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Advice on Klonopin taper for short term user


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Any advice on best taper plans for 4 months use?

 

I was able to get to .25 and .5 easily after a month but struggled to decrease from there but was cutting 1/8 pill or for 3 days tried cutting daytime entirely, not realizing how fast I was going (was going by what psychiatrist recommended)

 

Psychiatrist added ssri and told me to go back to .5 and .5 while I onboarded ssri. And I’m nearly 3 weeks in and increase in anxiety from Zoloft improved.

 

Looking for advice or success stories from other short term benzo users.

 

Never used a benzo before this - but did use Ambien historically (quit cold turkey in Oct, started Klonopoin in Nov)

 

Cut 1/4 day pill 4 days ago and slight increase in anxiety but doing ok thus far. Debating if I can go 1/4 to half pill since I have only been at .5 and .5 4 weeks and was able to cut .5 in half for day easily last time... I just tried moving too fast after that, and will plan to do 10% taper after that.

 

Thanks for any advice!

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Any advice on best taper plans for 4 months use?

 

I was able to get to .25 and .5 easily after a month but struggled to decrease from there but was cutting 1/8 pill or for 3 days tried cutting daytime entirely, not realizing how fast I was going (was going by what psychiatrist recommended)

 

Psychiatrist added ssri and told me to go back to .5 and .5 while I onboarded ssri. And I’m nearly 3 weeks in and increase in anxiety from Zoloft improved.

 

Looking for advice or success stories from other short term benzo users.

 

Never used a benzo before this - but did use Ambien historically (quit cold turkey in Oct, started Klonopoin in Nov)

 

Cut 1/4 day pill 4 days ago and slight increase in anxiety but doing ok thus far. Debating if I can go 1/4 to half pill since I have only been at .5 and .5 4 weeks and was able to cut .5 in half for day easily last time... I just tried moving too fast after that, and will plan to do 10% taper after that.

 

Thanks for any advice!

Hello I am not a short-term user but I strongly recommend you divide your pills more evenly. I cannot see how you can cut a pill into eight and expect an equal dose.

An equal amount is essential for a smooth taper.

Have a look at the liquid titration section on this forum or ask your doctor for some liquid Clonopin.

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Thanks Journey!

 

Right now I’m using a scale so my pill is 16g and I’m cutting to ensure equal at 12g. But once I go down lower I will probably see if I can get it compounded to drop as I get lower.

 

So far 5 days post dropping 1/4 of day, in doing alright. Some increased anxiety (but also from reading this forum and seeing how hard this might be to get off of!) and a little swooshing in my ear as I went to bed last night. But otherwise doing ok.

 

I’ll see how I’m doing towards the end of the week and maybe drop to 10g (so a little over half a pill for day time) and judge from there. But I am trying to keep it consistent with the scale and hoping for the best!

 

I was able to get to .25 and hold at .5 for night when I first tapered, and just went up to .5 and .5 for a month while I got on an SSRI (first tried Lexapro and made me super out of it, been on Zoloft now almost 3 weeks) so hopeful I can get back to that without a ton of issues, but from there will make sure I do 10% or less, given the issues I had the first two times I tried to taper.

 

Thanks for your thoughts! I really appreciate the advice!

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Thanks Pamster! Just posted on that thread. I appreciate it!

 

Good news is 6 days in now on dropping 1/4 daytime pill and doing alright - increased anxiety but manageable (meditation, workouts, distracted by work, deep breathing, etc) so I'm glad for that, and hoping my next drop goes well. I meet with my psychiatrist on Fri and hope he supports a slow tapper. He's seemed to listen to my needs before, but also is very laissez faire about dropping Klonopin, saying I just start to take 'as needed' once the Sertraline kicks in, and telling me a few months ago to just 'drop the day time dose' if I wasn't anxious during the day (which 3 days later led to horrible panic, insomnia and me then getting put on an SSRI). Fingers crossed!

