Shake: clonazapam taper

[Shake]

Tips to taper off clonazapam 

[Carmie]

Hi Shake, 

 

Welcome to SA. You’ve found the right place if you want to taper off meds.  Can you please first fill out the signature of your medication history. At the top of the introduction page there’s a thread that says: “ Please start a topic about yourself in this forum.” In the first paragraph there’s a link that shows you how to do the signature. Thanks. 
 

It’s important to know your tapering history, when you went on medication, how much you started at, if you’ve tapered, how much you’re on now etc.

 

Are you having any symptoms at the moment? 
 

When you do taper it’s best not to taper any more than 10% a month. I’m tapering much, much lower, but everyone is different. I just listen to my body. 
 

Sending hugs🤗

Edited March 1 by Carmie
Typo

[Carmie]

Hi again @Shake

 

Thanks for your PM, but I’d prefer to keep all communication on your thread, so others can see it too and comment. 
 

You asked how much to taper by, as I mentioned, no more than 10% a month. You’ll have to figure out if that’s still too high for you or not. 
 

As regards insomnia, there’s no miracle cure. I would suggest going outdoors and getting some sunlight first thing in the morning and wearing blue light blocking glasses in the evening to help your circadian rhythms. Also, cut down your caffeine, it’s not good in withdrawals anyway. There’s a thread under Symptoms and Self-care entitled “Tips to help sleep: so many of us have the awful withdrawal insomnia.” You can read there what others have tried as well and what things may help. 
 

How much Clonazepam are you on now?
 

Please put in your medication signature, as mentioned above.Thank you💛

[Shake]

I’m on .5 mg and down to .25 mg my only problem is insomnia and benzo belly

[Carmie]

Me again @Shake😄

 

Were you asking me how much I personally taper by in your PM? My brain is so hypersensitive to every thing I do now that at the moment I’m only tapering by 1.5% or so every six or seven weeks. It’s slow going. I’m like a snail🐌

[Carmie]

On 3/1/2023 at 2:58 PM, Shake said:

I’m on .5 mg and down to .25 mg my only problem is insomnia and benzo belly

Hi Shake, 

 

I only just saw your last comment. What did you mean that you’re on 0.5mg and down to 0.25mg. Did you just recently drop from 0.5mg to 0.25? What date?
 

Was your original dose 0.50mg?  Could you please put that information into your signature. Thanks💛

[Shep]

On 2/28/2023 at 11:58 PM, Shake said:

I’m on .5 mg and down to .25 mg my only problem is insomnia and benzo belly

 

Hi, @Shake, welcome to Surviving Antidepressants.

 

We really need your drug history in your signature in order to answer your questions. Without knowing if you're taking any other drugs and when you've made reductions in the benzo, we aren't able to guide you in a taper. Please see the first post in this thread for instructions. 

 

How to Summarize Your Drug History in Your Signature

 

If you aren't able to add it to your signature, please post the information here in your thread and I'll add it to your signature for you. 

[Shake]

I was on .5 mg last March 2022. Now I am on half of .5 which is .25 the lowest pill form. I am using a compounded liquid form now. Soon I will be on .125 which is half of .25. My only problem so far is insomnia 

[Shake]

My taper is .2% ml every month 

[Shep]

@ShakeI see you have Gabapentin in your signature. When did you start taking that drug? Please list the month and year. 

 

What time(s) of the day do you take your drugs? Are you taking any supplements? If so, please list them. 

 

You mention insomnia in your signature. Here is some helpful information:

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 

[Shake]

I only take Gabapentin if I haven’t slept for 3 or more days. I started taking Gabapentin last March 2022. I also take magnesium threeonate. Correction I taper clonazapam at 10% per month. I take only 20 mg of Gabapentin 

[Shake]

Does Gabapentin slow down the healing process from clonazapam withdrawal? 

[Shake]

This is the hardest site to navigate. What exactly are they looking for in the “Signature “ I put the dates the drug clonazapam and the vitamins I’m taking. Still not good enough. Now they want the time of day I’m taking drugs . Why is this so hard and complicated? 

