Crossing from X to Clonazepam

Hi I'm in the US, (TN) am in the planning stage. My appointment w. Psychiatrist is Jun, he's "on board" and very cautious. Mostly to avoid making things worse per my age, prior brain damage... I'm VERY fortunate to have Dr, not a Clinic or State agency...

 

I got to do something, efforts to 'taper' off X have, in short failed. Surviving @ 3 mg daily.

 

Have several 1st hand reports Klonopin is more bearable to w/d. I expect this may take a year. Don't care.

 

Maybe because US, etc, the "Crossover of Choice". Doc knows there may be no other way I'll ever get better but may be up against "regulations" (can't Px 2 different things of same class) I know this varies by state.

 

CAN my Dr do a "cross over" (regulations)

 

Any input is welcome.

 

Thank you in advance

Hi I'm in the US, (TN) am in the planning stage. My appointment w. Psychiatrist is Jun, he's "on board" and very cautious. Mostly to avoid making things worse per my age, prior brain damage... I'm VERY fortunate to have Dr, not a Clinic or State agency...

 

I got to do something, efforts to 'taper' off X have, in short failed. Surviving @ 3 mg daily.

 

Have several 1st hand reports Klonopin is more bearable to w/d. I expect this may take a year. Don't care.

 

Maybe because US, etc, the "Crossover of Choice". Doc knows there may be no other way I'll ever get better but may be up against "regulations" (can't Px 2 different things of same class) I know this varies by state.

 

CAN my Dr do a "cross over" (regulations)

 

Any input is welcome.

 

Thank you in advance

 

What's your dosing schedule?  I'll see if I can come up with a decent crossover strategy for you to share with your doctor.

Hi I'm in the US, (TN) am in the planning stage. My appointment w. Psychiatrist is Jun, he's "on board" and very cautious. Mostly to avoid making things worse per my age, prior brain damage... I'm VERY fortunate to have Dr, not a Clinic or State agency...

 

I got to do something, efforts to 'taper' off X have, in short failed. Surviving @ 3 mg daily.

 

Have several 1st hand reports Klonopin is more bearable to w/d. I expect this may take a year. Don't care.

 

Maybe because US, etc, the "Crossover of Choice". Doc knows there may be no other way I'll ever get better but may be up against "regulations" (can't Px 2 different things of same class) I know this varies by state.

 

CAN my Dr do a "cross over" (regulations)

 

Any input is welcome.

 

Thank you in advance

 

I was asked to step in thiss thread because I, too, am an the Autism Spectrum, and live in the US, and while I've been able to mostly compensate, I still have those days where words fail me too. Your doctor can mostly certainly do a crossover. Valium is the preferred choice due to it's extremely long half-life, however many doctors are reluctant to use it. But Klonopin also has a decently long half-life, and you can certaily taper off of that. I actually crossed over from Klonopin to Valium.

 

basocref has offered to come up with a crossover strategy for you to switch  over from X to K, but he needs to know how many times a day you are taking your 3 mg X daily dose. Is it 1 mg 3x's a day, or is it something different? I just want to make sure you understand what he's asking for, I know from being on the Spectrum, things are understood differently. And you have some other issues that may be affecting your comprehension along with being on the Autism Spectrum.

 

If you can give the information asked for, badsocref will provide you with a crossover strategy you can present to your doctor. Once you complete the crossover, there are a number of resources here on tapering Klonopin, and experienced members who can assist you. But lets get you set up with doing a crossover first.

I appreciate the clarification.  Sometimes, I'm too terse for my own good.

I appreciate the clarification.  Sometimes, I'm too terse for my own good.

 

That's okay, you're used to dealing with Neurotypicals like yourself, not Atypicals on the Autism Spectrum, Pamster saw the mention of Autism Spectrum in her sig, and asked if I could step in and try to help out. I hope my explanation helps her with providing you the information you requested.

Pamster's pretty amazing for the way she remembers and connects people who can help each other.

Pamster's pretty amazing for the way she remembers and connects people who can help each other.

 

Yes, she is. Now we just have to wait to hear back from LostCause with the information you requested.

