Short term user of clonazepam getting conflicting advice from 2 docs

Hi there,

I was started on Lexapro in March for GAD and given Xanax .25/ 2x per day while adjusting to the Lexapro.  I was afraid to take the Xanax, so I didn't begin taking them until April.  They gave me severe interdose withdrawal at 24 hours between doses. Between 4/7 - 5/10 I took a total of .5 Xanax, 25 times in total.  My psychiatrist then had me discontinue Lexapro over a three day period.  I ended up in the ER with suicidal ideation.  I was then switched to Clonazepam at .25/ 2x per day and 12.5 Seroquel and 7.5 Remeron were added.  That was on 5/11/18.

I am attempting to discontinue the clonazepam that was started 5/11 and have reduced to .375 per day, held for a week.  I'm now at .25 per day (taking quarters of the .5 pill, 2x per day, 12 hours apart.)

I went to a new psychiatric practitioner affiliated with the ER I went to, and he said to keep this dose (.25 per day) for a week and then stop based on my short time use.  My regular psychiatrist thinks things can be stopped in three days...hence the rapid Lex taper.

Question: because I have only been on benzos since 4/7/18 at these doses, am I doing the right thing by quickly tapering and stopping?  Certainly I don't need to follow the Ashton protocol to get off of the clonazepam? 

I plan to d/c the Remeron and seroquel over the next few months.  Any help or insight greatly appreciated.  I am in an extremely stressful period right now financially and socially.  Thank you so much for your help!

You poor thing, that's a ton of drugs in a short time. I've been on all of those at some point except the seroquel and xanax. Without knowing your history and your other resources it is hard to know what to recommend. Do you think the seroquel and remeron are helping you? Maybe not since you say you already want to taper off those? Based on what happened to me, in the absence of any other information, I would stop the remeron and seroquel first (fairly rapidly), then taper the klonopin somewhat gradually. That's assuming that the GAD you started with was mild and the more severe symptoms were due to starting and stopping the lexapro. If that's the case then all these drugs seems like overkill. If you want to keep the remeron and seroquel, then I would suggest holding everything steady for another two weeks, then reducing to 0.125 K for two weeks, then trying to stop that. While waiting to taper you could work on making sure your non-medical support systems (friends/family, exercise, meditation, healthy diet) are in place to support you as you make this difficult transition.

Take care,

JKS

Thank you so much for replying JustKeepSwimming.

The GAD I started with is severe.  It is situational, and I don't see it letting up anytime soon.  I know that benzos are a band aid and I have to get off.  I have severe insomnia and I have lost 24 lbs since January 2.

So the 0.125 clonazepam I move to after a week here at .25 ...you think I should keep for two weeks?  Not one and then jump given that I have only been on clonazepam since May 11?

I have a fairly good support system but I am leaning on them too much, I fear.

I recommend you feel your way forward with the taper. If you go down to 0.125 and feel fine then you don’t have to hold two weeks. If it’s rough then maybe hold longer and do a smaller reduction next time.

Good luck,

JKS