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Anja: Buspar and clonazapam: which to taper first?


Anja

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'm new to the forum and feel like I've found a place where I can get some well informed answers. You all seem amazing! I'm trying to taper off Buspar (25mg- 5 weeks) and clonazapam (7 weeks - made it to .25 mg and am stuck). Which should I do first? I just read on this forum about tapering off ADs before Benzos and wonder what holds true for Buspar? I know Buspar affects seratonin in some way, but don't understand the mechanism and know it's different than ADs so maybe I should go for the Benzo first?

 

While I have not been on them very long, it is clear to me that for some odd reason I have an extremely sensitive nervous system. I tried to go off the benzo twice and failed miserably. I had horrible incapacitating symptoms (I was on Ativan for 3 weeks and cold turkey-ed off at my doctors insistence which was a huge mistake) Then she switched me to clonazapam and after getting more stable i was able to go down from .5mg). My doc and psychiatrist are pushing Zoloft or lexapro and doesn't believe these symptoms are due to withdrawal but i really feel that I am stable now (had a stressful event in Aug/Sept which is gone and felt good at the start of Oct) and just anxious about the tapering down and withdrawal symptoms since both times I tried to stop they were so incredibly traumatic. Psychiatrist told me To just stop Buspar cold turkey but there is no way. I've tried reducing the dose by 10% the past 2 nights and it's been rough- not like the benzo but I can tell it isn't going to be easy. (Super nauseous and increased anxiety, physical symptoms). I've got more background but wanted to keep it shorter! Thanks for thoughts about which one to stop first!

Ativan (0.5mgx1 daily): Aug 24-Sept 14 2016; Sept 27-29 2016 for anxiety brought on by possible serious illness (stopped for 1 week and had BAD withdrawal)

Buspar (22.5mg over 2 doses daily): Sept 20-present 2016

Clonazepam (0:5mgx1 daily): Sept 30-present 2016 (titrated down 25% per 5 days after illness scare passed, but had bad withdrawal at 0.125mg, so went back to .25mg Oct 17)

Clonazepam liquid taper: Oct 26: 0.22mg, (11.11% cut) Nov 7: 0.2mg, (12.5% cut) Nov 12: 0.175mg, (14.3% cut) Nov 16: 0.15mg (16.7% cut) Nov 24: 0.125mg

 

Supplements: D3: 1000 IU (drops), B12: (Methylcobalamin- 2500mg; Folate- 400mg; B6- 10mg), Pro-biotics: 25 billion, Magnesium glycinate: 100 mg x 2-3, Fish oil: 2000mg, Chromium picolinate: 200 mcg, Holy Basil: 500mg, Phosphatidylserine: 100mg, Curcumin:500mg; Zinc Picolinate

 

 

 

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  • Moderator Emeritus

Hi Anja and welcome to SA.

 

So that we can offer suggestions based on your individual situation it will be helpful if you would Please put your Withdrawal History in Signature.  Please include details for the last 12-18 months of  all drugs, dates, doses and discontinuations & reinstatements.  If you can't remember dates, please write it as "early March" or "mid-August".  Please provide a summary of any drugs prior to that which can just be listed with start and stop years. Please include all prescription, non-prescription drugs and supplements you are currently taking.  Don't include symptoms in the signature, just the original reason for starting on the drug/s.

 

Before you begin tapering what you need to know

 

Why taper by 10% of my dosage?

 

Tips for tapering off busipirone (Buspar)

 

Taking multiple psych drugs? Which drug to taper first?
If you're not having an adverse reaction from the other medications, taper the most activating drug first. This is usually an antidepressant or stimulant (ADHD drug).

 

What should I expect from my doctor about withdrawal symptoms?


How do you talk to a doctor about tapering and withdrawal?

 

These helped me to understand SA's recommendations:

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

 

 

You can ask questions here in your Intro/Update topic and journal your progress.  Click "Follow" top right and you will be notified when someone responds.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Chessie Cat,

Thank you so much for the quick and very helpful links! This forum is so wonderful.  I didn't see Buspar listed in this post: Taking multiple psych drugs? Which drug to taper first? I saw that in this post Tips for tapering off busipirone (Buspar) that buspar affects dopamine receptors...so does that make it an 'accelerator' or a 'brake'? According to the multiple psych drugs, if it is an accelerator, I should wean it first, before the clonazepam. I have tried dosing down both at different times and have had withdrawal reactions to both, as I am apparently HIGHLY sensitive. I had a particularly traumatic reaction twice to benzo withdrawl that has been really scary.

 

​(I don't understand its mechanism of action, but I found this description that possibly someone more brain literate could interpret: Buspirone works through multiple mechanisms and is classified as a selective serotonin subtype 1A (5-HT1A) partial agonist, with activity at both presynaptic and postsynaptic 5-HT1A receptors.[2] The drug also uniquely interacts with dopamine receptors as an agonist and/or an antagonist. Buspirone appears to block presynaptic dopamine receptors selectively and produces an increased firing of midbrain dopamine neurons.[3] Thus, buspirone produces anxiolytic effects via postsynaptic receptor activity, while its activity at autoreceptors initially suppresses neuronal firing but gradually restores serotonergic neurotransmission.)

 

Buspar causes some dizziness and rapid heart rate for me, clonazepam doesn't cause any side effects for me that I can tell. My fear is running out of clonazepam if I do not wean that one first. Both my MD and psychiatrist are pushing hard to get me on Zoloft or Lexapro if I cannot handle getting off the benzo which is making me nervous that they will not prescribe more if my titration down isn't 'in time'. I strongly feel that my current anxiety is due to fear of withdrawal symptoms since my biggest stressor has passed. My main complaint is what seems to be a cortisol spike at 3am-7am where I lie awake experiencing the terrible physical symptoms like nausea, diarrhea, hot flashes every hour, rapid heart rate, and insomnia which are worse when I attempt a titration down of either. Days remain manageable for the most part once the nausea passes after lunch, but I'm finding life challenging and exhausting, so work and taking care of my 2 young kids has been impacted.

