Klonopin Liquid Titration Plan Needed Please

I am finally off Depakote ER and all other psychiatric medications except for Klonopin and managing 5 to 8 hours of sleep per night.  So, now I need to focus on the final battle which is coming off the Klonopin safely.  I requested a titration plan in late 2014 but after reading various posts here in the middle of 2016, it appears that there may be some new methods / improvements to existing methods.  So I am requesting help in starting from scratch with creating a Klonopin Titration Plan. 

 

Here is the info requested in the Titration Instructions thread:

 

I take three 1 mg Klonopin pills (Teva brand) for a total of 3 mg Klonopin in my system anywhere from 11:00 PM to 3:00 AM every day.  I take the Klonopin pills all at once in that "bedtime range" because of insomnia.

I would like to do a slow taper.

I will be using a 100 ml graduated cylinder.

The graduated cylinder has 1 ml graduations.

I would like to use whole milk for the liquid.

 

Insomnia has been my most severe withdrawal symptom from just about every single psychiatric medication, especially Klonopin and other benzos.  Crossing over to Valium is not an option for me anymore.  I need to do this with Klonopin only.  Direct taper did not work well for me as I was coming off at a rate of .125 mg each time.  I have a lot of equipment for the liquid titration taper such as a gram scale, 100 ml graduated cylinder, pipettes, oral syringes, half gallon of whole milk, small round mirror, jam jars, mortal and pestle set, pill splitters, scalpels.  The only thing I can see that might be problematic with the equipment is that all of this was ordered back in December 2014, so it is somewhat old, although only the gram scale and pill splitters have been used.

 

I was hoping to finish the taper off of 3 mg of Klonopin by June 2017.  I was thinking of going down by .01 mg per day, so that would be 3 mg, 2.99 mg, 2.98 mg, 2.97 etc. down to 0 mg and holding when needed (approximately 300 to 365 days for a complete taper) but I am not 100% sure if what I am doing is correct.  Please let me know if you need any additional information and once again I thank you in advance for your assistance.

The taper you are proposing is a linear taper (same reduction on a weight basis every day).  Some people prefer a 1st order decay model (reductions made on a percent basis every day).  Both methods start out about the same, but the decay model slows down as you taper to maintain the same percent cut each day.  Both are viable approaches, and it's fine to switch from one mode to the other if you want to.

 

Your first step will be to switch part or all of your klonopin dosing from solid to liquid.  Sounds really simple, but a lot of people find that they need to increase their dose a little (maybe 10%) when they switch to a liquid formulation.  You'll want to get stable at 3 mg (liquid) for awhile before you begin your taper.

 

After that, you would simply begin reducing your dose by a little bit each day except if/when your withdrawal symptoms get nasty.  Then you need to stop/hold until you get mostly stable again.

The taper you are proposing is a linear taper (same reduction on a weight basis every day).  Some people prefer a 1st order decay model (reductions made on a percent basis every day).  Both methods start out about the same, but the decay model slows down as you taper to maintain the same percent cut each day.  Both are viable approaches, and it's fine to switch from one mode to the other if you want to.

 

Your first step will be to switch part or all of your klonopin dosing from solid to liquid.  Sounds really simple, but a lot of people find that they need to increase their dose a little (maybe 10%) when they switch to a liquid formulation.  You'll want to get stable at 3 mg (liquid) for awhile before you begin your taper.

 

After that, you would simply begin reducing your dose by a little bit each day except if/when your withdrawal symptoms get nasty.  Then you need to stop/hold until you get mostly stable again.

 

badsocref,

 

Thank you very much for your reply.  Please let me know if this is the correct way to do things just to test if I respond well to the liquid Klonopin form.

 

1.  Put the three 1 mg Klonopin pills in a mortar

2.  Crush the Klonopin pills into a powder with the pestle

3.  Pour whole milk up to the 100 ml mark of the graduated cylinder

4.  Pour the whole milk out of the graduated cylinder into a jam jar

5.  Put the crushed Klonopin powder into the milk that is in the jam jar

6.  Cover the jam jar with a lid

7.  Shake the contents of the jam jar to make the "Klonopin Milkshake"

8.  Do not do any reductions yet

9.  Uncover the jam jar

10.  Drink the entire contents of the jam jar i.e. the "Klonopin Milkshake"

 

Does this sound correct or am I missing something?

You might want to start by doing a solid pill twice a day and liquifying just one pill for the other dose.  That's a small change, and smaller changes usually cause fewer issues.  After a 3-4-5 days, you could liquify the 2nd pill.  After a few more days, liquify the third.  If symptoms start to rev up, hold where you are until things settle down a bit.  Once your stable with all liquid doses, then start your titration.

