Harm Reduction Tapering help: Klonopin, Seroquel, Auvelity. Which first?

[remorse.code]

Hello, first time posting. Advanced apologies if not posting correctly. I am currently on 100mg Seroquel XR, 2mg Klonopin (1mg 2x day) and Auvelity 100mg/night. I have suffered from severe treatment resistant depression and anxiety along with loss of appetite for the past 4 yrs. Klonopin prescribed for past 15 yrs., Seroquel 1 yr., Auvelity 6 mos. I am also receiving regular Ketamine infusions for chronic pain and mental health. Ketamine has done wonders. Ketamine has helped with mental health and appetite. Have gained 20 lbs since beginning Auvelity despite still struggling to eat a lot of the time. Not as concerned about weight as I am about keeping appetite and keeping myself balanced so I don't end up in a tailspin again.

My psych nurse wants to work towards weaning me off of these meds, especially the Klonopin. I have had previous horrific experience in weaning down from Klonopin, even at slow taper. I was down to 1mg for years and then increased again to stop uncontrollable anxiety and inability to eat. When I spoke with her about tapering, she just said to maybe start skipping a dose here or there and build up to stopping! This is absolutely NOT the way to get off benzos and it seems that most of the doctors I talk to have no idea about this. I understand how to taper from Klonopin.

TL;DR: MY QUESTION: Considering the three medications I'm currently taking (and the regular ketamine infusions), which medication would be the best to start tapering first? I'm hoping that maybe the other meds will help with tapering if I do them in the right order. I understand that diazepam can be helpful in Klonopin taper as well. As for the Seroquel, it is XR, so no way to break down to less than 50mg. The Auvelity should be the least of the problem, but even that will be a challenge.

For reference, I have successfully weaned myself down from 4mg Klonopin +PRN 15 yrs. ago (down to 1mg) and last year I decided to wean myself off of 15 yrs. of 40mg vicodin/day. It was brutal, but I did it alone at home.

Sorry so long, I'm hoping one or more of you can help me with my plan. Medical staff just don't seem to believe or understand the reality of weaning off of these medications. Thank you in advance.

 

[Miprocinadmirer]

Seroquel first, as I think itl be easiest? Then whatever room that frees up stop the benzos, but if ur not go a fit just grind it out there's things like replacement drugs that aren't benzos I think
Sorry for the addiction, I'm stuck myself

 

[snmfmy]

Hello, first time posting. Advanced apologies if not posting correctly. I am currently on 100mg Seroquel XR, 2mg Klonopin (1mg 2x day) and Auvelity 100mg/night. I have suffered from severe treatment resistant depression and anxiety along with loss of appetite for the past 4 yrs. Klonopin prescribed for past 15 yrs., Seroquel 1 yr., Auvelity 6 mos. I am also receiving regular Ketamine infusions for chronic pain and mental health. Ketamine has done wonders. Ketamine has helped with mental health and appetite. Have gained 20 lbs since beginning Auvelity despite still struggling to eat a lot of the time. Not as concerned about weight as I am about keeping appetite and keeping myself balanced so I don't end up in a tailspin again.

My psych nurse wants to work towards weaning me off of these meds, especially the Klonopin. I have had previous horrific experience in weaning down from Klonopin, even at slow taper. I was down to 1mg for years and then increased again to stop uncontrollable anxiety and inability to eat. When I spoke with her about tapering, she just said to maybe start skipping a dose here or there and build up to stopping! This is absolutely NOT the way to get off benzos and it seems that most of the doctors I talk to have no idea about this. I understand how to taper from Klonopin.

TL;DR: MY QUESTION: Considering the three medications I'm currently taking (and the regular ketamine infusions), which medication would be the best to start tapering first? I'm hoping that maybe the other meds will help with tapering if I do them in the right order. I understand that diazepam can be helpful in Klonopin taper as well. As for the Seroquel, it is XR, so no way to break down to less than 50mg. The Auvelity should be the least of the problem, but even that will be a challenge.

For reference, I have successfully weaned myself down from 4mg Klonopin +PRN 15 yrs. ago (down to 1mg) and last year I decided to wean myself off of 15 yrs. of 40mg vicodin/day. It was brutal, but I did it alone at home.

Sorry so long, I'm hoping one or more of you can help me with my plan. Medical staff just don't seem to believe or understand the reality of weaning off of these medications. Thank you in advance.

You should request a change from Klonopin to either diazepam or Librium.

They are much longer acting and longer half life and are more disposed to tapering.

 

[remorse.code]

Thanks, both of you. I'm actually now tapering off the Auvelity as it has severe and moderate interactions with the other two meds and I've only been on it for about 6 months. Auvelity is a new antidepressant with dextromethorphan and buproprion. It has done nothing for my depression. Psych nurse said just cut dose in half (two xr pills) and take half in morning, half at night. I'm taking whole in morning, half at night. 25% taper is more than my body wants. I can't even consider getting off the seroquel or benzo until after I level off.

Seroquel is going to be a beast as it cannot be cut (XR) and it's two 50mg pills. Lowest dose 50mg.

Thanks for the info on the benzo, I didn't realize diazepam had such a longer half life. That would be helpful.

Miprocinadmirer, sorry to hear you're suffering too.