Hi- need help and guidance

Hello,

I was started on clonazpeam 0.5 mg qhs in April of this year for severe insomnia after stopping sertraline 3-4 months beforehand.

The insomnia was so severe and I had tried everything under the sun so I was desperate for something to get me a few hours of sleep. I was prescribed the clonazepam which did give me 4-5 hours of sleep while I was restarted on sertraline. I could not tolerate the sertraline due to more anxiety and worsening insomnia so ended up taking the clonazepam for longer than I ever intended (over 3 months now) and have clearly developed tolerance.

I tried to reduce to 0.25 at night alternating with .375 over a week ago and 3-5 days later developed terrible tinnitus, wired feeling, severe fatigue, and brain fog. I then went back to 0.5 mg 3 days ago as I work in a professional setting and am the sole bread-winner and single parent of 2 daughters.  I feared that I could not function at work in that state. In looking over the forum, I now realize that was too large of a reduction for me.

I am terrified as I need to work and function as I go through this process and it seems like that is so difficult for people.

I read about the different types of tapers on here but its overwhelming to me. Frankly, my whole situation is overwhelming as I don't know what I will do if I can't work due to the brain fog.  I did schedule an appointment with a nurse practitioner whose practice was recommended for being helpful for those who want to taper but its not until the first week of August.

Hi Kozmo9

I moved your thread here because members don't generally read the Introductions section.  I'm really sorry you find yourself in this situation. I know when you first realise the gravity of withdrawal and tapering it is very scary and overwhelming. We've all been there. I promise you, these feelings will get better as you go along and find acceptance of what happened.

I can tell you it's possible to get through this in a functional way. If you taper slow enough you can work through withdrawal, I did. I was functional all throughout my taper, taking care of my family. Brain fog, head pressure and headaches are some of my worst symptoms. It's not easy but you learn to fake it while you get through the day.

As you've discovered,  your cut was too big and that caused a severe withdrawal reaction. If you make smaller cuts you should tolerate them better.. Are you feeling better since the updose? And can I ask you why you think you've become tolerant to the drug?

Thank you for moving my post. I am feeling much more clear-headed and the tinnitus has diminished since returning to 0.5 mg on Saturday.

Yesterday I still felt very mentally foggy and numb.  I don't know how to rate the severity of the withdrawal I had either but the tinnitus was super loud and I had a super wired feeling as well as brain fog and inability to concentrate.

I think I am tolerant as it doesn't have as much of an effect on my sleep as it used to. I have had weird symptoms crop up over the past 2 months but had also been increasing citalopram dosage and I thought some of them were due to that.

I work at a job in which I need to be cognitively functioning. This is what scares me about starting the tapering process. I can take sick days but not be out for weeks at a time over an extended period. 

I am not sure which way to go and could sure use some guidance on how to figure out what method tends to be smoother for people. I realize nothing is guaranteed.

I think for now you need to hold your current dose for a couple of weeks to stabilize again. Your brain has to recover from the large cut before you introduce another cut again.

I have tried a multitude of tapering methods and reductions and I personally don't think one is better or easier (symptom-wise) than the other. I do think the majority of the time it comes down to your percentages and how fast you taper. In your case I would not recommend going above 5% cuts if you're concerned about keeping your job and cognitive abilities. Most people start tapering by shaving their pills and weighing it on scale. Is this something you might be willing to consider? There are lots of other methods, but generally this is where everyone starts.

You are right. I am still feeling off from going from 0.5 to 0.25 for a week. I had a very rough night last night with only 3 hours of sleep and then really negative thoughts all night. My ears are still ringing a bit and skin feels hot. I was planning on staying at 0.5 until I can meet with the nurse practitioner who will hopefully agree to work with me on a very slow taper.

I am thinking that shaving the pills and weighing would work best for me. I just don't know how to really proceed with choosing a taper plan.

