Newbie grateful for support- Klonopin 0.25

Hi all! I have done a fair bit of poking around and research on here, but I'd be incredibly grateful for more advice and clarification on my taper plan(s)

 

Long story short:

 

Beginning 9 years ago, severe panic disorder led me to being rx'ed 1.5 mg/day Clonazepam and Sertraline (between 25-75 over the years)

I asked almost every appt. "Do you think I should still be on this?" always, "Yes, yours is severe" Fair enough. I was able to do things I'd never done before, like fly. I went from never having been on a plane to Australia. Also, over the years I never went up on my initial dosage once, but plenty of times cutting out a half a pill at a time (0.25) or so.  Wound up here wondering if it was my benzo or rough WD from an Effexor trial causing my suddenly intense brain fog and DPDR.

 

So, here we are:

 

I've been on 0.75 mg Clonazepam daily for at least a couple years.

Asked newest Dr. about taper ,and got the "do it in 4 weeks" response. (Its been 9 years!)

 

On June first  I cut my nightime dose (0.25) entirely. I've been fine.

 

It's been a month, and I'm wondering where to go. I'm thinking dry taper... I can get them into 1/4 but 1/8 seems hard.

 

- Since I was able to handle a larger dose reduction previously should I try a more generous deduction first, or a micro-taper?-

-  I've got 0.5 tabs and 0.125 orally disintegrating pills. Is it ok to cut the OD pill? Or, should I move over to the other board and think about liquid titration?-

 

Thanks 

Tapers are just big experiments we perform on ourselves, we try one thing and if it works we continue doing it, and if it doesn't we change course.  Your taper should be driven by your symptoms so you'll need to pay close attention. 

 

Can you tell us, what did you feel when you eliminated your nighttime dose of .25, did you experience any symptoms?  I'm trying to figure out how quickly you can taper, your story appears to be a bit different from what we typically see.

 

 

Hi Pamster, thanks for your reply.

 

When I went down I honestly didn't feel much of anything. Maybe a little increased anxiety and jitteriness the next week, and some days more lethargy.

I did have 2 days last week where I had some heart palpitations, though, come to think of it. They went away.  I've been feeling a steady level of anxiety and exhaustion for the last couple years though.

 

Right now I'm taking 0.125 AM and PM for a total of 0.25.

 

Also, I just realized my dose had been a quarter of  my tab, so I was on 0.375 for the last month. 

It sounds like you've been dealing with some symptoms and although they've been manageable, it probably means you'll need to take this slow.  I wouldn't recommend cutting your OD pill and you're right, cutting your .5 into eights will be tough, although I've seen members accomplish the impossible with razor blades and metal files, shaving those little pills to get the right dose. 

 

Have you thought about asking your Dr for a prescription to take to a compounding pharmacy or for the liquid version to make it easier to taper?

I hadn't thought of that. I have an appt. next week and I'll see if she is willing. She seemed to think I could jump off at this dose, too.

Which, no, I am not doing. I plan to go down to around 0.005, not... .25 

 

I know it seems silly, but dissolving the OD tabs in water would be ok, you think? Seeing as it's meant to dissolve.

I think I'll  shave the pills I have off and then switch to a compounding liquid or water later.

 

I used the alwaysdata benzo microtaper calc, but I'm considering a cut and hold. 

 

My biggest question is could I stand to do 10%-15% every couple weeks or so.

I'd speak with your local pharmacist about adding water to your OD pills just to be on the safe side. 

 

I like your plan, many will dry cut until they get to the lower doses, the inconvenience of having a lab in your kitchen can get old so I'm told.  As for your question about a 10-15% drop every couple of weeks, your body is going to let you know if it's possible.  An important fact to remember is you're healing as you reduce, tapering allows you to somewhat control your symptoms.  Once you're off the drug, you will still be healing and your symptoms will be what they will be so your plan to taper to a very low dose is wise.

Hello, Healingeveryday.

 

I agree with Pamster, it would be wise to consult with a pharmacist about using a homebrew liquid made with clonazepam Orally Disintegrating Tablets (ODTs) and water. I’ve underlined the word “disintegrating” because it’s important to understand that this type of tablet disintegrates (as in, breaks up, deconstructs) when exposed to the saliva in your mouth.  It does not dissolve (as in, the active drug substance in the ODT does not go into solution).

 

So, if you disintegrate an ODT in water, the resulting liquid would be a suspension not a solution.  Moreover, it would be a short-lasting suspension (water is a very poor suspending vehicle due to its low viscosity). If you decide to go the homebrew route with your ODTs (or regular tablets), you might want to ask your pharmacist about using a professionally formulated suspending vehicle such as OraPlus.  (You could also ask him/her for references to a qualified, reputable compounding pharmacist who could prepare a stability-tested clonazepam oral suspension for you.)

 

We have at least one member (Intend to be off) who uses whole fat, homogenized milk to make a homebrew liquid using ODTs. Per the Titration: FAQs, none of the homebrew liquids have been professionally analyzed so we don’t know anything about their properties (e.g. are they solutions, suspensions, both? how much of the active drug substance is available over what period of time before degradation occurs?).  In the case of milk, one hypothesis is that at least some of the active drug substance in clonazepam ODTs (or regular tablets) may go into solution with the fat globules in the milk but the fat globules themselves are in suspension with the water in the milk (which is why using homogenized milk is important).

 

I’ve read about three members who dry cut clonazepam ODTs: Lets be brave, Wavesontheshore, and Osu2001.  You can read through their posting histories to learn more.

 

I will close with a personal observation about the online tool you referenced.  The tool is based on a specific tapering strategy and assumptions that may or may not be appropriate in your case. Like other tapering strategies, the strategy has pros/cons, risks/benefits; it works for some individuals but not for others.

 

Sending all good thoughts and best wishes your way for a smooth and successful taper ... Libertas

Thank you so much! I really appreciate the clarifications and support 

I'm feeling more confident knowing I have some flexibility in terms of schedule and method.

We'll see how it goes! I am ready! 

You are most welcome, Healingeveryday.  fwiw I have been mini (not micro) tapering using a stability-tested, compounded oral suspension of clonazepam. 

Do you mind if I ask how to figure out calculations for that? Is a mini just a higher amount deducted daily? Or are you doing like a cut and hold? I think mini vs micro might suit me.

My layperson understandings are:

 

(1) Daily micro-tapering involves making very small reductions in dose — in the range of 0.001mg—every day. One microgram (mcg) is one thousandth of a milligram (mg); 1 mcg = 0.001mg.

 

(2) Mini-tapering involves making “small enough” reductions in dose with “long enough” intervals between reductions for withdrawal symptoms to fully emerge and then stabilize (i.e. stop changing/become tolerable). Discovering what “small enough” and “long enough” mean for a given individual requires experimentation.  Factors to consider include the individual’s drug history, dependency and tolerance status, physiology, current total daily dose, and tapering stage as well as the potency and pharmacokinetic properties of the benzodiazepine being tapered.