Clonazapam 1mg taper plan

I'm very new here and need advice. I'd like to develop a slow taper plan. I take clonazapam in 3 divided doses. I take .25 mg at 10am, .25mg at 4pm and .5mg at 10 pm., a total of 1 mg per day. I’m scared to death to begin with, but am in tolerance right now. My doc up dosed me .25mg for 12 days, then I dropped that dose and went back to 1mg per day in my divided doses as before. How can I make a plan where I can mix my total 1mg per day into 3 divided doses and come up with a slow taper plan? I'd like 3 exact doses. Saw a video about mixing med in 300ml water, pour into three small containers for the day. Was told to try this for 10 days before I begin my taper. After holding for 10 days, how much would I withdraw of the liquid for a slow taper, as I am very sensitive to these meds. I’m feeling horrible being 2 wks out from the recent up then down. Can I use water in this amount? Or only milk? Any help would be appreciated. I see my docs this week to discuss, but being a primary care doc, I’m sure she has no clue. I see my psychiatrist the beginning of November and am afraid he’ll just want me to cut pills. HELP ,

Water will not work, full fat homogeneous milk will. I would wait 2 - 3 weeks to acclimate to this dosing method, 3 divided doses a day will help to keep benzo levels even.

 

1mg K w/100 Mls milk will work. You can create a more dilute emulsion if you wish to, just double or triple the milk and subsequent numbers above & below.

 

Example after your acclimation period:

1mg K -100 mls milk =remove .1ml/.01mg day 1

  "            "                remove .2ml/.02mg day 2

  "            "                remove .3ml/.03mg day 3, etc..

After each days removal, you would then divide them in to your 3 doses.

 

With that example, you start with a conservative cut rate, after 2 weeks and if you feel little to no symptoms, double the removal amount, repeat until you reach your max removal rate cut without increasing symptoms. This could be your first, second or third rate cut, your body will let you know.

 

Always rinse your prep and dosing jars and drink, rinse your oral syringes and keep them in the fridge. Make your batch(s) the day before for the next day, shaken gently a couple of times while they're in the fridge.

 

Avoid msg, caffeine, smoking, eating clean is best.

 

Hope that helps.

Thank you ! Is this a slow enough taper for sensitive med people? Do people hold for awhile if they start having symptoms? I also smoke and don’t think I could stop that too. I have more questions, but haven’t seen my docs to let them know I’m doing this. Can I respond back to you?

You can hold as you feel necessary, it is your taper and you should control it.

 

About the smoking, I am not going to tell you to stop, I understand.

 

In the examples given, if you reduced .1mL/.01mg every day from the ratio of 1mg K in 100 MLS milk, it would take you 1000 days. I am not saying it will take that long, and I am not saying it will not take longer, there is no way to predict. The best taper, IMO, is a slow, symptom based one using a liquid preparation with fractional cuts. During your taper, you can increase or decrease the cut rate as you see fit, it is your taper.

 

My doctor doesn't care how I taper nor understand, all I need them for is the medication.

 

Good luck.

 

 

I don’t understand what second, third cut rate means.

 

Hello, Gerbera.  Apologies in advance to NoremoreKP for jumping in with a question, but I’m guessing she would like to know the answer as well.

 

Based on multiple credible sources indicating that clonazepam has very low solubility in water, I agree that water alone is probably not a good choice if one decides to make a “homemade” liquid.

 

Unfortunately, I haven’t found much about the solubility of clonazepam in whole fat, homogenized milk. I have learned that homogenized milk is indeed an emulsion (i.e., milk fat globules are reduced in size and dispersed uniformly throughout the milk), but I haven’t found any research about what happens to the active drug substance in a regular clonazepam tablet when it is placed in whole fat, homogenized milk.  The tablet itself disintegrates, but does the active drug substance actually dissolve? Or does it form a suspension?  Something else? 

 

It sounds like you have access to research/studies/information on this topic!  Would you be willing to share these with us? Thank you in advance for your help.