[littlebird]

14 hours ago, Shake said:

I started taking Gabapentin last March 2022. I also take magnesium threeonate.

 

Do you space these out? Magnesium can lower the effects of Gabapentin. I'm not an expert, but it seems if you have them spaced out you're okay. Hope you feel better soon!

 

Saw you other thread, the signature can be a little confusing to navigate. I'm still not sure mine is correct or optimal! 

[Shake]

No I don’t space them out I only use Gabapentin when I haven’t slept it’s like a sleeping pill. Thank you

[littlebird]

20 minutes ago, Shake said:

No I don’t space them out I only use Gabapentin when I haven’t slept it’s like a sleeping pill. Thank you

 

You may want to look this one up, and make sure you're not taking them together. When I started spacing a multi-vitamin that had magnesium out from my Gabapentin, I felt the effects of it more strongly. It may help the mods to lay out a schedule of when you take everything too, and start logging times of day and symptoms.

[Bego82]

Hello! It’s all explained in here:

 

There’s a link on the second paragraph that takes you straight to your signature settings 🙂

[Shep]

On 3/3/2023 at 7:43 AM, Shake said:

I only take Gabapentin if I haven’t slept for 3 or more days. I started taking Gabapentin last March 2022. I also take magnesium threeonate. Correction I taper clonazapam at 10% per month. I take only 20 mg of Gabapentin 

 

If you need to add in drugs for sleep, that's a sign you're tapering too fast and / or not holding long enough in between reductions. You may benefit from stopping your taper and holding until your nervous system recovers. Continuing to taper and masking your symptoms with another drug isn't advised and likely will lead to worsening problems. 

 

We don't recommend adding in drugs with periodic dosing because it can lead to dependency, but even if you don't become dependent, having varying doses in your bloodstream can rattle the nervous system, leading to worsening symptoms. 

 

Just a thought, Shake, but from what you've written, it sounds like you're tapering beyond what your nervous system can handle. There's no rush to get off. Better to be functional and take your time getting off this drug. That will cause less trauma to your nervous system in the long run. 

[Onmyway]

Dear @Shake, 

please ask questions in the appropriate forum and ask questions regarding your own case in your own thread (here)

The signature thread is under the "READ THIS FIRST" topic in the SUPPORT forum. 

 

Shep also posted a link to the thread that tells you how to summarize your signature above - you need to read the links posted to you. 

 

OMW

[Shake]

Thank you Shep. One major symptom from withdrawal is insomnia. How is slowing down my taper going to help my insomnia? Wouldn’t my insomnia go away once I am completely off clonazapam? Clonazapam robs people of true deep sleep. Prolonged taper will just prolong my insomnia won’t it? Also I am not “adding drugs” for sleep. I am taking amino acids supplements on occasion like L-theanine, valarion root, magnesium melatonin. Should I just tough it out and not take these supplements? Thank you for your responses 😊

[Shep]

On 3/5/2023 at 10:28 PM, Shake said:

One major symptom from withdrawal is insomnia. 

 

Yes, if you taper too fast, you will experience insomnia as a withdrawal symptom.

 

On 3/5/2023 at 10:28 PM, Shake said:

How is slowing down my taper going to help my insomnia?

 

Tapering slowly helps with any withdrawal symptom, including insomnia. 

 

Why taper by 10% of my dosage?

 

The slowness of slow tapers

 

On 3/5/2023 at 10:28 PM, Shake said:

Wouldn’t my insomnia go away once I am completely off clonazapam?

 

Your insomnia will go away once your nervous system stabilizes, whether or not you are on clonazepam. If you can slow down your taper and stabilize on your current dose and then do a micro-taper off the rest of the drug, you may not have to suffer as much throughout your taper. 

 

Micro-taper instead of 10% or 5% decreases

 

On 3/5/2023 at 10:28 PM, Shake said:

Also I am not “adding drugs” for sleep.

