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Klonopin Taper Going Awry


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I have been trying to get off Klonopin and am in bad withdrawals. I need help deciding where to go back up in dose, to start a "proper" taper. I'll try to explain my history as best as I can. I've been on Klonopin for not quite 3 years, first as a "PRN" dose of 1mg "as needed," which I took 1x/week for the first year or so. During this time, I tapered off of antidepressants. After my antidep. taper, I increased 1 mg. PRN to 2-3x/week (more anxiety after ADs were gone).

 

This past December, I tried to stop the Klonopin, figuring it was "only" PRN.  Haha, yeah right... I got so delirious and was staggering around and ended up at the hospital. At the hospital, they instituted me on 1mg. daily (instead of PRN), which was for about a week, then I was prescribed a lower dose of Klonipin (.5mg.) daily, which I took for about 6 weeks. I hated how I felt, so I've been trying to take .375 BUT the withdrawals are beyond the worst ever (see below).

 

I worry because the .375 actually seemed to be okay for the first day or two. Now it doesn't touch my withdrawal much at all. I assume I'm trying to come off way too fast, but I'm looking for advice on whether to updose back to 5 mg. and start microtapering from there.

 

In sum:

1 mg. PRN (1-2x/week) from about July 2017-July 2019

1 mg. PRN increased on average to 3-4x/week from July 2019-Jan. 2020

Put on 1 mg. daily for one week in Jan. 2020, then reduced by doc to:

.5mg daily began 1/23/20.

On my own, on 2/13/20, I tried a reduction from .5mg to .375 (daily then sporadic then daily again).

 

I am wondering if my horrid withdrawals are residual from going from 1mg. down to .5 mg. six weeks ago, or from .5 down to .375 a couple of weeks ago. I heard sometimes it can take weeks for really bad withdrawals to kick in.

 

Also: If I updose back to .5 mg., which I guess I might have to do: I do not understand dry cuts or water dosing very well. I want to get my doc to write a compounded rx. but don't see her for another month.

 

Advice is appreciated! The .375 mg. is resulting in paranoia, hallucinations, burning muscles, delirium, etc. Very bad stuff. I obviously cannot stay at this dose... It's terrifying. Is this an example of tolerance or just plain "jumping too far too fast?" Thanks to anyone able to help.

 

 

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First of all, I am not a taper expert. I was forced to go cold turkey off a huge dose of Klonapin and 2 SSRIS. Utter hell ensued. So, I cannot advise you on a taper, but I CAN advise you about benzo wd.

It sounds like you are super sensitive to benzos. Take that as a warning. You need to get off benzos and sort of start over.

I had to. Oh GOD, did I have to. Benzos came so close to killing me... SO close.

Here on BB I am known to be sort of against updosing, holds, and other stuff that prevents your brain from truly healing itself. As long as you are taking a benzo, your brain cannot heal from them. Your goal should be to be OFF benzos once and for all. HOW you do that js up to you.

I would suggest you learn a bit more about what benzos do, and how they do it. Understanding this might help you get through this......knowledge IS power.

east

 

 

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I posted this under "withdrawal support" but feel it is more appropriate here, as what I'm actually seeking is taper advice:

 

I have been trying to get off Klonopin and am in bad withdrawals.

 

History:

1 mg. PRN (1-2x/week) from about July 2017-July 2019

1 mg. PRN increased on average to 3-4x/week from July 2019-Jan. 2020 (after taper of antidepressants was finished).

Put on 1 mg. Klonopin daily for one week in Jan. 2020, then reduced by doc to:

.5mg daily began 1/23/20. (No withdrawals but hated how dysphoric I felt).

On my own, on 2/13/20, I tried a reduction from .5mg to .375 (daily then sporadic then daily again).

 

I am wondering if my horrid withdrawals are residual from going from 1mg. down to .5 mg. six weeks ago, or from .5 down to .375 a couple of weeks ago. I heard sometimes it can take weeks for really bad withdrawals to kick in.