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Its great to hear you're employing so many coping skills, this is exactly what you should be doing but I'm concerned about your doctors attitude, it doesn't sound like he's encountered a patient who has had difficulty getting off of these drugs.  That's the problem, not everyone does so they tend to lump us all in together.  I hope he's willing to listen to you and learn from your experience so he can help the next person.
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Yea 100% agree. It definitely worries me. I have reached out to a few other docs in the area that sound like they do support slower tapers, but they aren't on insurance. So will start first by talking to my current psychiatrist to see how he responds to the discussion. And decide whether he'll support me or if I should pay out of pocket and find a new doc. Fingers crossed!
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I actually just got an email from my CBT-i (insomnia specific treatment) therapist I have been working with. Again, it doesn't sound like she's seen people have as much trouble as I think I was having coming down off the med at .25 each week and seems to think that pace is safe. So I will push back and talk about the 10% method (especially bringing up my history with Ambien before this as what might make this harder, and make me respond more like a longer term user), but thought her approach with relaxation techniques and CBT tactics to work through the withdrawal sounded interesting. Would love you (and the groups) thoughts on this and the research she cited:

 

"I think it makes sense that your anxiety at night would improve slightly now that you've been on Zoloft for 2 weeks. 2-3 weeks is typically when people experience the initial benefit, and 6-8 weeks is when they should experience the full benefit.

I feel really confident about being able to wean off the Klonopin once you're at full benefit. That leads into the question about the weaning process - most of the time when people are experiencing horrible side effects it is because they are weaning too quickly or because they have been benzodiazepine-dependent for years. Since you are under 6 months of consistent use, I don't expect the latter to be a factor. In terms of setting up the wean, I have worked with people tapering off of Klonopin and Xanax and typically we decrease by 0.25 mg at a time. The clients I've seen haven't had negative effects from that, and most of them have been on an SSRI prior to the weaning process. That being said, if you are worried that 0.25 mg decrease alone may not work for you, there is research showing that the Otto method is effective. With this, you would decrease by 0.25 mg every 5 days and we would use relaxation training to mitigate symptoms during the taper. Here's a link to the study on the Otto method:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962448/

Essentially, they say that many people experience "withdrawal" symptoms during a taper even when it is slow enough (i.e., 0.25 mg every 5 days) due to anticipatory anxiety and somatic sx associated with knowing they are starting the weaning process. The relaxation training condition and the CBT exposure condition both helped people to not experience withdrawal symptoms. There is no biological reason for withdrawal symptoms at a schedule of -0.25 mg every 5 days, so their hypothesis is that it is a somatic anxiety condition (which makes sense, because all of the people weaning have anxiety disorders, particularly those that are more physical in nature like panic disorder). Some people find the relaxation training more helpful (in the article, it is the IRT condition) and some people find the CBT exposure training more helpful (in the article, it is the PCT-BD condition). I know how to do both, so we can do whichever you feel would be more helpful for you.

 

For the ketamine question about digging into the WHY (for context I'm starting ketamine treatment with another therapist tomorrow that is supposed to help dig into the why for my initial insomnia/anxiety): I think it could absolutely be helpful. I have a client now who is just realizing his anxiety, in part, comes from his daughter having a serious undiagnosed health issue as an infant which led to a stay in the ICU. Working through the why alone is typically not helpful, but I think that working through the why while also training in the how is very helpful. If you understand your why, it will help to notice, and either challenge or accept, intrusive thoughts associated with anxiety. It can also help people to be more compassionate and caring with themselves, which will only help anxiety recovery.

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This frustrates me, .25 mg every 5 days, anticipatory anxiety, no biological reason?  Okay it more than frustrates me, it makes me want to scream!

 

I get it, they have to go by the research and their experience but this leaves all of us out in the cold because they don't see us, they don't recognize us and won't treat us with the care we need.  Our members don't make this stuff up, we're not all mental patients trying to get attention, we hurt and need help. 

 

Okay, I'm done.  :-[

 

I'd like to suggest you put this information into a post on the Chewing the Fat board to generate some discussion.

