standard dry-cut taper is raising my tolerance to klonopin

I started my taper as advised starting at 1.0 mg klonopin 10-14 days and then cut 10% of current dosage. I was taking 1.0 mg klonopin and getting 4-5 hours of sleep per night. But now this is only the first week of my taper and it now takes 1.5 mg to get 3 hours of sleep, which indicates to me that my tolerance is increasing. I have a simple exponential equation that tells me approximately hoe much klonopin is in my system at any time, and it has gone from 1.274 mg to 3.18 mg in 6 days because of it's average half-life of 35 hours. I know that my tolerance should br going slowly down in this program , not up. Maybe I should take it every other night to stabilize my tolerance because of klonopin's long half-life. Are there any suggestions?

Hello concernedforall,

Did you stay at 1mg/day until you were fully functional i.e. stable? Depending on how your nervous system was doing, this could take a week to a month, it's very individual.

 

You say this is your first week of tapering, but you also say you've raised your dosage from 1mg/day to 1.5mg/day, which is not a taper. Were you dosing "as needed" each day? It seems like this would be your habit, given your benzo use history; this strategy doesn't seem to work for tapering, in my experience. What seems necessary to stabilize and then to taper is a consistent dose that doesn't change based on day-to-day symptoms. Sometimes we taper too quickly and need a higher dose to regain functionality, but I've noticed that there's more often the need to weather some discomfort and hold until stable.

 

Dosing every other night is not generally advised. This doesn't seem, in my opinion, to promote the kind of nervous system stability that is needed throughout a slow taper.

 

I suspect that your dosing behavior and by association your relationship with the drug as a coping strategy for anxiety, are two important areas to focus on right now. I suggest setting a personal goal to pick a dose (originally you'd chosen 1mg/day, but maybe 1.25mg/day would be more manageable, it's entirely up to you), and dosing this consistently for at least two weeks. Consistency of dosing is paramount, IMO, to tapering.

 

It sounds like falling and/or staying sleep will be something you struggle with; but it's also something that can be learned and gets easier with practice. I suggest turning to skill-building around these symptoms, and not using the clonazepam to fix these symptoms unless they are completely debilitating.

 

I hope this helps.

Hi slownsteady,

 

1,0 mg worked fine for the first 3 nights and I got 4-5 hours of sleep. then I suddenly had to use 1.5 mg to get 3 hours of sleep, so I'm assuming that my tolerance is going up, and 1.0 mg is not working any more, at least for sleep.

 

concernedforall

It takes sometimes a week or longer for the peak of withdrawal symptoms after a clonazepam reduction, due to it's half-life. I doubt that your tolerance is going up; I think your physical dependence is just to a higher dosage than you realized.

 

If you decide to stabilize on 1.5mg/day, it can take 5 days or longer of regular dosing to experience the full effect of this dosage. Over that time, the doses will layer, again due to the half-life. You've said you understand as much.

 

I think your sleep disturbance isn't a direct indicator of your dosage requirements going up; I think that given your changing dosages, it's more of an indicator of misjudging your physical dependence combined with the disruption to your nervous system from these adjustments. In my experience, stabilizing the nerves can take more time than just bringing the drug up to full potency on a previously stable dose.

 

In my mind, your situation does not indicate a clear case for significant tolerance at 1.5mg/day. Instead I see a situation where your irregular dosing made it hard to know what daily dose you'd be stable on, and I think 1mg/day may have been a little too low from your dependent dose than you are willing to tolerate right now in terms of withdrawal symptoms. 1.5mg/day may be much closer to what you've become physically dependent on, and I suggest holding at this dose until your nervous system can stabilize.

 

I'm a little concerned that you went "suddenly" to 1.5mg to get more sleep. That was why I was cautioning earlier about dosing consistency being fundamental, IMO, to tapering success. If you weren't functional and you made a well-considered decision to updose, then I understand that and I support your efforts to remain functional. But if you grabbed more medicine impulsively to feel better quick, perhaps suggested by such a large increase in dosage, you might want to be aware of this behavior pattern going forward.

 

Either way, I hope you start feeling more functional soon. 

You could be right about my physical dependence being higher that 1.0 mg . I started at 1.0 mg because I could sleep at that dose. Then it suddenly didn't work anymore.Maybe I should start at 1.5 mg. Insomnia seems to be my main symptom, and I never had this before my tolerence to the drug went up.

