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Hospitalized Need Help!


[Ri...]

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My wife was hospitalized on Sunday. We started her taper from 2.75 mg of Klonopin and got down to 0.05 mg, over a 16 month time frame. I believe the last part of the taper was too fast . Due to the severe symptoms we brought her to the hospital, they decided to remove her from her taper, big mistake; within 72 hours the doctor was worried about seizures and decided to put her back on klonopin at a dose of 0.125 x 2 per day. They put her on 2 other meds besides the Klonopin

My thoughts are that upping the dose from 0.05 mg to .25 mg was a mistake.

At what mg concentration should the taper be re instated?

Is this a good time to switch to Valium, if so, what dose?

Feedback would be appreciated

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RichardF: I am so sorry your wife is suffering.  It would help other members help you if you would add your wife’s benzo history to your signature.  If you need help in doing so, please say so.

 

You’ve had your hands full so may have missed my attempt at summarizing her history on your other thread. I’ve included it again below.  Can you make any changes needed plus add the latest info?

 

It would also be helpful to know the total amount of clonazepam she was taking the last time she felt “OK.” (OK does not mean no symptoms but rather that symptoms were tolerable.)

 

DRAFT History:

 

Ativan, 3mg/day/ one dose at night for 11 years. Switched to Valium at rehab facility.  Switched to clonazepam at hospital.

2.75mg    sometime in March 2019

1.18mg    October 17, 2019 (a 57.09% reduction over approx 7 months)

1.02mg    November 17, 2019 (a 13.56% reduction over 1 month)

0.83mg    December 27, 2019 (a 18.63% reduction over approx 1 month)

0.04mg    early June 2020 (a 95.18% reduction over approx 5 months)

0.075mg  June 3, 2020 (a 87.5% increase over 2 days)

 

 

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Thanks Libertas,

Here is some added taper information:

I am a biochemist and have the capability/equipment to microdose, started a liquid microtaper on 9/12/19: all doses were divided in 3 equal portions and taken at 11pm, 7am, 3pm

 

9/12/19  dose @ 1.35 mg of Klonopin (three doses of .45mg every 8 hours)

10/12/19            1.20 mg

11/12/19            1.05 mg

12/12/19            0.90 mg

1/12/20              0.74 mg

2/12/20              0.59 mg

3/12/20              0.40 mg

4/12/20              0.29 mg

5/12/20              0.10 mg

6/7/20                0.05 mg

 

In retrospect we should have gone at a slower pace. The question now is since she has been on a dose of .125 x 2 per day (.25 mg) for a few day has her body adjusted to the new normal; should we consider transitioning to Valium.

Thank you for all your help

 

 

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Hello, RichardF.  You are most welcome.  My undergraduate degree is in chemistry and I greatly enjoyed the biochemistry courses I took.

 

Thank you for documenting your wife’s history for us.  If it’s ok with you, I will give a shout out to the admins to ask them to add it to your signature.  If correct, the fact that she took Ativan for 11 years is highly relevant as were the abrupt switches to Valium and then clonazepam. 

 

Can you help me fill in the last little bit of her history?  What was the date the hospital discontinued her clonazepam?  What was the date the hospital reinstated the 0.25mg?

 

How many days has she been on 0.25mg?  How is she doing?  Are her symptoms tolerable?

 

One last question ... during her taper, was there a dose where she felt “OK”?  If so, what was the amount of that dose? 

 

The answers to the last two questions will be helpful in responding to your question about Valium.  If you and your wife decide to go that route, you’ll need to ballpark an equivalent dose.  According to Ashton, 0.5mg of clonazepam is equivalent to 10mg of diazepam (Valium).

 

PS I had the same thought as you about the pace of the clonazepam taper, especially given the 11-year history of Ativan use.  However, that’s water under the bridge.  It’s time to focus on what can be done moving forward.

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Hello,

The last email I got was from Buddies, but I can't find it, can you send it to Buddies?. They wanted the following info:

Last dose of Klonopin was on Sunday, dose was 0.05mg

Re instated at the hospital Thursday after noon, 0.125 mg afternoon + 0.125 night

Friday one dose so far .125mg , will get another dose tonight at .125mg

She said the last time she felt OK was at .25 mg

I believe the last part of our taper was too fast

 

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Hello again, RichardF.