 

Advice is appreciated! The .375 mg. is resulting in paranoia, hallucinations, burning muscles, delirium, etc. Very bad stuff. I obviously cannot stay at this dose... It's terrifying. Is this an example of tolerance or just plain "jumping too far too fast?" Thanks to anyone able to help.

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I agree that benzos are not my friend; however, I don't want to set myself up for failure in the long run. These last couple of weeks, I've been trying to taper willy-nilly, as in some days taking .375 mg., some days not; I noticed when I tried to cold-turkey that the psychotic symptoms were too unbearable/unsafe, so for me that is not an option. I need to stay safe. That being said, I see a lot of people on here saying severe symptoms can be reduced with a sensible, slow taper. That is not what I've been doing. I've been massively jumping in milligrams.

 

It has not been that long since I was at .5 mg and wonder if I should return to it. This is my legally-prescribed dose. Then maybe I can do a slow/proper taper from there. I don't know. I contacted a compounding pharmacy who offered to do a liquid for me, if I can get my prescriber to write for it.

 

Day 3 at .375mg is doing almost nothing. But I have made some big jump-downs recently. So I don't know.

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[db...]
Cutting from .5 -> 0.375 is a 25% cut.  Sounds like that was too big for you.  We usually suggest cuts of no greater than 10% to help ease the impact of the withdrawal symptoms.  Many people make much small cuts than 10%.
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Hello delsol, I am not an expert in tapering, so I Will tell you my case.

 

I am tapering from 0.5 mg Klonopin . First step 0.4375, second 0.375, third 0.3125 and now 0.25. Cuts  every 7, 8 or more days, listening to my body and brain, knowing that some bads days are normal, but always haaving a bad time or hellish time is unbereable.

 

Try to stay at a dosage level that you can bear the sxs because maybe the tapering can last months. Once there, you can plan your taper .

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Hello, delsol.  Let me begin with the standard disclaimer .... like most other members of this community, I am a layperson not a healthcare professional.  Having said that, based on what I’ve read here and elsewhere, if I were you I would consider one or more of the following:

 

(1) updose back to 0.5mg

 

(2) start taking my dose on a consistent schedule (every day at the same time or times) instead of “willy nilly”

 

(3) hold at that dose for at least a week to see if my symptoms stabilize (stabilize means that your withdrawal symptoms are not changing and are tolerable)

 

(4) learn more about my benzodiazepine and the general principles of tapering

 

(5) create a preliminary taper plan (one month at most — taper plans are living documents that must be monitored and modified based on how our unique physiologies respond to reductions)

 

Hats off to you for contacting a compounding pharmacy about preparing a liquid you can use to taper your clonazepam!  Compounding pharmacists can be excellent allies in planning and implementing a taper.

 

If you have not already done so, you might want to ask the compounding pharmacist what formulation s/he plans to use (e.g., in the U.S., there is a stability-tested formulation for a 0.1mg/mL oral suspension using OraPlus/OralSweet or OraBlend as the suspending agent).  You also might want to ask the compounding pharmacist if s/he would be willing to use tablets from the same manufacturer you are currently using to prepare your compound (some individuals are sensitive to changes in manufacturers).

 

Finally, fyi, your compounding pharmacist can tell you exactly what your prescriber needs to include on the prescription. (If your prescriber does not have experience with compounding, demonstrating that you have already “done your homework” and are in contact with a knowledgeable compounding pharmacist can increase your prescriber’s comfort level with using this approach.)

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Thank you for this info. It makes sense. Additional info is requested: I want to plan ahead, in case I go into bad withdrawals soon after re-instating the .5 mg. I am hoping my brain can adjust and at least not go into psychotic symptoms at that level.

 

Options could be to try and do a crossover to valium, yes? If so, I would need a knowledgeable prescriber to do that, and bringing the Ashton manual could help with that?

 

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Thank you for this info. It makes sense. Additional info is requested: I want to plan ahead, in case I go into bad withdrawals soon after re-instating the .5 mg. I am hoping my brain can adjust and at least not go into psychotic symptoms at that level.