I'm not sure what you're understanding of a taper plan is, but I prefer to just plan the next 2-3 cuts and then decide the rest based on how I feel. We call it a symptoms based taper. You keep a daily journal where you keep track of all your symptoms and you rate each symptom on a scale of 1-10. This way you can easily see if your symptoms are getting worse and if you need to adjust your taper rate. It's very important to be flexible in your taper in order to remain functional.

So I would suggest you shave and weigh your pills and start by reducing 5% every  two weeks. You do this for 2-3 cuts and then see how it goes. Oh and the 5% is calculated on each new dose not the starting dose.

I have looked at different taper plans and thought maybe the cut and hold at 5% might work best until I can get down to a lower dosage.  Someone had posted a similar plan recently so I would just need to weigh my pills.  I am just so worried about keeping my myself together as I need to stay functional enough to go to work. The experience i had last week was really scary for me. I also need to ensure that this nurse practitioner will work with me through this process.

I am looking for a scale on amazon and am anxious about the scale being precise too. Did you use the Gemini one that is recommended by many on here or a different brand?

Cut and hold at 5% every two weeks sounds good. I used a different scale but they're all pretty much the same. I wouldn't stress too much about accuracy. Thousands of people have used scales to taper so I don't think you need to stress about it now. This is the one I used https://www.amazon.com/Smart-Weigh-Precision-Milligram-Calibration/dp/B011J88S8M/ref=sr_1_1?ie=UTF8&qid=1541012152&sr=8-1&keywords=Smart+Weigh+Premium+High+Precision+Digital+Milligram+Scale+with+Case%2C+Tweezers%2C+Calibration+Weights+and+Three+Weighing+Pans%2C+50+x+0.001g.

I didn't shave and weigh, I crushed, weighed and filled capsules but the maths for this method is very complicated. Shaving would be easier.

You could give this document Colorado Consortium Benzodiazepine Deprescribing Guidance to your NP and hopefully she'll support your taper.

Please let us know if you have any more questions. Hopefully your symptoms will settle some more too. 

Thank you. I am not starting to taper until I get back from a vacation. I have been having second thoughts about even going on it as I hadn't been feeling well but I don't want to disappoint the kids and everyone else. I will have to tell my aunt and uncle what is going on with me.

I read about the crushing and filling capsules but it seems a little overwhelming for me and I don't want to screw it up.

I will start with the shave and weigh method and cutting by 5%- I will probably give it 3 weeks per cut?

I saw that at some point you switched to a DMT? I read that can be smoother as you get down in dosage.

Also, I don't even know for sure that the nurse practitioner will accept me as a patient. I guess they do an initial consultation and decide if they can work with you.  So, of course that has me keyed up as well. I have a psychiatrist who has been prescribing who had no idea about people struggling with tapering by 50%. I showed her the Deprescribing guidance and she couldn't believe how slowly the tapers are for some people. I just need to make sure that I have some prescriber in my corner so I don't have to stress about having enough to do a long taper. Ugh.

oh well, one thing at a time...

I thank you for your support.

I'm sure it will all work out. As long as they see your desire to get off, it seems most NP's are good. I know when we go through withdrawal things that are supposed to be fun like holidays often feel like a chore. But I do feel it's important for our relationships to keep these things going. You might be surprised and even enjoy it.

I started off with DMT but I also did cut and hold during my taper. I do think it's better to start with cut and hold as you can better determine your reduction percentage. With DMT it's much more difficult to figure out what percentage rate works for your body. And if you taper slow enough then cut and hold should be fine at lower doses as well. But ultimately it's about finding a taper method that works for you.

If you're going to be shaving and weighing you might want to read about other members who are doing the same.  I know Rocknroll is currently tapering Clonazepam using this method and he has a blog you can read, and hereforhelp  has recently finished his taper of Clonazepam using the same method. He also has a blog.

Thank you for your advice. I am going to try and enjoy the vacation as best I can.

I know my family is supportive.

I will check out rocknroll's posts.

I can't thank you enough for your support. I have to adapt  a more positive mindset about this process....