Klonopin BID Dosing Tapering Question

hi all,

 

i made it down to 3mg from 4mg/day of klonopin without a ton of issues. has it been pleasant? no. has it been hellish thus far? thankfully also no.

 

anyway, i was prescribed the medication to take BID and am currently taking 2mg in the morning and 1mg in the evening. given that my next drop will be in a week or so, is it advisable that i next cut from the morning dose to avoid super imbalanced am/pm dosing or do have many of you in my position eliminated one first and then the other (am vs pm)?

 

my doctor doesn't have much information, but is supportive and isn't rushing/forcing me off of the drug.

 

thanks for your insight and support.

I feel dosing is an individual thing, most members dose to suit their lifestyle.  If taking the bulk of your dose in the morning helps you get through your day then its perfectly acceptable to leave that one heavy for as long as you need to.  You can shave off of both doses or just the one, its totally up to you.

 

I'm glad to hear your doctor is letting you drive this taper and its good to know it hasn't been horrific so far. 

thanks, pamster! it hasn't been horrific. contrarily, it's been significantly easier than the withdrawal from lyrica/pregabalin which was indeed hellish.

 

the only worry that i have removing the 1mg from the evening and leaving the remainder to be taken in the morning is interdose withdrawal. i'm not sure how much of a problem that will be/become, but i've read horror stories here about it. i do suffer from some pretty severe anxiety disorders and layering off the benzodiazepine may prove to be problematic once i get closer to zero, although a lot of the psych symptoms are being covered by the SSRI escitalopram that i'm on. i'm just very unsure as with the lyrica withdrawal i did the am reduction followed by pm reduction and so on so that i didn't have a period where the medication wore off and left me with no recourse.

I agree you could be setting yourself up for inter-dose if you completely eliminated it, I'd keep some of your nighttime dose to stave that off.  Your dosing is kind of unique around here, most members leave the nighttime larger dose to help with sleep but you seem to do better with a heavier daytime dose.

yep, because a lot of my anxiety revolves around daytime activities, so taking klonopin in the morning helps significantly. i think that it'd be wise to follow your advice and not set myself up for interdose withdrawal. so i suppose the next cut that i make will come from the morning dose.

 

the logistics of this are difficult to say the least, but i think following the same methodology that i used during the lyrica taper might work best? this is uncharted territory for me and for many of us.

What was your strategy for tapering Lyrica and how can we help?

lyrica's tapering was A LOT more difficult and just to eliminate a fourth of my overall daily amount took months and months; the entire process took seemingly forever and there was a lot of physical and psychological pain. i was making decreases by the smallest capsule strength, 25mg, and then waiting until i stabilized before making another cut of 25mg, alternating between am and pm cuts. i had to use the liquid formulation to get down to 50mg/day and i didn't feel as though i could reduce it further, so i'm stuck (for now) on 50mg/day.

 

thus far, reducing klonopin feels a lot more similar to eliminating ambien in that there is some physical discomfort, but it's nowhere near as intense nor debilitating as reducing lyrica. i mean, in just under a month, i've eliminated a fourth of my overall dose without much distress. that's pretty fantastic given that i was expecting the absolute worst. granted, i am still on a sizable amount of the drug taking 3mg/day, so i don't know what the future will bring, but i'm hoping for the best.

 

right now i just need support from others when i happen to have a question as i did this morning to rationally think things through, e.g., in how to proceed after eliminating 1mg and taking an imbalanced dose am/pm. if i have issues, i'll come here to see what others have done. this is a great community and i can't thank you and others enough for the support and encouragement.

Your Lyrica taper sounds brutal but I'm glad to hear Ambien wasn't too rough, it wasn't for me either but Klonopin hurt a lot, hopefully you'll sail through your Klonopin taper.  It sounds like you've got tapering down pat but yes, use us when you need input, that's what we're here for. 

I was on clonazepam 1mg three times a day and I rotated my reductions between the three doses every two weeks or so i.e. I reduced the morning dose, two weeks later the afternoon dose, and then the evening dose, etc.  I kept my dosing even but the last dose I eliminated was the nighttime dose because of insomnia.  If sleep isn't a struggle for you then that might not be a consideration.