Hi.  I am in need of setting up a liquid titration plan for clonazepam.  I have been doing the cut and hold method of .0625mg every two weeks but this is proving to be intense.  I think I accidentally kindled plus nervous system is taxed.  I am currently taking 3 doses a day that total .75 mg.  I am down from 1 mg.  I have been rotating the cuts but would be fine with 3 doses of .25 mg to evenly switch over.  Not sure how much to taper from liquid. Will purchase a 100 ml cylinder.  Please advise.  Don't want to go too fast neither too slow given i still have to function for work.

 

Would I take all .75mg of clonazepam and place in 75 mls of milk.  Thinking if I could cut .03 mls daily so .01mls from each dose that would be most tolerable and hold or increase as necessary.  Would this way work? 

Hi.  I am in need of setting up a liquid titration plan for clonazepam.  I have been doing the cut and hold method of .0625mg every two weeks but this is proving to be intense.  I think I accidentally kindled plus nervous system is taxed.  I am currently taking 3 doses a day that total .75 mg.  I am down from 1 mg.  I have been rotating the cuts but would be fine with 3 doses of .25 mg to evenly switch over.  Not sure how much to taper from liquid. Will purchase a 100 ml cylinder.  Please advise.  Don't want to go too fast neither too slow given i still have to function for work.

 

Would I take all .75mg of clonazepam and place in 75 mls of milk.  Thinking if I could cut .03 mls daily so .01mls from each dose that would be most tolerable and hold or increase as necessary.  Would this way work?

 

You probably need to slow down and also it might help to cut smaller.  .0625mg every two weeks is 18% a month...that's kind of aggressive.

 

Whole milk will work with K.  There are also other ways.  .75mg into 75ml is a good choice.  If you have .5mg pills, put 1.5mg into 150ml or if you have 1mg pills, put 1mg into 100ml.  You'll need 1ml and 10ml syringes.  The cylinder is also helpful.

Still not clear on the liquid titration plan given where I am at. Why would I add 1 mg  to 1 ml if I am already down to .75mg? This is where I am confused with my benzo brain. I do have  .5 mg pills. I thought the recommendation of lowering anywhere from 5 to 10 percent every two weeks was ok. But my body goes crazy with each cut. I am tough but this is a beast. Could you explain this to me in greater detail? Looking to buy cylinder of 100 mls. Thanks for your response. Any further input you could provide would be much appreciated. I guess I was thinking I needed this out of me the sooner the better.  This stuff never really calmed my anxiety. It actually made it worse pretty fast. Either tolerance or paradoxical reaction. Not clear. It increased obtrussive thoughts from the start. It has been a rough ride and living in my body has been uncomfortable to say the least.

Still not clear on the liquid titration plan given where I am at. Why would I add 1 mg  to 1 ml if I am already down to .75mg? This is where I am confused with my benzo brain. I do have  .5 mg pills. I thought the recommendation of lowering anywhere from 5 to 10 percent every two weeks was ok. But my body goes crazy with each cut. I am tough but this is a beast. Could you explain this to me in greater detail? Looking to buy cylinder of 100 mls. Thanks for your response. Any further input you could provide would be much appreciated. I guess I was thinking I needed this out of me the sooner the better.  This stuff never really calmed my anxiety. It actually made it worse pretty fast. Either tolerance or paradoxical reaction. Not clear. It increased obtrussive thoughts from the start. It has been a rough ride and living in my body has been uncomfortable to say the least.

 

The drug has damaged your CNS and the idea is to coax your body to reverse the damage by removing a little at a time.  In the meantime you need the drug so you don't want it out.  5-10% every two weeks is a guide.  You need to find what you can do.  You tried near the high end of this range and it seems to be a struggle.

I just feel horrible on it and horrible coming off of it. But you are right. My CNS was already damaged prior to starting these as well given I had some major trauma happen right before taking these. I started to taper because I was already experiencing either tolerance withdrawal, a paradoxical reaction or interdose withdrawal. Not sure. Plus it increased depression and anxiety. Made me physically lethargic and weak. This dose/med never calmed me down. My body never liked it. Just barely touched the anxiety. Ironically I have less anxiety as I come down. Maybe I will try waiting and cut every three to four weeks. The weird thing is my mental clarity gets better but physically tough. Insomnia as well.  Still need a tititration schedule laid out for me for smaller cuts. Brain fog strong today. I am all over the place. Sorry. Thanks for your input.

I just feel horrible on it and horrible coming off of it. But you are right. My CNS was already damaged prior to starting these as well given I had some major trauma happen right before taking these. I started to taper because I was already experiencing either tolerance withdrawal, a paradoxical reaction or interdose withdrawal. Not sure. Plus it increased depression and anxiety. Made me physically lethargic and weak. This dose/med never calmed me down. My body never liked it. Just barely touched the anxiety. Ironically I have less anxiety as I come down. Maybe I will try waiting and cut every three to four weeks. The weird thing is my mental clarity gets better but physically tough. Insomnia as well.  Still need a tititration schedule laid out for me for smaller cuts. Brain fog strong today. I am all over the place. Sorry. Thanks for your input.

