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Please help me set a taper plan


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Hi,

I'm currently at approx. .375 mg of clonazapan each night before bed.  I have .5 mg tablets which I split in half and take one and a quarter half.  I'm thinking titration might be best for me because I'm just feeling pretty lousy (like everyone on this stuff).

 

I ordered a 100 ml graduated cylinder with 1 ml increments which I hope to get tomorrow.  So, I'd like to start tomorrow (11/27) night if possible with a taper rate of what most people are okay doing (10% per week?).

 

I've been taking the clonazapan (Klonopin) at night since I started.  Will that be the same if I switch to titration?

 

Thanks so much for any and all help!!  I'm so happy to have found this site and can't wait to be off this stuff.

 

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Hi,

I'm currently at approx. .375 mg of clonazapan each night before bed.  I have .5 mg tablets which I split in half and take one and a quarter half.  I'm thinking titration might be best for me because I'm just feeling pretty lousy (like everyone on this stuff).

 

I ordered a 100 ml graduated cylinder with 1 ml increments which I hope to get tomorrow.  So, I'd like to start tomorrow (11/27) night if possible with a taper rate of what most people are okay doing (10% per week?).

 

I've been taking the clonazapan (Klonopin) at night since I started.  Will that be the same if I switch to titration?

 

Thanks so much for any and all help!!  I'm so happy to have found this site and can't wait to be off this stuff.

 

 

Hi, Misa. I don't think Colin could make you up a schedule overnight and you may not get the cylinder tomorrow anyway.  I imagine he'll see your post tomorrow and respond with an estimate of when he can have it made up. 

 

If you want to go on taking your dose only at night, you can do that.  Many people find that they fell better splitting their dose up and taking it 2x/day.  Because of clono's half-life, some of your misery could be due to interdose withdrawal - the nighttime dose wears off hours before you are due to take it again.  Just something to think about.

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Oh no, Colin, there's no hurry, I can wait.

 

Sometimes I don't know if I'd be better just sticking to dry taper.  I've never tried splitting the dose up ever.  - Should I do this now?  Would it help me? I'm just afraid I wouldn't be able to get to sleep, what do you think?

Any suggestions would be greatly appreciated.

 

Thanks so much for everyone's help!

 

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Oh no, Colin, there's no hurry, I can wait.

 

Sometimes I don't know if I'd be better just sticking to dry taper.  I've never tried splitting the dose up ever.  - Should I do this now?  Would it help me? I'm just afraid I wouldn't be able to get to sleep, what do you think?

Any suggestions would be greatly appreciated.

 

Thanks so much for everyone's help!

 

 

I don't really know, misa.  If you are more symptomatic in the evening, it might indicate interdose withdrawal.  If you feel pretty much the same throughout the day, your symptoms are more likely from becoming tolerant in which case the only solution seems to be to continue with a reasonable taper.  You could try taking the .25mg piece when you usually do and then if you haven't been able to sleep within your normal time frame, take the other piece (.125mg).  If you are able to sleep with the .25mg, then you could take that .125mg piece about 12 hours after the previous dose.  However, you should know that a certain amount of sleep difficulties tend to go along with benzo withdrawal so you may eventually have a problem falling asleep even if you don't split up your dose.  That's why we have an Insomnia board where members can share what works for them.  Check it out. http://www.benzobuddies.org/forum/index.php?board=83.0

 

Want to pick a new date to start titration, like Dec. 1?   If so, that date along with the information you have already posted should be enough for Colin to make up a schedule for you.  :thumbsup:

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Oh yes I have had many nights with sleep issues since starting this.  I used to be able to sleep great, but went to see a doctor because I had a couple nights where I had trouble sleeping and some anxiety so that's where this all started.  I've been having a lot of anxiety throughout the day even upon waking.  So, if the dose helps me to sleep and I get a decent night's sleep, I think it's better for me to stick with when I'm taking it. 

 

I just pray that the anxiety will ease after I'm off this.  Is this the case for most????

 

Thanks!!!

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Oh yes I have had many nights with sleep issues since starting this.  I used to be able to sleep great, but went to see a doctor because I had a couple nights where I had trouble sleeping and some anxiety so that's where this all started.  I've been having a lot of anxiety throughout the day even upon waking.  So, if the dose helps me to sleep and I get a decent night's sleep, I think it's better for me to stick with when I'm taking it. 

 

I just pray that the anxiety will ease after I'm off this.  Is this the case for most????

