Tapering Clonazepam (Rivotril)

Hello there,

My name is Alex. I had some issues some months ago with panic attacks, just 1 / month, looked good, until I had an awful one (with depersonalization and derealization that I did not encounter until then) and the anxiety / anxiety disorder hit me afterwards.

I am really angry with myself that I did make the decision to go to a psychiatrist and ask for guidance  (but I did not knew better then), mostly driven by fear. Back then in the first days I had anxiety, but not so long during the day, it come and go and also had some days with no anxiety at all.

Guess what, after taking medicine first month was fantastic, I was me again. After few months later it became worse then before medicine. Another real proving that taking benzo more then a few weeks is strongly not recommending.

I was prescribed 0.5 Clonazepam (Rivotril) and 0.5 Escitalopram (Cipralex). Of course I did hit tolerance / dependency and started to have withdrawal symptoms while taking the same dose for 4.5 months.

Reading all that is needed to read and document myself over my affection, I am strongly determined to say it did not pass or gone even worse because I took benzo to much time in the first place (not so much as many of you are, but still enough to harm myself) and also the AD is not good either, nor it has been in the first month (basically the benzo took care of things until it didn't).

That being the short story, now I will go directly to tapper advice  :

Week My dose My Weight (grams)

start           0.5         150

1           0.45 135

2           0.4         120

3           0.35 105

4           0.3         90

5           0.25 75

6           0.2         60

7           0.15 45

8           0.1         30

9           0.05 15

10           0         0

I know it looks a bit rough and fast (10% from original doze, not previous taper), but I am trying to "listen" to my symptoms and stabilize after each dose (Thank you Pamster for this hint).

I did start very harsh from 0.5 to 0.3 (current dose) in just 3 weeks and it look a bit to much, had anxiety till most of the day (mild and moderate), head aches, blurred vision, could not concentrate well, dizziness and some mild depression.

As I understood it is not a good idea to taper fast, as it could harm yourself  not only per moment, but after finishing the taper, the brain will heal harder and will make the acute / post-acute withdrawal longer and harder on yourself.

Now I can say I am "stable", the anxiety is bearable (mild and some moderate) and not taking so long during the day, mostly 50% of the day I am anxious (usually things go smother at night like I see many tapers are feeling the same) and the other symptoms are pretty ok.

I will probably stay at 0.3 a couple of more days and then go to 0.25 slowly. As I can see the results just after few days, because Clonazepam has a fairly high half-time.

One more thing. I am tappering Escitalopram as well. Will go 20% cut per month, to see in second month how I am.

Any advice would be much appreciated. 

Note: Reading all guidance from this forum and everything from https://www.benzo.org.uk/manual/ makes much sense to tapper this awful drug from your system (it is not good!)

Hi Alex

This is probably not the feedback you're looking for but here goes. Your post is quite long with a lot of information to absorb. Most of our members are going through withdrawal like myself and majority of us suffer from benzo brain and cog fog. Therefore less is more. We struggle to get through such dense information. Maybe if you edit your post and include only essential info to what you require you might get a better response. 

You are right jelly baby.

Here it goes.

Prescribed 0.5 Clonazepam / day (Rivotril aka Klonopin) + 1/2 Escitalopram , taking it from 5 months now.

Hit tolerance / physical dependency after 2-3 months. Month 5 decided to tapper.

My initially tapering plans :

Week  My dose  My Weight (m grams)

start            0.5          150

1            0.45              135

2            0.4                120

3            0.35              105

4            0.3                  90

5            0.25                75

6            0.2                  60

7            0.15                45

8            0.1                  30

9            0.05                15

10            0                    0

Got from 0.5 to 0.3 to fast (3 weeks), big withdrawal symptoms, I am holding and doing better now.

I thought that being just 5 months on this will not be a problem, never been more wrong .

Hi lex1989!

Thanks for shortening your post. We're here to help!

It sounds like you are tapering your antidepressant and benzodiazepine concurrently. They both have the potential for significant withdrawal symptoms, and I think tapering two physically dependent psyche meds at the same time is a recipe for confusion and difficult decision-making.

Would you be willing to consider holding on you dose of escitalopram until you're finished with your clonazepam taper?

Hello, lex1989.  FYI ... here’s what the folks at Surviving Antidepressants have to say about which psychoactive medication to taper first:

Taking multiple psych drugs? Which drug to taper first?

https://www.survivingantidepressants.org/topic/2207-taking-multiple-psych-drugs-which-drug-to-taper-first/

Hello, lex1989.  FYI ... here’s what the folks at Surviving Antidepressants have to say about which psychoactive medication to taper first:

 

Taking multiple psych drugs? Which drug to taper first?

https://www.survivingantidepressants.org/topic/2207-taking-multiple-psych-drugs-which-drug-to-taper-first/

That is a very interesting link; thank you Libertas.