 

Here: https://benzo.org.uk/ashanswer.htm

 

Question: Is the Post-Withdrawal Syndrome caused by benzodiazepines being "locked up" in tissues for years or is it the result of brain damage occasioned by long-term benzodiazepine use?

 

Answer: Benzodiazepines are fat soluble and do enter fatty tissues including the brain. But these tissues are in equilibrium with the blood, so that if the concentration in the blood is lower than that in fat, some will come out of the fat and re-enter the blood where it is metabolised and excreted. This will again lower the blood concentration, so more will leach out of the fat, and so on. So the body is more or less cleared, even of long half-life benzodiazepines, within 30 days. There is no evidence that benzodiazepines are "locked up" in tissues for years. I have looked into this question with an expert pharmacologist, Dr Clare Stamford of University College in London. There is a reference to this in the Manual (Chapter III, pp 33/34 in the UK version).

 

Long-term effects of benzodiazepines that persist after withdrawal are largely due to changes they have caused in GABA/benzodiazepine receptors, and not due to bits of drug being retained in the body. Of course lots of other factors, like post-traumatic stress disorder in people who have had a traumatic withdrawal experience, may also be operative in different individuals.

 

When writing the Manual I did attempt to find out from many sources, including Roche, whether anyone had measured benzodiazepine concentrations in tissues after withdrawal, even in animals. The answer was no. There was one post mortem study in geriatrics which found a surprisingly high concentration of benzodiazepines in muscles. But these were bedridden old people and there was no record of the doses of benzodiazepines they were taking or not taking before they died. Dr Clare Stamford at the University College in London, who has done a lot of rat benzodiazepine work, said that it was most unlikely that benzodiazepines could be sequestered for long periods of time in tissues as these are in equilibrium with blood and continually washed out.

 

Benzodiazepines are not known to be chemically bound anywhere like some metals – so it comes down to receptor changes that are only slowly reversible. The complete alleviation of long term symptoms with the benzodiazepine antagonist flumazenil seems to point in this direction (also mentioned in Chap III of the Manual). You could still get windows if your receptors were unstable, switching from one state to another. A similar thing, involving other receptors, is thought to account for rapid swings between mania and depression in so-called bipolar patients. You could call receptor changes brain damage if you wanted to, but I think they are reversible or potentially reversible; probably with receptors in different areas reversing at different rates, and some more readily than others.

 

The question of permanent damage is discussed in "Protracted withdrawal from benzodiazepines: The post-withdrawal syndrome" Psychiatric Annals 25, 174-179. This article is available here. The article clearly states that the evidence about permanent (structural) brain damage due to benzodiazepines is equivocal and there is at present no definite proof of this although some evidence is suggestive. However, occasionally people do have "withdrawal" symptoms which appear to be permanent and may persist till death. This has been reported in the medical literature by others and also observed by myself.

 

 

If Ashton said it, it must be true.

 

Your "gotcha" tactic didn't work. Anyone with half functioning brain cells can see what "the team/former team" is doing.

I don’t understand what second, third cut rate means.

 

All that means is if you wish to increase your cut rate from your initial first cut rate, you'd go to your second cut rate, then third, that is all. You never need to increase it, or you can increase it then decrease it, it is all up to you and how you feel.

 

Sorry if it confused you, wasn't my intention.

 

How and when do you decide to do a cut rate? I have no clue how this works...

I’m still not understanding this taper plan. Can someone Please help me ?

Hi there,

 

I'm tapering off klonopin as well.  I too am a poor metabolizer.

 

Keep in mind:

 

1.  The only rule is what works for you.  Tapering rates, are going to be different for everyone. 

2.  SLOW AND LOW - this is a marathon, not a sprint.  Think turtles.

3.  See rule #1

 

 

When I started, I decided to start with a 2% cut (reduction), "cut and hold" (meaning I hold that taper until I feel that my body is ready for the next) from my daily dose to see how I reacted.  Why 2%  - I just pulled that number out of the air.    I had started with doing a "dry" cut using a jewelry scale to shave off 2% of each dose.  What a pain. 

 

I went to liquid because it is much more accurate - with shaving off each pill, you don't actually know how much is filler, medication, etc.  With liquid, all the medication is dissolved. 

