taste, when to start, what to titrate (need info by jun 20, 230 CST if poss)

I'd posted this in another topic somewhere, but I think it is more appropriate in its own forum.

Three questions to save thread space.

 

First: How does the solution taste, with either temazepam or clonazepam? The taper schedule says water, but that means milk doesn't it, for temazepam? Does milk adequately cover the taste? If not, what does? I'm very sensitive to pill taste. Oh, and does the dose hit faster being liquid when previously a capsule?

 

Second: There are a lot of stressors in my life right now. I have apparently not stabilized from my doctor induced rapid reduction/ct/whatever you'd call it. Reinstating slightly didn't help so much.  I should say the last 2 days have been the worst since I first experienced the wd symptoms. I have an impending interprovincial move coming up, with the process started already, next weekend being important, and find out from there. I do need to be able to be functional this weekend.

Should I just pick a time and start, or wait till the stress is gone, or I get another window or what?

 

Third: Being on 2 benzos, which is more often best to cut first? Temazepam does help me sleep. But I do generally feel good in the morning, crappier as the day progresses, slightly better with my 5pm klon, at about 6-7 and usually a little worse again till bed when I take the taz. The clon was a partial reinstate from a dr induced ct. The temazepam was introduced immediately after to help me sleep. I've been on temazepam for a month. Cutting it in half was very bad, though still not as bad as this wave even though I only took one day of 15mg. Titrating it would likely be easier due to capsule form. but clonazepam is a partial reinstate. o which would you guys suggest to try first?

 

I ask this because I need to discuss the entire withdrawal to my dr as she is ignorant of the wd effects. The more idea I have of what I'm needing, the better support she will be, and I want to lay out both options to her and their pros/cons so she can make the best decision as to how she will support my titration. I understand this is not medical advice. I'm just going to use a collaboration of data as a starting point to give her.

I'm not familiar with Temazepam, but I am titrating Klonopin.  I am using Rice Milk and I taste no Klonopin whatsoever, just the Rice Milk.  I plan on cutting .01 mg of Klonopin (which is equal to .01 ml. in my case) every 3-4 days.

 

Hope this helps.

 

Sincerely,

 

fg

thanks

Hi sliceofpi

 

I am also not familiar with Tamazapan but I am titrating using smooth vanilla yogurt and it conceals any of zolpidem taste.

 

If you are currently under a lot of external stress which is only going to be of a short term (week or two) you would be fine holding till the stress has let up.  However if it is just going to ebb and flow for a longer duration you may as well pick a day and start. 

 

I have always read that it is better to first completely taper the Benzo with the shortest half-life and then stabilise once that taper is completed (some recommend as long as a year between tapers) before you proceed with tapering the benzo with the longer half life.  I did it the other way round but the decision is up to you. 

I'm finding the structure of your past and current dosing a little confusing as I'm not entirely sure where you started, what you got transitioned to and where you are now exactly.  From what it appears you were taking 2.5 mg of K and then got switched to 30 mg Temazepam and now are taking 30 mg temazepam at night to sleep and I'm not exactly sure how much K @ 5 pm. 

 

If you were on 2.5 mg of K (equivilant of about 50 mg of Valium) and transitioned to 30 mg of temazepam (equivilant to about 20 mg of Valium) thats a fairly substantial drop.  Also, temazepam, like ativan it s shorter acting benzo and if you are taking it at night and then not taking the K until early evening there may be a bit of interdose w/d happening during the day.  However, since you are taking K, which is a longer acting benzo, that might be counteracting some of the interdose w/d.  But if the dose of K combined with the dose of Temazepam you take in any one day is substantially less then what you were on originally, that may be why you are feeling the drops as well.  Again, I'm not entirely sure what doses of which and exactly when you are taking them, but if you are having some challenges stabalizing, this may be why.

 

Ashton has equivilance charts that you might want to look at to determine where you were dose wise and where you are now.  This way you can determine what the dose difference really is and provide it to your doctor to help her understand some of the challenge you are facing as a result. 

 

Is temazepam the only one that helps you sleep or if you were to take the equivialnt amount of K at night would that work as well?  The reason I ask is that instead of trying to transition off of both benzos, because K is the longer acting one and the drug you were originally on, it may not be a bad idea to consider c/o'ing fully back to a sufficient amount of K, stabalizing and then slowly taper directly off K.

 

I may have misunderstood what you said, but from what I read, this may be a viable option to consider.

 

WWWI

Yeah my history is confusing. I was on 2.5mg clonazepam, then had that removed and temazepam added. After 3 weeks and an ER visit, I went back on 0.25mg bid clonazepam (6-7am and 5pm). If I miss the 5pm dose of clonazepam I feel positively rotten until I do take it. I consistently start to get wd symptoms at 1-2pm, lasting until 1-2 hrs after taking 5pm klon, which provides slight relief till bed and my temazepam. I sleep well on temazepam, getting 5.5-8 hrs sleep, though the previous 2mg evening dose of clonazepam helped me sleep, I just didn't sleep as fast or hard.

