide to titrate the rest of the way down! 

Hi,

 

Let me know if you decide you need to titrate.

 

Good luck.

Thanks guys - will give titration some serious consideration.  Will continue to dry cut at present but when it gets down to one eighth of a tab, sometimes I think it is just guess work as the exact dose anyway.  Those little pills are not easy to split!!

Will keep in touch and get back if I decide to titrate - for me it is so near yet so far and it has been a rough journey, as it is for almost everyone on benzos.  At present I am in a good place, exercising regularly and getting on with life as best I can.  The bad days are further apart and my mind is now firmly focussed on getting off this crap and getting on with life, even if I do have to deal with the original anxiety which has come back to some extent.  However being drug free is my main focus at present, the anxiety I can generally cope with and work on in my own time with the help of my psychotherapist.

Thanks again. :)

Thanks guys - will give titration some serious consideration.  Will continue to dry cut at present but when it gets down to one eighth of a tab, sometimes I think it is just guess work as the exact dose anyway.  Those little pills are not easy to split!!

Will keep in touch and get back if I decide to titrate - for me it is so near yet so far and it has been a rough journey, as it is for almost everyone on benzos.  At present I am in a good place, exercising regularly and getting on with life as best I can.  The bad days are further apart and my mind is now firmly focussed on getting off this crap and getting on with life, even if I do have to deal with the original anxiety which has come back to some extent.  However being drug free is my main focus at present, the anxiety I can generally cope with and work on in my own time with the help of my psychotherapist.

Thanks again. :)

 

When you get down to 1/4 of a tablet and going to 1/8, you can crush the 1/4 piece and put it into 1/2 cup of milk, mix well and drink 1/2 of the 1/2 one day and the other 1/2 the next day. It would make it a little easier. 

Thanks, that makes sense.  Will keep you posted.  Great forum, good support.

Have reviewed my previous decision to continue cutting - ridiculous trying to cut tabs down to 1/8th and get accurate dose.  Even sometimes the quarter does not break accurately.  Would like to look at titration and will try and get a cylinder from somewhere - don't quite know where but will do some investigation.  In the meantime if I decide to use the dissolving method to get the accurate 1/8th dose, is it okay to do it in water as I don't like milk that much?  Could probably tolerate it if I have to but would prefer water.

Will get back to you for a titration schedule when I can get hold of a cylinder.

Thanks

LB

hey you can just google 100ml cylinder and plenty of sites will pop up. im glad your going the titrating route. your in control of an exact reduction to your dose at all times. small tiny miniscule deductions. a bit of work and elbow grease is required that you eventually get used to but it will sure sail you down a smooth road to healing. in my opnion.

 

goodluck

dave

Have reviewed my previous decision to continue cutting - ridiculous trying to cut tabs down to 1/8th and get accurate dose.  Even sometimes the quarter does not break accurately.  Would like to look at titration and will try and get a cylinder from somewhere - don't quite know where but will do some investigation.  In the meantime if I decide to use the dissolving method to get the accurate 1/8th dose, is it okay to do it in water as I don't like milk that much?  Could probably tolerate it if I have to but would prefer water.

Will get back to you for a titration schedule when I can get hold of a cylinder.

Thanks

LB

 

You can use water, you just have to make sure the water is mixed really well as most of the benzos are not water soluble.

Thanks Theresa.  Am looking for a cylinder before going down the titration route.

Just note that you had issues with your thyroid.  How did you know your thyroid was out of whack.  Did your doc just do a random test?

 

Thanks Theresa.  Am looking for a cylinder before going down the titration route.

Just note that you had issues with your thyroid.  How did you know your thyroid was out of whack.  Did your doc just do a random test?

 

 

I have had to take thyroid meds since I was 17 and have it checked a couple times a year. I did not know my thyroid was out of whack when it was only because I had it checked in February and didn't suspect it. The symptoms I had were very similar to w/d symptoms so did not suspect it. Things were just so bad that I went to an Urgent Care Center and they checked my thyroid levels and they were really off. So I started the new dose and started feeling better within a week and by the end of six weeks, it was stabilized. From there, my taper was very tolerable albeit extremely slow. I was only tapering by 1/4ml per day when I was so ill but did increase it to 1/2ml when I was feeling better. Too afraid to "rock the boat". I have had to have my thyroid meds adjusted again this last February?? I've never had it this unstable before in all these years and just makes me wonder what effect benzos have on the endocrine system??

