How fast and what size steps for clonazepam taper

After resting at .25mg per day of clonazepam for about a month, I am ready to start tapering again.

I had thought I would drop .0125 each step.  Since I make 2 days at a time from a .5 mg pill, I thought each step would be either 6 or 8 days, depending on how I was doing.  On my way from .375 to .25mg, my steps were just 4 days each, and that was a bit quick for me.

The first step from .25 (less .0125) to .2375 is 5%.

My question is, instead of .0125 every 8 days, is .00625 every 4 days better? Or .003125 every 2 days (about 1.25%)? Does it matter?

Do most people do better taking a moderate step, experiencing symptoms for a few days, and then stabilizing for a few days and doing it again.  Or do most people do better with many smaller steps. 

And also, however I do it, is what I propose considered "cautious" or on the fast side?

thanks

In my opinion everyone is different, your taper has to be adjusted to best keep you comfortable. Experiment and then stay with what allows you to feel your best while still toaering down.

Good luck.

Beth

After resting at .25mg per day of clonazepam for about a month, I am ready to start tapering again.

 

I had thought I would drop .0125 each step.  Since I make 2 days at a time from a .5 mg pill, I thought each step would be either 6 or 8 days, depending on how I was doing.  On my way from .375 to .25mg, my steps were just 4 days each, and that was a bit quick for me.

 

The first step from .25 (less .0125) to .2375 is 5%.

 

My question is, instead of .0125 every 8 days, is .00625 every 4 days better? Or .003125 every 2 days (about 1.25%)? Does it matter?

 

Do most people do better taking a moderate step, experiencing symptoms for a few days, and then stabilizing for a few days and doing it again.  Or do most people do better with many smaller steps. 

 

And also, however I do it, is what I propose considered "cautious" or on the fast side?

 

thanks

BBFs advice is of coarse correct.  We should all do what works best for us.  The answer to your question as to if it makes a difference is yes.  As you break any rate up into smaller and smaller pieces the drug will remain in your body longer to help with symptoms.  The smaller the step, the more the drug remain in you until it is ready to be removed.  This is a real advantage, and when you are tapering drugs like benzos where a cut of few percent can cause bad symptoms it can be very important.

So if I dropped .003125 mg every other day, to get from .25 to .125, would that be considered a conservative place to start, given that the dosage itself is low? On the slow side?, Too fast.    .003125 is 1.25% of .25mg every 2 days.  Which would equal .0625%/day.

Just looking for the proper ballpark to start in.

Separately, my concern with smaller steps is that by the time you have symptoms, 2 or 3 days may have passed from the cut that caused them. I guess the answer is that so little has changed that it doesn't matter that you hold a little bit lower than the level that caused the problem. Any thoughts?

Thanks.

If you don't know where to start and you want to cut every other day.  I probably would not begin at .003125mg every other day.  That's 18.8% a month...pretty aggressive.  .002mg or even .0015mg might be better.  You could do the same rate and get a bit more advantage by breaking that cut up into daily cuts if you wanted.

Right, the smaller steps will be fine since the cuts are so small.  If you feel symptoms coming on, just hold.  You'll get a feel for it by doing it.

Oh dear, this is disappointing.  I was expecting to go from .25 to .20 in one month and then, if necessary, slow a little.

Here is my situation.  I am in my 70's.

from 2000 to 2015  I took 60-90 .5mg lorazepam per YEAR for sleep as needed.

Dec 15 to Jan 2016  .5mg lorazepam 4 times a week for sleep

For many years, my Doc believed that my various physical complaints were due to anxiety and depression. However, at my insistence, he checked other possibilities and found that I had a parathyroid problem. All my issues resolved when I had successful parathyroid surgery in March of 2015.

But Doc did not notice or change his opinion. For no reason, Doc suggested I try zoloft on February, 2 2016. I had a very bad reaction and Doc  said take my nighttime  Lorazepam during the day to get past bad reaction to Zoloft.  I took 1.5 mg daily for a week.  Another doctor in the same office saw what I was doing and switched me to clonazepam. Said it would be smoother. He also said since Zoloft did not work, try Paxil. Again I had a bad reaction to Paxil. I took .75 mg of clonazepam for 2 weeks. The drugs were "as needed so I would start and stop and react, I think to stopping.  No one told me what to expect or what to do. Finally, I googled the drugs and came across the term benzodiazepines.

Then:

2/23/16 drop from .75 to .625 clonazepam

2/24 to 2/27 hold 0.375

2/29 - 3/11 taper to .25

3/12  up to .356

3/14 to 4/5 tapered .356 to .25

4/09 .238

4/13 .225

4/18 back up to .25

Holding .25 until now

So most of my use has been holding at .25.  does the short duration of my use or any of the history change your opinion. The taper of .00325 every other day was half as fast as my previous taper.

Thanks for your comments.

How do you feel?

A few months ago you were on .75mg.  Now you're at .25mg.  You can taper at whatever rate your body is okay with.  The rate I suggested is just a starting point.  You'll adjust to what is right for you and that is not something you get to choose...it just is.

That's a lot of psych med jerking around.  Your poor brain.

As always, thanks for your helpful response.

I feel better now than I have in weeks. I don't want to jinx it by saying I feel good, but I'm tempted to say so.  Tinnitus, Insomnia, tired all day, too weak to use my arms for much, waves of severe depression and waves of anxiety focused on nothing have subsided now that I have been holding.  I expect them back, hopefully not too bad, if I taper slowly.

I think I will try the taper somewhere between your suggestion and  as I planned, but be very quick to hold and slow if there are any issues. 

thanks.

If you feel ready to taper, give it a try.  Sounds good.  Ease into it.  You came down .5mg since Feb...three months.  That's moving pretty quick in benzo terms.  It may be you can move quicker than most.  Some people can do over 20% in a month.  It's not all that rare from what I see.  But I'd ease into it like you plan.

FWIW, IMO, a key to benzo tapering is to focus on feeling well and remaining well, rather than getting off.  Let getting off be a by-product.  This can be very demanding on patience, but I think it is best, and also fastest.  Try to get rid of existing symptoms by holding and cutting small.  I think it's the quickest way to health as, if you get to zero, but feel sick, you'll just pay with more time on the other side.  There's nothing magical about zero.  You just keep feeling the same for a long time.  If you arrive feeling good, it's over at that point.  If you arrive feeling lousy, you'll feel lousy for months or even years (like me).

If you feel ready to taper, give it a try.  Sounds good.  Ease into it.  You came down .5mg since Feb...three months.  That's moving pretty quick in benzo terms.  It may be you can move quicker than most.  Some people can do over 20% in a month.  It's not all that rare from what I see.  But I'd ease into it like you plan.

 

FWIW, IMO, a key to benzo tapering is to focus on feeling well and remaining well, rather than getting off.  Let getting off be a by-product.  This can be very demanding on patience, but I think it is best, and also fastest.  Try to get rid of existing symptoms by holding and cutting small.  I think it's the quickest way to health as, if you get to zero, but feel sick, you'll just pay with more time on the other side.  There's nothing magical about zero.  You just keep feeling the same for a long time.  If you arrive feeling good, it's over at that point.  If you arrive feeling lousy, you'll feel lousy for months or even years (like me).

That is great advice SG. I feel the same way. I have been on Ativan for over 30 years, most of my adult life and at first it was all about getting off the drug but I was so ill all the time I could barely function. Now I concentrate on steadily getting of Ativan but keeping myself at a functional level too. I want to enjoy these years of my life. The last 2 years have been really rough.

Anyway just wanted to say, great support!

Beth