Benzos New here, but looking for advice on Benzo tapering

[czguy99]

I've been on Clonzepam (Klonopin) legally for about 7 years at 3mg/day and have been stable. My psychiatrist retired and referred me to a new one who has a strict UA policy screening for illicit drugs. Their policy is that they will cut you off of controlled substances if you test positive for illicit drugs. I'm a semi-frequent cannabis user (not in a legal state, but decriminalized) and it helps me with my anxiety and insomnia problems. I have an appointment in 2 weeks and there's no way for me to flush the THC metabolites out of my system nor am I going to resort to synthetic urine since they test for benzo levels to make sure you're not abusing/selling/etc. So that being said I'm extremely concerned that the new psychiatrist is going to cut me off cold turkey.

I'm sure most here know how nasty benzo withdrawals can be, especially with Klonopin. I've already started a taper coming from 3mg to 2.5mg for a week and have had no withdrawal symptoms to speak of, but I'm still on a decent dose. I still consume cannabis as it's the only thing that truly helps my mental health and I really do not care about the legality status of it as I prefer to be mentally and physically healthy.

On the other side of the coin my previous psychiatrist before he retired gave me 2 months worth of refills at 3mg/day so if I have to taper I can do so, but I don't think I have enough to do a proper taper, but perhaps it will avoid the whole seizure/psychotic/coma/death thing. I'm admittedly scared to death of going into severe and life-threatening withdrawals. I've read that cannabis consumption can help with benzo withdrawals, so while I realize this may not be the right forum to post in, I was hoping for some advice or stories from those who have tapered/withdrew from benzos with the addition of cannabis.

My appointment is in 2 weeks and each day that it comes closer I'm more and more anxious.

Anyhow, that's about it for now. Would really appreciate any insight from other forum members.

 

[Trex_Echoes]

Hi czguy99,

There's a benzo tapering manual available online called the 'Ashton Manual'.

Hope it helps.

 

[czguy99]

Thanks Trex, I've already studied the Asthon Manual for the last week, but I don't have access to valium for a cross taper and I only have 2 months of klonopin. I think with what I have I can prevent "severe" withdrawal symptoms along with cannabis, l-theanine, and other natural supplements. But my biggest concern is seizures, coma, and death obviously. On the plus side I'm currently working on a plan to move to Colorado (legal state) where I can medicate with high CBD strains to help me detox. But that won't be for another 3-4 months at least. Admittedly scared shitless.

 

[Scrofula]

Klonopin is one of those long lasting benzos, and that alone will help prevent the serious risks with quitting. I don't think there's any reason to switch to a different benzo.

The real reason for a slow taper off clonazepam is comfort, and that's for you to determine. But even if you cut your dose in half tomorrow, you won't have major risk of seizures, and definitely not coma or death.

You should note that taking CBD, while it might help with anxiety, would NOT reduce seizure risk--you'd still need to taper.

 

[czguy99]

Klonopin is one of those long lasting benzos, and that alone will help prevent the serious risks with quitting. I don't think there's any reason to switch to a different benzo.

The real reason for a slow taper off clonazepam is comfort, and that's for you to determine. But even if you cut your dose in half tomorrow, you won't have major risk of seizures, and definitely not coma or death.

You should note that taking CBD, while it might help with anxiety, would NOT reduce seizure risk--you'd still need to taper.

Thanks for your input, I think part of the problem is I'm reading all these horror stores of people having seizures/coma/death and it's scaring the living piss out of me. As mentioned I've cut from 3mg to 2.5mg and am holding with no withdrawals so far. But it also should be noted that in 2015 my NP decided that 3mg was too high of a dose and she immediately cut me to 1.5mg in a day. I went through severe withdrawals for about 3 months before I stabilized, the only thing that helped me get through it was cannabis. I think there is a silver lining here too. I'm on Depakote for mood stabilization and it's a pretty decent anti-seizure medication and I have 6 months of refills on file, so taking that should help prevent seizures in theory. I'm talking to my new doc on the 9th so we'll see what happens. Either way whether they cut me off or I do it myself I want off of Benzos as it's been of no benefit besides keeping me out of withdrawals. My plan is to taper .5mg every 2-3 weeks until I'm done and medicate with cannabis to keep me from blowing my gasket so to speak. The Asthon Manual suggest that a .5mg cut is too fast, but I really have no choice since I only have 2 months worth of refills before I'm completely out.

Hoping to to hear from others who may have tapered down as well, but any response is helpful and greatly appreciated

 

[Scrofula]

Eek, Depakote isn't one you want to leave out of the equation. That's kind of a nutty drug with all kinds of bizarre side effects and has a definite role in preventing seizures. Be careful, and make sure you don't miss a dose with that.

