Coleman Out, Ashton In

Unfortunately, I don't have the stomach for The Coleman Institute at this point (rapid, Flumanezil-based "detox").

 

After reading many stories here, and speaking directly with a buddy, I've weighed my options and just cannot do it. I'm really disappointed, I had high hopes for this. I've been on Klonopin for 20+ years and just don't think I'll respond well to a rapid detox, even though I've tapered down to nothing before on my own, with very minimal issues.

 

I really wanted to get off sooner than later because I've been suffering from a MDD episode for over 500 days - I can almost guarantee was brought on by this poisonous drug. I want to pursue psilocybin treatment, but can't with this junk in my system, so I'll need to wait 6-9-12 months to taper the textbook way. I've put together a customized spreadsheet from Ashton's recommendations for coming off 1.5mg of Klonopin with diazepam substitute (https://www.benzo.org.uk/manual/bzsched.htm#s5). The starting date will likely change until I can get another pill pusher to write a script for diazepam for me. I don't have a psychiatrist at this point, and never want one again, but I'll use one to suit my needs. I took myself off 3 AD's and a mood stabilizer meds they put me on at the beginning of this 500 day MDD, and to no surprise, I feel almost NO different off the meds than I did on them. If anything, even a touch better.

 

The long road begins.

I'm glad to hear you're going to be gentle with your body!

What are MDD and TDD?

 

It sounds like once you have a prescribing doctor you can do a gradual step-wise crossover to diazepam and, if tolerated, taper from there. I don't know if you need a psychiatrist; my old PCP and my new PCP were both willing to prescribe benzos as needed, including liquids and pharmacy compounding. Is that an option in your situation?

 

Also, tapering clonazepam directly is something myself and other buddies have been able to do. It's a little bit more complicated, but doesn't come with the risks inherent in crossing to diazepam.

I'm also wondering if you have considered directly tapering clonazepam? If you run into problems with clonazepam then you can always consider switching to valium? Just a thought. I'm tapering clonazepam.

Thanks for replying!  TDD: Total Daily Dose (of what ever med you take multiple times during the day, the total amount) & MDD: Major Depressive Disorder. I’ve found a great doc who has already swapped me over to diazepam. I may start the slow taper down next week. It’s the Ashton method essentially.

 

In my opinion only, I don’t trust tapering K only. The dosing increments you can get (in the US) and the high potency make it feel like you’re going down big steps, instead of a smoother slide with V. It’s not perfect for me given MDD, but I’ve listened to too many docs who don’t even know about the Ashton method, but are more than happy to keep pushing more scripts for benzos long term. So, I’ll stick with what’s published and known.

 

Thanks again.

 

Chris

I'm glad to hear you're going to be gentle with your body!

What are MDD and TDD?

 

It sounds like once you have a prescribing doctor you can do a gradual step-wise crossover to diazepam and, if tolerated, taper from there. I don't know if you need a psychiatrist; my old PCP and my new PCP were both willing to prescribe benzos as needed, including liquids and pharmacy compounding. Is that an option in your situation?

 

Also, tapering clonazepam directly is something myself and other buddies have been able to do. It's a little bit more complicated, but doesn't come with the risks inherent in crossing to diazepam.

Hi Grant3405,

Thanks for clarifying your abbreviations! I'm glad to hear you have a supportive doctor.

 

I understand from your signature that you have been rapidly crossed to diazepam from clonazepam. It looks like you began your three step crossover 8/23 and began the third step 8/27. This is not the timeline used for clonazepam in Dr. Ashton's slow taper schedules; for example her schedule for 1.5mg of clonazepam to diazepam suggests six steps, for a suggested total adjustment period of 6-7 weeks.

https://www.benzoinfo.com/ashtonmanual/chapter2b/#schedule5

 

I just want to caution you that from what we know about the pharmacokenetics of these two drugs (K & V), there are a few complications that may arise doing a crossover this quickly.

 

First of all, I want to clarify that if the third step of your crossover began on 8/27, that's not, in my opinion, a completed crossover. Instead my understanding is that the last step of a crossover is a final adjustment period that may take an additional 1-2 weeks, per Ashton's guidelines. I'm concerned that in thinking you're done crossing, you may be confused when withdrawal symptoms emerge or intensify during this time-period.

 

Clonazepam has an average half-life of ~35 hours; diazepam's primary metabolite has an average half-life of ~120 hours. What this means is that on each step of your diazepam crossover, you are making a clonazepam reduction which takes maybe 3-9 days to actually be eliminated from your body, and starting a diazepam build-up in potency which can take maybe 1-3 weeks. So there is some discrepancy, on average, between when the clonazepam is eliminated and the substitution dose of diazepam is up to the potency used to define it's Ashton equivalency.

 

My suggestion is to hold on your current dose of diazepam for 1-2 weeks minimum, and to consider any symptom changes as a possible combination of insufficient diazepam potency (which is building) and/or incompatibility with the diazepam as a drug or as dosed; hopefully nothing like this will happen, but I think it's not uncommon.

 

You may not experience any withdrawal symptoms during this crossover; it's an entirely unique-to-you kind of thing, like the rest of benzo tapering. But the pharmacokenetics are important to me in terms of anticipating and minimizing the risk of symptom severity, and where I would look first if things are getting rocky for you in the near future.

 

I am wishing you continued ease and progress on your crossover and following diazepam taper! I hope this helps.