 

Options could be to try and do a crossover to valium, yes? If so, I would need a knowledgeable prescriber to do that, and bringing the Ashton manual could help with that?

 

It might help to bring the Ashton Manual to your doctor should you wish to crossover to valium. I did that a couple of times. The first time my PCP said he wouldn't consider it because he had a patient that could not get off valium. Of course, he's also the doctor that said he didn't know what was wrong with me when I got so sick after the cold turkey. 

 

I found another doctor who agreed to help me follow the Ashton method, we were both learning at the same time consequently both of us made mistakes with my taper. I didn't find this forum until after I jumped off.

 

pianogirl

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Going back up to .5mg last night felt pretty wiggy. In fact it felt like my sense of unreality and depersonalization increased after going back up.

 

I know there's no easy way around this taper. Wondering though if, due to tolerance, I should try finding out about a valium crossover, or if it's too late for that as well. I am struggling so badly. It's clear that my brain can no longer handle Klonopin.

 

If symptoms are so bad that they don't stabilize, do some people eventually just ditch the benzo and hope for the best? Trying to understand what my options are. My understanding of tapering is that it minimizes symptoms, but if symptoms are extreme despite tapering (or returning to most recent dose), it seems my choices are to abandon ship of Kpin or to do a crossover and hope it is more kind. Advice is appreciated.

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So I went back up to .5mg. last night. I feel so strange and unreal and like despite returning to .5mg., psychotic withdrawal symptoms are inevitable, as they are returning again. I am so terrified. I guess I tried to taper too fast, and my brain got used to not being on the .5mg.

 

I am really in a bad place. I never thought I would end up dealing with Klonopin like this. I don't know how to proceed. I am pacing, rocking, feeling at rock-bottom, hearing things, feeling like my body is disappearing and/or melting, feeling doom, lots of intrusive thoughts, akathisia. I am also getting delirious, not able to think clearly, barely able to make myself a cup of coffee. My spouse is gone during the days during the week. Without her here I don't know how I am supposed to even fix myself food. The cognitive challenges are the scariest, because I need my cognition in order to live.

 

Recommendations/suggestions please... Thank you.

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Hi delsol,

 

Thanks for adding your medication history, and just to let you know, I merged your thread in Withdrawal Support with this one on the taper board so you can collect your suggestions in one place.

 

Valium is an option, but it's not without it's downside, let me explain why.  One, the crossover can be unsettling, Valium has two inherent traits, it can produce sedation snf depression, some can't handle it and end up going back to the original benzo.  The crossover takes time, you're slowly adding the Valium and withdrawing the Klonopin.

 

Some Dr's won't prescribe Valium, they don't see the point to this method, so you'll need to find out if this is an option.  Once you've made the cross, you most likely will still have issues tapering, not many people get out of this without pain, at least those of us here, so it's best to be prepared for this.

 

As for quitting cold turkey, it's not a good idea.  With a taper you can at least have some control over how much pain you're in, but if you stop taking it, you won't.  It can leave you non functional for awhile, with possibly longer than necessary withdrawal symptoms so I wouldn't recommend it.

 

Pamster

 

 

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Thanks for the advice. I am sure cold turkey isn't a good idea; it feels as if I've already CT-ed (though that's probably not the case and can probably get even worse if I decide to CT).

 

I'm trying to remind myself of my resources at a time like this. Cognitive problems and psychosis are getting in the way. I have friends and family, fortunately, who are supportive. But when I'm alone, I really struggle to get through each minute. I feel like isolating in the house (because of terror of leaving) is a slippery slope, and I don't understand how people manage that. My baseline personality is outgoing and likes going to stores, etc.

 

I have a feeling I'm going to be on Benzo Buddies quite a bit for a while...

 

 

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We lose ourselves through this process, it's one of the scariest things we have to face, the loss of self.  I was fearful, my personality changed and I isolated too, but these are things you must fight against.  Too many of us give into the agoraphobia and fear, please don't do this.  You need to do whatever you can to maintain the life you had in order to have it to go back to when you're healed from this.