 

[Jabberwocky]

When tapering benzos, keep the taper very slow. Given clonazepam’s half life don’t taper more than once a week and take breaks from tapering if it becomes uncomfortable. If you make a really uncomfortable drop there is nothing wrong with increasing your dose a little, stabilizing, and then continuing a slow, methodical taper.

There is a case for switching to another long acting benzo like diazepam, but if you can’t get it you’ll have to work with what you have.

The golden rule of tapering is to take it slow. Once you get down to 1-2mg don’t reduce your dose more than 0.25mg/week and it should be relatively managible. There are lots of things you can take to make the end of the taper more comfortable/safer, but these come into play more when you’re actually transition to 0mg clonazepam.

 

[czguy99]

Eek, Depakote isn't one you want to leave out of the equation. That's kind of a nutty drug with all kinds of bizarre side effects and has a definite role in preventing seizures. Be careful, and make sure you don't miss a dose with that.

I take it on time and as scheduled. So far I've not have any side effects from it (been on it 2 months). I guess I'm the lucky one. I will make sure not to miss a dose.

 

[czguy99]

When tapering benzos, keep the taper very slow. Given clonazepam’s half life don’t taper more than once a week and take breaks from tapering if it becomes uncomfortable. If you make a really uncomfortable drop there is nothing wrong with increasing your dose a little, stabilizing, and then continuing a slow, methodical taper.

There is a case for switching to another long acting benzo like diazepam, but if you can’t get it you’ll have to work with what you have.

The golden rule of tapering is to take it slow. Once you get down to 1-2mg don’t reduce your dose more than 0.25mg/week and it should be relatively managible. There are lots of things you can take to make the end of the taper more comfortable/safer, but these come into play more when you’re actually transition to 0mg clonazepam.

Thanks for your input. We'll see what my pdoc says then they give ma UA. They may take mercy on me and allow me to taper. I still have 2 months worth of 3mg/day on file for refill so if he cuts me off I'll probably survive this but it won't be terribly pleasant. As mentioned I cut from 3mg to 2.5mg with really no problems and I'm going to hold for a week before my next cut. If the pdoc refuses to slow taper/cross taper I'm going to have to embrace the suck and deal with it. I can manage anxiety, insomnia, tremors, etc, but my worst fear is seizure or worse so I'm taking it slow. I know if I get in a bind I can probably go to a "market", but I really want to try to stay away from that.

In the meantime the cannabis is doing a lot of good for me, and honestly I can't wait to be in CO where I don't have to worry anymore.

 

[Jabberwocky]

Good to hear about the cannabis. Please let us know what happens with your appointment and if worse comes to worse we can help you work out a specific tapering schedule. Good luck!

 

[czguy99]

Good to hear about the cannabis. Please let us know what happens with your appointment and if worse comes to worse we can help you work out a specific tapering schedule. Good luck!

Will do, I'll keep you folks up to date. Right now my "shooting from the hip tapering schedule" is .5mg every 2-3 weeks until I get down to 2mg, then .25mg cuts every 2 weeks. Not sure if the amount that I have on refill will cover that taper schedule but I'll taken inventory and report back.

But yes, the cannabis is a godsend.

 

[Jabberwocky]

That’s a good plan for now.

 

[rainyday107]

I take Klonopin (as prescribed), too, for ten years now. My psychiatrist and I are discussing titrating my dose down a bit, perhaps in the Spring. (My dad died last month so now isn’t a good time.)

I’ll be following your thread with interest and you have my support! Cutting your dose in half is harsh. Hugs if needed.

Rainy

 

[benzoheadplus44]

I too know about the Ashton method, and had Valium so I was able to do it myself...

But I also have come off of klonopin with klonopin as it has a long half life. Work with what you have and drop around a quarter of a mg a week or every two weeks. Even if you do it weekly you will be fine but there may be some discomfort toward the end. It's usually not the worst but it depends on the individual. If I could I would get my hands on some gabapentin if I were you too. It will help tremendously with discomfort and seizures. You probably won't seize once you get low enough anyways...

 

[Doc Aliquot]

The withdrawal protocol we use for benzo tapers is a switch to chlordiazepoxide (Librium) at a 25mg. bid dosage for a week, then drop to 10 mg. bid for a week, then 5mg bid for a week, then 5 mg. qd for the final week.

Librium is the prototype benzo, and the longest acting and safest of all of the family, with a half-life of 30 hours, and an active metabolite with a half-life of 300 hours. It's widely used for controlling withdrawal symptoms from benzos, alcohol, barbiturates, and opioids. Be honest with your doc, and tell him you want to quit the clonazepam, and if he's not a total asshole, I'd bet he'll help you.

Good luck,

Doc

 

[czguy99]

I take Klonopin (as prescribed), too, for ten years now. My psychiatrist and I are discussing titrating my dose down a bit, perhaps in the Spring. (My dad died last month so now isn’t a good time.)

I’ll be following your thread with interest and you have my support! Cutting your dose in half is harsh. Hugs if needed.

