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Discussion: Titration Schedules


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Hi all,

 

The following references milliliters (so, applies directly to liquids), but it mostly may be applied to powders too.

 

To be frank, I am not appraised with the various methods employed on these boards for creating schedules. Many years ago, I used a spreadsheet and other software to produce HTML tables from generated spreadsheet data. When I became less involved, I had to stop doing this for members. But the reality is that although a spreadsheet/table might be nice to have, it is far from a necessity. More ad hoc systems can work just as well.

 

It seems to me that producing schedules to particular taper rate might not be very straightforward, unlike my old spreadsheet which would generate the numbers from any desired reduction (as a percentage) spread over however many days required, and would round then numbers to the nearest ml or what ever scale was desired. It was completely adaptable. It just wasn't available to members to do for themselves.

 

The problem with the formulas and methods that I have seen is that they do not fit very well with desired taper rates. It is not easy to compare one schedule with another. Alternatively, we might use a formula which fits an overall taper rate very nicely, but the generated numbers do not fit into nice, discrete increments (not in full milliliters or multiples thereof).

 

So, instead of working the premise of creating set volume of liquid, we instead let the volume of liquid be dictated by the desired taper rate and the number of days for the desired reduction. Let's assume that members tend to use 100ml cylinders. This does not mean that they need to produce 100ml of liquid. This is formula/method I propose.

 

P = Desired percentage cut to dose

N = Number of days over which the reduction takes place

V = Total volume

A = Amount number of tablets (or dose) being titrated

T = Total number of tablets (or dose) taken per day

 

Simple version (for those using a single pill for all of their daily dose).

 

Formula:

 

N x (100/P) = V

 

Example 1:

P=10

N=14

 

14 x (100/10) = 140ml

 

The above means that the amount consumes from the total volume of of 140ml is reduced by 1ml per day.

 

Since 140ml is larger than the cylinder being used, we'd divide 140ml by 2 (70ml) and instead reduce dosage of 1ml every 2 days. 140 daily decrements of 1ml are equal to 70 every two-day decrements of 1ml. Both take 14 days to complete. So, to be clear, just make up 70ml of liquid and reduce by 1ml every 2 days.

 

Example 2:

 

P=6

N=10

 

10 x (100/6) = 166.7ml

 

Example 3:

 

Titrating 1 pill from a total daily dose of 3 pills.

 

N x (100/P) x (A/T) = V

 

P=8 percent

N=14 days

A=1 pill titrated

T=3 pills total dose

 

14 x (100/8) x (1/3) = 58.3ml

 

Example 4:

 

Daily dose consists of (1 x 5mg) + (2 x 2mg) pills (total of 9mg). A single 2mg pill from the daily dose is titrated.

 

N x (100/P) x (A/T) = V

 

P=10 percent

N=15 days

A=2 milligrams

T=9 milligrams

 

15 x (100/10) x (2/9) = 33.3ml

 

In all of the above cases, you would simply round to the nearest convenient number - this will be you total volume each day.

 

If the volume is too large or too small for your measuring equipment, increase or decrease the volume by a convenient factor. 33.3ml might be multiplied by 3 for a total volume of 100ml. To compensate, instead of decreasing the volume consumed each day by 1ml, you would instead decrease by 3ml each day. In both cases it will take 33 days to reach zero.

 

If the volume of liquid too great, then divide it by a convenient factor. If the total is 166.7ml, and you use a 100ml cylinder, divide by 2, for total volume of 83.3ml. To compensate, instead of reducing the amount consumed by 1ml per day, you would instead reduce the volume consumed by 1ml every 2 days. And let's round this to a convenient daily total volume of liquid of 83ml. In both cases, it will take 166 days to titrate the tablet.

 


 

The above is a rough, first draft outline of the idea. It does not involve any intermediate steps which might be employed in a particular method (the how-to of making a liquid) - it does not need to. It merely attempts a method for creating total volume which easily relates to any desired taper rate. Does it make sense to you all? How might it be improved and/or made more clear? Any other thoughts?

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This probably would work better as small coded utility. That way, with a little extra code, it could even take account of the size of measuring cylinder utilities, size of desired decrements (no point in producing a schedule for 1ml decrements if the cylinder is marked only every 5ml, and 5ml (or eyeballing 2.5ml) is good enough).

 

My point is that the above is me explaining the rationale. A formula (or better, a utility/app) would be a lot more straightforward. No spreadsheet required. Just keep a note of the start date and the previous dose and date of each change (so that you do not forget where you are in the taper).

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This probably would work better as small coded utility. That way, with a little extra code, it could even take account of the size of measuring cylinder utilities, size of desired decrements (no point in producing a schedule for 1ml decrements if the cylinder is marked only every 5ml, and 5ml (or eyeballing 2.5ml) is good enough).

 

My point is that the above is me explaining the rationale. A formula (or better, a utility/app) would be a lot more straightforward. No spreadsheet required. Just keep a note of the start date and the previous dose and date of each change (so that you do not forget where you are in the taper).