 

Distraction is key, it's amazing how it can work.  I tell a story of how I rescued a dog from the middle of the road in traffic and for just a few moments, I felt normal because I wasn't focused on my pain.  Your distraction doesn't have to be that dramatic, it can be doing a task that fills your mind for just a little while, you'll find your symptoms will diminish or be gone completely for just a little while.  There are tricks you can learn to help you through this.

 

I'm glad you have support in your life but they can't possibly understand what you're going through so keep coming back here for help.  Avoid the horror and read the success stories, you will get through this.

 

I know it sounds ridiculous to say but faking it is a useful tool, push yourself to do what you do, fake it to make it.  I worked full time and had to be around people who didn't know what I was going through so I got adept at letting them think I was okay when I wasn't and it's really a great distraction to do this.  Sometimes I would forget for a few moments how miserable I was, other times I just had to grit my way through it.  Fight against this with everything you have, don't give it anymore power.

 

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This .5mg isn't holding long at all. I woke up feeling agitated and shaky. Sounds are distorting again; paranoia is creeping in again. I think I need to try switching to a longer-acting benzo in order to have a shot at tapering. I called a detox center, thinking maybe they help with crossovers, but this one did not. I took another .5mg this morning (not supposed to have another dose until 6 p.m.), hoping to stave off some of the worst symptoms and buy myself some time, cognitively, to make some phone calls and decisions.

 

My confusion is over whether I can ever stabilize on a dose that is no longer working for me; options seem to be to see if I can get doc to increase dose (and then try taper), to taper from here despite severe withdrawal symptoms that are getting scarier by the minute (distortions, fear of going outside, delirium is starting), or switch to something else. My next doc appt. isn't until April 2 and I know my body and mind won't be too stable in the interim. I just don't know what to do.

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[db...]
It takes 2-3 days for klonopin levels to even out after a change in dosage, so you might want to wait a day or three before asking for a dose increase. 
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Ok -- I don't really deep down want to increase my dose, as Kpin no longer helps but makes me feel dysphoric and depressed.

 

Does anyone know about librium crossover? The reason I ask is that my genetic testing said I don't process valium very efficiently. I am going to wait for now (appointment isn't for a while anyway) .  But I'm starting to do my homework  :thumbsup:

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I am NOT an expert on crossovers, but my "gut" tells me you should not do this. I know why you think this might help, but from what I have seen over 7 years on BB, it most likely will NOT help you a bit.

Good for you, doing your homework! That was something I sorely neglected when I first started taking benzos.

If I were in your shoes I would continue to taper off the K. Its a powerful benzo. Your goal is to be OFF benzos, so keep on going.

Your wd symptoms will eventually fade away, just as they did for me.

Keep me posted on your progress, please.

east

 

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If I were in your shoes I would continue to taper off the K. Its a powerful benzo. Your goal is to be OFF benzos, so keep on going.

Your wd symptoms will eventually fade away, just as they did for me.

Keep me posted on your progress, please.

east

 

 

East: I think deep down you are right. Continue to taper from my regular dose. Going up a little basically felt like nothing. I will stay on the .5mg for now. And slowly taper. Even though it feels like I am already in dire straits. This is so surreal. I am holding onto your story and the countless other success stories. I feel so much loss. I look back to how much I was doing a year ago: Grad school, work, theater, etc. I need to believe I can do those things again. Right now it feels like it will never happen.

 

As I type this, it feels like my hands are changing shape, I am starting to sweat again, my spouse and cat look unreal, I hear buzzing, my lips feel numb. If I had to go out of the house, I don't think I could do it because everything feels too scary. I don't understand how people work during withdrawal; I don't think I could. I quit my job.