 

What is your dose, pill size, and number of doses?

 

You probably need to hold for a while before beginning a slower taper.  Then, when you begin, the idea is not to schedule, but rather to find a pace that keeps symptoms down.  You'll want to taper based on symptoms.

Currently my doses are: Noon (.1875mg) evening (.25mg) 

Night dose now: 0.313 mg.  For a total of .75 mg. This is all new to me and frustrating. I am willing to slow down but not sure if my symptoms will alleviate or plateau. Guess I haven't given it a chance. I did wait 3.5 weeks after the first time I cut  then cut .0625 again. But was still feeling crappy when I cut.  This is the smallest cut I can get. May need to weigh on gram scale. Maybe had I started cutting smaller doses to start I wouldn't be having all the symptoms I am experiencing. I just noticed my moods around my cycle were getting intense and bringing me down. Any suggestions on how to proceed after holding? I know symptom based but %. Should I make all three doses equal ? May I ask how you proceeded in your taper?

Currently my doses are: Noon (.1875mg) evening (.25mg) 

Night dose now: 0.313 mg.  For a total of .75 mg. This is all new to me and frustrating. I am willing to slow down but not sure if my symptoms will alleviate or plateau. Guess I haven't given it a chance. I did wait 3.5 weeks after the first time I cut  then cut .0625 again. But was still feeling crappy when I cut.  This is the smallest cut I can get. May need to weigh on gram scale. Maybe had I started cutting smaller doses to start I wouldn't be having all the symptoms I am experiencing. I just noticed my moods around my cycle were getting intense and bringing me down. Any suggestions on how to proceed after holding? I know symptom based but %. Should I make all three doses equal ? May I ask how you proceeded in your taper?

 

3.5 weeks is a good long hold, but you hit on the real criteria which is to keeping holding until you feel well enough to cut again.  Generally, I think it is a good idea to taper at 5-10% a month until you know you can do more.  Yes, I think it may help to even out your doses, and also to space them evenly, and liquify the K so you can cut smaller.  A thing about these symptoms is if you get into the weeds they can be very long-lasting so it is best to control them and nip them in the bud.  Try to stay out of them altogether and if you have them, work on getting rid of them instead of getting off.

Right now insomnia was and is what is affecting my mood a lot. Feeling down and depressed. Super sensitive to noise, tremors, mild anxiety. Basically wired nervous system and feeling crappy and can barely get out of bed. How do I control them and nip them in the bud? By holding? I really appreciate all the suggestions you offer. Feeling lost in this process.

Right now insomnia was and is what is affecting my mood a lot. Feeling down and depressed. Super sensitive to noise, tremors, mild anxiety. Basically wired nervous system and feeling crappy and can barely get out of bed. How do I control them and nip them in the bud? By holding? I really appreciate all the suggestions you offer. Feeling lost in this process.

 

Yes, holding or even updosing, although updosing does not always work.  To me the name of the game is to focus on getting rid of symptoms and not focus on getting off.  Getting off will come eventually, but if you reach zero with symptoms they will stay with you long after, so you really are not done.  Much better IMO to remain on the drug and reach zero feeling well and have it be over at that point.  It can be a long process, but time goes quicker when you feel well.

Dosing once per day at bedtime should improve your sleep, but it comes at the expense of being able to take it 3x per day (which evens out your level a little bit).  You just have to weigh the relative importance of some additional sleep to better coverage throughout the (waking) day.

 

Compromise is to combine evening and nighttime dose while still keeping something available for mid-morning/noon.

Right now insomnia was and is what is affecting my mood a lot. Feeling down and depressed. Super sensitive to noise, tremors, mild anxiety. Basically wired nervous system and feeling crappy and can barely get out of bed. How do I control them and nip them in the bud? By holding? I really appreciate all the suggestions you offer. Feeling lost in this process.

 

Yes, holding or even updosing, although updosing does not always work.  To me the name of the game is to focus on getting rid of symptoms and not focus on getting off.  Getting off will come eventually, but if you reach zero with symptoms they will stay with you long after, so you really are not done.  Much better IMO to remain on the drug and reach zero feeling well and have it be over at that point.  It can be a long process, but time goes quicker when you feel well.

 

Is this how you titrated down? I will resist updosing because I hear that does not always work. I will hold until I feel I can move on.  I guess I was stuck on this idea of getting off by a certain time frame. I have to make peace with giving my body time to adjust with all my cuts I have not felt well before cutting again. Just plowed through. I was just having tolerance withdrawal symptoms so I had heard to keep going regardless of symptoms but now not so sure. I felt stuck in which way to go.  Thanks again for your input.

