5 months on Clonazepam (Rivotril) with 0.5 dosage

Hello,

 

My name is Alex, I had / have problems with anxiety and I was prescribed Clonazepam( Rivotrol) 0.5 a day + Escitalopram (Cipralex) 1/2 x 10mg.

The duration of these 2 drugs is now about ~5 months.

My present dose is 0.25 (as I am tapering down).

Would like to ask some advice regarding the taper.

 

After around 2 months I've developed tolerance / psychical dependency on the benzo and started to have more anxiety symptoms and disturbed sleep as well.

As this happened and became more intense and decided to start tapering the benzo, as I already got withdrawal symptoms just taking the same doze for 4-5 months, developing tolerance / dependency.

 

This is my current schedule of withdrawal that I wanted to respect (but gone a bit more rough on it):

 

Week My dose My Weight (grams)

0.5 0.15

1 0.5 150

2 0.45 135

3 0.4 0.12

4 0.35 0.105

5 0.3 0.09

6 0.25 0.075

7 0.2 0.06

8 0.15 0.045

9 0.1 0.03

10 0.05 0.015

11 0 0

 

Note: Would be much appreciated if I would get a hint for the antidepressant tapering as well.

As I know, for 1/2 of 1 capsule I took for 4-5 months, I can tap down in 1 month, but I am unsure.

 

Hello lex1989, welcome to BenzoBuddies,

 

It looks like you're benzo free, how are you feeling?  I would imagine you're still dealing with symptoms and if you are I would suggest not tapering the Escitalopram until things settle down a bit.  We have many members taking other medications so you'll get lots of helpful input.

 

I'll provide some links to get you started but please let us know how you're doing and if you need support, we're here to help you.

 

Pamster

 

The Ashton Manual

 

Post-withdrawal Recovery Support

 

Other Medications   

 

Thank you for the response Pamster.

 

I am not benzo free unfortunately, I still have 0.25 to go down. I would like to know what do you think about my schedule. Is it to fast ?

As I did took just 0.5 in ~ 4.5 months, about 2 months tapering should be fine ? Of course the anxiety started to be more long during the day, after started the tapering, but I assume this is normal until the drug is out of the system.

 

I don't feel great, but now worse either, I have anxiety in most part of the day and some depression as well (but this I got mostly after starting tapering down) , but not severe (mostly mild and medium), usually just accepting it there and moving on (this is the best way, see Paul David - at last a life, great book).

 

And also I see that I have pretty much the same overall feeling like many other do while tapering, being anxious in the morning, some in afternoon and finally in the evening it's starts to go down pretty well.

 

Should I ask / reply further on this post for advices or should I post directly to the Direct Simple Tapers topic : http://www.benzobuddies.org/forum/index.php?board=56.0 ?

 

 

I'm sorry I didn't understand your situation, thanks for clarifying.  Yes, presenting your taper plan and getting feedback on the direct taper board is a good idea but I will say that its always a good idea to pay attention to your symptoms so they can guide your taper.  It helps to keep a journal of them and their severity, we tend to think the worst while going through this so it's good to try to be objective from time to time in order to make taper decisions.

 

 

Welcome, lex1989.

 

Re: your request for information about tapering escitalopram ...

 

Do you know about Surviving Antidepressants — a peer support forum for discontinuing ADs?  Here is a link to a thread with tips for tapering off escitalopram:

 

https://www.survivingantidepressants.org/topic/406-tips-for-tapering-off-escitalopram-lexapro/

Thank you Pamster, I will post in direct taper board and indeed making a symptom journal seems legit, will do.

Thank you very much Libertas, I will check it !

One more thing guys.

 

I've look into the https://www.survivingantidepressants.org/ as well and someone posted that for a specific AD the active ingredient in the pill is spread among the pill itself , that meaning you need to crush the pill and mix it, then put it in a empty capsule and tapper from that.

 

It is the same with benzo ? I am tapering Clonazepam and usually I have a precise scale (milligrams) where I weight my pill and just cut it with something sharp.

If a pill is scored you can be reasonably certain the active ingredients are evenly divided into the two halves but after that, is tough to know for sure.  I've watched members dry cut their way to freedom with a razor blade, just eyeballing the amounts, others will use a scale to weigh the crushed tablet, other will use capsules or liquid.  All of these work and I think that what works for you is partly based on your personality.  If you're the type who wants things exact, leaving nothing to chance then the more elaborate methods will be for you, if you're comfortable with taking a less laborious approach then keeping it simple will work.  At the end of the day, as long as you're getting the dose you need in each 24 hour period you're doing it right. 

