How do I switch from PM dosing to AM dosing??

I’m currently at 0.14 mg of Ativan once daily in the evening. I’ve been taking it this way since I started my taper with no problem, but lately I’ve been feeling more anxiety during the day and would like to switch my PM dose to the morning instead. What’s the best way to make the switch without messing up my taper and blood levels??

Thanks!

Have you considered splitting your dose and taking it twice a day?

If you want to stay with one dose and move it to the morning, I think the gentlest approach would be to move your dose up by about 2 hours a day until you get the dose-time where you want it.

Have you considered splitting your dose and taking it twice a day?

 

I actually tried switching to twice a day about a month ago and felt really awful. 😔

If you want to stay with one dose and move it to the morning, I think the gentlest approach would be to move your dose up by about 2 hours a day until you get the dose-time where you want it.

 

Thanks, badsocref. I'll give that a try. I tried moving to twice-daily dosing about a month ago and I felt pretty bad so I went back to once a day. Do you think with these low doses I'll be able to continue with once-daily dosing until the end of the taper? If I split the dose, I'm taking half of my dose twice daily and I feel like it's too much of a cut per dose.

Yes, the overall drop from a split dose could be a bit brutal, esp. at low dose (and depending on ones response to half life and interdose wd).. A different situation and med, but fwiw, when I did similar I balanced out for the most part over the same period as a decent cut took.. I  did also go from one to twice daily at low dose valium with no change, but went back to a single dose (for splitting ease) after only 2-3 weeks..

 

I was thinking if you DID want to go to twice daily, perhaps a slower transition, either by slowly extending out half the dose (as per Bads ^) or/and moving a much smaller portion and building that up to half a dose 12hrs apart.. That might need titration for the dose sizes, Im not sure if you are titrating from memory..??

 

Personally, I would be reluctant to upset the cart unless there is a defined need though.. Low dose can be “interesting” at the best of times, giving consistency even more value (imo)..

 

Just some general thoughts, not so much specific to you as such..

 

 

There is a strategy for going from one to two doses per day.  You can't simply take half the dose at 9 am and take the other half at 9 pm.  If you do, you'll be in a slight withdrawal for 2-3 days.  There is a 'fudge factor/dose' that needs to be employed.  It's a little tricky.

Thanks, everyone. I am going to try and stay at one dose/day and slowly change the time. Fingers crossed it goes fine.

Cantfly, I agree that it's not a good idea to make too many changes at these low doses!

There is a strategy for going from one to two doses per day.  You can't simply take half the dose at 9 am and take the other half at 9 pm.  If you do, you'll be in a slight withdrawal for 2-3 days.  There is a 'fudge factor/dose' that needs to be employed.  It's a little tricky.

 

 

Hello. I have thought about splitting my klonopin 0.5 mg from just at night to 0.25 mg twice a day and then tapering. I am interested in the strategy you are talking about. Can you elaborate further? 

 

thx seekingtoheal

Let's imagine you take your current 0.5 mg dose at 9 pm, and that you want to split to two doses 12 hours apart (9 am / 9 pm).  If you simply start taking 0.25 mg the next morning at 9 am, you end up increasing your dose since you didn't normally add drug at 9 am.  But if you wait until 9 pm and take a half dose, you clearly get less drug.

 

The approach is to model the hourly blood level of the drug, then to estimate the amount of drug required to keep your average daily blood level constant.  For split of 0.5 mg klonopin going from one to two doses, I calculate that you'd want to take a 0.133 mg dose of klonopin the first morning that you move to two doses, then take 0.25 mg doses thereafter (both mornings and evenings) until you begin your taper.

Let's imagine you take your current 0.5 mg dose at 9 pm, and that you want to split to two doses 12 hours apart (9 am / 9 pm).  If you simply start taking 0.25 mg the next morning at 9 am, you end up increasing your dose since you didn't normally add drug at 9 am.  But if you wait until 9 pm and take a half dose, you clearly get less drug.

 

The approach is to model the hourly blood level of the drug, then to estimate the amount of drug required to keep your average daily blood level constant.  For split of 0.5 mg klonopin going from one to two doses, I calculate that you'd want to take a 0.133 mg dose of klonopin the first morning that you move to two doses, then take 0.25 mg doses thereafter (both mornings and evenings) until you begin your taper.

 

 

Thank you. What is the formula to convert pill weight to mg?

 

Thx

You have to weigh an intact pill to do that calculation.  Best to weigh ten pills and get a good average weight.

Basically is 0.17 g for 0.5 mg pills

 

I can feel more symptoms in the afternoon after taking a 11pm dose.

 

Thank you

If 0.170 grams of pill = 0.5 mg of drug, then how much pill weight does 0.133 mg of drug equal?

 

= 0.170g x 0.133mg / 0.5 mg = 0.045 g

If 0.170 grams of pill = 0.5 mg of drug, then how much pill weight does 0.133 mg of drug equal?

 

= 0.170g x 0.133mg / 0.5 mg = 0.045 g

 

Thank you

If 0.170 grams of pill = 0.5 mg of drug, then how much pill weight does 0.133 mg of drug equal?

 

= 0.170g x 0.133mg / 0.5 mg = 0.045 g

 

Hello.

 

I took the 0.133 mg yesterday and then started with 0.25 mg that night around 11:30 pm and took 0.25 mg this morning around 11 am. Since I had been on 0.5 mg at night I would assume it takes a few days for the body to adjust to the split dosage, is that correct?  My plan is to stabilize on the split dose then start a taper on my daily dose.

 

thx

Yeah, it makes sense to me to wait at least a few days to see how you're doing.  Hopefully, the switch goes pretty easily.

thx....main symptom is the feeling of rapid heartbeat and feeling jittery...and my tinnitus sounds louder

Yeah, it makes sense to me to wait at least a few days to see how you're doing.  Hopefully, the switch goes pretty easily.

 

badsocref do you still have tinnitus? I am on day 2 of my split dose and am hanging in there. I have tinnitus which started me down this path and am not sure if they klonopin seems to make it louder.

I have some tinnitus.  It's not bad.  I usually don't notice it unless somebody asks.