Dosing once per day at bedtime should improve your sleep, but it comes at the expense of being able to take it 3x per day (which evens out your level a little bit).  You just have to weigh the relative importance of some additional sleep to better coverage throughout the (waking) day.

 

Compromise is to combine evening and nighttime dose while still keeping something available for mid-morning/noon.

 

Not sure I could handle combining the evening and night dose  given I have been dosing 3 times a day from the start. Maybe I could gradually cut a piece off from the evening and add that to night dose. I reached tolerance quickly on 1 mg so my choice was to either updose or taper. Hence I started to taper but have not felt great from the start. I think I cut way to fast now in hindsight. Will consider this option. Thank you.

warriorforlife,

 

I know you need similar help, but this was a thread I created for my own liquid titration plan.  Can you create a new thread for your own plan, so we can keep things separate and organized for each of our plans?

Yes. I apologize if I have overstepped my bounds with my inquiries on your thread. I will gladly create a new thread. Good luck on your titration.

Hi.  I am in need of setting up a liquid titration plan for clonazepam.  I have been doing the cut and hold method of .0625mg every two weeks but this is proving to be intense.  I think I accidentally kindled plus nervous system is taxed.  I am currently taking 3 doses a day that total .75 mg.  I am down from 1 mg.  I have been rotating the cuts but would be fine with 3 doses of .25 mg to evenly switch over.  Not sure how much to taper from liquid. Will purchase a 100 ml cylinder.  Please advise.  Don't want to go too fast neither too slow given i still have to function for work.

 

Would I take all .75mg of clonazepam and place in 75 mls of milk.  Thinking if I could cut .03 mls daily so .01mls from each dose that would be most tolerable and hold or increase as necessary.  Would this way work?

 

You probably need to slow down and also it might help to cut smaller.  .0625mg every two weeks is 18% a month...that's kind of aggressive.

 

Whole milk will work with K.  There are also other ways.  .75mg into 75ml is a good choice.  If you have .5mg pills, put 1.5mg into 150ml or if you have 1mg pills, put 1mg into 100ml.  You'll need 1ml and 10ml syringes.  The cylinder is also helpful.

 

I was just reading over this post and wanted to clarify, wasn't my reduction only 12.5% a month or was I doing the math wrong?

 

 

 

I was just reading over this post and wanted to clarify, wasn't my reduction only 12.5% a month or was I doing the math wrong?

 

From your siggy:

 

"Noon (.25 mg) evening (.25 mg)

Night dose (.25 mg)

 

Started cut and hold taper in April 16' at 0.0625 mg every two weeks. "

 

3X.25mg=/.75mg daily dose

 

.0625 per 2 weeks = .125 per mo (28 days) reduction

 

.125/.75=16.7%

 

 

Well crap. So this whole time I thought I was going slow by taking 1/16th out of 1 mg every two weeks. Goes to show  how good I am at math. How much should I have been cutting and holding to be at 6% reduction every two weeks from 1 mg? Lifeinchaos, excuse me from using this thread again. Just needed to figure this out. Most of my physical symptoms are under control but I have definitely been experiencing intense depression and SI. I had started cutting due to feeling depressed originally. I am not sure holding will improve these symptoms. Thoughts or any suggestions based on experience?

Well crap. So this whole time I thought I was going slow by taking 1/16th out of 1 mg every two weeks. Goes to show  how good I am at math. How much should I have been cutting and holding to be at 6% reduction every two weeks from 1 mg? Lifeinchaos, excuse me from using this thread again. Just needed to figure this out. Most of my physical symptoms are under control but I have definitely been experiencing intense depression and SI. I had started cutting due to feeling depressed originally. I am not sure holding will improve these symptoms. Thoughts or any suggestions based on experience?

 

6% every two weeks is 12.8% a month.  12.8% of 1mg is .128mg.  Broken into daily cuts that is .0043mg a day.  My suggestion is to do what it takes to get rid of symptoms.  Hold or taper slowly, but get them to reduce, not increase.

Holding is torturous but trying so the symptoms do not increase more but my mood is unstable showing I cut too fast for my little self. Or did you mean not to increase as in updosing? I know that is for me to decide whether to do or not.. Have you ever had to updose? Given that I did not hold long enough at any dose before cutting not sure where I would stabilize. Now my sleep is starting to suffer again.

Holding is torturous but trying so the symptoms do not increase more but my mood is unstable showing I cut too fast for my little self. Or did you mean not to increase as in updosing? I know that is for me to decide whether to do or not.. Have you ever had to updose? Given that I did not hold long enough at any dose before cutting not sure where I would stabilize. Now my sleep is starting to suffer again.

 

Once you get into the weeds this can get trickier.  There is a support thread on long holding and they seem to be getting good results.