 

And let me tell you, I screwed up on my first solution and didn't do the maths properly on the ratio, so had to adjust (see my post on my fail, lol).  But, folks here helped me through that - and it wasn't as bad as I thought.

 

The liquid is more intimidating at first, but more accurate.  The scale is less intimidating, but less accurate.

 

And because there are a lot of ways to do this and not one "here's how to do all the things and why" place, it's daunting.  And there aren't a lot of dr's out there that really understand what we've got to do. 

 

And there will be some experimentation.  I changed my dosing to be more even doses throughout the day bc I had noticed that my highest doses were at night and in the morning, and I was having trouble in the afternoon. 

 

Hope this helps!

BB

Hi there,

 

I'm tapering off klonopin as well. I too am a poor metabolizer.

 

hey BB how do you find out if you're a poor metabolizer? did you do a test or find out some other way? what sxs does it show if you are?

Hi there,

 

I'm tapering off klonopin as well. I too am a poor metabolizer.

 

hey BB how do you find out if you're a poor metabolizer? did you do a test or find out some other way? what sxs does it show if you are?

 

There is a lab test:  you can do a search on "poor metabolizer" for more information.

 

You said you were "sensitive" to medications (and I am assuming you meant psychiatric medications).  That is saying you are a poor metabolizer.  I know that I am bc I respond really well and need less of the regular doses.

 

If you are looking to taper, I personally think it doesn't hurt to start off with a smaller percentage to see how you will react to withdrawal bc it is different for everyone.  There are others who have been helping others (and doing this for years) for years, and they may have different opinions. 

Nomorekp,

 

I used the water titration method to successfully taper from 1 mg clonazepam.  I have been benzo free for four years now.  The method I used is explained and there are links from my story that is linked in my signature below.

Hi there,

 

I'm tapering off klonopin as well. I too am a poor metabolizer.

 

hey BB how do you find out if you're a poor metabolizer? did you do a test or find out some other way? what sxs does it show if you are?

 

There is a lab test:  you can do a search on "poor metabolizer" for more information.

 

You said you were "sensitive" to medications (and I am assuming you meant psychiatric medications).  That is saying you are a poor metabolizer.  I know that I am bc I respond really well and need less of the regular doses.

 

If you are looking to taper, I personally think it doesn't hurt to start off with a smaller percentage to see how you will react to withdrawal bc it is different for everyone.  There are others who have been helping others (and doing this for years) for years, and they may have different opinions.

 

thanks BB!

 

i have been notorious for having adverse reactions, most of the listed side effects and many of the rarely reported side effects for most of the drugs (psychoactive and "regular") for my whole life. this has been known to me, but when i tell dr's they would just laugh it off as  "she's crazy, one of those high maintenance patients" so i quit telling them. now in the light of thsis "new" information, my reactions to drugs make a whole lot of sense! i'm  NOIT crazy or imagining things and yes i'm a high maintenance patient because my damned symptons are a direct result of my metabolism/metaboliozation or lack thereof which is genetic! i need to get that pharmacogenomic/genetic testing done so i can show the drs what they've been gaslighting me about once and for all.

Nope!  Not crazy at all!

I buy into these tests.....to a degree.  I have always had horrible adverse reactions to meds also.  And apparently, I am an U/R metabolizer for the CYP2C19 enzyme, which WOULD explain why I always got horrid SX to SSRIs in the beginning of starting them.  But with other meds that I was a normal metabolizer for, and this includes Klonopin, I STILL think I am an U/R metabolizer and had/have adverse reactions.  I truly think that my whole CNS just does not like this stuff and I metabolize stuff poorly no matter what the drug....and I would just guess that there are others out there that are very similar to me.  When I was at Mayo, and met with someone in psychiatry there, some of them believe in the genetic testings and others not.  They said there's a LONG way to go with it.  And my own stupid psychiatrist, who got me into this horrid mess, had me get the tests to begin with (for which I paid $400), and bought into this originally completely, then told me many months later that he was finding it wasn't so accurate. 

