Cleerity: clonazepam, alprazolam, aripiprazole & mirtazapine

[Shep]

21 hours ago, Cleerity said:

My intention is not to abstain from moderate drinking on social occasions, but the daily consumption I was involved with is definitely at an end!  

 

Thanks for the update, Cleerity. I'm very glad to read you're doing so well. I just want to briefly comment on this. I have seen many people throw themselves into long waves due to having just one or two drinks during their taper (and even in the earlier months after a taper). This is especially true for people dealing with benzodiazepine withdrawal due to the fact that alcohol and benzos affect the same GABA receptors. 

 

Because you are doing so well with your taper and having very few symptoms, I would caution against using any amount of alcohol. It would be great to see you get to the finish line off all of these drugs with minimal symptoms. 

[Cleerity]

On 10/30/2019 at 8:10 AM, JimH said:

Hello Cleerity,

 

Definitely one of the best news! Congratulations for the good job! Please know that I follow your progress and I'm sure I'll learn one day that you are completely free of your chain and ball.

 

Hi Jim.  Very happy to know you are still out there and rooting for me!  Thank you!  

 

On 10/30/2019 at 1:21 PM, RubyJ said:

That's great news, Cleer!  I'm so happy to hear it.  Also happy to hear you're down to 50%!  Congratulations   Hope things continue well with few symptoms!

 

Hi Ruby.  Thank you for chiming in with your voice of support!  I also hope I continue with minimal symptoms ... that would be very good!  Time will tell.

 

On 10/31/2019 at 4:24 AM, Shep said:

Thanks for the update, Cleerity. I'm very glad to read you're doing so well. I just want to briefly comment on this. I have seen many people throw themselves into long waves due to having just one or two drinks during their taper (and even in the earlier months after a taper). This is especially true for people dealing with benzodiazepine withdrawal due to the fact that alcohol and benzos affect the same GABA receptors. 

 

Because you are doing so well with your taper and having very few symptoms, I would caution against using any amount of alcohol. It would be great to see you get to the finish line off all of these drugs with minimal symptoms. 

 

Hi Shep.  Your advice is very well taken.  I am sure that, because I have successfully abstained from any alcohol since July, I can (and will) continue without it.  

 

Best,

Cleerity

[Cleerity]

Hello...  I cannot believe it is over 7 months since I have shared here. 

 

I am now at .40 mg/ml on my aripiprazole titration.  It's really slow going. 

 

My withdrawal symptoms have been manageable.  There's some depression.  For many months, I did not like to look at myself in the mirror, because I even looked distraught and unhappy with my eyes tearing over for no apparent (acute) reason. While some depression remains, that feeling and presentation/affect has dissipated.  I am more in touch with my feelings since I began taking this medication and am glad for that. 

 

I did have one curious symptom as I worked down from .5 mg to where I am now and that was some pretty profound vertigo.  I only ever had a similar bout of vertigo back in 2012.  I did not immediately make the connection, but 2012 was also when I began taking the aripiprazole.  Because we could not find any cause for the vertigo in 2012, it was diagnosed as BPPV.  I did get a vestibular workup with the recent episode of vertigo (which lasted for about 10-14 days), just to make sure all was well with me, and it is. 

 

What I have wondered is if in fact it was the aripirpazole which brought on the vertigo in 2012?  And if, perhaps, as I am titrating down, it may have resurfaced as my body/mind system mends from over 8 years of using it? 

 

Having lived through nerve damage/injury in the past, I know that the presentation of symptoms of nerve damage goes in reverse order as nerves heal.  I may never know for sure, but this is what I imagine "may" be happening. 

 

I continue to refrain from alcohol consumption.

 

Best wishes to all,

 

Cleerity

[Altostrata]

Vertigo is a very common symptom of withdrawal from psychiatric drugs.

 

I recently had a bout of vertigo that seems to be due to a common inner ear problem that can come and go. I did these exercises 

 

and it went away over about a week.