 

 You posted this:

 

On 3/3/2023 at 7:43 AM, Shake said:

I only take Gabapentin if I haven’t slept for 3 or more days.

 

If you are going for 3 or more days without sleep, you are definitely tapering too fast. The fast taper is what is destroying your sleep. If the clonazepam were causing your sleep problems, you would feel better by being on less of the drug. 

 

When did the insomnia start? Please post the month and year. 

[Shake]

Thank you. Looks like you’re right. I am tapering too fast. My insomnia started even before my taper. Back in 2021. I started my compounded formula taper last March 2022. From 0.5 mg now I am down to half that amount. I hate to increase my dosage and waste all this time. 

[Shake]

I’m not sure I’m allowed to ask this question. Am I at risk for seizures from clonazapam if I’m down from my taper from 0.5 to 0.23 I am currently at 0.23

[Shep]

Increasing (updosing) at this stage may or may not be a good idea. It sounds like it's been a long time since you were stable on this drug. Here is some information on updosing benzos:

 

Benzo Support - Notes on Updosing

 

If you were at a dose where you were stable in the past few weeks, updosing may help. However, if you haven't been on a dose where you were stable in over the past one or two months, updosing may not work. This is because your nervous system may already have started adjusting to the lower dose and may hyper-react to a higher dose. 

 

In this case, it may be best to hold for awhile and see if some of your symptoms get better. 

[Shake]

Thank you. So I’m down to .23 once before bed. I slept a full 8 hours last night. Am I still at risk for seizure? And being as I’m at .23 do you think this is still a substantial dose or do I pretty much have this beat?

[Shep]

21 hours ago, Shake said:

Thank you. So I’m down to .23 once before bed. I slept a full 8 hours last night. Am I still at risk for seizure? And being as I’m at .23 do you think this is still a substantial dose or do I pretty much have this beat?

 

Do you have a history of seizures? If not, than your risk is very low for a seizure, especially with a slow taper. You have a compounded liquid form, so you have what you need to taper no faster than 10% a month. 

 

Have you seen this list of great non-drug coping techniques?

 

Non-drug techniques to cope with emotional symptoms

 

As you taper, bring in some non-drug coping techniques such as mindfulness and gentle stretching or yoga (many people find that their muscles tense up when going through benzo withdrawal, so stretching is very important - you can find videos on YouTube with gentle stretching and beginner's yoga, etc.).  Going out for a gentle walk in sunshine every day can also be helpful. Some people like to take pictures of nature on their smartphones as they walk. This is a great distraction from the difficulties of withdrawal. 

 

Make sure you're eating healthy, getting plenty of water, and avoiding alcohol, caffeine, and sugar. Many of us also try to avoid processed and fast food. 

 

Very glad to read you slept 8 full hours last night. Was that with clonazepam alone or with gabapentin?  Be careful not to rely too much on the gabapentin, though, as that's also a drug than can also lead to dependency.

 

 

[Shake]

Thank you Shep. No I do not use Gabapentin anymore. I was only using a very small amount 10-20 mg. And yes I started at 5 ml compounded which is equivalent to 0.5 mg pill form. And I am now down to 2.3 ml compounded just before bed. Is this still a lot? I use a very small amount of Taurine and Magnesium too before bed. 50 mg. I am also going to try the Epson salt and baking soda bath and see how that works. Also when I get the confidence I will try the sleep restriction. Thank you yes I will check out the non drug tips for sleep even though the tips seem to be pretty weak tea anything helps. I’ve had this insomnia for  over 2 years and it’s only getting slightly better and I know it’s chemical induced insomnia. I have a feeling that no matter how long I hold or how slow my taper my insomnia won’t go away until I am completely off clonazapam. I have slowed my taper today going down from 0.2 to 0.1 ml per month. What percentage is this? Is it too slow? A very small amount of Gabapentin or gaba or natural sleep aids or pumpkin seed flower or just a plain Advil pill will put me to sleep and I hear people say it’s better to be hooked on Gabapentin than on clonazapam. What are your thoughts on this. And for such a tiny amount of anything will put me to sleep maybe my insomnia IS getting better! I noticed it seems like other people on this forum I’ll have one night of bad sleep then one night of good sleep. On the nights of bad sleep I am completely exhausted the next day as if the clonazapam is robbing my energy. This is why I believe my insomnia will get better once completely off clonazapam. I feel bad that I have slowed my taper from 0.2 ml to 0.1 ml per month. I have been tapering one full year so I feel good about that and can see a tiny light at the end of this nightmare tunnel.