Thank you Pamster.

Scored you mean having the amount of mg typed on it?

 

Well, as long as I stabilized at 0.27 Clonazepam by just cutting it with a razor blade then scale it, I assume it works.

I'll see how it goes and maybe will crush it if things go sideways, trying not to be a perfectionist anymore. 

 

By the way, off tipic.

I have been told on https://www.survivingantidepressants.org/ that if you want to tapper, the AD should be tapper first, as being the active and more "problematic" drug, then the benzo.

What do you think ? You have information related to this?

 

https://www.survivingantidepressants.org/topic/2207-taking-multiple-psych-drugs-which-drug-to-taper-first/?tab=comments#comment-21436

By scored I mean the dividing line across the tablet, not all pills have them but many do.  I think your approach to tapering is just right for you and being a perfectionist can be exhausting, trying to please one can be too.  My step mom has very high standards I can never seem to meet them and I make myself crazy trying to. 

 

I've always thought that having an A/D on board while trying to taper benzo's is a good idea if you've been on the drug for awhile, going on an A/D while withdrawing from benzo's can be challenging and sometimes backfires.  Surviving antidepressants is a great group and its natural they would consider A/D's worse to withdraw from than benzo's but most here wouldn't agree.  What makes me crazy is doctors who will prescribe a benzo to their patients so they have an easier time starting an A/D then they come here because they're having a difficult time with the benzo! 

Hah, yeah it has the line across the tablet, the A/D has as well, but on surviving A/D they say Escitalopram should be crushed anyway, because of the divided active substance, anyway 

 

Bit confused now if I should finish the benzo tapering, or keep it and start with the A/D 

How many reductions have you made of the Clonazepam, how are you feeling?

 

In my time here I've seen short term benzo users recover sooner than those who have taken it for longer than 4 months, we're talking weeks in terms of recovery for many of them, not months and years so I'd suggest continuing your benzo taper for the best chance of a shorter recovery time but whatever you decide we'll support you.

I am at 0.27 mg at the moment (2nd day after reducing from 0.3) , feeling great almost , I think 200 mg of Theanine works as well.

 

Here is the reply I got from surviving A/D (I can't attach picture) :

 

"me : I am stable with 0.27 mg Clonazepam now and would need 1.5 months to get rid of the completely"

"reply : It looks like you just reduced your Clonazepam today. If I were you, I would not reduce the Clonazepam. I would go back to 0.3 mg Clonazepam, hold your 5 mg of Escitalopram for a while, stabilize before I would make any more dose changes. If you reduce benzo first, you are likely to go into painful WD that may include high anxiety and sleeplessness and you don't want this, trust me. Please don't be in a hurry to get off any drugs. This could very possibly cause severe WD and destabilization of your nervous system, which could necessitate you reinstating and taking a long time to stabilize. In the long run, it will make it take longer to get off your drugs, and you could be miserable in meantime"

 

The idea is that after I got fast from 0.5 to 0.3, I got much slower, took 14 days to stabilize and as I said above I am good now, after 14 days I got to 0.27. Following the rules of tapering and listening to my symptoms I did not see any rushing here, anyway.

The idea is that they are always considering tapering the A/D first, not the benzo. So that makes me confused now 

 

And one more thing, if I listen to the A/D forum, that means I will extend my benzo treatment and that is not what I want. I am now at 5 months, that means if I start with the A/D tapering it will mean to extend at least 3 more months on 0.27 Clonazepam. Confusiiiiing

Its great you're getting input from multiple sources, but I can see it can make decision making more difficult, and on top of that, when withdrawing from benzo's our cognitive abilities are compromised.

 

I get the impression from your words that you're leaning more towards tapering the benzo first, may I ask why you want to taper from the Escitalopram, is it causing you problems?

Yes it is nice to have more data, but hard to make a decision, mostly because they are conflicting.

 

To be honest I am almost certain both psychiatric drugs where not good for me in the first place.

As we know benzo it's definitely not good (taking it more then a few weeks), we know also A/D tend to not be good in a lot of cases and then the doctors prescribe you another and another and so on, a lot of people that have anxiety disorders don't respond to either of them.

I am almost certain that Escitalopram did not help me, but made my condition worse and probably is not helping now either (not 100% certain, but maybe if I get rid of Clonazepam I can see actually if it's good or not).

