LotusRising: Buspar, Ativan

[LotusRising]

@Frogie @Altostrata

 

Oct 26 Notes:

0600am -0.125mg clonazepam

0700am - mild tinnitus

0700-0800 - slept

830 - woke with chest tightness 5/10

830-1000am - lot of breathing exercises

1000 - chest tightness 6/10, tinnitus

1000 - 0.125mg clonazepam

1100 - mild tingling sensations, slight increase anxiety, tinnitus

1155 - anxiety 4/10, tinnitus

1200 - went for a walk

1215 - anxiety 6/10, increased HR, crying

200pm - 0.125mg clonazepam

330pm - mild chest tightening 2/10, tinnitus

430pm - chest tightening 4/10 

430pm-600pm -  mild scalp burning on and off

600pm - chest still tight, breathing exercises, took 0.125mg clonazepam

840 - mild tinnitus

900pm - in bed, asleep within 20minutes

1000pm - woke up with a start, anxiety flooding my body 3-4/10, but fell back asleep

1100pm - woke with anxiety, fell back asleep

0200am - woke, back to sleep

0400am - woke, back to sleep

0600am - 0.125mg clonazepam

0700am - short increase in HR, mild tinnitus

 

 

[LotusRising]

@Altostrata @Frogie

 

Just starting into the second day of the .125mg at 4 hr intervals. I'm noticing currently that with the first dose of my day today, I am getting some anxiety symptoms, as well as nausea at 2 1/2, now 3 hours after taking my dose. Could this just be related to my clonazepam levelling out from the big doses the pharmacist recommended, or would this be considered breakthrough anxiety? @Frogiesuggested moving to every 3hrs 5x/day if I get breakthrough, so I'm not sure if I should go ahead and do this or try to ride it out. It doesn't feel like the panic attacks I've been getting, as there is no chest tightness.

[Frogie]

No I said you could possibly take an extraordinary dose at night if you have breakthrough anxiety in the middle of the night. But I don’t want you to become dependent on that dose. 
 

It’s going to take time for your body to get used to this dosage. Please give it 4 days or so and see how you are doing.

 

With all of this up and down, your CNS is probably just wreaking havoc and needs a steady schedule/dose to even out.

 

Take care,

 Frogie xx 

[LotusRising]

@Frogie

 

Ok, sorry, I must have totally misunderstood when we were making the original schedule. I'll ride it out with some yoga. Extra dose is only if I absolutely need it in evening, which I decided not to take last night.

 

Thanks so much for your very quick reply.

[Frogie]

You’re welcome. I just don’t want you taking too much and having more symptoms than necessary 😊

[LotusRising]

Is the tapering schedule/timeframe the same for benzodiazepines, as it is for antidepressants? I thought I saw somewhere on the site some specific info related to benzodiazepine tapering, but now I can't find it when I search. Could someone direct me? I'm trying to load up on knowledge before I get to the point I need to taper.

 

Thanks so much

[LotusRising]

@Frogie@Altostrata

 

Here's my Day 3 Notes Oct 27 - Clonaz 1.25mg every 4hrs 6/10/14/18

 

0600 clonazepam 1.25mg

0700 slight increase in heart rate <2mins

0830 anxiety, mild 3/10

0900 anxiety increasing 6/10, restlessness - yoga for 30mins, nausea

1000 clonazepam 1.25mg, tinnitus (mild), still have anxiety 4/10 with some restlessness

1100 increase in anxiety to 5/10, but waned; tingling, feeling lightheaded, tinnitus (mild)

1200 another wave of anxiety, nausea, lightheadedness

100pm anxiety seems to have diminished somewhat

100pm-200pm - calm

200pm clonazepam 1.25mg

330pm - center of chest starting to tighten up, hard to breathe, anxiety 4-5/10, breathing exercises

510pm tinnitus (mild)

600pm clonazepam 1.25mg

645pm mild anxiety (I am still always a little anxious around the time I take the pills), emotional (sobbing)

920pm in bed and asleep by 1030ish

0100 woke, back to sleep

0200 woke, back to sleep

0400 woke, back to sleep

0530 woke with chest tightness/anxiety 6-7/10

0600 clonazepam 1.25mg

 

I seem to be chasing anxiety in the mornings as I am trending the same way this morning as well. I got a scale today, so I can more precisely measure my doses. I am getting some sleep, so that is reassuring, as I know I need this for any kind of healing to happen.