Rainy

As the others mentioned, be careful with your taper. I've noticed at higher doses a major cut like .5-1mg is not too bad, it seems to be when you get down to the 2mg threshold the cuts are harder. The support is mutual

 

[czguy99]

I too know about the Ashton method, and had Valium so I was able to do it myself...

But I also have come off of klonopin with klonopin as it has a long half life. Work with what you have and drop around a quarter of a mg a week or every two weeks. Even if you do it weekly you will be fine but there may be some discomfort toward the end. It's usually not the worst but it depends on the individual. If I could I would get my hands on some gabapentin if I were you too. It will help tremendously with discomfort and seizures. You probably won't seize once you get low enough anyways...

Thanks for your feedback. After doing some reading, talking to you fine folks, and doing some "soul searching" I think I can get off this crap. I don't have access to valium otherwise I'd cross taper myself down. So my plan is to talk to the pdoc on the 9th and see what he says. It's a new practice but luckily the person I'm seeing is my NP from the previous practice and knows me very well. So I feel comfortable being honest with him and telling him what's going on. He's pretty compassionate so I'm not overly concerned at this time that they will just cut me off cold turkey due to cannabis use. They may not be happy about it, but it is what it is.

 

[czguy99]

The withdrawal protocol we use for benzo tapers is a switch to chlordiazepoxide (Librium) at a 25mg. bid dosage for a week, then drop to 10 mg. bid for a week, then 5mg bid for a week, then 5 mg. qd for the final week.

Librium is the prototype benzo, and the longest acting and safest of all of the family, with a half-life of 30 hours, and an active metabolite with a half-life of 300 hours. It's widely used for controlling withdrawal symptoms from benzos, alcohol, barbiturates, and opioids. Be honest with your doc, and tell him you want to quit the clonazepam, and if he's not a total asshole, I'd bet he'll help you.

Good luck,

Doc

Hey Doc... are you a doc? (Just curious). I've read that Librium can help with a rapid detox and I'm actually ok with that. Again my biggest concern is seizures or worse. The new practice has a UA policy that is pretty strict, but I can't imagine them cutting me off CT just for some cannabis use. I've already sent a note to my NP who I will be seeing on the 9th telling him I want off the benzos "safely/slowly" so he has a heads up of my intentions on the 9th. At this point in my life I just want to get off the benzo as it lost its efficacy years back and they have me on it now just to prevent withdrawals which is a really crappy reason to take a drug.

If for some reason he does cut me and wont' slow taper me, are there outpatient options available to taper with Librium? I have two jobs, a family, and lots of responsibility and am frankly scared shitless of going into a rehab facility/inpatient. I've never abused my medication or taken more than required so I don't feel like I'm the stereotype "addict", but I do know that after years on this medication I've developed a physical dependency.

Anyhow, thanks again for chiming in.

 

[czguy99]

Quick update. I started doing the math with what I have on hand + 2 refills at the pharmacy and it comes out to the equivalent of 4 months at 3mg. So if I taper at medium speed following my schedule I posted I THINK I might be ok. Again this is all dependent on whether or not the new psych CTs me or not. But I'm starting to build confidence that I can do this without too much suffering. The .5mg cut has been no issue whatsoever and it's been days. I remember in 2012 deciding to cut from 3mg to 2mg and I did that in one day and had zero issues minus a bit of rebound anxiety which was mild and I combatted with L-Theanine (Amino acid).

 

[300THB]

Quick update. I started doing the math with what I have on hand + 2 refills at the pharmacy and it comes out to the equivalent of 4 months at 3mg. So if I taper at medium speed following my schedule I posted I THINK I might be ok. Again this is all dependent on whether or not the new psych CTs me or not. But I'm starting to build confidence that I can do this without too much suffering. The .5mg cut has been no issue whatsoever and it's been days. I remember in 2012 deciding to cut from 3mg to 2mg and I did that in one day and had zero issues minus a bit of rebound anxiety which was mild and I combatted with L-Theanine (Amino acid).

Just wanted to drop you some advice as i recently came off a years of Ativan use.

First off if you have no history of seizures then you can rest assured, its not going to happen at these dosages, its extremely unlikely. Seizures happen when people go cold turkey.

Doing .5mg cuts is easy now but it wont be when you get lower. I've managed to drop from 6mg to 2mg in the past with virtually no withdrawal symptoms. A mate of mine dropped from 4mg to 2mg and again no withdrawals. Once you get to about 1.5mg this will probably become an issue. In my experience dropping from 1.5mg to 1mg is hard and 1mg to .5mg is absolute torture. So once you get to 1.5mg i would advise shaving the pills with a blade and dropping .25mg at the most!

Once you get to 0.5mg i would advise dissolving the pills in a liquid and dropping 0.125mg for each cut or just get as precise as you can with a blade.

Just remember ITS WORTH IT :D