![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Hlar on May 16, 2005, at 1:56:41
Some sources seem to suggest that it's more dangerous to withdraw from a long-term benzo addiction than to continue usage permanently.
That withdrawal can lead to permanent damage that at least taking the drug masks.
I'm currently on 2mg of Klonopin a day,and my Dr. has asked that I cut to 1.5 immediately. From what I've read here,I know it's too soon. I've been taking this drug for panic attacks and insomnia for 5 years--although now I suspect it's a matter of taking it to stave off withdrawal. I don't want to be one of those people wearing crash helmets with TDK and brain zaps the rest of my life. Is there truth to these horror stories?(Okay,I admit my source is a fellow bipolar who may or may not be thinking clearly,she's the Klonopin poster girl)...
Hlar
Posted by SLS on May 16, 2005, at 7:53:46
In reply to Need advice from someone knowledgeable(SLS?), posted by Hlar on May 16, 2005, at 1:56:41
Hi Hlar.
> Some sources seem to suggest that it's more dangerous to withdraw from a long-term benzo addiction than to continue usage permanently.
I have not come across this suggestion. Can you perhaps provide a few links to literature that supports this opinion?
> That withdrawal can lead to permanent damage that at least taking the drug masks.
I can see how discontinuing one of these drugs abruptly and inducing a severe and protracted state of withdrawal *might* produce long lasting effects. It is also possible that, in your case, you might provoke rebound anxiety and panic attacks.
At this juncture, I should think that an effective taper and discontinuation of a BZD is preferable to continuing to take it when it is not needed.
> I'm currently on 2mg of Klonopin a day,and my Dr. has asked that I cut to 1.5 immediately.
Why?
Why the urgency?
> From what I've read here,I know it's too soon. I've been taking this drug for panic attacks and insomnia for 5 years--although now I suspect it's a matter of taking it to stave off withdrawal.
It is possible that you may not have much of a problem with reducing the dosage to 1.5 mg. However, my guess is that from there, you will need to be a little more creative in your discontinuation strategy.
For now, try to spread out the dosing evenly throughout the day. At night, use as little as is necessary to prevent severe insomnia.
> I don't want to be one of those people wearing crash helmets with TDK and brain zaps the rest of my life.
You won't. Don't worry. My first time coming off Klonopin, I had no real strategy in tapering. I experienced some aweful withdrawal effects. Among them were the brain zaps. I have no special immunity to drug withdrawal syndromes. The only lasting effect from that experience is the memory of how bad it was and a desire to find ways to minimize or prevent it.
After some experimentation, I developed a strategy to discontinue both BZD and SRI medications that works for me.
> Is there truth to these horror stories?
What specifically are you referring to?
- Scott
Posted by Hlar on May 16, 2005, at 11:52:40
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by SLS on May 16, 2005, at 7:53:46
I want to thank you for your prompt reply. I will try to find the links I referred to,I know some of the references were in 'Your Drug May be Your Problem'--Peter Breggin,MD--he makes references to sad cases where benzo users don't ever fully recover--also from nueroleptics(long term use of either or both)such as the Zyprexa I weaned off 4 months ago. Unfortunately the book upset me so much I threw it in the trash.
I do not know why my Dr. finds it so urgent to withdraw me from the Klonopin. Maybe because he feels I'm overly sedated.(which should have improved with the removal of the Zyprexa)I've noticed though,on days where I do cut down to 3x.5mg instead of 4x.5mg,if I try to rest I get "twitches" that keep me awake and tension in my jaw. When I last saw him,he prescribed 90 .5mg tabs for the month(3x a day)instead of the usual 120. Now I have the pleasant task of calling him and telling him I only succeeded(and only half the time)in cutting to 1.75mg a day,and need more. I hate feeling like an addict.
Can I ask if you still take any psychiatric drugs,and how long you were on the drugs you withdrew from?
Sorry for all the tedious detail,but it helps to hear from someone like yourself who's dealt with this sort of thing. You'd think those people would be the Pdocs. Thanks for the reassurance that I won't be wearing a crash helmet.
Hlar
Posted by ed_uk on May 16, 2005, at 16:15:38
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 16, 2005, at 11:52:40
Hi,
>I hate feeling like an addict.
Just remember that you're not an 'addict'! You might be physically dependent on your meds but you're not a drug addict.
Ed.
Posted by SLS on May 17, 2005, at 9:41:26
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 16, 2005, at 11:52:40
> I want to thank you for your prompt reply. I will try to find the links I referred to,I know some of the references were in 'Your Drug May be Your Problem'--Peter Breggin,MD--he makes references to sad cases where benzo users don't ever fully recover--also from nueroleptics(long term use of either or both)such as the Zyprexa I weaned off 4 months ago. Unfortunately the book upset me so much I threw it in the trash.
In my opinion, that's where it belongs.
> I do not know why my Dr. finds it so urgent to withdraw me from the Klonopin. Maybe because he feels I'm overly sedated.(which should have improved with the removal of the Zyprexa)I've noticed though,on days where I do cut down to 3x.5mg instead of 4x.5mg,if I try to rest I get "twitches" that keep me awake and tension in my jaw. When I last saw him,he prescribed 90 .5mg tabs for the month(3x a day)instead of the usual 120. Now I have the pleasant task of calling him and telling him I only succeeded(and only half the time)in cutting to 1.75mg a day,and need more. I hate feeling like an addict.
Perhaps you should take your normal night dose and try reducing and spreading out evenly your daytime dosages. Don't worry too much about the twitching or jaw-clenching if it is not affecting your functioning otherwise. Unfortunately, you are going to experience some discomfort. The question is, to what extent it can be mitigated during the process of discontinuation.