HI @BenzoLottie, @basocref & THANK YOU (pamster, also)

 

I should have been clear I'd be "throttling" interaction, when first came to BB I dove in 'gung-ho' (as taught in original SUD recovery) & made many folks uncomfortable (an Autie? Making ass of self?) and then my computer broke  ...

 

I think a sane "throttle" might be 24/48 hours... e.g. use BB (under directions) as part of my Program. (Check tail of my sig. ms. Pamster already has surely... there's other places for that) I should turn email notification back on for PM.

 

In TN - Px monitoring imposes limits. The rule was only ONE Px of BZ class... When I tried this before, doc first wrote my X and then "changed" me to K - (Good Pharmacist deserve more credit) I need to check with Pharmacist to see what's possible now.

 

'PLAN' also includes round up a 'Posse" - accountability PPL, etc. Have made some progress there

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Currently X is 3mg "prn, keep sX at bay" Saving at least 1.5 for sleep... (PTSD related insomnia)

 

X has 'hardwired in' an indelible death wish. all Doc's attempts to Px for "depression" fail under 4 days in... I don't expect getting "crossed over" to un-wire 'The Reaper', only make it possible to eventually detox. Doc's very concerned per "depression" so... Got to tell him X is the cause, and the reason it's not treatable - yet.

 

Willing to accept the drowsy, etc. Even the inevitable "never fully REM sleep"... (I'll figure how to cope as I go) And anything else - please fill me in? I'm expecting getting past the last .25 of X, and through the first couple weeks w/o it, suck it up don't go backwards "no matter what"

 

If going from 3mg X - to equivalent K what's the estimated (success) time-line? Could be I simply tried to get "crossed over" too quickly last year.

 

Want to have a Practical, possible "basic PLAN" then make deliberate decision to COMMIT... So I can be "clear" when I ask Doc this time.

 

SINCERE THANKS

 

Lc

 

 

 

 

basocref has offered to come up with a crossover strategy for you to switch  over from X to K, but he needs to know how many times a day you are taking your 3 mg X daily dose. Is it 1 mg 3x's a day, or is it something different? I just want to make sure you understand what he's asking for, I know from being on the Spectrum, things are understood differently. And you have some other issues that may be affecting your comprehension along with being on the Autism Spectrum.

 

Thanks for intervening - "other issues" - The tricky one's 'Primary Insomnia'. Mini-Stroke took out my "sleep switch" age 38

 

I just turned 63, so...  No, not quite. It's abundantly clear X accelerates "old age".

 

To help clarify for @basocref - 1.5-2mg "at night ONLY" was how it started 4 years ago (insomnia) ... Then "interdose", my now schedule's a 'Bell Curve' to maintain sleep/wake cycle.

 

My son works 2nd shift, comes home around Midnight, I go to bed soon after. Usually I wake up +/-11am

 

I divide the 3mg into 1/2's (six in the little tin).

 

First dose 5-6PM, .5mg, another .5mg w 60-90 min between  = (7:30PM, 1 mg)

9:30-10pm, take .5 = (10pm, 1.5mg)

11:45 take full 1mg , = (2.5mg)

usually I'm "down" 12:30-1AM

the last .5 saved in case I'm genuinely "stuck awake" (this seldom happens)

Now most nights at 3-4AM, ??? wakes me up, if I can't "re-Settle" 90 minutes,

That's the last .5

= 3 per 24 hour

 

Hope this helps.

 

If at all possible - I hope to retain some sort of sleep/wake cycle ?

 

My son works HARD, if I'm going to hit a spell of even LESS "able to keep house, cut grass, etc" please advise.

 

=======================

 

Please pardon late response, I'll be checking in here 24-48 hourly. ANY help is hugely appreciated.

 

Sincere thanks in Advance

LC

Thanks for the information.  It will take me a day or three to devise some cross-over approaches for you.  I'll post here when I've got something for you.

Thanks for the information.  It will take me a day or three to devise some cross-over approaches for you.  I'll post here when I've got something for you.

 

Humble thanks - open to anything you come up with.

 

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Meanwhile (@ everyone else)

 

I don't expect this "Cross-over Process" to be easy or without discomfort - As things unfold, someone advise how to know when I'm forcing the process too fast, etc. (or prolonging it). Am deeply invested per: DON'T Fail.