 

There are many other factors involved - just metabolism in general, tolerance, nervous system, etc. 

I buy into these tests.....to a degree.  I have always had horrible adverse reactions to meds also.  And apparently, I am an U/R metabolizer for the CYP2C19 enzyme, which WOULD explain why I always got horrid SX to SSRIs in the beginning of starting them.  But with other meds that I was a normal metabolizer for, and this includes Klonopin, I STILL think I am an U/R metabolizer and had/have adverse reactions. I truly think that my whole CNS just does not like this stuff and I metabolize stuff poorly no matter what the drug....and I would just guess that there are others out there that are very similar to me.  When I was at Mayo, and met with someone in psychiatry there, some of them believe in the genetic testings and others not.  They said there's a LONG way to go with it.  And my own stupid psychiatrist, who got me into this horrid mess, had me get the tests to begin with (for which I paid $400), and bought into this originally completely, then told me many months later that he was finding it wasn't so accurate. 

 

There are many other factors involved - just metabolism in general, tolerance, nervous system, etc.

I have been DLMT with water to decrease my bedtime dose from .5 mg to .25 mg. I’m at day 65 of a 75 day taper to achieve this. When I’m at 3 equal doses of .25mg, I  dose 3 times a day currently, I need a very detailed taper plan the rest of the way. Can someone help me with this? I’ve been told by a previous group to begin with 300 ml of water, I don’t tolerate too much dairy and want the portability of water, removing 1 ml each day and so forth. It would be nice to not have to use that much liquid. The %rate is just under 7% right now. I’m tolerating this without too many holds. I’m in tolerance and maybe will feel better the lower I go? I have many health issues, age 64 and I’m on many meds, no other AD or benzos, including blood thinners. Not sure if I’d be able to use alcohol mixing my med “potion”. Any suggestions or help would be much appreciated. Are your taper plans 10 months?

Thank you so much !

Hello, NomoreKP.

 

Here’s an infobit and a question ...

 

If you are in the US, clonazepam is available in 0.125mg Orally Disintegrating Tablets. 

 

Have you considered using a professionally compounded suspension of clonazepam to taper?

I do not have a compounding pharmacy available to me. The smallest tablets available are .5 mg. Can a builder contact me regarding a plan?

I started with a compounding pharmacy and am at .4 mg of clonazepam. I am trying to make a schedule that reduces by 10% of my last dose per month. Does anyone have a formula or calculator for this? THANKS.

 

I started with a compounding pharmacy and am at .4 mg of clonazepam. I am trying to make a schedule that reduces by 10% of my last dose per month. Does anyone have a formula or calculator for this? THANKS.

 

Hi 52andforward,

 

Here is a link to the direct taper board, if you'll start a new thread with your question it will make it easier for members to help you.  Just click on the link, hit New Topic on the upper right of the page, put in a subject title, ask your question in the body and hit post. 

 

http://www.benzobuddies.org/forum/index.php?board=56.0

 

Pamster

Designing a taper with a goal of reducing 10% per month is very easy.  Simply multiply the dose you're currently taking by 0.9 to calculate the dose for the following month.  Do that calculation each month.

 

You didn't indicate your starting dose volume.  Whatever that volume is, you'd simply multiply that volume times 0.9 to give your dose for the second month.  For example, if you were taking 50 ml the first month, you'd take 50 ml * 0.9 = 45 ml the second month.  For the third month, multiply the 2nd month dose times 0.9.  Again, if you were taking 45 ml the second month, you'd take 45 * 0.9 = 40.5 ml the third month.

 

Hope this makes sense.

I started with a compounding pharmacy and am at .4 mg of clonazepam. I am trying to make a schedule that reduces by 10% of my last dose per month. Does anyone have a formula or calculator for this? THANKS.

 

Here is a sample taper made with this calculator. It is easy to work with. Let us know if you need any more help

NoMoreKP ...

 

I use this plan and it figures it all out for you after you plug in the parameters.  It's what I needed to simplify things.  After you click on Liquid Taper, be sure to read under the Readme First tab at the bottom right hand corner.

 

http://benzo.alwaysdata.net/