 

Is the tapering schedule/timeframe the same for benzodiazepines, as it is for antidepressants? I thought I saw somewhere on the site some specific info related to benzodiazepine tapering, but now I can't find it when I search.

 

Thanks so much

 

         

 

          

 

[Altostrata]

Are you taking 0.125mg or 1.25mg clonazepam? Either way, it's too much.

 

If 1.25mg, stop taking it immediately. You may need to go to the hospital.

 

If 0.125mg -- @Frogie, how can MedRN reduce this to 0.10mg per dose?

[LotusRising]

@Altostrata @Frogie

 

My apologies! I completely wrote that wrong!

 

No, I am definitely taking 0.125mg for a total of 0.5mg daily.

 

I'm feeling pretty good at the moment. I have had very little anxiety since 1000a.m. this morning. The anxiety seems to get worse overnight and into the morning, but as I said I am only on Day 3 of this schedule and it is just starting to feel like I am starting to regulate somewhat. I just got a scale so I am now measuring for accuracy as of today.

 

Do you still feel like this is too much? Last time I checked in with @Frogie, I had thought we were going to hold at this dose for a number of days due to all the recent fluctuations in dosages.

 

My apologies again for writing that incorrectly. 

[Frogie]

@Altostrata

 

Do you think @MedRNshould hold at the .125 mg for a few days? The above answer seems they are evening out.

 

If not, I can certainly advise how to get down to .10 mg within a few days.

 

Thank you.

[LotusRising]

@Frogie @Altostrata

 

What should I be looking to see in my symptom pattern? And can I do the .10 with a scale? I’m not super comfortable converting to a liquid. Now that I have my scale I can see that some pieces of the pill weigh more than others, so I’m guessing the accuracy of the last two days would not be great. But it takes 3 days to notice changes with clonazepam, is that right?

 

i also know that the pill I took at 1000 this morning weighed .022 when a 1/4 tab of clonazepam should be about .40. I figured this out once I picked my new prescription and weighed a full tab. I wonder if this is why I have been more calm since my 1000 dose? Because it was less?

 

I’m happy to try less if someone can help me out with the math. 

 

 

 

[Frogie]

You can go down to .10 mg.

 

What you need to do is weigh 10 of your tablets to get an average weight. Then crush them and weigh them to .10 and put them in a gel capsule.

 

Example: 10 tablets weight 1.50 grams, so the average would be .150 grams. You would crush 10 tablets and weigh it to .10, put it in a gel cap to take. Then you don’t have to keep weighing the tablets because you’ve established a baseline weight. So you would just crush 10 more and weigh them to .10.

[LotusRising]

@Frogie @Altostrata

 

Ok, so my total dose per day would be .40mg and I would take .10mg 4 times per day, correct?

 

This is all a lot to take in. I only have 1 tablet currently. My pharmacist gave me 1 and was ordering in the .25mg so that I wouldn't have to manipulate the pills as much. I wasn't expecting to make changes. 

 

But I think I've got the math on 1 tablet, maybe you can confirm if I'm correct? I'm honestly way more comfortable weighing each individual tablet.  I'm hoping that when I see the psychiatrist next week, I can get the prescription in a liquid format.

 

0.5mg tab. x 0.4mg tab

0.168g              X

 

0.5X = 0.168 x 0.4

 

0.5X = 0.0672

0.5         0.5

 

X = 0.134 

 

So, a .4mg would weigh .134g, divided by 4 doses, which would be equivalent to .03g (weight) per dose, or 0.10mg.

 

I know I've made that way more complicated, but does that work and is it correct?

 

Are we looking to help that night time/morning anxiety by reducing the dose?

 

[Frogie]

It doesn’t matter the dosage.

 

But weigh 10 of the 25 mg tablets at one time. Then divide that weight by 10 to establish a baseline weight.

 

You’ll then crush all 10 tablets and weigh them so they weigh .010 on your scale. Put them in gel caps to take. Yes, 4 times a day.

 

You won’t have to re-weigh them after you get the baseline weight. You’ll just continue to weigh the crushed tablets at .010. Then you’re always getting the correct amount of medication.