 

I appreciate any advice about physiologically, and biochemically- which makes sense to withdraw from first- clonazepam or buspar?

Thanks!!

Ativan (0.5mgx1 daily): Aug 24-Sept 14 2016; Sept 27-29 2016 for anxiety brought on by possible serious illness (stopped for 1 week and had BAD withdrawal)

Buspar (22.5mg over 2 doses daily): Sept 20-present 2016

Clonazepam (0:5mgx1 daily): Sept 30-present 2016 (titrated down 25% per 5 days after illness scare passed, but had bad withdrawal at 0.125mg, so went back to .25mg Oct 17)

Clonazepam liquid taper: Oct 26: 0.22mg, (11.11% cut) Nov 7: 0.2mg, (12.5% cut) Nov 12: 0.175mg, (14.3% cut) Nov 16: 0.15mg (16.7% cut) Nov 24: 0.125mg

 

Supplements: D3: 1000 IU (drops), B12: (Methylcobalamin- 2500mg; Folate- 400mg; B6- 10mg), Pro-biotics: 25 billion, Magnesium glycinate: 100 mg x 2-3, Fish oil: 2000mg, Chromium picolinate: 200 mcg, Holy Basil: 500mg, Phosphatidylserine: 100mg, Curcumin:500mg; Zinc Picolinate

 

 

 

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  • Administrator

Hi, Anja.

 

Welcome to the forum from me, too.

 

We have a members-only benzo forum, and I would invite you to start a new topic for yourself there. 

 

Members only benzo forum

 

The Ashton Manual will give you more information on what to expect with benzo withdrawal:

 

The 2002 Ashton Manual is at http://www.benzo.org...anual/index.htm

 

The April, 7 2011 Ashton Manual Supplement is at http://www.benzo.org.uk/ashsupp11.htm

 

It will help in the decision of "which drug to taper first" if you could be very specific with your symptoms. Please follow the guidelines in this post:

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

Because you have a previous history of coming off and on Clonazapam, you are most likely dealing with kindling. Kindling can make each subsequent taper more difficult, so you'll want to proceed very cautiously.

 

Here is more information on kindling:

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

Wishing you much luck on your taper. 

Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

 

My Success Story:  Shep's Success: "Leaving Plato's Cave"

 

And what is good, Phaedrus, and what is not good — need we ask anyone to tell us these things? ~ Zen and the Art of Motorcycle Maintenance


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

 

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  • 1 month later...

I am wondering if someone can help me figure out how to better take my meds to avoid some annoying side effects? Currently I take:

-Clonazepam: 4 or 5am (down to .125 liquid taper)....originally took it at this time due to severe anxiety/diarrhea/hot flashes at this time of morning

-Buspar 7am (12.5mg)

-Bupsar 7pm (10mg)

 

I get really dizzy, tired, rapid heart rate after I take the morning buspar dose, but I don't notice this at night. It interferes with my ability to get my kids off to school (2 drop offs) and me to work (some days I can work from home, but still).

 

I had these ideas:

1. Separate the buspar and clonazepam dose by taking the benzo at night right before I sleep (10pm). I'm worried this is too drastic of a change...at this point the benzo doesn't do much but originally make me tired. Would this affect my daytime feelings- feel more withdrawal sx during the day if I am used to taking it as more of a daytime dose. I thought maybe the benzo and buspar were combining to create this symptom. I don't feel it upon waking, so it's not the benzo, it's after I take the buspar

2. Take higher dose of buspar at night instead of morning. Worried that this option might create my body to think its in w/d from decreased morning buspar dose since it wears off so quick

3. Take buspar at 5am WITH the benzo to see if it wears off by the time I need to do my morning hustle with my kids. Worried this option may make it so that I feel worse...but seems like the easiest to 'try'.

 

I tried decreasing the buspar (I went from 25mg to 22.5mg) and felt w/d sxs unfortunately. Otherwise I'd love to stop it bc I don't think it does much....but I figured I'd work on the benzo first since supposedly buspar is 'non-addictive', so I gave up on trying to reduce the dose for now.

 

Other ideas? Thanks for any insight!

Ativan (0.5mgx1 daily): Aug 24-Sept 14 2016; Sept 27-29 2016 for anxiety brought on by possible serious illness (stopped for 1 week and had BAD withdrawal)

Buspar (22.5mg over 2 doses daily): Sept 20-present 2016

Clonazepam (0:5mgx1 daily): Sept 30-present 2016 (titrated down 25% per 5 days after illness scare passed, but had bad withdrawal at 0.125mg, so went back to .25mg Oct 17)

Clonazepam liquid taper: Oct 26: 0.22mg, (11.11% cut) Nov 7: 0.2mg, (12.5% cut) Nov 12: 0.175mg, (14.3% cut) Nov 16: 0.15mg (16.7% cut) Nov 24: 0.125mg

 

Supplements: D3: 1000 IU (drops), B12: (Methylcobalamin- 2500mg; Folate- 400mg; B6- 10mg), Pro-biotics: 25 billion, Magnesium glycinate: 100 mg x 2-3, Fish oil: 2000mg, Chromium picolinate: 200 mcg, Holy Basil: 500mg, Phosphatidylserine: 100mg, Curcumin:500mg; Zinc Picolinate

 

 

 

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  • Moderator Emeritus

To help us help you, Anja, please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms

 

Post the notes from 3-4 days here in your introduction topic. You can post them daily or all at one time.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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