Need a titration schedule

Hi.  Started taking ativan in April '08.  Wanted to switch to diazepam to taper, but doctor would not agree and said I should taper using clonazepam.  I switched over to the clonazepam last week and am currently take .25 mg of clonazepam 2 times a day (first dose around 8 am, second dose around 4 pm).  I must admit that I like the clonazepam much better - much less interdose withdrawal, however, I still want to get off of them.  Also currently taking ambien CR at bedtime, but plan to deal with that after I am done with the benzo. 

I would be most grateful for a suggested taper schedule for the clonazepam.

Many thanks, Becky

Hi, ashley.

Welcome to BenzoBuddies.  We can certainly help you get off clonazepam. 

Your post indicates you want to do a titration taper, is that correct?  Do you already have the 100 ml cylinder and 10 ml syringe that's needed?  Colin will work up an individual schedule when you post how much you want to taper; ie., 10% every 10 days, and what day you want to start.

I'm glad the clonozepam is working well for you now but you are wise to get off it before you start experiencing tolerance withdrawal.  If you have any questions, just post away and someone will get back to you.

Hi Ashleyrm,

Welcome to BenzoBuddies.

What dose of Ambien do you take? I should point out that while technically Ambien is not a benzo (a so-called 'z-drug'), z-drugs act so similarly to benzos, we make no distinction. I am not sure how long Ambien CR lasts, but Ambien CR tablet cannot be split into smaller doses as they will loose their slow release properties. You could titrate the Ambien CR, but again they will loose their slow release properties - this is a problem because plain old Ambien has very short half life.

Perhaps your doctor will prescribe an equivalent dose of Clonazepam to replace the Ambien. Clonazepam has a half-life of 18-50 hours (much more reasonable), so should work ell through the night. Additionally, there are no issues with titrating Clonazepam, unlike the Ambien CR tablets.

Thanks for the responses.  I take 12.5 mg of Ambien CR.  What would the equivalent be for Klonopin.  I could probably get my doctor to switch over.  Probably can't do it right away as my prescription plan limits 30 days supplies, and I just got refills for both the klonopin and ambien CR.  My doctor did write the klonopin prescription for .5 mg/twice a day and I am only taking .25 mg/twice a day, so I do have an extra .5 mg/day if that would be enough to substitute for the Ambien. 

Thanks, Becky

Hi,

Different authorities suggest different equivalencies, and what constitutes an equivalent dose will vary within an individual anyway. We tend to find Ashton's equivalents the most useful, and this would equate to about 0.6mg Clonazepam in substitution for 12.5mg Ambien. Obviously, this suggests that you would use 0.5mg Clonazepam as it the nearest convenient dose.

Because Clonazepam is fairly slow to build up in your system, and because you might get away with less than 0.5mg Clonazepam in substitution (as I said, what constitutes an equivalent dose will vary), you might be able to take less. If you feel the Clonazepam works well after a couple of nights, then take just 0.25mg instead from then on. The reasoning for this is that the Clonazepam will be still building up in your system at this stage, so your blood levels are much less than they would be after a week or two of use of 0.5mg (probably nearer to 0.25mg Clonazepam if taken on an ongoing basis). If you feel relatively well with these lower blood levels (equivalent to a lower dose), then take a lower dose. I cannot be exact about this - I'm just trying for you to avoid taking more Clonazepam than you need do. On the other hand, if it takes many days (5-7) before you feel the 0.5mg Clonazepam is a good substitution, you should certainly consider the 0.5mg as the correct substitution level, and should be more cautious about your cuts. We will help you with your taper when it is time to cut.

Anyway, on the face of it, your spare 0.5mg Clonazepam per day is enough. You should, however, have discussion with your doctor about any changes to your medication.

okay, I think I figured this out.  According to the Ashton manual

20 mg of ambien = 10 mg of valium

0.5 mg of Clonazepam = 10 mg of valium

12.5 mg of ambien = X mg of Clonazepam

12.5 mg of ambien would be .3125 mg of Clonazepam

So, I think I'll try to take .25 mg of Clonazepam tonight instead of the ambien and see if it works.  If so, then I will be taking .25 mg of Clonazepam  3 times a day (8 am, 4 pm, and I don't know, maybe 10:00 p.m.?)  I usually take the ambien about 1/2 hour before sleep so I'll try the same with the Clonazepam.