 

concernedforall

Hi concerned

 

When we first started this discussion I suggested you start at 1.125, as I had my doubts about 1mg.

Hi concernedforall

 

Usually the best starting point is to stabilize by taking a regular dose at a regular time. You've been taking 1-1.5mg of K. It might be good to see how you respond to a regular dose of 1.25mg? That means taking 1.25mg every day for the next week or two to see how you're responding. You should feel the effect within 2-3 days. If your symptoms are manageable, great! If your symptoms are too difficult to manage, then you can go back up to 1.5mg. Ideally we want to start at the lowest dose possible. But I'm a bit hesitant to cut you straight to 1mg as that might be a bit too much handle.

 

I agree with slownsteady that it's probably not tolerance but rather your physical dependence you have underestimated.

 

It would probably be better to stabilize at a higher dose, either 1.125 or 1.5mg. If you start at 1.125mg you will likely experience withdrawal symptoms. It is also important to realize that unfortunately you will encounter withdrawal symptoms and sleeping difficulties as you go lower in dose. The best way to mitigate the sleeping issue is through alternative strategies such as acceptance and meditation and probably a slower taper rather than reaching for more meds.

 

Ever since I started my taper I have had sleeping problems and I had to accept it as part of coming off these meds and made peace with it.

 

I suggest you choose a starting dose to stabilize at that you feel comfortable with and take that dose consistently for a few weeks before you start tapering. Then let's see how things are going. 

 

Hopefully the higher dose will give you better sleep .

Keep us posted how you're doing.

 

Hi jelly baby,

 

I think that you and slownsteady are probably right about my underestimating my dependent dose, although I did get e few nights of good sleep at 1.0 mg Maybe I should try 1.25 mg which is the average of 1.0 mg and 1.5 mg and see how that works.One thing that I noticed is the muscle spasm along my left arm has disappeared. It's now just acute insomnia and frequent peeing. Before I started to taper, I would sometimes go for 5 nights with only 1 hour sleep. I guess you know what that is like.

 

Your input is always appreciated. Have a good rest of your day.

 

concernedforall

Yes either 1.25 or 1.5mg would probably be a good start. I see I mistakenly referred to 1.125mg in my previous post but you picked up on that. 

 

We're always happy to help. Most of us have been where you were before so we understand what it feels like.

hi jelly baby,

 

I'm starting with 1.25 mg, but it may take 1.5 mg. I'm experimenting at this point. Here is something that you may find interesting. I started taking large quantities of garlic into the start of my taper, and shortly after that I had that one night when even 2 mg didn't put me to sleep. At first I thought that my tolerance was suddenly climbing, I looked up mixing garlic and benzos on google, and found that garlic reduces the effectiveness of the benzos. So if you take a large clove of raw garlic and say 1.0 mg klonopin, the klonopin won't work. By taking raw garlic, I was completely ruining my taper. Well, I stopped the garlic immediately, and now I'm starting to sleep again. I don't know the exact mechanism as to why raw garlic nullifies benzos, but it does. Just thought you might want to know that. I actually went through 3 months of spring before I realized what was actually going on with me. I thought it was "Spring fever".

 

I hope your taper and your life is going smooth!

 

concernedforall

Well that's really interesting. It's incredible how many things interact with benzos. Thanks for sharing. 

 

I'm glad your sleep is returning. Lets hope your taper will be able to settle and stabilize. Please keep us updated!

Hey concernedforall,

I don't doubt your experience, but a quick web search yielded this:

 

The results of the clinical studies suggest that garlic does not affect the metabolism of alprazolam or midazolam, and therefore no dosage adjustments would be expected to be necessary if patients taking these benzodiazepines also take garlic supplements.

http://medicinalplants.us/herb-drug-interactions-garlic#Garlic_Benzodiazepines

 

I could not find any evidence or articles supporting a significant drug interaction between benzos and garlic. Would you mind sharing what you found? 

Hi jelly baby,

 

I guess I spoke too soon. I got 4.5 hours of sleep on the 1.25 mg and felt pretty good. Later on I went to the gym and had a pretty intense work-out. I know not to work-out at least 4 hours before you try to sleep, but a lot of times my adrenaline is still raging through my system even after 8 hours from working-out. So, despite taking my dose of 1.25 mg, I only got 1 hour of sleep. I suppose that I should expect that, even taking a dose of klonopin with my hyper-adrenaline system. I guess what I'm asking is it pretty normal to have your sleep time wildly fluctuate like that even when you are taking a stable dose of klonopin?

