Titration help in general thoughts

I have a quick question for anyone out there I'm on 40 mg of Klonopin I take two doses during the day one in the morning one in the afternoon and I take that as a pill form I am titrating my night time dose. If I take 20 of my pills add 40 Noah leaders of propylene glycol and 160 mL of water that makes a ratio of .1 to 1 ml then I can reduce from there anyone have any experience with titrating this way versus the milk method. I find it hard An Inconvenient to carry milk around but right now I'm only doing night time so it might be plausible just trying to Hash this out before I begin

I have a quick question for anyone out there I'm on 40 mg of Klonopin I take two doses during the day one in the morning one in the afternoon and I take that as a pill form I am titrating my night time dose. If I take 20 of my pills add 40 Noah leaders of propylene glycol and 160 mL of water that makes a ratio of .1 to 1 ml then I can reduce from there anyone have any experience with titrating this way versus the milk method. I find it hard An Inconvenient to carry milk around but right now I'm only doing night time so it might be plausible just trying to Hash this out before I begin

 

1mg:2ml PG:80ml water is probably the most common method for liquid tapering.  So you ratios are correct: 20mg + 40ml PG + 16o ml water = .1mg per ml.

And if I wanted to titrate 5% a month I would remove .002 or am I way off I use the calculator that was online for that one

First I need you to verify/clarify some of your numbers.

 

You say your taking 40mg of  K.  That's 800mg Valium equivalent.  I really don't believe that.  I've been here on BB for a while, and seen a few folks o pretty high doses, but nothing anywhere near that.

 

So, 1)  What size are your pills and how many do you take and 2) how many mls of your .1mg per ml liquid do you take?

 

And BTW, 5% of 40mgs would be 2mg, or .2ml of your .1mg/ml liquid.

 

I suspect your maybe on 4mg?

 

Hi Sully0979

 

I've been in this BB for 6 months and the highest dose of Klonopin I happened to read is 2mg/day. It's actually 4 times what I took during 3.5 years. I suspect the dose in your case is rather 4mg/day, made of 4 x 1mg pills. But feel free to correct me if I'm wrong.

 

Besides that, I understand that you wish to taper 5%/month. While I can see you really want to go slow to avoid rough withdrawal symptoms, I also learnt that the recommendations are to reduce the daily dose by somewhere between 5% and 10% every 10-14 days. Of course it remains a rule of thumb but otherwise to get rid of 4mg/day of Klonopin will take you years giving chance to benzo to remain long time in your body.

 

Wish you a good start and a smooth journey towards a full recovery.

I'm sorry that's a typo it should be for mg I apologize I didn't realize it said that I want to go down by 5% a month so would I remove point to does that sound right thank you for all your help guys

I had to have five discs fused in my neck that's why I want to go so slow doing all the physical therapy and everything that comes with that is going to be hard while my Dr is making me come off of 4 mg of Klonopin. I am at 19 ml right now and want to reduce 5% every two weeks or so

I had to have five discs fused in my neck that's why I want to go so slow doing all the physical therapy and everything that comes with that is going to be hard while my Dr is making me come off of 4 mg of Klonopin. I am at 19 ml right now and want to reduce 5% every two weeks or so

 

OK, to make sure we're using the same data...you're currently at 3.9mg K, 2mg tablets +1.9mg (19ml) dissolved liquid.

 

5% X 3.9mg = .195mg  2 week reduction

.195mg/ 14 days = .0139mg/day  (round up to .015mg/day) daily reduction

 

Your schedule would be:

 

2mg tablets    1.9mg (19ml) liquid

2mg tablets    1.885mg (18.85ml) liquid

2mg tablets    1.87mg (18.7ml) liquid

2mg tablets    1.855mg (18.55ml) liquid

etc...

 

Just reduce your liquid portion by .015mg (.15ml) each day.

 

Exactly Builder thank you so much for all your help I fully understand now I appreciate everything you've done for me

Hi,

 

I hope I do not raise additional confusion with the following considerations. If it was the case, just ignore the post.

 

By following the reduction of 5% every 14 days starting from the current 3.9mg of Klonopin, we drop 0.195mg every 14 days (5% X 3.9mg = .195mg). A calculation shows that the symbolic doses of:

- 3mg will be reached after 1.5 months

- 2mg will be reached after 3 months

- 1mg will be reached after 6.5 months

 

If we keep the reduction percentage of 0.195mg (every 14 days) fixed during the entire taper period (about 2 years), the resulting reduction percentage will vary as the starting dose has changed meanwhile. Actually, when we are at:

- 3mg: the reduction percentage becomes 6.5% (0.195/3)

- 2mg: the reduction percentage becomes 9.75% (0.195/2)

- 1mg: the reduction percentage becomes 19.5% (0.195/1)

 

While I don't think there's a problem with 6.5% or 9.75% reduction, perhaps 19.5% could be a little bit high? Starting from the 4th month this ratio will exceed the symbolic 10% (if it means anything!) and steadily increases over the time along with the diminution of the daily dose.

 

While I think that having a fixed amount to decrease is immensely simple to understand and to apply, a periodic reassessment would be perhaps useful to adapt the reduction dose (Eg. every 3 months).

 

A daily micro taper, like all tapers, should be symptom based.  Your progress needs to be controlled by your response.

 

Unlike a cut-and hold taper, you will not get slammed with sxs with a daily taper.  Sxs, is any, will emerge gradually and you will be able to respond to avoid any significant discomfort.

 

The general advice is continue with a taper rate as long as there are no significant sxs.  If significant sxs begin to emerge, you can hold and/or change your taper rate.

Hi Builder,

 

Thanks. I can see your point. That makes sense.

 

I personally would reduce on a daily basis keeping unchanged the reduction percentage to 5% (over 14 days) until otherwise decided. The reason is that in Ashton Manual, I understand the recommended reduction is in terms of percent/time and this is spread in this BB as the rule of "reduce the daily dose by somewhere between 5% and 10% every 10-14 days".

 

The calculation I've sent in previous post was bugged (reference to a residual column)! I apologize. Here is the corrected version if it can be of interest to anybody. Its purpose was not meant for cut&hold practice. It is to provide a global view of the withdrawal timetable so the patient knows exactly where he/she is in the journey.