Does this sound like a plan?

Hi,

According to Ashton, 12.5mg Ambien is equivalent to 0.3125mg Clonazepam - you are correct. I used the wrong equivalent dose - sorry.

So, yes, you would take just 0.25mg Clonazepam to replace the 12.5mg Ambien CR. As I said though, you should talk to your doctor about changes to your meds. After all, I'm not a doctor!

Do be aware, it might take two or three nights for the Clonazepam to build up enough to be a full substitution. It should be quicker than it would normally, since you already have Clonazepam in your system.

Colin,

Thanks for your reply.  I have switched over to taking .25 mg of klonopin at bedtime.  The first night was a bit tough.  Woke up a couple of times, had some really weird dreams and woke up with some morning anxiety. Last night was much better.  Slept through the night and felt pretty good this morning.  I didn't even take my morning klonopin dose until around 10 a.m. So I think I'm pretty much crossed over from the ativan and ambien to klonopin.

My current schedule is now .25 mg of klonopin three times a day (8 am, 3 pm and 10 pm).  I would like to start tapering so if someone could put together a taper schedule for me, it would be greatly appreciated.

Thanks, Becky

ashleyrm 

Do you want to do a titration taper?  Do you already have the 100 ml cylinder and 10 ml syringe that's needed?  Colin will work up an individual schedule when you post how much you want to taper; ie., 10% every 10 days, and what day you want to start.

I'm so glad the transition to klonopin only went so smoothly.  You are going to do great. 

Hi Ashley,

We can put together a taper paln for you. Please let us know (or ask for feedback) what taper rate you wish to follow.

Good to hear that you are feeling better.

Colin,  I guess I'll go with the 10% every 10 days since that seems to be the preferred method here...

Thanks, Becky

Hi Becky,

I will need a start date (allow me a couple of days); the size of your cylinder (and the size of the marked increments); and size (dose) of the pills you use.

Colin,  I guess I'll go with the 10% every 10 days since that seems to be the preferred method here...

 

Thanks, Becky

 

 

Becky I wouldnt really say thats the "perfered rate" around here or anything. That would be just a bit too fast for me personally. I was and will be doing 10% per 12 days and a few times in the titration I had to slow down. Some people do 10% per 14 days also, some slower...Either way you are going to be fine. thats the good thing about this method is you can slow down or speed up

good luck

Hi, Becky,

I can see you are going to do well with the taper program.  Welcome to the forum.

Patty  xo

Okay,  I don't have a graduated cylinder yet, but I will get a 100 ml one with 1 ml markings.

My pills are .5 mg which I break in half to take .25 mg/3 times a day.

I likely won't start until after next week, as I have a deadline project at work that is due Sept. 29th and is causing lots of anxiety and stress and I'd like to finish that first, so let's target October 1 as my start date.

Let me know if you need anything else.

Thanks, Becky

Becky,

Good luck you are going to do great. Have you got a syringe yet? in case you have not, Many pharmacies ofcourse have them, and some people even get them from their pets vet..

Good luck, and you are going to do fantastic

Got all of my supplies and am ready to go.  Just need  a schedule....

Hi Ashley,

Colin will have your schedule ready well before your requested start date  of Oct. 1. 

Hi Ashley,

Sorry for the delay.

If you don't pick up this schedule in time for tomorrow, just go to the second day - it will make no noticeable difference.

If I understand correctly, you take one-and-a-half 0.5mg tablet per day. At the start of this schedule, you will continue to take one whole pill (halved, or whatever suits you), and titrate your second pill. Each day, you will prepare 100ml of liquid, but drink just the amount indicated by the schedule. Of course, 50ml from 100ml, using one whole 0.5mg tablet, would equate to 0.25mg. So, 49ml is is your first tiny cut to your dose.

Here's your Schedule: http://www.benzobuddies.org/spreadsheets/tt-ashleyrm-2008-09-30.html

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