Pre-Taper Questions & Concerns

Yesterday I posted this to Colin, but now am putting it out there for all.  It appears, as a result of last night's inability to fall asleep upon waking in the middle of the night (and taking the dose mentioned below), I caved in and took about .125 additional K.  I HAD to sleep!  So it appears that I was at that dose long enough to develop a tolerance to it.  I'm really quite worried that I'm going to be exhausted throughout this taper and I don't think I can handle that.  I'm praying that titrating will make the taper tiny enough that my neurons won't notice it.  So now I think I need to stabilize at perhaps 1 mg divided up - once before bed and once when I wake up.

Anyone who has been on benzos for insomnia and titrated off - please give me some advice/encouragement.

This is what I wrote to Colin but haven't heard back from him at the time I'm posting this:  Maybe he'll have to answer the specific math part of it.

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.

B

Hi Bluebird,

I moved your post here because it seems like you have more concerns than titrating.  Hopefully some buddies will see this and be able to help you feel a little better about what's happening to you.

Many of us have sleep issues before, during and after benzo's.  I've been able to learn how to sleep on my own now that I'm healed and I'm sure you will too. 

I don't have any experience with titrating or liquid benzo's, hopefully someone else will.

Pam

Hi Bluebird,

I've only just read the above - I've already replied to your other post about titration.

I would not worry about a one-off extra dose. I'd leave it a few days before starting your taper though. It is probably not a good idea to start your taper unless you have managed to stabilise your dose. Again, don't worry about this one-off extra dose.

Not sure what you mean by "one-off" extra dose.  Are you saying that I should just stabilize at 1mg (using a fraction of that before bed and the balance upon middle of night awakening)?  I'm thinking the .875 that I had been at is not going to be therapeutic and that I need to stabilize at 1 mg. before starting taper.

Also, do I not start the liquid titrating until I can't get an accurate dry cut?  Or do I start titrating with the 1mg?

Do people normally react the same to the crushed pill in milk as they do the "old fashioned" way?

Thanks.

Hi Bluebird,

I just meant that you should not worry unduly about your one-off extra dose last night - I did not mean to imply that you should normally take the higher, 1mg daily dose.

The most accurate way is to use whole pills for titration (rather than half-pills), but please refer to my reply to you on the titration board thread.

Normally, people do react similarly to the liquid as they do to a pill. Again, refer to my other post.

bluebird, I cut from 1.5 mg of k in 2 weeks to .75mg, and hit a brick wall,  took 3 weeks to feel like I was at least stabilizing , unfortunately , I went to my shrink, and he convinced me to add in .25 mg of k to boost me back to 1mg total,  big mistake  , as I look at it now.  having spent the 3 weeks going thru hell with the .75mg.  I now had to start my taper from 1mg. 

anyway,  I am down to .45mg. of the k, titrating down at 10% per week, and my symptoms have , for the moment anyway, all but dissapeared.  I am considering myself one of the very lucky ones at the moment anyway.  point being .  going up is not what you want to do.  I take half my poison in the evening and 1/2 in the morning.  I am surprised you need to take the k in middle of night, since it has a long half life , but thats the problem with this poison,  acts differently in everyone.  8weeks ago before starting titration , I was in severe depression , suffering anxiety attacks, that I never had in my life before getting on the k.  now depression has lifted and have not had anxiety attack in over 4 weeks. 

try not to go up.  wait for the symptoms to stabilize ,  which means alot ofdifferent things to different people , to me stabilize meant that I was getting some good windows mixed in with the bad symptoms.  so that was when I felt it was time to start the titration. 

Have not regretted it for one minute. 

good luck.

ST

Hi bluebird,

I didn't read your other posts about titrating.  And I'm not a "titrator", I was a "dry-cutter" off Klon, so I won't get into the titrating issues.  But I did take Klon to sleep every night for 5 years.  Long enough to get pretty sick on it, as so many do. 

