Water tapering problems

Hello, I am halfway through tapering 1 mg klonopin. I had been using a liquid compounding pharmacy but due to costs I had to switch to water taper. It’s been 18 days since I switched, held the first week it was also a brand change to TEVA. .

My withdrawal symptoms are so much worse!! Instead of just morning cortisol surge, it’s lasting all day. I can’t function or think. Chest pain and palpitations, severe headache, trigeminal neuralgia,, toxic sleep, burning legs, all sorts of awful symptoms.

Could it be from switching from sugar syrup water with meds crushed in it or the brand change? Will I ever acclimate?

I am putting 0.5 mg tab in 180 mls water, withdrawing by 1 ml increments every day, dosing 3 times daily.

Please help!, I am 64 years old and have lost everything including my career and home in past 18 months

Ativan is very poorly soluble in water.  Some people try to make a suspension in water alone, but it's probably one of the least effective/reproducible approaches available.  A publication I recently found demonstrated an average 10% reduction in the actual amount of delivered drug when water (only) was used to disperse the pill.  And the variability was also much higher versus when the pharmaceutically-prepared formulation was used.

So I think you're getting less drug - perhaps quite a bit less drug. 

I think the drug dispersion works much better if the pill is mixed first with a few ml of alcohol (or propylene glycol) for a few minutes before adding the water.

Hello Maureen1957,

I agree with badsocref that there is very little reliability in a pure water taper, especially for clonazepam. This may be causing some or all of your increased symptoms.

It sounds like you're doing a daily water discard method, and you're missing an important step. To get your clonazepam to at least partially dissolve in the water, you will need to add a very small amount of solvent. A rule of thumb is 2.5ml of 180 proof alcohol to each 1mg of clonazepam.

The strength of the alcohol is important for this dissolution stage to happen quickly; I use 180 proof. If you can't source something like this, I can go over some steps that will help make better use of more dilute alcohol.

For your described formula, I suggest combining a 0.5mg tablet with 1.25ml 180 proof alcohol (1/4 US teaspoon) stirring occasionally and waiting 20-30 minutes or longer if you have time. This will allow the clonazepam to hopefully dissolve.

After this dissolution stage, add water carefully to create your full volume of 180ml. This doesn't mean to simply add 180ml; it would be more like 178.75ml water added to the alcohol and tablet slurry. If you do the alcohol step in your measuring vessel, you'll then just add water carefully until it reaches the 180ml mark. You can create a 180ml mark with tape or a sharpie on just about any vessel if you have another way to measure 180ml (it's 3/4 of a US cup btw).

Be sure to stir your 180ml solution/suspension of clonazepam thoroughly, and then withdraw your discard dose from the middle of the volume of liquid.

I see that at least for the initial pulls, 1ml will equal about 0.55% reduction of your total dose per day. This is middle-of-the-road for a DMT; but once you get down to 0.375mg/day (135ml of solution after reductions) this will be closer to a 0.74% reduction and may be unmanageable. At this point, I suggest using the same recipe above, only with 0.375mg of tablet pieces (3/4 of a 0.5mg tablet) and beginning again at 180ml, removing 1ml per day (from the beginning!); this will again be a 0.55% reduction per day.

What are you using to withdraw your discard amount?

Do you have any other questions or concerns?

Badsocref, do you mind if we keep our tapering discussions on the forum, and not in private messages?

SlowNSteady,

 

You posted, "A rule of thumb is 2.5ml of 180 proof alcohol to each 1mg of clonazepam."

 

If we're going to post 'rules', we need support.  Where is the evidence that 2.5 ml of 180° alcohol is required to solubilize 1 mg klonopin?

Just for clarity, a "rule of thumb" is:

1 : a method of procedure based on experience and common sense

2 : a general principle regarded as roughly correct but not intended to be scientifically accurate

https://www.merriam-webster.com/dictionary/rule%20of%20thumb

Ultra2007 is the Benzo Buddie who taught me this rule of thumb. I've used it both for daily water discard tapering and for creating a concentrated form of liquid clonazepam.

I hope this clarity about my use of phrasing is helpful for you Maureen1957.