 

It is actually "funny" now when I am tapering down Clonazepam, I actually feel better / much better then some good weeks / months ago (when I was on 0.5 mg Clonazepam). I am not sure if the L-Theanine (200 mg / day) is such a difference or just going down with Clonazepam helped me not having anxiety in the first place (because of the withdrawal symptom's from tolerance and physicals dependency)

 

So that being said I wish to tapper them both, but I am not decided which to do it first, but I still incline for the Clonazepam, as I feel I am so close to get rid of it.

 

What's your opinion Pamster ? Also this post is making things more confusing  : https://www.survivingantidepressants.org/topic/2207-taking-multiple-psych-drugs-which-drug-to-taper-first/?tab=comments#comment-21436

 

I've taken both Klonopin and Lexepro and stopped both cold turkey and I can tell you that stopping the Lexepro was easy, I didn't have any symptoms but stopping the Klonopin was the worst experience of my life so I'm much more afraid of it than the A/D.  I'm obviously biased from my experience and from the experiences of thousands of members I've seen pass through this forum so my opinion for what it's worth is to taper the Clonazepam first, recover from your experience then tackle the Escitalopram if you feel its not helping you after discussion with your doctor of course.

How was your tapering regarding Lexapro (Esctitalopram) ? Steady or CT? I hope I can go for 3-4 months tops, not 10% each month like they are assuming on surviving A/D, I understand very well their support and experience, but I hope that I took just 5mg in 5 months I could tapper better and faster, then other that did took for years.

I mean, I am taking it for 5 months and I should tapper in 20 months, that is to much tbh.

 

Will taper Clonazepam after that, much slower / careful (as it's more of a poison I think)

 

I'm gonna taper the A/D first and keep 0.3mg Clonazepam until I am free of Lexapro.

I'm glad you have a plan, indecision is hard on us and ramps up our anxiety which of course makes us feel worse.  I agree, I believe you should be able to taper the A/D faster than suggested, just listen to your symptoms so they can guide you.

I've taken both Klonopin and Lexepro and stopped both cold turkey and I can tell you that stopping the Lexepro was easy, I didn't have any symptoms but stopping the Klonopin was the worst experience of my life so I'm much more afraid of it than the A/D.  I'm obviously biased from my experience and from the experiences of thousands of members I've seen pass through this forum so my opinion for what it's worth is to taper the Clonazepam first, recover from your experience then tackle the Escitalopram if you feel its not helping you after discussion with your doctor of course.

 

Hello Pamster,

 

Do you remember how was your tapper of Lexapro (Escitalopram) ? From how much dosage in how much time did you tapper ? I have a plan, everything should be smooth as possible (I hope), I know that every person is different, but I want to know different opinions and examples.

I quit both Ambien and Lexepro cold turkey at the same time, I think most of my symptoms were from stopping the Ambien but I felt great in about a week once I started sleeping again.  I don't think I had any symptoms from stopping the Lexepro although it would be difficult to know since I stopped the Ambien at the same time.

Hello Pamster,

 

I want to make an appeal to your expertise again .

Few questions :

 

#1 When tolerance occurs, physical dependence occurs and also withdrawal starts to develop, while taking the same dosage as before you are basically in withdrawal. That means you are not well, you already have withdrawal symptoms => after starting tapering, even cutting small dosages and make it steady, this not means that you are well, you are the "best you can be" in that moment and be at least functional. I am right ?

I am asking this because I already felt withdrawal when I got into tolerance ~ 2-3 months ago and it started to get more worse. Now that I am tapering slowly, this can't mean I may be without anxiety (mainly) whatsoever, as I was in tolerance before.

Basically, just when I get rid of all dosage and get through the acute and post-acute (hope no prolonged withdrawal) I will normally start to heal and the anxiety should go down naturally over time.

 

#2 I was thinking about a "rule", don't take me granted, as this is just an idea of mine. When one has taken X years / months of benzo, that one could at least taper the medicine as maximum in the same amount of time. E.g.: I taken it 5.5 months, I should be good tapering 5.5 months the whole dosage.

It seems a bit to much to think about the taper should be longer than the treatment time. Of course it's important to listen to your body and adjust accordingly.

What do you think about this ?

 

#3 I started to taper the A/D, after I stabilized the fast taper from the Clonazepam (down from 0.5 to 0.3). But I was thinking to taper them both at the same time if my body let's me do this.