 

Oh ok...now your talking...a coded utility would be great, especially if a person was able to change inputs etc. (similar to "Jim hawks create your own" utility.) It would be helpful if the utility could create a suspension/solution too. The syringes do work well for those who are sensitive and do need to make tiny, accurate cuts. I know this is debatable but for those who are sensitive/fast metabolizers a 5ml reduction of a .10ml=1mg solution/suspension would most definitely be felt by some. I would imagine this would be even more pronounced with a fast acting benzo such a Xanax. Anyhow, present us with a utility and we will put it to the test :thumbsup:

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This probably would work better as small coded utility. That way, with a little extra code, it could even take account of the size of measuring cylinder utilities, size of desired decrements (no point in producing a schedule for 1ml decrements if the cylinder is marked only every 5ml, and 5ml (or eyeballing 2.5ml) is good enough).

 

My point is that the above is me explaining the rationale. A formula (or better, a utility/app) would be a lot more straightforward. No spreadsheet required. Just keep a note of the start date and the previous dose and date of each change (so that you do not forget where you are in the taper).

 

Oh ok...now your talking...a coded utility would be great, especially if a person was able to change inputs etc. (similar to "Jim hawks create your own" utility.) It would be helpful if the utility could create a suspension/solution too. The syringes do work well for those who are sensitive and do need to make tiny, accurate cuts. I know this is debatable but for those who are sensitive/fast metabolizers a 5ml reduction of a .10ml=1mg solution/suspension would most definitely be felt by some. I would imagine this would be even more pronounced with a fast acting benzo such a Xanax. Anyhow, present us with a utility and we will put it to the test :thumbsup:

 

Ah, well, there's the rub. I'm no coder. having said that, what I am proposing is so simple, I might have a stab at it.

 

All the above does is, instead of a set of instructions for creating a set volume, and this not being directly relatable to a specific taper rate, we instead chose the taper rate and the output is the volume of liquid we would crate each day. If we are reducing the dose consumed by 1ml per day, starting at 99ml would take three times as long to complete compared with starting at 99ml.

 

The inputs would be:

 

Desired cut (as a percentage)

Timescale for the above to take place (number of days)

Total dose or number of pills

Number of pills (or dose) being titrated

Size of cylinder

Size of each cut (this relates to the size of increments in ml marked on the cyilnder)

 

The outputs would be:

 

Volume of liquid we would create each day

The size of each decrement of dose

The frequency of each decrement

 

The reason for including information about the number/dose being cut against the total number of pills/dose, is that we should be making larger and/or more frequent decrements to a titrated dose when the liquid forms only part of our daily dose. Whereas when the whole dose is being titrated, we probably would make smaller and/or less frequents cuts to dose.

 

Because people should not be locked into a schedule, they can hold for additional days between cuts. However, what would be better is for them them to choose a new titration rate, plug in their present total daily volume and dose (amount consumed) into a second utility to inform them where to start on with the new schedule (equivalent dose form the new volume).

 

So, say they are down to 50ml (from a total volume of 80ml), the equivalent dose in their new schedule might be 30ml from 48ml, or 43.75 (which we would round to 43 or 44ml) from 70ml.

 

50/80 = 30/48 = 43.75/70

 

So, just a simple fraction applied to the new volume of liquid to indicate the equivalent starting dose as the starting point.

 

This should be very simple to use. And although it is extremely close to what I was doing with the spreadsheets (highly flexible), it fully places the responsibility where it should be, with the individual. What I did not like about producing the spreadsheets/tables was that I had to ensure to not make any mistakes in transcribing the desired taper rates, start dates, cylinder size, etc., from the member to the spreadsheet, then to software for converting the data into an HTML table, or some other mistake/error.

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Thinking about this, I will probably try working it up with a Google Docs spreadsheet. I think that will be able to handle anything I nned from it.
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Thank you for this info! I will ready carefully when I have a chance.

 

I see you mention 100ml cylinders. I don't use a cylinder to measure total volume, rather I use a 30ml syringe and draw up milk needed (30, 30, 30, 10 to make 100) and put that in a jar.

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[7d...]

Hi Coling!

Thanks for your efforts to improve the taper.

I didn't go that deep as far as the calculations and the mathematics of it but it seems to me that the method you lay out fits really well for foxs that mainly do DMLT  using water and have limitations as far as pills available and preservation issues that may occurred after 14 days. Obviously is not an issue for Direct taper. 

I've been using Jim hawk's program and it's been great. My doctor was impress when I showed the printed pdf sheet and the lay out of my taper plan. This is a very important issue when you have to convince your doctor of a more low pace taper and you need the pills to do it. As you know the majority don't agree on a very gradual taper. I wish and I say this with all respect that this program should be more promoted and handy to find in the BB site.

I'm using Ora plus and preservation is not an issue. It last more than a month and half and gives a good time margin of use till the next batch.

I'm very sure that the more taper plan alternatives we have the better will be for all of us.

Thanks

 

 

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Hi Coling!

Thanks for your efforts to improve the taper.

I didn't go that deep as far as the calculations and the mathematics of it but it seems to me that the method you lay out fits really well for foxs that mainly do DMLT  using water and have limitations as far as pills available and preservation issues that may occurred after 14 days. Obviously is not an issue for Direct taper. 

I've been using Jim hawk's program and it's been great. My doctor was impress when I showed the printed pdf sheet and the lay out of my taper plan. This is a very important issue when you have to convince your doctor of a more low pace taper and you need the pills to do it. As you know the majority don't agree on a very gradual taper. I wish and I say this with all respect that this program should be more promoted and handy to find in the BB site.

I'm using Ora plus and preservation is not an issue. It last more than a month and half and gives a good time margin of use till the next batch.

I'm very sure that the more taper plan alternatives we have the better will be for all of us.

Thanks

:thumbsup::)
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