[Cleerity]

Thank you for sharing this, Alto.  I will have to remember (bookmark) this maneuver in case I need it in the future.

[Altostrata]

How are you doing, Cleerity?

[Cleerity]

Hi Alto, and thanks for checking in with me.  I am doing well.  Presently at .33 mg/ml on the Aripiprazole titration.  The vertigo I experienced has not returned.  That's good.  Still experiencing depression, but coping well.  I feel (and hope) that I am past the worst part of the withdrawal.  Steady I go. 

[Cleerity]

Wow!  I just updated my signature and realized that I have been tapering this medication for almost 2 years now.  And it was only 2 mg when I started!

[ChessieCat]

55 minutes ago, Cleerity said:

Steady I go. 

 

That's the best way to do it.

[RubyJ]

On ‎8‎/‎21‎/‎2020 at 6:02 PM, Cleerity said:

Still experiencing depression, but coping well.

 

I'm glad to hear that it's still going relatively smoothly for you and my thoughts are with you! 

 

On ‎8‎/‎21‎/‎2020 at 6:05 PM, Cleerity said:

Wow!  I just updated my signature and realized that I have been tapering this medication for almost 2 years now.  And it was only 2 mg when I started!

 

Isn't it crazy how long it can take and you don't even realize it?  I was also amazed when I realized it had been over 2 years!  I think my total time was about 2.5 years but I went too fast at one point.  Best of luck for your continued tapering!

[Cleerity]

On 8/21/2020 at 7:58 PM, ChessieCat said:

On 8/21/2020 at 7:02 PM, Cleerity said:

Steady I go. 

 

That's the best way to do it.

 

Hi Chessie!  It's working!  🙂

 

3 hours ago, RubyJ said:

On 8/21/2020 at 7:02 PM, Cleerity said:

Still experiencing depression, but coping well.

 

I'm glad to hear that it's still going relatively smoothly for you and my thoughts are with you! 

 

On 8/21/2020 at 7:05 PM, Cleerity said:

Wow!  I just updated my signature and realized that I have been tapering this medication for almost 2 years now.  And it was only 2 mg when I started!

 

Isn't it crazy how long it can take and you don't even realize it?  I was also amazed when I realized it had been over 2 years!  I think my total time was about 2.5 years but I went too fast at one point.  Best of luck for your continued tapering!

 

Hi Ruby ... and thank you!  Glad to hear from you and hope you are also doing well!   Yes, slow going, but manageable which makes it worth the wait.  I will get there!

 

Best,

Cleerity

[Cleerity]

Good Evening. 

 

My final steps in eliminating the last bit of Aripiprazole from my life went against the recommended advice and protocol of this forum, but I can now say I am finished with the Aripiprazole.  I am glad for this. 

 

I belabored my way down to .25 mg/ml as of 10/28/2020 - and then decided to take it down by .05 about every 14 days.  I took the last dose of .05 on 1/14/2021.  I do NOT recommend others following suit.  A safer path is to always stick to the 10%/month reduction rule.

 

Honestly, I personally did not observe any uptick in symptoms as I took it from .25 mg down to 0.  I had a pretty good hunch that the earlier period of vertigo spells was the worst of it for me.  I am going to rest/normalize for a few months before working on the next medication.  I am doing well.  May this remain true.

 

I almost did not share this, as I want not for any one here to take license from my words.  But I also did not want to avoid the forum simply because I chose my own path in the end game of this medication.  

 

Best wishes,

Cleerity

[brassmonkey]

Hi Cleerity-- congratulations on making the jump to "0". Good idea to hold for a few months before attempting your next taper.

 

The Endgame Taper is a very personalized part of the journey for which we are still developing a strategy to publish. In effect is is listen to your body and follow it's dictates. Keep the symptom load as small as possible and make adjustments as you go along to keep it there. It is almost impossible to follow the 10% a month schedule when the dose gets below 1mgai. It looks like you have done just that with your method.