I am 1.5 months now in tapering, 3.5 months to go (hope so).

Hi lex1989,

 

I'm hoping you'll ask some of your questions on the Withdrawal Support (during your taper) board so you can get input from the wider community, not many member visit the introductions board since its mostly to welcome new members.  The real work of the forum takes place on the support boards.

 

I agree with your assessment in question number one, you're probably not going to feel 'good' until you're done with your taper and past acute, although some members report feeling better as they taper and do just fine when they jump off, we never know how it's going to go.

 

As for number two, members who hope to remain functional will listen to their body and taper accordingly, we can't think it terms of length of time taking the drug vs length of taper although its certainly understandable that we do.  I agree that a short time user will hopefully be able to get off the drug sooner than someone who has been taking it for decades but as with everything, we just don't know who will get hit with extreme symptoms and who won't.  This question would be good for a discussion with others on the forum, you may be some interesting feedback.

 

I hate to see you hold your Clonazepam taper while you taper from the A/D, the A/D may be providing you with some support as you taper the Clonazepam.  And I really hate to see you taper both at the same time.  How will you know what drug is causing what so you can mitigate your symptoms?  Tapering is a tool we use to rid ourselves a drug, this allows us to take action if we begin to feel terrible by slowing the taper down, how will you know which drug to slow if you're tapering both?

 

 

Hi lex1989,

 

I'm hoping you'll ask some of your questions on the Withdrawal Support (during your taper) board so you can get input from the wider community, not many member visit the introductions board since its mostly to welcome new members.  The real work of the forum takes place on the support boards.

 

I agree with your assessment in question number one, you're probably not going to feel 'good' until you're done with your taper and past acute, although some members report feeling better as they taper and do just fine when they jump off, we never know how it's going to go.

 

As for number two, members who hope to remain functional will listen to their body and taper accordingly, we can't think it terms of length of time taking the drug vs length of taper although its certainly understandable that we do.  I agree that a short time user will hopefully be able to get off the drug sooner than someone who has been taking it for decades but as with everything, we just don't know who will get hit with extreme symptoms and who won't.  This question would be good for a discussion with others on the forum, you may be some interesting feedback.

 

I hate to see you hold your Clonazepam taper while you taper from the A/D, the A/D may be providing you with some support as you taper the Clonazepam.  And I really hate to see you taper both at the same time.  How will you know what drug is causing what so you can mitigate your symptoms?  Tapering is a tool we use to rid ourselves a drug, this allows us to take action if we begin to feel terrible by slowing the taper down, how will you know which drug to slow if you're tapering both?

 

#1 I can say I have a few days feeling a bit better than before starting to taper, but just after I slowed with taper and stabilize.

 

#2 I agree with you, should I put these questions on my taper topic that I posted to get a wider response ?

 

#3 If you remember, this was a debate on my taper topic what should I taper first, I asked you as well. But I was deeply in the discussion with the people from survivingantidepressants and got this answers:

 

" We're aware that the prevailing ideology on Benzobuddies is that benzos are the most evil drugs ever. They're not, they're just another psychiatric drug. (Antipsychotics are far more destructive.) If you are not getting severe adverse effects from the benzo, we advise leaving it in place to protect sleep while you taper the more activating drugs first.

We have many people here who went off their benzo first, then started tapering antidepressants, ran into awful withdrawal insomnia, then went back on a benzo -- which of course will require tapering after the antidepressant."

 

" If you reduce the Benzo first, you are likely to go into painful WD that may include high anxiety and sleeplessness, and you don't want this, trust me"

 

Also you are right of not tapering both, but would take me more than 5 months to taper them both in case of tapering individually and that is more than I took the drugs in the first place.

 

Please read this when you have time :

 

https://www.survivingantidepressants.org/topic/2207-taking-multiple-psych-drugs-which-drug-to-taper-first/?tab=comments#comment-21436

 

Should I put all these questions in my taper topic then ?

 

You're right, I forgot about your situation with the A/D, I hope you'll keep documenting your journey because your experience may change my perception of which drug needs to go first.

 

Yes, please start a thread on a more active board to get feedback from other members who are more experienced with tapering, I've never done it.

Here is a link of all my journey of tapering so far : https://docs.google.com/spreadsheets/d/1z6soHabsz6IRcfkVdjWTq-dO8GYtmwR0MSYc5mW1omM/edit#gid=0.

 

Please tell me if you have access.

 

Also, where should I put a thread regarding this questions ? On what board ?