 

Thanks!!!

 

To tell the truth, misa, it can take a number of weeks to feel less anxiety once you are off - or not.  It varies from person to person.  I actually started having less anxiety about 6 weeks into my taper and that lasted for months.  Just kind of have to take what comes and roll with it.

 

So do you still want a titration plan?  Have you picked a new start date?

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Yes I'd still like a titration plan..............However, I haven't received the cylinder yet. Hopefully tomorrow it will be here.  Once it's here, I'll reply to this post and ask for a plan with a start date.

 

Thanks so much for all the help!! 

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Hi Misa,

 

I will look at this tomorrow for you. At low doses, a titration schedule is usually straightforward - you are unlikely to require a formal written plan. I'll walk you though it.

 

Take care.

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Hi Misa!

 

Glad to read you are going to continue going down! We ARE all different on the klonopin (I was on its generic, clonazepam). But I developed more sleep issues on it and anxiety issues as well. I was taking it for sleep and I now think it was preventing me from sleeping (due to tolerance) for well over a year before I started to get a clue. Just didn't know how this 'med' (hard to dignify it with that!) worked and how bad it was. Colin gave me some very clear advice on how to reduce my dose toward the end. I actually began taking my bedtime dose in the morning (my idea, not Colin's) to try to improve my sleep. It didn't help. Nothing has until I have gotten off it and am working on getting back to a 'new' normal. Just keep following the steps the mods give you on here and keep reading the posts from other BBs. You will make it. You are already making it!

 

Be well!  :mybuddy:

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Hi

Thank you all so much!  It's so scary going through all this.  I feel so lucky to have come across this site because I didn't know what was wrong with me.

 

Thank You All!

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Colin,

 

Just to let you know, where I still hadn't received the cylinder, I made another dry cut on Saturday (11/28).  So now I'm at about .310 mg and have been feeling okay the past couple days.  I thought I read somewhere that on the third day the withdrawal symptoms get worse. Is this the case? 

 

I just wanted to let you know so I wouldn't be wasting your time yet with a schedule.

 

Thanks for everything and I'll keep you posted on things!

 

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Hi Misa,

 

I was coming to this thread to see if I needed to reply to you. ;) Let me know when you receive your cylinder, and your requirements for a taper. Just to let you know, there is little need for a formal taper plan at a low dose - there is no need for complicated calculations made through the use of a spreadsheet. Instead, you simply decide upon what seems like reasonable amount of time to taper off your remaining dose, and reduce your daily dose accordingly. The easiest way to do this is to make up a liquid for the number of days you guess you will need for the remainder of your taper, make up this same volume each day, but reduce the amount you consume by 1ml each day. So, fifty days would mean making up 50ml each day: day1, you would 49ml (from the 50ml); day2, you would drink just 48ml (from the 50ml); day3 ,you would drink just 47ml (from the 50ml); and so on.

 

Anyway, we can go through this again when you receive your cylinder.

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Is what I'm on about now considered a low dose?  Like I said I just cut tapered a couple nights ago, so I'm at approx. .310mg clonazapan.

 

Also, should I hold this for 7-14 days?

 

Thanks, I'm just not sure

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Well, it's an approximate amount.  The way I figured it is............I have a .5mg tablet which if I divided by 8's would come out to be .0625.  So, I take a half of a .5 mg which would be .25, and for the other half, I cut 1/4 off which would be (.0625).  Add the .25 plus the .0625 would equal .3125.  Does this make sense?  I know when your dry cutting, it's hard to be precise, so that is my approximate amount.  Am I doing this right?

 

Thanks!!

 

 

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Hi,

 

This is what I thought you might be doing - like you said, it is not very precise to split your pills like this.

 

When titrating, you would decide upon how many days you think it would be reasonable to taper off the remaining 0.3125mg, and apply the following formula. To make life easy for yourself, reduce your dose by 1ml per day.

 

First, for accuracy, you should use a whole 0.5mg. Let us suppose (for example) that you would like to taper off the remaining 0.3125mg in fifty days.

 

0.5 (the tablet dose)

50 days (the length of taper)

0.3125mg (present dose)

 

0.5/0.3125 = 1.6

 

1.6 x 50 = 80

 

The amove means that each day you would prepare 80ml of liquid (with a 0.5mg tablet), and 50ml would equate to your present dose of 0.3125mg. So, 49ml (from 80ml) would be the first small cut from your present dose. You would reduce your dose by 1ml each day.