 

concernedforall 

It sounds like your nervous system is what's still fluctuating, not your dose. So yes, I expect symptoms will vary from day to day, especially if you're putting your system under variable amounts of stress.

 

An intense workout is probably not a good idea for stabilizing; working out is not the difficult part for me, it's calming down after the excitement. I stick to a gentle body-weight routine right now, and sometimes I notice even a walk can disturb my sleep a little.

 

If you're having trouble winding down at bed time, you might want to explore the world of "sleep hygiene". There are articles all over the web describing strategies to help lower adrenaline before sleep. Something that I think also helps me is low-dose melatonin; I take a liquid form that is 0.1mg/drop, and I take 5 drops for 0.5mg at 8pm every single night. Larger doses don't seem as effective for me.

 

Again it sounds like it's your behavior and the condition of your nerves that are doing the fluctuating now not your dose, so with attention and time I think this will definitely keep improving. 

Hi jelly baby,

 

Starting my taper at 1.25 mg seems a bit too erratic. when I was going through that tough time in my life, I started using an average of 1.5 mg. It was after the time had passed, that I found I could hardly sleep without taking klonopin. So I'm going to up my starting dose to 1.5 mg.

 

I also have a question regarding the use of klonopin. It has an average half-life of 35 hours, so using a rate of decay equation, after using 1.5 mg for 10 days, you have accumulated about 3.925 mg in your system. Could that have any bearing on your tolerance to the drug? This was bothering me so I had to ask.

 

Also, I guess no matter what your starting dose is, will you find that your sleep time will go up and down?

 

concernedforall

 

It sounds to me you could possibly be in tolerance which means you'll constantly have to increase your dose to get the same effect on your sleep. I also started having sleep problems a year after starting clonazepam. I now suspect it was the start of tolerance.

 

Unfortunately it seems members who used benzos for insomnia have a particular difficult time with their sleep. I think it might be insightful to read some threads on the Insomnia board. I don't want to discourage you but once you've reach tolerance the only real option you have is reducing.

 

My sleep is also suffering and if yours is extremely bad like some folks on Insomnia you might want to consider some of the remedies discussed on that board to help you every now and again.

 

I don't understand the maths you're referring to related to half life but I don't necessarily think half life is indicative of tolerance. I have seen people on short half life benzos develop tolerance over a short time and others on long half life benzos developing tolerance after decades. So I think tolerance is an individual biological thing. That's just my opinion, I'm happy to be proven wrong.

 

I'm sorry this is such a struggle but as you said your sleep will likely go up and down throughout this process.

 

 

 

 

 

I have to question WHY you are going up again?  STAY at the lower dose until your brain adjusts and you WILL get more sleep..you are just causing more problems for yourself by going up and down..it's not alllowing your brain to heal...start at a dose, then taper slowly down between 5-8% every few weeks depending on symptoms....but pretend you can't go up at all...

 

LIsa

I have to question WHY you are going up again?  STAY at the lower dose until your brain adjusts and you WILL get more sleep..you are just causing more problems for yourself by going up and down..it's not alllowing your brain to heal...start at a dose, then taper slowly down between 5-8% every few weeks depending on symptoms....but pretend you can't go up at all...

 

LIsa

 

Hi nurselisa,

 

I can see you're very concerned about concernedforall's situation but it's important to remember that we don't tell members what they must or should do, this would be prescriptive, please familiarize yourself with our policy.

 

Pamster

Please adopt a non-prescriptive writing style. Relating your experiences, stating options, or posting suggestions of what other members might do are all welcome. However, advising members of what they should or must do is against the ethos of the BenzoBuddies Community. Nor should you attempt to 'diagnose' medical problems or suggest medical treatments to other members. This policy also applies to members with medical qualifications. A more detailed explanation of this policy can be found in our Guidelines Regarding the Giving of Medical Advice document.

  STAY at the lower dose until your brain adjusts and you WILL get more sleep..

 

Unfortunately this is not guaranteed for everyone especially if you've hit tolerance.

thank you for your suggestions on how to help others. I really appreciate the feedback, and will pay closer attention to how i respond.  You are totally correct.

 

thanks

 

Lisa