I was unaware of the arguments for tapering an AD before a benzo; I have known so many buddies who either got on an AD to better handle benzo tapering, or tapered a benzo before their AD, or tapered a benzo before their anti-psychotic. I am curious how effective these suggestions from user Altostrata really are in practice.

lex1989 mentions being in tolerance withdrawal on the clonazepam in his original post; I wonder how that factors into the which-drug-first equation. I hope a buddy with personal experience tapering both an AD and a benzo can chime in on this thread.

lex1989,

This is a recent Withdrawal Support thread; you may have seen it. A number of buddies who've tapered both antidepressants and benzodiazepines have weighed in on their experiences. It might be useful for you to consider...

http://www.benzobuddies.org/forum/index.php?topic=260664.msg3293794#msg3293794

Thank you for the reply guys.

Wow, this is exactly what I spoken these days with a good fellow from www.survivingantidepressants.org/ as well.

This topic : https://www.survivingantidepressants.org/topic/2207-taking-multiple-psych-drugs-which-drug-to-taper-first/.

Thank you Libertas.

Having this into consideration I might keep 0.27 mg Clonazepam and start slowly tapper 0.5 mg of Escitalopram first.

I will also look into that topic as well slowandsteady, thank you.

Still very confusing, some say to go and taper the A/D first , some say that Clonazepam is poison and should taper that first.

The idea is that I don't really want to extend the duration from 5 months (current) to 8-9 months of taking another 0.27 Clonazepam daily, because I should hold until I taper the A/D.

Very confusing.

You're right, all of this can be extremely confusing.

I think you've been presented with both sides of the argument. One thing to remember is that there are no guarantees. No one can guarantee that tapering one before the other is going to result in a better experience. Benzo withdrawal especially is a very individualized experience and we seldom have tapers that mirror each other 100%. Personally, I think you need to take the information you have, look at your own personal circumstances and just make the decision that feels comfortable to you. 

You're right, all of this can be extremely confusing.

 

I think you've been presented with both sides of the argument. One thing to remember is that there are no guarantees. No one can guarantee that tapering one before the other is going to result in a better experience. Benzo withdrawal especially is a very individualized experience and we seldom have tapers that mirror each other 100%. Personally, I think you need to take the information you have, look at your own personal circumstances and just make the decision that feels comfortable to you. 

Well said Jelly Baby.

The most important thing in my opinion is to taper one drug at a time.

You can do this lex1989! 

Thank you guys. I've decided to taper Escitalopram first, as it's the most active drug, then the Clonazepam.

I'm not proud that I will add probably 3-4 more months or even more taking the Clonazepam, reaching 8-9 months, but at the moment I am on 0.3mg so I guess it's not that much, can't tapper both at the same time anyway.

Cheers !

Thank you guys. I've decided to taper Escitalopram first, as it's the most active drug, then the Clonazepam.

I'm not proud that I will add probably 3-4 more months or even more taking the Clonazepam, reaching 8-9 months, but at the moment I am on 0.3mg so I guess it's not that much, can't tapper both at the same time anyway.

 

Cheers !

This sounds like a great plan to me!

I suggest letting go of any shame about being on these drugs; it's not your fault that our medical industrial complex peddles such dangerous band-aides in place of meaningful and effective long-term treatments. I think you deserve to feel proud of yourself for taking these brave steps towards your freedom and self-understanding. It's not easy for any of us.

I'm glad you're on a relatively low dose of clonazepam, and I hope it supports you in your escitalopram taper. 

Thank you slownsteady, I really appreciate the support.

The withdrawal is hard and I only just started, I never had so much anxiety, not even before taking the drugs. If I remember, 5 months ago I was much better regarding anxiety, but I did not knew how to handle it and I got into the drugs, now after tolerance and withdrawal giving me a harder time than before taking it in the first place 

I will take it slow and steady ).

I hope I'll get rid of the Escitalopram (depends on my symptoms), in about 3-4 months tops, then start a slow tapper on Clonazepam (as it may be harder to get of this poison).

Cheers 

I'm glad to hear you felt supported and that you're going to take it slow and steady. 

I understand, WD anxiety is a beast! But I believe you are up for this challenge.

We're all rooting for you!

All the best!

Hope your taper is uneventful.

Hello guys,

I am back with some questions and require your expertize:

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).

#4 Which drug to tapper first ? Is still a bit of polemic regarding this and I am still unsure of what to do here, I am at the crossroads to which to taper first and abstain myself from tapering both at the same time as this is not a good idea as far as I know.

Please read this when you have time (important link from surviving antidepressants) :

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