So naturally, tapering off and being off Klon led to the usual sleep (or non-sleep) issues.  I remember those crazy nights in the beginning.  So unpredictable because you never knew....would I fall asleep?  Would I stay asleep for at least a few hours?  I was all over the place.  But it gradually and slowly got better and better.  I can tell you that I now sleep pretty normally.  I go to bed at the same time, keep my room dark, keep the evenings and bedtime stress-free (as much as possible).  I really had to change a few things to make sleep work again!  But it's been worth it. 

Being afraid to sleep -- having the fears around it, is really common.  Just be prepared for them.  If worst comes to worst, I just tell myself that I'll lay and relax in bed, no pressure to sleep.  Afterall, if the body gets too tired, it will sleep.  Even if it's the next day. 

Keep up the good work!

adelia

Thanks for your input, Softail and Adelia.

Taking K for insomnia is such a double-edged sword.  I had actually stabilized at .75mg for well over a year, and then, BAM! the roller coaster started.  When I go for just a few days not getting a solid night's sleep I feel so bone tired.  So - I guess I've made it clear - I'm really concerned about tapering.  I'm not so young and I know that feeling like you're 100 years old all the time is not healthy.  Does anyone know if there is a non addicting medication one can take for sleep while one is tapering?  I know we don't want to replace one drug with another, but if it's temporary and not a benzo, then that may help me get through this.

Also, for the insomniacs out there who have tapered, did your body ever adjust to the new taper amounts so that you slept - at least enough to get by and be able to function?  Also, any other meds that helped?  Hope you don't all think I'm a wuss...but apparently I am.

Thanks,

Bluebird

Hi bluebird,

The lower I got on my xanax the better I slept.

Patty  xo

Hi Bluebird,

Well, we're probably all "wusses" in the end, aren't we?  I took Klon to sleep, but somehow I wanted off so bad, I just didn't worry about sleeping.  I decided to have faith that my body would be able to heal itself, somehow.  And that included sleeping normally.    Actually, I don't use that word "normall" anymore.    Because what might work for me, might not work for someone else.  And vice versa.  I just told myself (and my body) hey let's just get some sleep, enough to go on.  That's good enough for me. 

At the end of my taper, I started to crash at 7 pm.  So...I thought alright, let's go with it.  If this is what I'm getting, I accept it.  Went to bed at 7 (partly because my body temp would get low which makes ya sleepy).  Then wake up at 2 am or 3 am after waking quite a few times.  Can't remember what I did then to be honest.  It's a bit of a blur.  Probably turned the TV on...that was what I had to do a lot in the early days. 

But after I got off, and as a few weeks went by, I started getting sleepier later...10 or 11.  I just went with what I got.  I also took lots of magnesium (to relax) and Vit E and warm milk at bedtime, whenever that was. 

I used to hear folks here on BB say..nothing else works too well (meds to sleep).  And now I think:  why get dependent on other meds if you want to get off this one?  Because guess what?  We already TRIED some of the best meds for sleep!!!  Those would be benzos.  So I hesitate to even recommend any.  I tried a few here and there, whatever I had on hand...but they would invariably make me more miserable the next morning, rev up some symptoms and even cause me to sleep worse.  All...miserable experiments.  The more I forced myself to take nothing, and just deal, worked out better and better. 

Now?  I take two tylenol (plain, no p.m.) at bedtime usually.  Not always.  For my aching legs.  I ship-shaped my "sleep hygiene"...and I'm sleeping pretty adequately, most nights.  All on my blessed OWN. 

What have you tried? 

adelia

I've tried lots of stuff.  I also take supplements at night, which I believe help me to sleep.  I take additional magnesium/calcium/D.  During a middle of the night wakeup I take a B-complex and sometimes a multi-mineral tablet.  I know some people say that B's rev up their system, but I think for me it has a calming effect.  I've also noticed that Zinc seems to help as well.  Never tried tylenol pm, but years ago I tried benadryl.  It helped out at first but then it just made me feel crummy.  Also have tried melatonin but this also makes me feel drugged when I get up.  I notice hot milk or hot soy milk helps as well as staying "vertical" for a little while after taking anything to get it into your system faster.

I appreciate your words of encouragement.   Your take on being tired helps.

Bluebird