So in effect you were on 2.5 mg K (50 mg valium equivilant).  You are now on 30 mg Temazepam (20-25 ish mg Valium equivilant) and .25 mg K (5 mg Valium equivilant) for a toals of about 25 - 30 mg Valium equivilant.  That means you dropped from 2.5 K to about 1.5 mg K, which is a  pretty significant chunk.

 

In addition you are taking temazepam at night and it has, I believe about a 6-10 hour half life, which means if you take it @ about 10 at night, at the latest by 8 am half of it is out of your system  and which steadily declines further as the day goes on and therefore you may be suffering a form of interdose w/d during the day which would explain why you feel "positively rotten" especially if you don't take the K around 5 pm.

 

Whether you decide to go back to the equivalent dose (or close) you were originally on or choose to stay on the dose you are currently on only you can decide.  However, the first thing I'd suggest is if you are going to keep things kind of how they are, you may want to consider also taking a morning dose of one or the other when you first wake up (probably k since temazepam makes you more sleepy).  If you were to add some more K in the morning, my guess your days would be easier.  You are not getting a steady dose at this time.  And even if the total dose you are taking is enough, because it's not steady, you may have challenges trying to stabalize since your levels are going up and down every day.

 

That make sense?

 

WWWI

 

 

oh I must have forgot to mention I take K in the morning too, 6-7am

And I do want to go down, its just a matter of when, and how receptive my dr is to a slow taper. 3x now I've been told to make drastic cuts. Thankfully the 1st time went ok, but these last 2 were bad. At least I had BB to know to go back up to the full temazepam when the wd hit bad. I still have apparently not stabilized at what I'm on now. I have no wish to reinstate back to my original dose. I just want to get off as soon as possible while minimizing the debilitating wd symptoms.

I appreciate your desire to get off the drugs.  If you are not planning to increase your dose, then you may want to consider holding until things stabilize some especially with the stressors you mentioned that you are currently dealing with.

 

To answer your questions below, since I've never tapered off either ( I was on Temazepam and ativan for a while but c/o'd to Valium) I don't know much about pill taste.

 

As far as tapering of both, again, if you can sleep on K, it might be something to consider to c/o entirely over to the equivilant amount of K since you are dealing with different half lives, which might effect how the cuts go and would allow you more consistency being on only one drug.

 

I wish I could be more help.

 

WWWI

That's help enough Thanks a lot!

cutting close on time, but if I were to do thw switch to klon entirely, would it be too risky to do this:

 

30->15mg taz +0.5mg klon for 2 days

15mg taz changed to 0.25 klon

hold few days at 0.25mg am, 0.25 supper, 0.75 bed

switch to 0.5 am, 0.25 supper, 0.5 bed

 

PI

 

You may want to start a new post specifically asking for help for a c/o to K or a taper plan.  You may get more responses quicker.

 

WWWI

It doesn't matter anyways. My doctor does not believe I am in withdrawal. She says that I can't be having withdrawal when I am still taking benzos. She said it was something else, maybe a UTI. She finally humoured me by the end of the appointment and said that we would wait until I was done my current supply of meds, roughly 2 weeks, and then she would give me one 2mg clonazepam to take instead of the 0.25 clonazepam and 30mg temazepam, and if I sleep, then go from there. And that I could do whatever dosing schedule I wanted, prepared by a pharmacy, not myself, as slow as I wanted, but not to think about it until I'm completely done with temazepam. An abrupt change from temazepam to clonazepam, no taper.

 

Doesn't this sound like she's just thinking I'm making it all up, and it will pass as if I were just psychotic right now or something? She didn't humour me until I said that my symptoms were checked out by nurses. Am I just a hypochondriac?

 

And my counsellor said to not look for support online, not to look at my symptoms or research or even success stories, just look at only what is positive in a day and ignore how I am feeling.

 

I'm feeling rather er degraded?

Personally, I believe in doing as much research as possible and being an informed patient.  Not being an informed patient got me on benzos.  If you need to get a 2nd or 3rd opinion, feel free to do that as well.  I had to go through several doctors before I found one that was somewhat "benzo-wise".

 

I certainly wish you well.  I know how frustrating it can be.

 

Sincerely,

 

fg

I just wish I had the option of another doctor. When I move I will, but for now she is the only one.

It doesn't matter anyways. My doctor does not believe I am in withdrawal. She says that I can't be having withdrawal when I am still taking benzos. She said it was something else, maybe a UTI. She finally humoured me by the end of the appointment and said that we would wait until I was done my current supply of meds, roughly 2 weeks, and then she would give me one 2mg clonazepam to take instead of the 0.25 clonazepam and 30mg temazepam, and if I sleep, then go from there. And that I could do whatever dosing schedule I wanted, prepared by a pharmacy, not myself, as slow as I wanted, but not to think about it until I'm completely done with temazepam. An abrupt change from temazepam to clonazepam, no taper.

 

Doesn't this sound like she's just thinking I'm making it all up, and it will pass as if I were just psychotic right now or something? She didn't humour me until I said that my symptoms were checked out by nurses. Am I just a hypochondriac?