 

I hope your hold period goes smoothly, there are usually some post "0" hiccups so don't be surprised, but they will settle out as you go along.

[JimH]

Dear Cleerity,

 

I’m simply DELIGHTED for this huge performance! You deserve to be happy!

[Cleerity]

23 hours ago, brassmonkey said:

Hi Cleerity-- congratulations on making the jump to "0". Good idea to hold for a few months before attempting your next taper.

Thank you, BrassMonkey.  While I feel well, I do believe/agree that rest is in order as I continue to mend from 9 years on the Aripiprazole.  I am still re-learning who I am without it.  I will be aware of the possibility of post-0 hiccups that might present and trust that, should they arise, they will also subside in time.

 

12 hours ago, JimH said:

Dear Cleerity,

 

I’m simply DELIGHTED for this huge performance! You deserve to be happy!

Still, you are there in the wings!  Your message made me smile with warmth.  Thank you, Jim.  Yes, I do deserve to be happy and I really am - both happy and proud!

 

I did it!  Slowly and safely!  And thank you for your calendar/calculator, the printed form of which has occupied space on my kitchen counter for the past two+ years!

____________________________________________________________________________________________________________

Thank you both for sharing in/congratulating my success with this one!

 

I will likely come back to provide some post-Aripiprazole reflections concerning my use of the medication, what it did to me, what my overall withdrawal was like, and how I feel now in comparison.

 

Perhaps by April or May, I will feel ready to begin working on the Mirtazapine.  I have not looked back at the notes earlier in my thread, but, as I recall, my plan is to taper the Mirtazapine down to 7.5 mg, then taper/eliminate the .5 mg of Clonazepam, before I return to my endeavor to eliminate the Mirtazapine entirely.  I hope and pray that in time I shall accomplish both of these.

 

Best,

Cleerity

 

[RubyJ]

 

Grats, Cleerity!  I'm so glad to hear you've reached this point.  I was just wondering about where you were in your taper the other day, so I'm glad you updated us.

 

6 hours ago, Cleerity said:

I am still re-learning who I am without it. 

 

This was probably the hardest part after I reached 0.  I'm still rediscovering my normal.

 

I will say that I kept waiting for the other shoe to drop and for some bad w/d symptoms to hit me, and I'm still waiting 10 months later.  I hope your experience is similar, in that you have few hiccups.

 

6 hours ago, Cleerity said:

Perhaps by April or May, I will feel ready to begin working on the Mirtazapine. 

 

Good luck.  I am still hoping to taper down both my fluoxetine and buproprion but I personally find that I'm not ready yet.  Whenever it feels like time, my best wishes for you!

[Cleerity]

10 hours ago, RubyJ said:

 

Grats, Cleerity!  I'm so glad to hear you've reached this point.  I was just wondering about where you were in your taper the other day, so I'm glad you updated us.

Hi Ruby and thank you!  
 

I actually feel very good. I am not feeling any anxiety or worry about a shoe may drop.  I just want time to adjust to my present, new normal, while continuing to gain insight and develop fresh perspective, free from the chain of Abilify!  

I send you Best wishes that you will arrive at the day when you are ready to work on eliminating the next medication!

 

Cleerity

[Cleerity]

Good Evening,

 

As of 10/21/2018, this below was my stated plan:

Quote

1.  Eliminate the Alprazolam.

2.  Hold @ .4700 mg Clonazepam.

3.  Begin reducing Abilify (by 10% steps), soon.

4.  When Abilify is eliminated, reduce Remeron (by 10% steps) down to 7.5 mg.

5.  When I have Remeron at 7.5 mg, begin reducing Clonazepam (by 10% steps)

6.  Finally, work on eliminating the remaining 7.5 mg of Remeron (using 10% steps)

 

The Alprazolam (Xanax) was eliminated in 10/2018.