 

Sincere Thanks

Lc

 

 

HI @BenzoLottie, @basocref & THANK YOU (pamster, also)

 

I should have been clear I'd be "throttling" interaction, when first came to BB I dove in 'gung-ho' (as taught in original SUD recovery) & made many folks uncomfortable (an Autie? Making ass of self?) and then my computer broke  ...

 

I think a sane "throttle" might be 24/48 hours... e.g. use BB (under directions) as part of my Program. (Check tail of my sig. ms. Pamster already has surely... there's other places for that) I should turn email notification back on for PM.

 

In TN - Px monitoring imposes limits. The rule was only ONE Px of BZ class... When I tried this before, doc first wrote my X and then "changed" me to K - (Good Pharmacist deserve more credit) I need to check with Pharmacist to see what's possible now.

 

'PLAN' also includes round up a 'Posse" - accountability PPL, etc. Have made some progress there

 

 

I'm just the mediator, Pamster read your sig and facilitated connecting us. I use BB as needed, it can be overwhelming for someone on the Autism Spectrum.

 

It's unfortunate your state allows only 1 RX of a benzo a a time, have you checked with your pharmacist to see if that's changed? Do you have any unused X lying around? Could your doctor increase your X so you can build up a stockpile you can then use for your crossover? That may be a way to get around that law, if it's still in place. I don't know what else to suggest.

 

Please pardon late response, I'll be checking in here 24-48 hourly. ANY help is hugely appreciated.

 

Sincere thanks in Advance

LC

 

 

Check in when you feel you can. I see you gave badsocref the info needed to create a crossover schedule for you.

 

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Meanwhile (@ everyone else)

 

I don't expect this "Cross-over Process" to be easy or without discomfort - As things unfold, someone advise how to know when I'm forcing the process too fast, etc. (or prolonging it). Am deeply invested per: DON'T Fail.

 

 

 

I can help with this part of your process, I'm not good at the numbers tapers involve but I can jump in with the coaching aspect of it.

There are two ways to do this cross-over.  I think that the 'gentler' approach is to use Xanax with klonopin for a week until the level of klonopin has built up in your body.  We'd just start the klonopin using the same schedule as you're currently doing Xanax and supplement with decreasing amounts of Xanax for about a week.

 

The other way would involve only klonopin (no 2nd benzo).  We'd have to deliver an increased dose of klonopin for a day to quickly bring up the levels of that drug in your body.  You'd basically take something like 6 mg of klonopin the first day (on a schedule) then drop back down to your normal dose of 2.5 to 3 mg per day.

 

If option #1 isn't possible in your location, then I guess it has to be #2.  You might wish to speak with your doctor about these options.  Sometimes, they have more options than you think.  Just takes an extra letter to the right people.

 

If option #1 isn't possible in your location, then I guess it has to be #2.  You might wish to speak with your doctor about these options.  Sometimes, they have more options than you think.  Just takes an extra letter to the right people.

 

Have noted both methods...

 

The Pharmacist wasn't in when I dropped by, but will check earlier in the day - it'll probably be after Wednesday. Is really good Pharm, he'll bring me up to date.

 

Will be checking back in soon - your 2nd method (starting high on Clonopin in order to "dump" the X straight off) I've not heard of before. 

 

Thanks to everyone

LC

So here's a little more explanation (and a picture) for you and your pharmacist...

 

http://enchantedskies.net/XtoK.jpg

 

The graph shows about 11 days worth of total benzo (in terms of therapeutic equivalence) in the bloodstream for a person taking 3 mg of Xanax at the time points you indicated (including the optional 3:30 am dose).  The top graph shows what happens if we abruptly switch to an equivalent therapeutic dose of klonopin.  The Xanax is eliminated very rapidly, but the klonopin takes several days to build up in your bloodstream.  Eventually, the average therapeutic level of klonopin reaches that of where the Xanax average was.

 

The amount of klonopin in your bloodstream can be jumpstarted by increasing the amount of klonopin on the first day.  After the first day, you'd go to the maintenance level.  I'm assuming it will also be 3 mg a day as the crossover value I saw for Xanax to klonopin was 1:1.  If your pharmacists prefers a different ratio, we can work that out.