 

To think I have to deal with this all during a taper and then afterwards seems like an eternity. How to stay positive? I am trying, I am trying, just to get through the next few minutes. I am trying to remind myself that it doesn't last forever and that this is just my brain trying to heal, but easier said than done; my brain though can barely think. Ironically I can write. It keeps my brain focused. So there's that. I wish I could just C/T off this stuff and be done. But the last time I did that I felt even worse than now.

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I'm glad you can write, and if it would help you can start a progress log to keep track of your journey, but to also express what you're feeling.  Members can't reply to it but if you feel the need to write, it's an option.

 

I'm glad you're not going to cold turkey, those don't give you any control over the process, tapering at least gives you some small measure of control.  I know the symptoms you're feeling are horrible but distract, distract, distract.  Staying positive is tough, I wasn't good at this, but I was good at distraction, so use whatever methods you think will work for you.

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Additional feedback needed:  It seems my symptoms really get worse about halfway through the day, like my dose just stops working approximately 12 hours after taking it. Then I spend half the day in more intense withdrawals than before. I don't understand, as Klonopin has a very long half-life. It's not like Xanax. So how does a long half-life medication poop out so quickly? I am just trying to understand. I also see that in the Ashton manual, it recommends divided doses.

 

The last time I tried dividing the .5 Kpin into 2 divided doses of .25 each, my withdrawals got worse. So I don't know if that's an option. I was wondering if asking doc to add an additional .5 would be better, so I could have a steady amount throughout the day; the problem then of course is more medication/a longer taper. I get it that ultimately I want to be off this drug; I just feel that the drastic changes in symptoms throughout the day is rough on my body/mind. Too much up/down.

 

In theory, is a taper of 2 doses of .5mg any different from tapering one .5 dose? Meaning if you slightly lower each dose (morning/night), you'd reach zero at the same time as if you were just tapering a once-daily dose? Is my logic confused here, or is there a point to this?

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How long has it been since you tried splitting your doses and for what purpose and how long have you been back at the .5 daily?

 

I've read other members say they dose Klonopin twice a day, once the withdrawal process starts, all bets are off when it comes to half life so many do what they have to do to be relatively comfortable. 

 

The beauty of tapering while dosing several times a day is you can taper whichever dose you want. If you need more in the morning but less at night, then you can work to lower or eliminate whichever you rely less on.

 

I hate to see you go up in dose, but since this was where you started initially it may provide you some relief.  However, as I said once the withdrawal process starts its difficult to get back to where you were and you may need to go up from the 1 mg, we just don't know.

 

Bottom line is, this is most likely going to hurt no matter what you do, so you have a big decision to make with lousy choices, I'm sorry. 

 

 

 

 

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Yeah this is one of the hard things: Finding a "sweet spot" from which to taper. I guess there's no exact sweetness to this -- like you said, it's going to be difficult regardless. I don't like the depression I feel from Kpin but I also don't like the withdrawal feelings of paranoia, terror, and fear of leaving the house. I hope to find some minimally happy medium, where maybe I can get out and be around people even if the other symptoms are intense.

 

I have a lot of self work to do too, accepting the very uncomfortable feelings. Patience is not my strong suit.

 

In retrospect, I think I would have tried to taper Kpin before tapering my antidepressants, because at least then, the ADs could buffer some of the agoraphobia. I'm such a sociable person and need to be out and about, so this withdrawal makes me so sad.

 

 

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How long has it been since you tried splitting your doses and for what purpose and how long have you been back at the .5 daily?

 

I realize I didn't answer this question. I tried splitting the dose into two .25mg doses about two months ago. It went miserably. I have been back at .5 daily (after trying to cut further and also failing to go CT) for just a few days.

 

 

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[db...]

Tapering causes a couple of things to happen...

 

1) You lose some of the therapeutic value of the drug.

2) When the level of the drug drops below your body's dependence level withdrawal occurs.

 

I'm guessing that about half-way thru the day, the level of drug in your body drops below some magical level where you need the therapeutic value and/or the level drops below your dependence level. 

 

You might be able to dose additional times per day to even this out a bit, but it might come at the expense of having more drug at night which probably helps your sleep. 

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