 

The Abilify (Aripiprazole) was eliminated in 1/2021.

 

The Clonazepam currently remains at .5 mg at bed (after a little up dose after the above stated plan). 

 

The Mirtazapine (Remeron) also remains at 15 mg at bed.

 

But I am not sure my logic to reduce the Mirtazapine by 50% before working on the Clonazepam is the best course of action…

 

Is not the Clonazepam a more consequential drug?  Is it more important to work on tapering it before the Mirtazapine?

 

Aside from the Clonazepam being considered a controlled substance and more “addictive” drug, I have also severed my therapeutic/analytic relationship with the MD who (still) prescribes these medications for me.  Being of advanced years, she may also stop practicing at any time.  As I do not plan to engage in analysis or therapy any longer, it would be my Primary Care doctor that I would ask to provide needed prescriptions (if my shrink stops practicing).  Because regular doctors are more hesitant to prescribe benzos (and for good cause), it seems to be smarter for me to work on the Clonazepam next. 

 

Side note:  I believe all psych medications are addictive/harmful, as our body/mind systems become habituated on any of them!

 

Would any of the forum moderators be willing to comment on this for me?  Opinions?  Suggestions?  Clonazepam or Mirtazapine next?  Is there any reason why working on the Mirtazapine first would be a wiser choice?

 

Best,

Cleerity

[Shep]

@CleerityI like the way you're coming at this from multiple angles.

 

For some people, mirtazapine can be sedating at even 7.5 mg, so you may be okay with reducing this drug last if you can't get ongoing benzo refills. 

 

I wouldn't go with the "benzos are the worst" narrative because you're right to note "I believe all psych medications are addictive/harmful, as our body/mind systems become habituated on any of them!"

 

The main question you want to ask yourself - which drug works best for sleep? 

 

You may want to touch base with your Primary Care doc, if you feel comfortable doing so. Let her/him know you are in the midst of lowering your drug burden (that can work better than telling doctors you want off) and see if you get a positive response. 

 

Let us know what you find out. 

[Cleerity]

@Shep  Thank you.  Truth is I do not know which of the Mirtazapine and Clonazepam is more sedating for me.  This is because though I have had a prescription for the Clonazepam since 2001, I never took it every day until 2010. 

 

Well, that is not entirely true, I did take it everyday for the first year (between 2001 – 2002).  After that, I only ever took it IF I was not able to fall asleep. 

 

Then, in 2010, I was experiencing a spiritual and emotional crisis and could not sleep.  It was at that time that my doctor increased the Clonazepam (from .5 mg) to 1 mg AND added the 15 mg of Mirtazapine. 

 

While I have since reduced the Clonazepam back to .5 mg, I have (since 2010) always taken both these two medications together.

 

Perhaps I can test myself, by omitting one of them in the evening(s), to see without which one I feel more sedated as I go to sleep... 

 

Cleerity

[Cleerity]

I have decided.  I will taper the Clonazepam next, chiefly because I can eliminate/taper the Clonazepam in half the time it will take me to taper the Mirtazapine.  So, I will have one more drug out of my system, sooner, than if I went the other route.  This will give me a greater sense of satisfaction and accomplishment.

 

My present intention is to begin my taper on 3/12/21.  That will have allowed me a full 8 weeks of rest/recovery since I completed the Aripiprazole taper.

 

Still, I continue to feel well, am not aware of any withdrawal symptoms.  

 

Cleerity

[JimH]

Hi Cleerity,

 

I have never had Mirtazapine but I know (unfortunately!) well Clonazepam. So when I read you are going to taper off this beast now, I feel happy. I really do. I also believe you might encounter some small hurdles during the process but with the good mindset acquired the last years you will succeed again.

 

May I ask you, what is the reduction rate are you going to try to start with? (Ex: 10% every 2 weeks?). I made some quick calculation taking into account the starting date of 3/12/2021 and 0.5 mg of benzo to taper and it came out that by mid-April next year, you will be Clonazepam free.