 

And my counsellor said to not look for support online, not to look at my symptoms or research or even success stories, just look at only what is positive in a day and ignore how I am feeling.

 

I'm feeling rather er degraded?

I'm a little testy tonight as a result of some blood tests and a diagnosis that I'm displeased with so please understand if my tone is a bit harsh.  With that said, your doctor is wrong.  If she were the first doctor to dismiss withdrawal, then perhaps there would be some question. HOWEVER not only are there countless stories on here of the increadible lack of knowledge that doctors possess about benzos and w/d and the trauma of hundreds if not thousands of people who have posted here because of that ignorance and people not being believed, being put on impossibly fast tapers or forced c/t's with the same statement that they were not in w/d. 

 

Since I was an ativan user, I'm more familiar with that drug, but they are all benzos.  In 2008 the FDA came out and stated that Ativan should NOT be used for longer than 2 to 4 weeks because of its highly addictive nature and that dependance can occur in as little as a week.  If the FDA states that it's highly addictive, it would mean that lowering the dose one is dependant on or removing the drug too quickly can lead to significant withdrawal.

 

Just because she's a doctor does not mean she knows anything about this as clearly she doesn't.  And as far as your councelor, I will tell you when I went to my doctor with the Ashton manual in hand, she tossed it to the side and said "you read too much".  Had it not been for the Ashton manual, and trusted the doctors and therapist to know what was best for me, by now I wouldhave probably been committed because each one told me what they believe to be best for me, including that it wasn't w/d but a reoccurance of my symptoms.  Problem was, my original symptom was insomnia, not anxiety or any of the symptoms I am.  experienceing in w/d.  I followed their suggestions initially and crashed and burned HARD.  It wasn't until I found this board and read everything I could that I began to dig myself out of the hole.  It took 5 months for me to leave my house.  All because my doctors said they were the experts and I was not and they knew better than I.

 

Your symptoms are classic w/d, even while you are on benzos.  Many people get a tolerance to the dosage they are on and experience w/d.  Your dose was lowered from what your body was used to and are experiencing w/d. 

 

Do what you have to to get the drugs you need and then devise a plan to slow taper.  Although it would be wonderful if you can get support from your doctor and counselor, but if you can't, you can still do this.  It is not your imagination, you are not a hypochondriac.  You are in w/d. 

 

I'm so sorry they made you feel this way.  You aren't the first and won't be the last, but that doesn't mean it doesn't suck to have to experience that kind of invalidation.

 

I'm really sorry.  If there is any information or support we can provide here, please ask for it.

 

WWWI

thank you for the validation. I was beyond frustrated. I called a pharmacy this morning to ask is they had suspensions or orally disintegrating tablets, and they don't, but he said that I should either cut down slowly by 0.125/however long needed (1/4 tab klon) and if that is still too fast, then talk to a compounding pharmacy. He'd asked my dr's name which I didn't want to give but had to. I don't want to slam her. i just have a feeling she has never had this situation before. Ok, maybe I do have the urge to slam her a little, but really, overall, she is great. Its just this assumption that I'm an addict and having a severe bout of hypochondria or something, which I've never had before.

Or even worse- malingering, which I've never had before either. Ok, maybe I let things go a little far when I was elevated and got into my head to prove that I could get extremely elevated if I stopped micromanaging moods, and I asked her to confirm my diagnosis after so that I wouldn't do something stupid like that again to prove to myself that I really did have a disorder I needed to take care of. I need to talk with her and get this cleared up.

I don't know where you live but I do know that if you can find a compounding pharmacy they may be able to provide you a liquid suspension.  Barring that you may want to again, post a new request giving your current dosages and asking for suggestions on how to titrate best (what liquids, dosing etc) since again i have no experience personally with titrating either drug.  I don't know whats right for you as far as which drug and how much but it would seem to me if you can survive this waiting period and get back on the 2 mg K, and if you are successful in getting to sleep, it might be easier to titrate of of K.  But again, that is entirely your choice.

 

I'm not sure I understand about the elevated thing.  But I'll trust that you understand now that she may never quite understand what you are going through and may or may not validate what is happenening to you.  The priority is to continue to get the meds consistently so that you can taper on your time, which it sounds as if she's willing to do.  There is always hope somewhere down the line that she will come around.  But probably best not to expect it.

I'm water titrating temazepam.  It has no taste in water, or very little if at all. 

 

I find it much easier to taper Temazepam than it was to be on Xanax with its interdose withdrawals.  Temazepam is short acting, but it's not very potent, about 1/2 as potent as valium.  So the interdose withdrawals are not as dramatic.  I do take a tiny dose of T at around 2:00 or 3:00 in the afternoon (2 mgs) and another one at around 7:00 or 8:00 in the evening.  So far I've dropped over 25% of my dose and I feel better than I did at 30 mgs.  I'm definitely having sx, but it's tolerable.  I'm going very slowly because I have other health issues.  I go down about 10 - 15 % per month.  But you can go faster if you can tolerate it. 

 

I put 30 mgs into 120 mls of water and pull .5 mls per night.  This rate keeps me functioning well enough.