 

Hope that helps😊

[LotusRising]

@Frogie 

 

I'm having a hard time understanding the math behind this.  I'll have to get my husband to run through it with me.

 

I only have a small number of pills so in the event that we change anything, I may not have the pills to do it. I think I will need to continue weighing out individual dosages for now until I know for sure I'll be at this dose for a while.

 

I really appreciate you trying to explain it all to me! - but, I've got a lot of ear pain and tinnitus right now, so trying to wrap my brain around it is not working. I only just figured out the scale for individual doses lol

 

 

[Altostrata]

@MedRN, I am confused. Are you feeling better today, taking 0.125mg four times a day? Please post your daily notes for today.

[LotusRising]

@Altostrata

 

Yes, I am feeling good today. I have had the least amount of anxiety today since we've started. I have been tending to have anxiety overnight and into the morning, but I believe the morning anxiety was better today. 

 

Here's my notes that cover Oct 28 (today) for the last 12 hours. Is that what you're looking for? 

 

0600 clonazepam .125mg

0700 fell back asleep for 1 hour

0800 woke with chest tightness/anxiety, 4-5/10

0830 chest tightness increased slightly to 6/10, also feeling shaky

0900 mild nausea, anxiety still 6-7/10, tinnitus 3/10

1000 clonazepam .125mg

          chest tightness mostly gone 1/10, did some yoga

1000- 200pm  feeling mostly calm

200pm clonazepam .125mg

              mild tinnitus

315pm - 445pm tinnitus, ear pressure/pain 4/10

515pm - feeling slightly shaky and generally anxious 4-5/10 (this was during all the talk about changing doses, so an                       anxiety-provoking time for me)

600pm - clonazepam .125mg

                    had supper and feeling less anxious at the moment

 

Are you thinking I should hold at .125mg?

 

I have only just started weighing my doses partway through today.

 

 

 

 

 

 

 

 

Edited October 29, 2021 by MedRN
added last sentence

[LotusRising]

@Altostrata @Frogie

I’m wondering if we should hold me at .125? I am now able to weigh my doses with a scale for more accuracy and I do tend to get more anxiety when making changes. Should I be stabilizing at this dose and then reevaluating in a couple more days? It feels like we’ve made a lot of changes lately … what do you guys think?

[Frogie]

I think it would be ok to hold at .125 as long as you are getting stable.

[Altostrata]

Yes, hold at 0.125mg, we need to get a read on several days of your symptom pattern.

 

Please try not to be alarmed by your symptoms. 

 

@Frogie I think we're all coordinated now. You've been a rock, thanks.

[Frogie]

25 minutes ago, Altostrata said:

Yes, hold at 0.125mg, we need to get a read on several days of your symptom pattern.

 

Please try not to be alarmed by your symptoms. 

 

@Frogie I think we're all coordinated now. You've been a rock, thanks.

You’re very welcome @Altostrata. Glad I could help.

[LotusRising]

@Altostrata @Frogie

 

So, with all of these changes, I think for the last 3 days I have been taking .0625mg 4 times a day, instead of .125mg. When we decided to split the dose on October 25, I split my pills, which I just realized were already split into .125mg. I'm not 100% confident, but fairly sure. I weighed two doses yesterday and they were both equivalent to what .0625mg would weigh. I can't confirm previous days because I was not yet weighing them. So, I think I've only been taking 0.625mg 4 times a day. I don't know what to do. We've made so many changes so quickly and I am so confused. Should I hold at .10, the middle ground between the two?

[Frogie]

Oh I’m so sorry.  It has been really confusing lately.

 

How are you doing on the .0625? If it’s working and you’re not having anxiety you could stay on that dose. If you feel like you are having too much anxiety, you can go up to .10 and hold.

 

Hang in there. It will get better.

 

 

 

[LotusRising]

@Frogie I seem to be doing ok. I even woke without anxiety today. If I've gone down too quickly, the only thing I would notice would be an increase in anxiety right? 

[Frogie]

6 minutes ago, MedRN said:

@Frogie I seem to be doing ok. I even woke without anxiety today. If I've gone down too quickly, the only thing I would notice would be an increase in anxiety right? 

Yeah you would feel anxiety and it seems that maybe you’ve found your sweet spot. I’d hold there for a few days and see how you feel.