 

It sounds like you are doing reasonably well and have a good attitude.  Setting reasonable expectations like you have is helpful.  Way to go on your progress!

thank you, kate! that's helpful advice and that's likely the method that i'll follow, although when i get closer to 0mg, i'll have to see which dose, the morning or evening, is most impactful. i was prescribed hydroxyzine to take prn, but i am taking a tiny amount of it daily due to the insomnia that would be present without it. it does make a considerable difference and it also squashes a significant amount of the anxiety associated with the klonopin withdrawal which was surprising because hydroxyzine is hydroxyzine and klonopin is a beast, but i'm not complaining, i'll take the help!

 

thanks for the well wishes and the progress celebration!

thank you, kate! that's helpful advice and that's likely the method that i'll follow, although when i get closer to 0mg, i'll have to see which dose, the morning or evening, is most impactful. i was prescribed hydroxyzine to take prn, but i am taking a tiny amount of it daily due to the insomnia that would be present without it. it does make a considerable difference and it also squashes a significant amount of the anxiety associated with the klonopin withdrawal which was surprising because hydroxyzine is hydroxyzine and klonopin is a beast, but i'm not complaining, i'll take the help!

 

thanks for the well wishes and the progress celebration!

 

Is the hydroxyzine helping you sleep during klonopin wd? Is it helping with the anxiety and if so does it cause side effects?

thank you, kate! that's helpful advice and that's likely the method that i'll follow, although when i get closer to 0mg, i'll have to see which dose, the morning or evening, is most impactful. i was prescribed hydroxyzine to take prn, but i am taking a tiny amount of it daily due to the insomnia that would be present without it. it does make a considerable difference and it also squashes a significant amount of the anxiety associated with the klonopin withdrawal which was surprising because hydroxyzine is hydroxyzine and klonopin is a beast, but i'm not complaining, i'll take the help!

 

thanks for the well wishes and the progress celebration!

 

Is the hydroxyzine helping you sleep during klonopin wd? Is it helping with the anxiety and if so does it cause side effects?

 

it does help, although there is a significant amount of insomnia present. i am getting enough sleep to get by, though. it also helps with anxiety in a manner that is quite similar to mirtazapine, although without the mirtazapine-associated weight gain. overall, though, i wish that mirtazapine didn't induce weight gain as that medication works better for me.

 

the only real worry that i have with using hydroxyzine is that i'll be stuck on it or have to take increasingly larger doses to control insomnia/anxiety as i continue the taper. granted, i'm only taking 12.5mg/night of the medication currently. there aren't any discernible side effects at this amount, however, if i take more there is a bit of cognitive impairment, presumably as it's an anticholinergic.

 

hope this helps!

hi all, i have a few more questions that i hope anyone can chime in to help me resolve.

 

i am at 3mg of klonopin right now down from 4mg and while i'm functional, i wouldn't say that i'm solidly stable. with severe underlying anxiety disorders, namely panic disorder with agoraphobia, how is one to discern the difference between the return of the disorder and withdrawal symptoms/CNS adaptation to the removal of the benzodiazepine? furthermore, what point of perceived stability is deemed psychologically safe to decrease further to minimise suffering? should i be feel solidly stable? should i feel *almost* solidly stable?

 

edit: i'll add that i take 1mg in the evening and 2mg in the morning and i am awakening often in the middle of the night with what feel to me like classic panic disorder symptoms/nocturnal panic attacks that subside upon taking the 2mg am dose of the drug but i'm not perfectly fine during the day either, just fine enough to function, i.e., continue on with everyday life.  i'm wondering how much of this is the drug's removal vs the disorder itself. i can't afford, mentally or physically, to go through the same thing during the daytime.

 

i do have an appt with my doctor on march 28th, but i know she isn't terribly well-versed with bzd tapering. she's also really not very well-versed on how to treat severe anxiety disorders despite being a psychiatrist.

 

thanks and best of luck to all going through this process!

With your preexisting disorders I can see where its tough to determine your current state when making decisions to reduce again but I don't feel qualified to address them.  I wish you had a doctor who understood your situation better and one who was also well versed in symptom management while tapering. 

 

Would you feel comfortable starting another thread with your specific questions about stability with an underlying condition to get feedback from more members?  I know we have many with conditions such as yours who might be wiling to offer their experience.

thanks, pamster. i definitely will!

 

edit: pamster, in which sub-forum should i create the new thread?

I think Withdrawal Support (during your taper).  Please put as much specific information into the subject title as possible.

thank you!