Clonazepam and the Ashton Manual

Hi everyone!

 

I'm not sure if this is in the right catagory. Lately I've been a bit more active on BenzoBuddies. I'm currenty in Benzowithdrawal 3.4mg. Diazepam.

 

I've been noticing some posts about people tapering Clonazepam. I've been responding here and there, but I don't have experience with it. Maybe you can share your thoughts on it when it comes to tapering.

 

I do know this from the Ashton Manual:

 

Some doctors in the US switch patients onto clonazepam (Klonopin, [Rivotril in Canada]), believing that it will be easier to withdraw from than say alprazolam (Xanax) or lorazepam (Ativan) because it is more slowly eliminated. However, Klonopin is far from ideal for this purpose. It is an extremely potent drug, is eliminated much faster than diazepam (See Table 1, Chapter I), and the smallest available tablet in the US is 0.5mg (equivalent to 10mg diazepam) and 0.25mg in Canada (equivalent to 5mg Valium). It is difficult with this drug to achieve a smooth, slow fall in blood concentration, and there is some evidence that withdrawal is particularly difficult from high potency benzodiazepines, including Klonopin. Some people, however, appear to have particular difficulty in switching from Klonopin to diazepam. In such cases it is possible to have special capsules made up containing small doses, e.g. an eighth or a sixteenth of a milligram or less, which can be used to make gradual dosage reductions straight from Klonopin. These capsules require a doctor's prescription and can be made up by hospital pharmacists and some chemists in the UK, and by compounding pharmacists in North America. A similar technique can be used for those on other benzodiazepines who find it hard to substitute diazepam. To locate a compounding pharmacist in the USA or Canada this web site may be useful: www.iacprx.org. Care must be taken to ensure that the compounding pharmacist can guarantee the same formula on each prescription renewal. It should be noted, however, that this approach to benzodiazepine withdrawal can be troublesome and is not recommended for general use.

 

I wonder what drives people to taper with Clonazepam in stead of doing a crossover to Diazepam. For me, unfortunately, a crossover never happened, but I can imagine crossing over can be very hard. Maybe that is the reason? Just wondering...

 

Naf1983

1)  Some people have a particularly hard time switching. 

2)  When I mentioned the possibility of a crossover to my prescribing GP, he just looked at me blankly.  Doctors seem loathe to prescribing Valium for whatever reason.

3)  I've seen a number of members experience depression switching to V.

It seems to me people who are on a short half-life benzo tend to do more cross overs than those on longer half-life drugs. The main reason is interdose withdrawal. If you're suffering from withdrawal and you have to deal with interdose withdrawal on top of it, I can imagine it can get pretty rough.

 

Clonazepam has an extremely long half-life, if I'm correct, the longest after Valium. I don't have interdose withdrawal. In my case I didn't do a cross over as I felt I'd rather stick with the drug that I know. I know my body can tolerate it, I know how my body is responding to it and I can 'read' it, if that makes sense? Taking a risk to switch over to a completely new drug was just not worth it.

 

Yes, unfortunately the pill sizes are not ideal, but there are so many different DIY tapering options. Are they perfect? Not by a far stretch. Is it risky? Absolutely. But for me I wanted to try this first and see if it works before taking the risk to cross over. I was lucky, it is working.

It seems to me people who are on a short half-life benzo tend to do more cross overs than those on longer half-life drugs. The main reason is interdose withdrawal. If you're suffering from withdrawal and you have to deal with interdose withdrawal on top of it, I can imagine it can get pretty rough.

 

Clonazepam has an extremely long half-life, if I'm correct, the longest after Valium. I don't have interdose withdrawal. In my case I didn't do a cross over as I felt I'd rather stick with the drug that I know. I know my body can tolerate it, I know how my body is responding to it and I can 'read' it, if that makes sense? Taking a risk to switch over to a completely new drug was just not worth it.

 

Yes, unfortunately the pill sizes are not ideal, but there are so many different DIY tapering options. Are they perfect? Not by a far stretch. Is it risky? Absolutely. But for me I wanted to try this first and see if it works before taking the risk to cross over. I was lucky, it is working.

 

jelly baby,

 

I am so glad that the DMT is working for you. I too, am K. I had a rough couple of months trying out the water, milk, and trying to weigh and crush. Somehow, I really messed up with my milk taper. It was very inaccurate and/or inconsistent. I am still trying to stabilize after over  weeks from stopping. Years ago I did do a water taper and I got down, but I was a lot younger.

I wanted to know if you are weighing your pill and then shaving or are you weighing and crushing.

I am no where near ready to taper, but when I do, I want it to be the last time.

Years ago, I tried the crossover and it did not work at all. I think it works better for those on very short acting benzos.

I would greatly appreciate your feedback.

 

Dana

I meant to add that between Dec and Jan, I cut .125mg by taking  off .0625mg each time.

I don't know how accurate it was cutting 1/8th of a .5mg pill, but it was not as painful as what I have just been through.

I could try that again, as my goal is about .0625mg per month which would be around 2% a month.

That is all that I can handle at this point. I am on a fairly high dose. Was on 2mg, but over 2 years I had to up dose due to antibiotic setback, brand switch, and the death of my Mom. Pretty discouraging, but I keep hoping.

 

Thanks,

 

Dana

I am so sorry to hear you're struggling Dana.

 

I've tried various methods. I couldn't get the shaving right and making small reductions was difficult. So I used Bob7's method: https://benzodrytapermath.com/ and it worked pretty well. I know member RogerThat also used Bob7's method for Clonazepam.

 

I'm now using alcohol, simply for the convenience.

 

But I've recently learned about this Oraplus method and if I wasn't almost done with my taper, I would've done this. This would be my first suggestion for liquid (if you can't get it compounded and want to make your own) because this is what pharmacies use: https://www.nationwidechildrens.org/-/media/nch/specialties/pharmacy/compounding-formulas/clonazepam-oral.ashx?la=en&hash=BBD3E4A5E334418EF12A25A8E09E6BF8

 

Please don't give up. I know you can do this! 

 

Edit: spelling

Thanks so much. Bob 7's method is one of the best, I believe. I think it might be the most accurate.

Yes, OraPlus is something that I have considered. I have a great compounding pharmacy that does my HRT. Sublingual drops. I have talked with them in the past and they have told me that it would fine to do at home. I had my math right and that is the big challenge.

I am glad that you are doing well with the alcohol.

Thanks again for your input and what you do on the forum.

 

Dana

If you're struggling with maths we do have folk that can help. I know it can be challenging. If you want a further discussion on methods particular to your situation, I suggest you start a topic in the Tapering section. We will gladly help. I do think you have some options to explore.