 

Thank you for providing a complete picture of your wife’s benzodiazepine use and tapering history.  Is the following correct?  Is it ok with you if a member of the BenzoBuddies team adds this “signature” to your profile on behalf of your wife?  Signatures allow other members to view essential information “at a glance.” (You can modify it at any time.)

 

Now back to your question, “Is this a good time to switch to Valium and, if so, at what dose?”

 

I don’t have experience with switching to Valium so regrettably have nothing to share on that topic.  Your wife’s system has been through a lot and may take a while to “settle down” whatever she decides to do.

 

Signature:

 

Supporting spouse. Ativan, 3mg taken at night for 11 years. Switched to Valium at rehab facility.  Switched to 2.75mg of clonazepam at hospital in March 2019.  On 9/12/19, began liquid microtaper. Total daily dose (TDD) divided in 3 equal portions per below:

 

9/12/19      1.35 mg

10/12/19    1.20 mg

11/12/19    1.05 mg

12/12/19    0.90 mg

1/12/20      0.74 mg

2/12/20      0.59 mg

3/12/20      0.40 mg

4/12/20      0.29 mg

5/12/20      0.10 mg

6/5/20.      0.075mg (updosed for 2 days; no relief)

6/7/20        0.05 mg (last dose)

6/11/20   reinstated at 0.25mg (0.25mg = TDD when spouse last felt “OK” during taper)

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My wife was hospitalized on Sunday. We started her taper from 2.75 mg of Klonopin and got down to 0.05 mg, over a 16 month time frame. I believe the last part of the taper was too fast . Due to the severe symptoms we brought her to the hospital, they decided to remove her from her taper, big mistake; within 72 hours the doctor was worried about seizures and decided to put her back on klonopin at a dose of 0.125 x 2 per day. They put her on 2 other meds besides the Klonopin

My thoughts are that upping the dose from 0.05 mg to .25 mg was a mistake.

At what mg concentration should the taper be re instated?

Is this a good time to switch to Valium, if so, what dose?

Feedback would be appreciated

 

 

Hi Richard,

 

I'm so sorry your wife has been hospitalized.  This must be a very difficult time for both of you.  I hope she stabilizes very soon.

 

As Libertas has suggested it will be helpful for you to create a signature -  other members can respond with the best information if they know your wife's medication history so I will ask you to create a signature line listing her medication and dose and history with benzos.  Go to the top of the page and select PROFILE then choose forum profile then insert drug history into the text box and remember to click change profile.  Please let us know if you need help with this.

 

Brighterday

 

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[dd...]

Hi Richard,

I'm sorry about your wife.

As you can see in my signature I reinstated after a long taper from 1 mg k and having been three months off.  When I reinstated the doctor put me on 0.5 mg but it was so bad that I dosed up to 1 mg after three days. I probably would have been ok at 0.5 mg but desperation made me take more. I got stabilized quick after two weeks and I started another taper immediately. I did cut 0.250 mg during the first 3 weeks and then cruise for a whole year till now at 0.030 mg. I didn't switch to Valium. K is already a long 1/2 life and switch to Valium may add another problem.

My second taper has not been much different than the first one. Still a roller coaster of new and old symptoms. I took other drugs for a very short time and low doses but I could stand any. I think less drugs less problems.

I wouldn't rush to taper or switch to Valium till she gets stabilized. If she can cope with her symptoms at 0.5 mg I would wait and see till she gets more comfortable. I did cut high at the beginning of both tapers without problems. Now if she has to go on a higher dose so be it! She is already conditioned to the drug and once stabilized she can start a long taper. At least not as fast as she seems she did on the first one. 

Hope this helps you.

Mice

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Hello Micedana,

Thanks for your feedback. I will set up a medical profile today. She is still in the hospital but is feeling better since they upped the dose to .25 mg (.125 morning + .125 night). Based on your experience stay with the Klonopin, no switch to Valium. What are the most common problems when switching to Valium from Klonopin.

One other issue she is having is not able to sleep; they gave her Zopiclone 3.75 mg (night) + Zyprexa as needed. I am not keen on either of these.

What has helped you for sleep?

Thanks for your help

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[c6...]