 

Keep pushing! We are behind you.

[Cleerity]

 Hi Jim...and thank you!

 

My plan is to taper by 10% every 28 days.  The slow and steady approach will assure me lesser chance of a setback and an easier transition while I continue to regain more of me.

 

I have already produced and printed my calendar using your calculator, still found here:   

 

At 10% every 28 days, I will still be down to .10 by day 400, which is 4/17/2022.  Once there, it is HIGHLY UNLIKELY I will belabor the last .10 for another year.  At that point, I will drop the daily micro taper and just resort to cutting and holding a few times over until I reach the finish line!   

 

So looking forward to being free of this medication!

 

Cleerity

 

[Shep]

On 2/20/2021 at 3:26 PM, Cleerity said:

Still, I continue to feel well, am not aware of any withdrawal symptoms.  

 

This is great, Cleerity. 

 

Your 10% reduction off the benzo sounds reasonable. If you're not already doing so, you may want to try the Brassmonkey Slide. The drops would be 2.5% weekly for 4 weeks, as opposed to a full 10% at one time. Please see:

 

The Brassmonkey Slide Method of Micro-tapering

 

This is gentler on your nervous system and you can still taper at the same overall monthly reduction rate. Also, if you feel symptoms creeping up, you can always hold before you've hit the full 10% reduction for that month. So it's a method of withdrawing that gives you more control over your taper. 

[Cleerity]

On 2/23/2021 at 8:42 AM, Shep said:

This is great, Cleerity. 

 

Your 10% reduction off the benzo sounds reasonable. If you're not already doing so, you may want to try the Brassmonkey Slide. The drops would be 2.5% weekly for 4 weeks, as opposed to a full 10% at one time. Please see:

 

The Brassmonkey Slide Method of Micro-tapering

 

Hi Shep,

 

I agree that the 10% over 28 days is reasonable and safe. 

 

Thanks for mentioning Brass Monkey's method, which has been shared with me at an earlier point in time.  But I am partial to and content with Jim's calculator/calendar.  Below is an example of the first 28 days.  This is (in my mind) a very gradual reduction method (less abrupt than repeated 2.5% chops) and very easy for me (personally) to manage.  It evenly spreads the full 10% over the course of 28 days.  If at any point in time I might feel the withdrawal symptoms are too great, I am wise enough to make a hold decision on my own - instead of assuming a 2 week hold after each 28 days.

 

I also want to note that I was incorrect in my earlier calculation when I said I will (can) reach .10 by day 400 (4/17/2022).  I actually will not reach .10 until day 440 (if all goes well, without hold periods being needed).

 

Best,

Cleerity

 

Day	Date	Dose 1		Total dose
#	/       /	mg	= ml	mg/day
1	/       /	0.4982	4.98	0.4982
2	/       /	0.4963	4.96	0.4963
3	/       /	0.4945	4.95	0.4945
4	/       /	0.4927	4.93	0.4927
5	/       /	0.4909	4.91	0.4909
6	/       /	0.4891	4.89	0.4891
7	/       /	0.4873	4.87	0.4873
8	/       /	0.4856	4.86	0.4856
9	/       /	0.4838	4.84	0.4838
10	/       /	0.4820	4.82	0.4820
11	/       /	0.4802	4.80	0.4802
12	/       /	0.4785	4.79	0.4785
13	/       /	0.4767	4.77	0.4767
14	/       /	0.4750	4.75	0.4750
15	/       /	0.4733	4.73	0.4733
16	/       /	0.4715	4.72	0.4715
17	/       /	0.4698	4.70	0.4698
18	/       /	0.4681	4.68	0.4681
19	/       /	0.4664	4.66	0.4664
20	/       /	0.4647	4.65	0.4647
21	/       /	0.4630	4.63	0.4630
22	/       /	0.4613	4.61	0.4613
23	/       /	0.4596	4.60	0.4596
24	/       /	0.4579	4.58	0.4579
25	/       /	0.4562	4.56	0.4562
26	/       /	0.4546	4.55	0.4546
27	/       /	0.4529	4.53	0.4529
28	/       /	0.4513	4.51	0.4513

[Shep]

Thanks for explaining your taper method. Please let us know how you do. 