[LotusRising]

Ok, I can't thank you enough @Frogie I've been up and down and then up and down again emotionally. Thank you for all your support.

 

And yes, hopefully I've found the sweet spot

[Frogie]

All of this can be very emotional. You are handling it very well though.
 

You’re very welcome. I’m so glad I could help you.

 

Keep me updated😊

[LotusRising]

@Frogie

 

Hey there, so I'm wondering, if I'm experiencing an increase in anxiety with my doses, does this mean my dose is too high? I assumed that I was taking approximately .0625mg prior to starting to weigh doses. Yesterday I started to weight my doses and tried to bridge between .0625mg and what altostrata had recommended (.10mg) so I dosed .085mg 4 times yesterday. I had increased anxiety overnight and am dosing the same today, also with increased anxiety. Would I assume that this dose may be too high? I'm confused because it seems too high of a dose can cause anxiety, but too low of a dose also can.  

[LotusRising]

@Frogie @Altostrata

 

Notes from yesterday and today:

As I mentioned above, I was trying to bridge between the doses, so dosed .085 yesterday, .09 today. I am currently waiting to take my 200 dose today, but am experiencing a sudden increase in anxiety and burning to scalp. I am guessing I should just take .0625mg for next dose

 

Oct 29

0600 clonaz 0.085

1000 generalized chest tightness

1300-1400 mild tinnitus

1400 0.085mg

1730 generalized chest tightness 2/10

1800 0.085

1900 mild scalp burning

2115 in bed

2300 still awake, little waves of anxiety

0000 awake

0400 awake, chest tightness 4-5/10

0430 chest tightness, anxiety 5-6/10, breathing

0500 anxiety 2-3/10

tinnitus

 

Oct 30

0600 clonaz 0.085

0730 chest tightness 3-4/10

0800 chest tightness 4/10

0915 anxiety up to 6/10

1000 anxiety 4/10

          0.09 clonaz 

1100 anxiety 5/10

1300 anxiety down to 1/10

1345 increase in burning to scalp and sudden increase in anxiety (is this one of those paradoxical reactions again?) some numbness to lips

 

Should I just take .0625mg for 200 and 1800 doses?

 

[Altostrata]

Please stop changing your dosing! We need to see a few days of notes without dosage changes to get a read on what's happening.

[LotusRising]

On 10/29/2021 at 9:05 AM, Frogie said:

Oh I’m so sorry.  It has been really confusing lately.

 

How are you doing on the .0625? If it’s working and you’re not having anxiety you could stay on that dose. If you feel like you are having too much anxiety, you can go up to .10 and hold.

 

Hang in there. It will get better.

 

 

 

Sorry, I was going off of this post.

 

So, hold at .0625 then, correct?

[LotusRising]

@Altostratathe reaction is ongoing so I have not taken my 200 dose - ir is 230 right now. 

[Altostrata]

You will need to stop changing your dosing. You tend to escalate. Now you've taken too much. You're causing your own problems.

 

We can't keep jumping in with ad hoc fixes, those continue the inconsistency of your dosing.

 

If I were you, I'd go back to 0.625mg consistently and push through the bumps for the next several days without these panicky course corrections. We've seen that's a mistake many times.

 

Since your dosing for today will not be consistent, you'll have to hold at 4 doses of 0.625mg per day for 4 additional days.

[LotusRising]

@Frogie@AltostrataOk, sorry for this. You're right. I have been changing my doses. I just have to trust you. I thought I was doing the right thing by bridging the two doses. This was my mistake. My reaction is still happening, but may be waning. I don't want to mess this up anymore than I already have.

 

Should I still be taking two more doses of .0625 today, or reduce them, and should I stick to my same schedule. It is 300 where I am, so I would be late by 1 hour. Next due would be at 1800.

[Frogie]

Changing like you are is causing a lot of havoc on your CNS. That’s what the anxiety is all about I’m relatively sure.

Just start taking the .0625 and don’t change anything for a few days.

 

Keep notes for us.

[LotusRising]

@Frogie Ok, so even though I've taken the two higher doses (.085mg) , I should be ok taking two more smaller ones (.0625) for today? I am still having what I believe to be the paradoxical reaction that @Altostratahas talked about previously.