Pre-taper Questions for Colin

Colin:

I am planning to start titrating off Klonopin as soon as I'm stabilized, but I have a few questions.  I take K for insomnia along with Remeron.  Have been on some kind of benzo for many, many years.  I'll deal with the Remeron later (after I'm off the benzo) and will not include it in this explanation.  I think I'm stable at .375 mg of K before bedtime.  Upon my first wakeup I take another .5 mg of K.  I have 1mg and .5mg tablets.  I recently picked up .125mg and tried it the other night and had a rough night.  It could be because that dose (made by Par) has phenylalanine in it as a binder.  Didn't think I was sensitive to it but I certainly don't want to try it again to find out.  So I'm back to cutting the .5 in 1/2 and then again 1/2 to obtain the .125 or as close as I can get.

My plan was to taper on the first dose, leaving the 2nd dose at .5 for awhile.  The rationale is that I used to be able to fall asleep on my own until a doctor (gggrrrrhh!) told me to take it before bed...so, now, of course, I need it before bed.

My questions: will I be able to use a .5 mg tablet to liquify and throw off a measured amount to equal .375?  And then, after I see that that works for me, I can start tapering.  I was thinking I would continue to take the .5mg tablet upon 1st wakeup.

I'm also wondering if people usually react the same to a liquified dose vs. a tablet dose. Can you address this?

I will be using a 100ml with 1ml increments.

If I'm completely off in my assumptions, please explain how so.

Thanks very much.

Bluebird

Hi Bluebird,

If I understand correctly, you take a total of 0.875mg Klonopin per day. If this is correct, I will also need to know your desired taper rate (in terms of percentage cut / time - ask for help from others if you are unsure); which dose pill you would prefer to use (you can halve your 1mg tablets into 0.5mg doses - you cannot mix and match pill sizes with this titration schedule - and consider these halved tablets as individual 0.5mg pills); and I need a start date.

I would anticipate that your liquid will hit your system a little more quickly, but the difference should be quite marginal, and the effects unnoticeable, especially with longer half-life benzos (Klonopin has a pretty long half-life). We have had very few reports of problems from members about switching to titration, even with short half-life benzos.

The titration schedule will start from your present dose. The number of pills and liquid will equate to your present dose, but include the first tiny cut. For your information, 0.375mg Klonopin would equate to 75ml from 100ml liquid made with a single 0.5mg tablet (or one half of a 1mg tablet, if you prefer). So, your schedule would likely start at a single 0.5mg tablet (or one half of a 1mg tablet, if you prefer), plus 73 or 74ml from 100 ml of liquid made with a second 0.5mg tablet (this dose would include your first tiny cut).

Thanks, Colin.  I understand your reply.  I have two more questions:

1) When I cut the 1mg tablets in half, most of the time one is slightly larger than the other - it's very hard to get a perfect cut.  Any feedback?  I think I should use the 1/2mg tablets even though it will be less cost effective.

2) I haven't been stable with my sleep at the .875 dose for the past month.  I just don't want to start this thing out tired as I have had many exhausted days this past month.  I think I need the full 1mg for awhile so I can catch up.  I don't know.  Am I deluding myself?  I just feel like I need to build myself up with some consecutive nights of good sleep before tackling this.  But maybe I'm just putting off the inevitable.  God, I wish there were an easier way to do this.

Hi Bluebird,

Yes, splitting your pills is not the favoured option, for the very reason you mention. It is much better to use whole pills.

I tell what I can do: I can draw up a titration schedule using your whole 1mg pills, but you must let me know about one week in advance when you will run out of the 1mg pills. I will then draw up a new schedule, one based upon 0.5mg pills, and it will start where the old titration schedule left off. I can match the starting dose of the second schedule to match the end dose of the first schedule. Just be sure to include a start date for the second schedule, and a confirmation that you have stuck the first schedule (or I'll need to know your dose at the time).

Again, I will need a start date for your first schedule.

Hi Colin,

I'm just reading your reply now (still getting used to using this site).  On that subject, I'm wondering a few things: Are these posts for all to see? (I'm assuming they are)  In a reply, how do you get that box of copy to show exactly what you are responding to?  Also, is there a print function on the site or do you just print from your browser bar or cut and paste into a word document?  I know these are not taper issues, but it would be convenient to know these things.

On the taper issue, given my routine is that I take a dose before bed and then when I wake up, would it be alright to take the titrated liquid before bed and the tablet form during night wakeup (or vice-versa)?  Or would you recommend that I take a slightly reduced amount of liquid at each dosing - or is this my preference?  I think I'm trying to figure out is if I'll be liquifying the total amount I'll be taking both before bed and upon awakening and at which dose I take the reduced amount.  Do you understand my question?

Please give me a little time to figure out the dose I will be starting at.

Hi Colin,

I'm just reading your reply now (still getting used to using this site).  On that subject, I'm wondering a few things: Are these posts for all to see? (I'm assuming they are)  In a reply, how do you get that box of copy to show exactly what you are responding to?  Also, is there a print function on the site or do you just print from your browser bar or cut and paste into a word document?  I know these are not taper issues, but it would be convenient to know these things.

Yes, everyone can see these posts, just as you can see all the other posts. The only exception is your posts to the Contact The Moderation Team board - only the topic starter and the moderators can read threads on that board.

At the top and bottom of each thread, there is a 'print' tab option. Click this, and printer friendly version of the thread will appear in a new window. You then use the print option from your browser.

On the thread view, click 'quote' immediately above the post in question, instead of clicking 'reply' at the top or bottom of the thread, if you wish to quote a post. You can also select additional posts to quote from the reply page (scroll down, and select 'quote' from a recent post) - the quote will appear where you curser is placed within the reply box.

Please refer to the Forum Help Pages (from the forum's main menu bar); or try the FUM (Forum User Manual), located on the Community Documents & Policies board.

On the taper issue, given my routine is that I take a dose before bed and then when I wake up, would it be alright to take the titrated liquid before bed and the tablet form during night wakeup (or vice-versa)?  Or would you recommend that I take a slightly reduced amount of liquid at each dosing - or is this my preference?  I think I'm trying to figure out is if I'll be liquifying the total amount I'll be taking both before bed and upon awakening and at which dose I take the reduced amount.  Do you understand my question?

 

Please give me a little time to figure out the dose I will be starting at.

My last post was supposing that you make up a liquid containing all your daily dose. So, if your dose was 87ml from 100ml of liquid (made up using 1mg Klonopin), you might take 44ml at night, and 43ml in the morning (or divided up as you feel would best suit you).

Usually, our titration method is based upon titrating just one pill from the total daily dose. My comments presuppose that you would be using a single 1mg Klonopin per day. If you are using two or more tablets per day, there are simple methods to still make up a liquid that contains the full daily dose, but I don't think is an issue for you.

Edit: typos and clarifications.

Thanks.  This is perfectly clear now.

Bluebird