 

 

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I know. It’s so frustrating and so similar to how my psychiatrist has talked about it in the past, and struggling to wean at .25 at a time must mean I have an underlying anxiety issue and need more meds.

 

I’m in my late 30s and never had an anxiety issue in the past, so how can they not see this is likely from the meds? How do I educate her and my psychiatrist to truly understand and help me take the right steps?

 

I like her thoughts on CBT and using that with withdrawal symptoms, getting comfortable and ok with the anxiety vs fighting it, etc. I agree that will help, but do they not know about PAWS? Why are so many skilled and experienced therapists and doctors so unaware how these drugs can impact us? I’m still going to push for a 10% reduction once I get to .75 (where I really struggled to come down from before) and do symptoms based weaning from there. Just because some people can reduce quickly doesn’t mean all of us can. And even in her study it showed like 40% that were ‘successful’ at getting off the benzos. How is that success?! What about the other 60%?!

 

It’s so frustrating that those that are supposed to be helping me, don’t really understand what can happen from benzos. I’m so glad I found this group to help me feel ‘normal’ with my response to drastic cuts. And want to prevent PAWS if at all possible, while figuring out the right way to wean (without staying on the drug longer than needed since it’s been short term)

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  • 1 month later...

Hey Pamster,

 

I just met with my CBT-i therapist who I worked with early on and had sent that response that I shared, where she didn't clearly didn't understand benzo withdrawal.

 

I told her today about my new benzo wise pscyh NP, and this forum, and all the data around benzo withdrawal and how I was going through acute withdrawal from Ambien when I saw her, which I didn't realize until after meeting with this doc, and how slow I am going to have to take it to get off benzos safely.

 

Her response was WONDERFUL. She apologized that she didn't know any of this, and that most patients she sees don't have issues getting off benzos, so she wasn't aware of what could happen, and how many people this can happen to. She asked me to share this forum with her, the benzo coalition and Ashton manual, as well as my taper log, so she can start getting better educated on benzos and what can happen and what to look for in the future. She then said this was her duty to fully understand this, given in CBT-i (insomnia specific therapy) so many people are on benzos or get on benzos, and that she will share this information with all of her colleagues to help better educate everyone, and be on the lookout for this, help people taper slower and send them the right info if she thinks they may be experiencing withdrawal like this.

 

She even said she will look into someone from the benzo coalition or my benzo wise doc to come speak to their team to ensure they are all better educated on this.

 

So while it's frustrating that this happened to me, and that she wasn't aware of what was happening (nor my psychiatrist, who was giving me these meds) I am so SO happy to know I am paying it forward, and am so glad she responded so so well to me giving her all this information and her desire to help improve education on this with her team and colleagues.

 

So huge thanks again to YOU and this forum for helping arm me with the right information, and cheers to getting more therapists better educated on benzo withdrawal and helping future patients get the support they need!

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This is such wonderful news and you're right, while it won't help you at this point it will help others going forward.  The fact that you're being listened to and validated is so important to your self confidence, I'm very happy for you.

 

Part of the acknowledgement you received I'm sure is because of how you handled the situation, if we come off as hysterical or accusatory our message won't be well received because defenses go up so for you to have this breakthrough speaks volumes to your delivery, well done.  :thumbsup:

 

 

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Thanks so much Pamster. I really appreciate that! I tried to just tell her my process as a story, vs. having anything accusatory towards her. She wasn't the one prescribing the meds anyway, but clearly didn't have experience in what withdrawal from these meds can look like. So she responded very well. And I think me seeing a benzo wise doc really helped it come to life for her. It's not just a board of (85k plus!) people, or a few random websites, but real experts that have medical degrees and know what is happening is real! So I'm really thankful I found Gail, the benzo wise doc, who I also found from BenzoBuddies. So I'm super grateful for you and this site. It is helping me and so many others through a very challenging time!! Thanks for all you do, Pamster!
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You're playing a huge part in bringing awareness of our plight, thank you for what you're doing!  :smitten:

 

Keep us updated on how you're doing. 

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