I'm glad she's feeling better on 2 x 0.125.  I don't think there's a need to crossover to valium, but I think you're correct that the later stages of the taper were too fast.  I'd suggest starting a nice slow micro-taper from 0.25 (emphasis - slow).  Keep the cuts first order until she's well under 0.05 mg.

 

Pretty much nothing helped me sleep very well.  I occasionally took some OTC sleep pills (Unisom or Benadryl) and they'd add about an hour to otherwise dismal sleep.  Cannabis actually worked better, but it's definitely not for everybody.

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[dd...]

Hi Richard!

Nice to hear she is doing better.

I had terrible insomnia when my ordeal started. Actually it was when my Dr. switched me to clonazepan (1 mg) that I started to stabilize and get some sleep. I took it for less than 4 months.         

I think however, that not all the solutions come thru pills. A good sleep hygiene, cutting sugar and coffee is part of a good start. Melantonin is also a more natural option to consider although it doesn't work well for some. I do take cold showers 1 hs before bed time and that helps me tremendously but I recon that it may not work for every one.

 

Switching from K to Valium could be tricky. You don't know how she is going to react to it. Seems like she did the taper using k and haven't been that long since she had it in her system. That helps!

The only thing you get with Valium is that you can go down to small doses using pills and also the long 1/2 life for a smoother taper mostly at the end. With K you don't get small doses pills (0.5 mg K=10 mg Valium) and you probably have to end up doing a liquid reduction if you want a long and less complicated taper. But, people do it and very successfully.

Again, I wouldn't rush to the taper or switching until she feels really stable. However, I would watch carefully for other medication. The least she takes the better.

The doses she is now are not high and it's better to wait for her to get some sleep and feel better. She is experiencing bad withdrawal symptoms due to her somewhat fast tapering.

You have to give her time and let her body to adjust and once she is stabilized start the taper. 

Mice

 

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Hello Micedana,

You have been very helpful. I have a few more comments and questions

She is now on 2 x .125 mg doses, 10am & 10pm but she is have painful (head, face swelling, jitters etc) inner dose withdrawal around 5 pm.  What do you think about 3 doses 8 hours apart 3 x .125 mg; she hates upping the dose especially since she was at .05mg/day 7 days ago, but the pain is bad.

I agree about the Valium, she is very sensitive to any changes; the last thing we want to do is make the process more complicated.

Making incremental liquid titrations very precise is not an issue for me, I brought some of my lab equipment home. I look forward to your feedback.

Richard

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[c6...]
Or maybe consider noon (or 1 pm) and bedtime (10 pm) for dosing.  Might better cover the day and she might not need as much coverage overnight.
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[dd...]

Is she taking pills? what is the manufacturer of the pills? (it should be at the bottom of the container).

I know it may be controversial but I would try to take the doses with empty stomach. Some brands coatings can't stand stomach acids and not the full dose gets in the system if taken with food.

Agree with badsocreft to take it middle of the day and at night before bed. Also she seems not to like the up dose idea but she may welcome the the changes of when and how to take it.

If it doesn't work you may consult with your doctors to up dose and go three times a day. Still not a big dose. Her aim should be to get into a sleep routine and more stable.

Hope it works! 

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Good suggestions

The medication in being giving in the hospital in not the same brand ; I've been getting it from Solco in the US, she has been this brand for well over a year.

Last night strong meds still did not help her sleep, in tremendous agony and pain.

She asked about a slow switch to Valium + gabapentide

The medical community is inept and we are reaching for straws

Help!

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I’ve read that a Dr. James Wright, in Vancouver, has helped patients withdraw from benzodiazepines using Valium.  Perhaps your wife’s physicians could consult with him?

 

This 02/16/2020 blog post to the Winnipeg Free Press quotes Dr. Wright:

 

https://www.winnipegfreepress.com/arts-and-life/life/health/ex-benzodiazepine-user-relating-to-peterson-says-withdrawal-hell-needs-awareness-567921682.html

 

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[c6...]

Unfortunately, the mind gets agitated during all of this 'fun' which makes sleep even more difficult.

 

Sleep is nice, but I think it's a bit overrated.  Encourage her to try to relax about the whole sleep issue.  Don't let it add more worry/anxiety.  Sleep's one of those things that can't really be sustainably forced to occur.  That's what a lot of us used those drugs for and we ended up paying a price. 

 

Maybe you could request that she get some valium at the hospital and see what that does for her.

