Should I Up My Kpin Dose Before Beginning to Taper?

I know this may sound like a dumb question - but please hear out my thought process on this, and let me know if it is in fact stupid haha.

Basically, I've been at 0.5mg of K for the past 8-9 months. I tried to get off 3 times (the first 2, way too fast) about 4 months ago. And I was unsuccessful. Since then I've only taken more than 0.5mg on rare occasions...but for the last 2 months I feel like I've been going through tolerance withdrawal.

I was told it's best to stabilize before beginning, but I've truly never stabilized again....instead feeling awful the past 2 months. I also have an autonomic nervous system condition which isn't making things any easier (however, all doctors have agreed I should get off K...but no one has tried to help). 0.5mg has done almost nothing for me anymore...and the past week or so I've been taking around 0.75 to help me sleep and relax a bit.

Should I up my K to 1mg to stabilize? But immediately begin a liquid taper if I do from there?

A question, you say you've been on .5 for the past 8-9 months, is this your total time on Klonopin or is has it been longer at a different dose?

Could you add your medication history to your signature so we can know at a glance in order to better help you? Add your history/signature 

I understand its difficult to stabilize after a failed taper attempt, oftentimes members will have to go up in dose when this happens but since you didn't, I'd advise against doing that now just as you're set to taper again.  If the .75 is helping you a jump to 1 mg doesn't make sense to me. 

Most members say that being stable doesn't mean feeling good, it must means your symptoms are tolerable, that you can face the thought of reducing again without going into a panic. 

A question, you say you've been on .5 for the past 8-9 months, is this your total time on Klonopin or is has it been longer at a different dose?

 

Could you add your medication history to your signature so we can know at a glance in order to better help you? Add your history/signature 

 

I understand its difficult to stabilize after a failed taper attempt, oftentimes members will have to go up in dose when this happens but since you didn't, I'd advise against doing that now just as you're set to taper again.  If the .75 is helping you a jump to 1 mg doesn't make sense to me. 

 

Most members say that being stable doesn't mean feeling good, it must means your symptoms are tolerable, that you can face the thought of reducing again without going into a panic.

Hi Pamster,

I've just updated my signature with med history and basic info on the health issue I'm currently dealing with. The 0.5mg for 8-9 months has been my total time on K. I've never asked my doc for a dose increase...but am about at that point right now.

My main issue with the 0.75 is that it's difficult to cut my pills accurately, and 0.75 is just a ballpark. On bad days I'll take between 0.625 and .85 I'd say...as I usually cut my second pill (if needed) into quarters and dose based on how I'm feeling. But I'm definitely not getting near a solid 0.75 accurately every time.

I suggested 1mg because I know K comes in 1mg tablets...and I wouldn't need to worry as much about inaccuracies in dose if just titrating from a whole 1mg or cutting in half down the score. Just seems more convenient. I planned on immediately titrating from 1mg (as I don't imagine I'd need to stabilize since the dose will be increased), but am not sure how logical this is.

As far as symptoms go, it's more physical than mental I think. But I wouldn't say they've been tolerable at all...which is why lately I've been feeling the need to up it a little bit every other day :/

Your right, going up to go down down (in a tolerance situation) doesnt make sense to me either..

Not sure what Prof Ashton was thinking, unless its psychological to get the ball rolling..??

Though following too fast or large reductions might be a different story...

For some people, tolerance symptoms might steady a bit once once one eases down a bit in dose, -a wild ballpark guess might be say 25%-ish reduced, but this appears very individual from what Iv seen...

Stable dosing might be worth pursuing though, so you may want to consider tablet sizes, liquid and/or scales...

Just my thoughts..

In any tapering scenario its best to get the smallest dose capsules or tablets that you can, so going to the 1 mg isn't your best option even if you're thinking of titrating. My suggestion would be to keep your .5 mg pills but ask your Dr to increase your daily dose if you plan on landing on .75 as your starting point in order to do a slow taper, you don't want to worry about running out of pills.

I've seen many members dry cut part of their dose and titrate the rest, meaning you could take your .5 tablet and use liquid titration for the .25 by cutting your pill in half  to make .75.  Or, have you considered asking your Dr for a prescription for professionally compounded Klonopin liquid?  There is also dry titration where you crush and weigh your dose on a jewelers scale, we have some great videos to explain this method.

One question, it sounds like you're not dosing the same every day, it's best not to take as needed, getting on a steady dose or a dose that's steadily declining is best to keep your blood levels stable.

In any tapering scenario its best to get the smallest dose capsules or tablets that you can, so going to the 1 mg isn't your best option even if you're thinking of titrating. My suggestion would be to keep your .5 mg pills but ask your Dr to increase your daily dose if you plan on landing on .75 as your starting point in order to do a slow taper, you don't want to worry about running out of pills.

 

I've seen many members dry cut part of their dose and titrate the rest, meaning you could take your .5 tablet and use liquid titration for the .25 by cutting your pill in half  to make .75.  Or, have you considered asking your Dr for a prescription for professionally compounded Klonopin liquid?  There is also dry titration where you crush and weigh your dose on a jewelers scale, we have some great videos to explain this method.

 

One question, it sounds like you're not dosing the same every day, it's best not to take as needed, getting on a steady dose or a dose that's steadily declining is best to keep your blood levels stable.

Ok, that makes sense - yeah most of my worry pertains to running out of pills. As right now I'm only getting 30 per month. I'll look into some of the videos as well.

As for your question, 99% of days for the last 8 months I've dosed the same. I always take 0.5mg once at night. However, I mentioned 0.75mg because over the last couple weeks, every few nights the 0.5mg hasn't been "doing it" for me, so I would take extra. This has not been a norm at all, but has started to become so...which is concerning me.

I'm pretty positive I've been going through tolerance withdrawals and/or interdose withdrawals. As for the first 4 - 5 months, taking 0.5mg at night would leave me feeling great for the whole night, and even pretty good for the entirety of the following day. But now (especially after 2 - 3 failed tapers in which I did so way too fast) 0.5mg is soooo much LESS effective than it used to be.

I feel pretty comfortable at night, but always feel sicker & sicker the next day until I take my nightly dose again.

Do you think it's a good idea to updose to 0.75 and stabilize before I taper? Or should I just try and stick it out on 0.5mg? My concern is I'm not really stabilizing at this dose though...I'm continuing to get worse each day. I should also note my nervous system is extremely sensitive. I'm officially diagnosed with autonomic dysfunction a year and a half ago after a really bad infection (which is why I started on benzos in the first place). All my docs have said they'll make me worse in the long run and further damage my ANS - but no one has been willing to help me get off them properly.

Also, have any members had success with slowly switching their dose to 2x per day instead of 1x per day to taper? Hoping taking K every 12 hours instead would keep my blood levels steadier.

Thank you!

Most members will dose more than once a day, even those who take Valium, this will help you feel better during the day but your sleep is going to suffer unfortunately.  I wonder if you might try splitting your dose before going up in dose, this may be a way to help you feel better or it may make it clear you need to go up to .75. 

Given your diagnosis, you may just want to go up to .75, stay on that dosing twice a day then begin.  The problem with all of this is that you're the subject in this experiment and all I can do is make suggestions. 

I've providing some links to you to check out, it will be good to familiarize yourself with your options while you're waiting to begin your taper.

Bob7 Benzo Dry Taper Method 

Dry Taper Math