[Shep]

20 hours ago, Shake said:

No I do not use Gabapentin anymore.

 

Please update your signature with the date you stopped. A direct link to your signature is here:

 

Account Settings – Create or Edit a signature

 

20 hours ago, Shake said:

And yes I started at 5 ml compounded which is equivalent to 0.5 mg pill form. And I am now down to 2.3 ml compounded just before bed. Is this still a lot?

 

If 5 mL compounded = 0.5 mg, than 2.3 mL = 0.23 mg. So you are on a little less than 1/2 of your original dose. 

 

Clonazepam is a very potent benzo, about 20 times the potency of Valium. So this isn't a large amount, but you still have a ways to go with your taper. Please don't rush this thinking that your sleep will improve on day one of not being on this drug. The insomnia is not caused by the clonazepam - it's caused by nervous system destabilization and the destabilization of the GABA and glutamate systems. 

 

This is a long post, but it has a lot of good information on benzo withdrawal and recovery:

 

What is happening in your brain?

 

Many people continue to have symptoms even after finishing a taper, but tapering slowly all the way down to the last spec of the drug will help minimize those symptoms. 

 

20 hours ago, Shake said:

I hear people say it’s better to be hooked on Gabapentin than on clonazapam.

 

I wouldn't say any one drug is better or worse. We are all individual in our level of dependency. Usually the drug that's hardest to taper is the one that's most helpful for sleep and is the last drug in our cocktail. 

 

20 hours ago, Shake said:

I feel bad that I have slowed my taper from 0.2 ml to 0.1 ml per month. I have been tapering one full year so I feel good about that and can see a tiny light at the end of this nightmare tunnel.

 

I'm very glad you're seeing the light at the end of this nightmare tunnel, but don't feel bad about slowly down your taper. 

 

I'm concerned about how you're doing your taper. Right now, reducing 0.1 mL per month is about a 4% reduction (2.3 mL - 0.1 mL = 2.2 mL, 2.2 mL / 2.3 mL X 100 = 95.65% or a 4.35% reduction)

 

But if you continue reducing 0.1 mL off each month, you will start going over the recommendation of no more than 10% off the previous month's dose (not off the original dose).

 

For example, reducing 0.1 mL from 1.5 mL = 1.4 mL. This is about a 7% reduction.

 

Reducing 0.1 mL from 1.0 mL = 0.9 mL, which is 10% reduction.

 

And then the rest of your taper will be over the recommended 10% reduction. 

 

You may want to switch to tapering by 5% - 10% of the previous month's dose instead of using a flat reduction amount of 0.1 mL each month. For example, if you wanted to reduce 5% from your current dose of 2.3 mL, you would reduce by 2.3 mL X 95% = 2.185 mL. 

 

And the next reduction by 5% would be 2.185 mL X 95% = 2.076 mL. 

 

Please see:

 

Why taper by 10% of my dosage?

 

Micro-taper instead of 10% or 5% decreases

 

Please post if you have any questions about doing this. 

 

[Shake]

Wow! I thought I was tapering at 10%. How do I measure 2.185 or 2.076 on a syringe? Can you give me the mathematical examples for 10% instead of 5%. At 5% this will take years won’t it?

[Shake]

Wow! I thought I was tapering at 10%. How do I measure 2.185 or 2.076 on a syringe? Can you give me the mathematical examples for 10% instead of 5%. At 5% this will take years won’t it?