 

Second example:

 

0.5 (the tablet dose)

30 days (the length of taper)

0.25mg (present dose)

 

0.5/0.25 = 2

 

2 x 30 =  60

 

The amove means that each day you would prepare 60ml of liquid (with a 0.5mg tablet), and 30ml would equate to your start dose of 0.25mg. So, 29ml (from 60ml) would be the first small cut from your start dose. You would reduce your dose by 1ml each day.

 

Third example:

 

0.5 (the tablet dose)

28 days (the length of taper)

0.1875mg (present dose)

 

0.5/0.1875 = 2.67

 

2.67 x 28 =  74.67 (round this to the nearest ml - so, call it: 75ml)

 

The amove means that each day you would prepare 75ml of liquid (with a 0.5mg tablet), and 28ml would equate to your start dose of 0.1875mg. So, 27ml (from 75ml) would be the first small cut from your start dose. You would reduce your dose by 1ml each day.

 

Hope this helps. ;)

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Hi Colin,

 

Thanks so much for planning all that out for me.  I so much appreciate you and everyone here!!! 

 

Just so I'm clear, if I start titration with my current dose at .3125, it would be 50 days to be off.  I was surprised it would be that long, but I guess that's the easiest to handle the withdrawals. Slow and Steady.

 

Like I said, thank you so much for everything!!

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Hi Misa,

 

No, 50 days was purely an example. Decide upon the number of days, and replace the "50" with your number of days in the formula.

 

So, in the first example, if we instead decide upon a 35 day taper, it would change from:

 

0.5 (the tablet dose)

50 days (the length of taper)

0.3125mg (present dose)

 

0.5/0.3125 = 1.6

 

1.6 x 50 = 80

 

The amove means that each day you would prepare 80ml of liquid (with a 0.5mg tablet), and 50ml would equate to your present dose of 0.3125mg. So, 49ml (from 80ml) would be the first small cut from your present dose. You would reduce your dose by 1ml each day.

 

to:

 

0.5 (the tablet dose)

35 days (the length of taper)

0.3125mg (present dose)

 

0.5(tablet dose)/0.3125(start dose) = 1.6

 

1.6 x 35(number of days) = 56(volume of liquid in ml)

 

The amove means that each day you would prepare 56ml of liquid (with a 0.5mg tablet), and 35ml would equate to your present dose of 0.3125mg. So, 34ml (from 56ml) would be the first small cut from your present dose. You would reduce your dose by 1ml each day.

 

If you use a full tablet to make up your liquid (this will improve accuracy), only a proportion of the total volume of liquid will equate to your dose at the time of starting titration. This is what the formual is used to determin. If you let me know your start dose, and how long you would like your taper to last, I'll work up the numbers for you. ;)

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Hi Colin,

 

I just received the cylinder today, so I'm eager to start titration soon.  However, (and I know this is all psychological), I really don't want to use the whole .5 mg tablet.  So - Where I'm almost at .25 mg and where I can cut that mark fairly accurate because of the line on the tablet. When I get to that point, based on length of taper at 30 days.  I could use the .25 dose, fill to the 30 ml mark and just reduce by 1 ml per day.  Would that work? 

 

Thanks for your help and I hope you understand.  Even though I know I'll be removing the other half, it just scares me to use that whole pill.

 

misa

 

 

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Hi Misa,

 

Using a whole pill is more accurate. Do you have plenty of tablets? An alternative route would be to make 60ml with a whole crushed 0.5mg tablet, and make the liquid last two days. This is more accurate, wastes no more pills than using 0.25mg (half-tablet) with 30ml of liquid per day, and might well satisfy your psychological need to use 0.25mg per day. Simply make up 60ml, drink 29ml one the 1st day, and 28ml on the 2nd. Make up a new batch of 60ml (ahaion with a 0.5mg pill), and drink 27ml on the 3rd day, and 26ml on the 4th. And so on.

 

The only other thing to decide is how long you wish to take to taper off 0.25mg clonazepam. 30 days sounds plenty to me. Most of our (non-titrating) members would reduce from 0.25mg clonazepam in two 0.125mg steps, each step lasting 1-2 weeks, so your plan fits within what most people do in your position.

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Colin,

 

Thank you!!  I think I will do what you suggested - making the 60 ml for a 2 day use using the whole .5 mg tablet!  I'll shoot for the 30 days too!  Hopefully it will go smoothly!

 

Thanks again !! You're terrific !!

 

Misa

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