questions about Klonopin taper 0.5mg

Hello. [repost of introduction, but questions applicable here]

My story with Benzos began innocuously with a General MD prescription.  At the time, I was married to a Sociopath and I was stressed out all the time.  I was prescribed Klonopin and took as needed from about 2008 till this year.  I went periods without taking any, but always came back.  My dose was always 0.5mg.  I probably averaged about 3 doses/pills per week for most of those 10 years.  It was generally very effective for a window of 2-6 hours, but I experienced a range of symptoms due to not keeping a constant amount in my system, at times completely leaving my bloodstream.  I took it as needed (as directed), meaning I never took it daily, until this year.  This year a therapist suggested for me to stop struggling and take more of the drug.  I talked to my NP Physiatrist about it and he reluctantly agreed.  0.5mg everyday. 

 

For 2 solid months, I felt that all my problems were solved.  No more highs and lows.  Lowered stress and very positive.  That changed after about 2.5 months. 

 

After a bit over 3 months, I've found the dose is no longer effective.  Sometimes I increase the dose and it isn't working as well either. 

It seems that I have built up a tolerance and the 0.5 daily is no longer effective.  I am now experiencing everyday my usual symptoms when things are bad- increased anxiety, negative thoughts, redness of skin (neck), and sometimes prickling in the same area- these last 2 causing the most distress.  Its very uncomfortable and causes a lot of negativity/frustration.

 

I am determined to come off of it in 2019.  I bought a 100mL cylinder and 10mL syringes to start titration.  My plan is to use whole (organic) milk. 100 days.  This is somewhat faster than the recommended...Ashton recommends tapering no more than 5-10% every 2-4 weeks.  While this is a general rule, I don't think the same math need apply to both situations: a person taking 5mg/day and another 0.5mg/day.  Even 2mg/day is 4x the quantity of 0.5mg.  Correct me if I'm wrong.

 

I have a meeting with the NP in 2 weeks to review my taper plan.  But he really doesn't understand what I go through, and he hadn't even heard of the Ashton Manual.  He suggested previously on my low dose I could just stop without much problems.  I think he is wrong.  My main questions are 1) should I start immediately - therapists say winter is bad time to do med changes...but what i have is not working 2) Should I increase the dose before starting so that I get symptoms back under control 3) Is my taper schedule of 100 days too fast  4) It isn't so convenient to dose twice a day with titration method, is this necessary on a 100 day schedule, or what other things do you recommend?

 

Your help will be so valuable!  2019 is my year to break free of this awful dependence.

Great plan! Start as soon as you can and be done in 100 days... wish I had done that.  I know you are feeling some mild symptoms but just be prepared for more discomfort and ACCEPT this healing process. Doing a great thing for your health! I bet you will notice some things improve that you weren’t even aware of ...  but slow and steady wins this race for sure. 

Thank you Leslie J!  So I'm assuming the general consensus is don't increase the dose before starting the taper?  Do you have any thoughts?

So you are currently taking 0.5mg daily and have only occasionally taken higher doses? If this is the case it would seem like upping your daily dose would be counterintuitive. Particularly if, like you said, taking a higher dose doesn't seem to resolve your symptoms.

Update:  I'm on day 22 (dose = 0.225mg) of a planned 40 day taper off 0.5mg Klonopin with liquid titration (2.5%/day).  The first half went much smoother than expected, my symptoms ranged from 2 (mostly) to 4.  Just 2 days ago at 50%, 0.25mg, I felt pretty good.  Today I'm at a 4 and now that I'm at less than 50% dose, wondering if worsening symptoms is just something to deal with? 

 

Since the first half went well, do you recommend continuing on or slowing the taper?  Should I jump back to 0.25mg until the symptoms go back ?  (I feel like that is defeating the purpose / progress, but maybe it is necessary. ) 

 

Note:  I met with Dr 2 days ago and he said this taper is only physciological, that I could do a faster taper and just cut the pills...i.e.. 0.5, 0.25, 0.  I don't buy it and believe it the taper is working.

 

Don't go back up if your symptoms are only at a 4. Maybe hold at your current dose for a week and see how you feel? I found that certain withdrawal symptoms pop up about 4-7 days after a cut, but some can take weeks to appear. For this reason, sometimes a hold is helpful to find out where you really are.

Update:  I'm on day 22 (dose = 0.225mg) of a planned 40 day taper off 0.5mg Klonopin with liquid titration (2.5%/day).  The first half went much smoother than expected, my symptoms ranged from 2 (mostly) to 4.  Just 2 days ago at 50%, 0.25mg, I felt pretty good.  Today I'm at a 4 and now that I'm at less than 50% dose, wondering if worsening symptoms is just something to deal with? 

 

Since the first half went well, do you recommend continuing on or slowing the taper?  Should I jump back to 0.25mg until the symptoms go back ?  (I feel like that is defeating the purpose / progress, but maybe it is necessary. ) 

 

Note:  I met with Dr 2 days ago and he said this taper is only physciological, that I could do a faster taper and just cut the pills...i.e.. 0.5, 0.25, 0.  I don't buy it and believe it the taper is working.

 

It's a good idea to taper based on how you feel, rather than timelines and percentages. One if the advantages of using liquid to taper is that you can accurately change your cut amount, based on how you feel. For some, they need to slow down the lower they go, for others, they can stay at the same rate. Listening to your body will answer your question best. Good luck.