[Shake]

Thank you for this valuable information. To make things less confusing for my doctor and the compounding pharmacy can you give me an approximate dose reduction say reduce by 0.1 or 0.2 ml every three months for example? This way I don’t have to tell the doctor and pharmacy to reduce my prescription to 2.875 example.

[Shep]

17 hours ago, Shake said:

Wow! I thought I was tapering at 10%. How do I measure 2.185 or 2.076 on a syringe? 

 

What size syringe do you have? You can get a .5mL oral syringe, which measures as small as .01 mL. And then you can round up, so for instance, 2.185 mL will be 2.19 mL. 

 

For more information on syringes, please see:

Using an oral syringe and other tapering techniques

 

A helpful video:

 

Proper Use of Adapter Cap and Oral Syringe video (2.5 minutes)

 

17 hours ago, Shake said:

Can you give me the mathematical examples for 10% instead of 5%. At 5% this will take years won’t it?

 

Please don't rush into a fast taper. From what you've written, you're going three or more days without sleeping (you noted that in this post).

 

You'll have to decide if your quality of life is better with a slow taper with sleep or a fast taper without sleep and the likelihood of a long, protracted withdrawal. Please remember - your symptoms don't end just because you come off the drug. Your symptoms are the result of pulling this drug out of your system, not from being on the drug. The faster this is done, the more it can destabilize your nervous system. Tapering slow is like walking down the stairs; tapering too fast is like jumping out the window. 

 

This is a great post for describing what happens when you remove a drug:

 

On 8/30/2011 at 3:28 PM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

So that's why we recommend a slow taper.

 

17 hours ago, Shake said:

Thank you for this valuable information. To make things less confusing for my doctor and the compounding pharmacy can you give me an approximate dose reduction say reduce by 0.1 or 0.2 ml every three months for example? This way I don’t have to tell the doctor and pharmacy to reduce my prescription to 2.875 example.

 

We don't recommend tapering by the same amount every month, but rather, by 10% or less of your previous month's dose. So it won't be the same reduction amount every month. As mentioned earlier, continuing to remove even 0.1 mL every month will send you over the 10% recommended reduction rate when you get to the lower doses of your drug. If you're reducing by 5%, that will happen sooner. From earlier in your thread: 

 

23 hours ago, Shep said:

But if you continue reducing 0.1 mL off each month, you will start going over the recommendation of no more than 10% off the previous month's dose (not off the original dose).

 

For example, reducing 0.1 mL from 1.5 mL = 1.4 mL. This is about a 7% reduction.

 

Reducing 0.1 mL from 1.0 mL = 0.9 mL, which is 10% reduction.

 

And then the rest of your taper will be over the recommended 10% reduction. 

 

For more on using a compounding pharmacy, please see:

 

Getting compound custom dosages at compounding pharmacies (US, UK, Canada, and elsewhere)

 

Please discuss this with your doctor so you can get what you need from your compounding pharmacy. 

 

You can always use a scale or make your own liquid from either tablets or an oral clonazepam solution, if it's available in your country. There are many ways to do a slow taper. 

[Shake]

I sure wish I joined this site sooner. Thank you for this information. Everything you say makes so much sense. I forgot to mention that I am going through “Benzo Belly” and I am taking PPI, Pepcid, and Tums, and milk of magnisia. I started these meds back in January 2023 to date. I will update my signature.

[MedRN]

@Shake I've had some difficulty with benzo belly as well. I think it's often related to release of histamine, which has been blocked by the benzo. Is there a reason you're using the PPI, pepcid, tums and milk of magnesia all at the same time?

 

 

[Shake]

Thank you. No I do not use them at the same time. I have been alternating. 

[Shake]

Am I past the point of rescue

 

I can’t go back and reinstate I’ve been in withdrawal too long I can’t hurry the taper or I’ll get worse. Do I just except my fate and know that I will suffer for many more years. What do I do?

Edited March 11 by Shep
added title after moving post from Tapering forum