[Cleerity]

Hello,

 

Yesterday, was the day (night), I was to begin my clonazepam taper, but I have decided I might wait another month, or two.

 

Reason being is that I have been very fatigued feeling, exhausted and unmotivated.  

 

I wish I knew more about Abilify withdrawal to know if this kind of fatigue is one of the symptoms.

 

I am dealing with some depression and feel I am doing well to process/cope with the emotions and cause(s) of the depression.

 

I just wonder how much the depressive affect may be compounded by having discontinued the Abilify...

 

If these are indeed withdrawal effects from the Abilify (exhaustion and depression), they are the only symptoms I am experiencing.  

 

Cleerity

[ChessieCat]

It may be related to menopause.

[Cleerity]

1 hour ago, ChessieCat said:

It may be related to menopause.

This may be true, Chessie!  Though I am only (nearly) 55, I have been post menopausal since I was 45 (my last menstrual cycle was in 2011).   I was a late bloomer in adolescence, but an early starter for the big pause/change of life.  I have already been through the raging hot flashes and wonky hormones, etc.  I have had intermittent periods of fatigue (sometimes crashing fatigue, which is like what I am presently enduring) since 2012.  If this is (STILL) menopause, does it ever let up?! 

 

In any event, it is good I am not experiencing an withdrawal anxiety, as this is promising for my clonazepam taper.  I am going to go ahead and get started with it.  As I am rounding, my first dose at .49 mg/ml will be tomorrow evening.

 

Best,

Cleerity

[Cleerity]

Hello All,

 

Just a quick update.  Continuing my taper of the clonazepam, I began my first dose at .39 mg/ml on 3/16/21.  Tomorrow will be my first evening at .38 mg/ml.  This means I (will) have nearly reduced the clonazepam by 25%.  I am, fortunately, able to say that I do not notice any difference thus far.  I have NO withdrawal symptoms to report.  I am gladdened by this.  May this continue to be true all the way down to Zero.  

 

The crashing fatigue I was experiencing a couple months ago has abated, thankfully.  

 

Best wishes to all here working to reduce and eliminate psychiatric medications from their lives.

 

Cleerity

[wantrelief]

Thank you for sharing your good news!  I am heartened to hear your clonazepam taper is going smoothly as I will be tackling that drug once I am off citalopram. I am nervous about it so it is helpful to read of your successful taper.  Wishing you the very best, WR.

[Cleerity]

Hello WantRelief!  You are welcome...and thank you.  I send best wishes for your tapering success!

 

Cleerity

[Altostrata]

@Cleerity, how are you?

[Cleerity]

@Altostrata Hi Alto.  Thank you for checking in with me.  I am very pleased to be able to report that I am doing good.  Today will be my first dose at .31 mg/ml on the clonazepam taper.  Still, there are no withdrawal symptoms to report.  Reductions now a little slower going than in the first few months (as is always the case), making me wish to go faster being I am doing so well with decreasing it, but steady I go.  Given these results, I feel confident I will have smooth sailing all the way down to zero.  And I am happy to know that in two more month's time I will be down to .25 mg/ml!  I continue my psycho-spiritual and emotional healing assisted by my faith.

 

Best,

Cleerity

 

 

[Altostrata]

Good to hear, please continue to let us know how you're doing.

[Cleerity]

On 7/17/2021 at 7:56 PM, Altostrata said:

Good to hear, please continue to let us know how you're doing.

Thank you, Alto. I shall stop in to share from time to time!