Thanks for that Theresa.  I had a thyroid check when I had my first panic attack and it came back okay but wasn't on benzos as that time.  However have not had one done since I've been on C/pam.  I have to go back to my doctor in the next week or so for another prescription of the dreaded poison (hopefully my last) so will ask for a thyroid test then.  Had some endocrine work done last year and it all came back negative and have also had a progesterone test.  I still maintain that hormone imbalance has something to do with all of this, despite what the medical professionals say as about once a month I go a bit la la, even through I am post menopause!

Anyway this is getting off the titration thread now.  Will endeavour to get a cylinder this week and all the other bits a pieces needed, get a schedule in place so I can get titrating and get this poison out of my system and then start the real headling process, ie dealing with my anxiety without meds (as it should have been done in the first place!!!!)

Lynn B

Thanks for that Theresa.  I had a thyroid check when I had my first panic attack and it came back okay but wasn't on benzos as that time.  However have not had one done since I've been on C/pam.  I have to go back to my doctor in the next week or so for another prescription of the dreaded poison (hopefully my last) so will ask for a thyroid test then.  Had some endocrine work done last year and it all came back negative and have also had a progesterone test.  I still maintain that hormone imbalance has something to do with all of this, despite what the medical professionals say as about once a month I go a bit la la, even through I am post menopause!

Anyway this is getting off the titration thread now.  Will endeavour to get a cylinder this week and all the other bits a pieces needed, get a schedule in place so I can get titrating and get this poison out of my system and then start the real headling process, ie dealing with my anxiety without meds (as it should have been done in the first place!!!!)

Lynn B

 

I totally agree about the hormone imbalance causing anxiety. Instead of figuring out what the causes could be, they would rather drug us.  Here is a website that explains how to interpret the thyroid tests.... http://thyroid.about.com/cs/testsforthyroid/ht/interpretresult.htm

Had a look at the site - very interesting.  Have some symptoms, but are they benzo related?  Who would know.  Will definitely ask for a check though just to eliminate one thing that could develop into a worry.

It's a good thing to listen to your body - it was after all my body which told me that c/pam was definitely not doing me any good and prompted me to start withdrawal.  If only I'd been told about the addiction when I was first prescribed.  Ho hum!!!  Must look to the future though and get on the campaign trail when I am better to help others in my situation. 

Thanks Theresa. 

Had a rough weekend and have been advised by support counsellors here in my home town that I am probably cutting too quickly.  They seem to favour a really slow taper to allow the body to adjust between each taper - up to six weeks between each cut.  They have both been through withdrawal from benzos and generally give out good advice.  I notice however that this site seems to favour a much more rapid w/d, so am now confused.  How do you know what is best??  Probably an impossible question but I am desperate to get off this poison asap but with minimum w/d symptoms.  Oh what a mess!   Have had two crap Christmases and had hoped that this one I could be benzo free and on my way to healing, seems that might not be the case. 

Don't want to go against my counsellors but would like a second opinion.  No use asking my GP, he recommended cutting 1/2 a tab every three weeks - boy did I go into a downward spiral then.  When I get to 1/2 a tablet per day (currently at 5/8ths) would like to use titration as I feel cutting the pills into eights doesn't give an accurate dose.

Had a rough weekend and have been advised by support counsellors here in my home town that I am probably cutting too quickly.  They seem to favour a really slow taper to allow the body to adjust between each taper - up to six weeks between each cut.   They have both been through withdrawal from benzos and generally give out good advice.  I notice however that this site seems to favour a much more rapid w/d, so am now confused.  How do you know what is best??  Probably an impossible question but I am desperate to get off this poison asap but with minimum w/d symptoms.  Oh what a mess!   Have had two crap Christmases and had hoped that this one I could be benzo free and on my way to healing, seems that might not be the case.   

Don't want to go against my counsellors but would like a second opinion.  No use asking my GP, he recommended cutting 1/2 a tab every three weeks - boy did I go into a downward spiral then.  When I get to 1/2 a tablet per day (currently at 5/8ths) would like to use titration as I feel cutting the pills into eights doesn't give an accurate dose.

 

I'm still not quite sure how much you are taking now??

 

Six weeks between cuts is a little much the other way. Two weeks is usually enough time to recover between cuts but it's fine to hold an additional week if necessary. We generally don't recommend holding much longer than 3 or 4 weeks. Keep in mind that tolerance can kick in if you hold too long.