 

You are correct that dealing with drug side-effects is a bit of a crap shoot at times.  Hopefully, she gets more stable soon and can do a proper taper and be rid of this stuff.

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Good advice badsocref

I told her not to be overly concerned about sleep right now.

I did some research and found that Valium acts on the same Gaba receptors as Klonopin; theoretically it should make a transition smoother than from other Benzo's .

Currently, she is on 2 x .125 doses, mid morning and night.

What I am proposing is to introduce 1.25 mg of Valium to the morning and night dose effectively giving her an equivalent of .375 mg of Klonopin. I want to get her stable before introducing a slow taper of ~ 10%/month

I am concerned with tolerance withdrawal, but there might be no way around this since she reinstated from 0.05 mg of K to .25 mg over the last week; she is still experiencing exacerbated symptoms at the much higher dose.

Any suggestions , greatly appreciated.

I will keep you posted as to our progress.

Thanks for all your help

 

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[c6...]

I imagine that at some point nearly everybody hits tolerance withdrawal as they taper.  The drug may work somewhat until the level drops below what the body is demanding.  That proceeds to full-time withdrawal when the body never gets as much as it's demanding.  Taper slowly and that withdrawal will hopefully not be too intense.

 

All benzos and z-drugs work on GABAA.  It's a popular receptor.

 

I think the additional 1.25 of V could help.  I guess we'll find out.  Good luck!

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She is in full blown withdrawal at the dose of .125 x 2 per day Klonopin,  suffering.

Dr. Does not want to add Valium but wants to up the dose of Klonopin . Are we on a slippery slope by keep on upping the dose. How do we know that the next up dose will stabize her.

What should we do?

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[c6...]

I think you should try to work with your doctor.  We're here to help, but ultimately you're gonna need to work with this doctor.

 

It probably doesn't make a lot of difference whether you add valium or more klonopin in terms of adding dosage. 

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I think switching to valium could possibly create more problems.  It's only been a week since she was taking .75mg?  I took months to get from .75 to .5mg of klonopin, and it still wasn't easy.  I think maybe going back up to the June 3rd dosage might help.  Also, it takes at least four days to feel a new dosage, and can take even longer to feel sort of *okay*. 
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Thanks for the feedback. Just to clarify,  her taper was at 0.05mg 9 days ago. Due to her symptoms the hospital doctor upped her dose to 0.25 mg (.125 am + .125 pm)

Doctor moved her to 2.5mg valium am + 2.5mg pm. Feels ok so far except some initial GI issue.

One more question.  She has been experiencing some intense pain in her hip, have you heard of this symptom

Thanks for your help

 

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[c6...]

If she's been in the hospital bed for a couple of days, the hip pain may just be from the bed.  My back gets sore if I lay in bed for a day.  If the bed is foreign to me, it can get sore in just a few hours.

 

But some kind of pain is often a regular companion during withdrawal.  Often, it can be handled simply with OTC pain meds (ibuprofen, acetominiphen).  The anxiety that accompanies withdrawal often yields tight muscles which are painful/sore much of the time.  Relaxing, non-vigorous stretching/exercise can help.

 

Glad the valium is helping.  I hope the GI issues resolve quickly. 

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Hi Richard  ,I was on 8 mgs K fr 16 years and the end of my 5 year taper was too fast too but I was under 100 lbs at that point and I was losing the battle . 

    These Drs should me forced to go through this  ( then jailed ) with us so maybe they see what they are doing to people .

 

She is going to be panicked and very needy for a good while , just try to stay with it . My husband is a nurse and this was one of the worst things he had ever seen .  I am totally off 18 months and still have pretty rough insomnia and I still panic over it , the first 4 months off were a nitemare of insomnia . like another poster here the only thing that would help me was high grade indica until I was totally off and after that nothing worked for a long time . Now 1.5 mg melatonin under my tongue at 8:30 pm with no tv and asmr in my earbuds, warm bath before that . Its a mess , I agree .

 

I did have severe nerve /muscle/joint pain in a knee that was part of a crushed leg 40 years earlier , swapping off advil and tylenol until advil sent me to the er after last dose . TRY to stay with tylenol if you can . Any place I'd had surgery or a bad injury burned like fire for 4 months . 

I am sorry you are having to go through this .

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