What was your experience discontinuing Zyprexa?
> Can I ask if you still take any psychiatric drugs,and how long you were on the drugs you withdrew from?I had been on Klonopin for 1 1/2 - 2 years.
I had been on Effexor for over a year.> Sorry for all the tedious detail,but it helps to hear from someone like yourself who's dealt with this sort of thing. You'd think those people would be the Pdocs. Thanks for the reassurance that I won't be wearing a crash helmet.
Perhaps the people here can help you go through the process of withdrawal and suggest ways to adjust your regime as you go through it. Yes, the difference between 2.0mg and 1.5mg is quite a large percentage - 25%. Surprisingly, most taper plans suggest in the literature ask for an initial dosage reduction of 40%, followed by a 10% per day reduction thereafter. No way. This way of thinking might be influencing your doctor's decision on how the 25% reduction should be reasonably well tolerated.
What I do:
I like using a flexible dosing strategy that allows the patient to determine dosing times and amounts based upon the rate at which the body accomodates the changes in daily dosage. Ultimately, I ended up biting off minute pieces of Klonopin as a PRN whenever I felt the withdrawal syndrome coming on - almost like using aspirin to treat a headache. The thing is, you must be sure not to exceed the total daily dosage that you had already worked down to. My general rule of thumb is to take as much medication as will allow me to make it 6-8 hours before the withdrawal syndrome re- appears. At this point, I take my next dose. It takes some experimentation to determine dosage amounts. Obviously, you will need to split the tablets. You don't have to be very precise, though. You will also need to become very familiar with what your withdrawal symptoms are to be able to judge the reappearance of the syndrome. It is important that you not take any more Klonopin until you are sure the symptoms are clearly present. Just don't allow them to persist for more than 30-60 minutes before taking your next dose.
I've probably done a better job at explaining this in prior posts. Maybe you can take a look at some of them.
It would have been interesting to see how the presence of Zyprexa would have affected your withdrawal experience. Do you have any Depakote lying around?
- Scott
Posted by SLS on May 17, 2005, at 9:52:04
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by SLS on May 17, 2005, at 9:41:26
Hi again.
I wanted to stress that although flexibility can be an asset at the beginning of a taper schedule, the type of tapered dosing I described in the latter part of my previous post is most applicable towards the end of a taper.
For now, you might want to maintain a more structured dosing schedule that involves dividing your dosing so as to take the minimum amount necessary to prevent severe insomnia and divide the rest of the daily dosage to every 6-8 hours.Just a thought.
- Scott
Posted by Hlar on May 17, 2005, at 12:06:30
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by SLS on May 17, 2005, at 9:41:26
No,but I can score some off the guy down the street. Would it help?
I will send the details of the Zyprexa wd later.
Thanks so much for taking the time to help me out again--I'll follow your advice.
Right now the main thing I'm experiencing is nausea--hard to figure out what's wd and what's due to my heroin habit.
HA!
Hlar
Posted by Hlar on May 17, 2005, at 12:08:43
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by SLS on May 17, 2005, at 9:52:04
okay.
hlar
Posted by JACJ on May 17, 2005, at 16:33:09
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 17, 2005, at 12:08:43
Hi,
I just wanted to add that in a period of 2.6 years I was put (drugged) on 13 medications. My heart still breaks and I am so very bitter but I am so much better. I am not 100 percent but hopefully soon I will get there. I was on AP's and benzos and AD's. I came off benzos and Ap's really fast and mostly had mental w/d. I am over a year off all meds and am doing well even though I have my setbacks. Please don't read all that scary and negative stuff about w/d b/c it will make you so much worse. Concentrate on getting better by eating and drinking lots of water with lemon. The brain and body are meant to heal and though it may take a long time there is hope.With regards to Dr. breggin, what exactly did he say about never recovering? Did he give specifics? You can't take everything to heart b/c there are so many variables that he doesn't mention such as other drugs used while on psychotropic drugs, etc.
Healing,
JACJ
Posted by Hlar on May 17, 2005, at 21:23:10
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by SLS on May 17, 2005, at 9:41:26
> > I want to thank you for your prompt reply. I will try to find the links I referred to,I know some of the references were in 'Your Drug May be Your Problem'--Peter Breggin,MD--he makes references to sad cases where benzo users don't ever fully recover--also from nueroleptics(long term use of either or both)such as the Zyprexa I weaned off 4 months ago. Unfortunately the book upset me so much I threw it in the trash.
>
> In my opinion, that's where it belongs.
>
> > I do not know why my Dr. finds it so urgent to withdraw me from the Klonopin. Maybe because he feels I'm overly sedated.(which should have improved with the removal of the Zyprexa)I've noticed though,on days where I do cut down to 3x.5mg instead of 4x.5mg,if I try to rest I get "twitches" that keep me awake and tension in my jaw. When I last saw him,he prescribed 90 .5mg tabs for the month(3x a day)instead of the usual 120. Now I have the pleasant task of calling him and telling him I only succeeded(and only half the time)in cutting to 1.75mg a day,and need more. I hate feeling like an addict.
>
> Perhaps you should take your normal night dose and try reducing and spreading out evenly your daytime dosages. Don't worry too much about the twitching or jaw-clenching if it is not affecting your functioning otherwise. Unfortunately, you are going to experience some discomfort. The question is, to what extent it can be mitigated during the process of discontinuation.
>
> What was your experience discontinuing Zyprexa?
>
>
> > Can I ask if you still take any psychiatric drugs,and how long you were on the drugs you withdrew from?
>
> I had been on Klonopin for 1 1/2 - 2 years.
> I had been on Effexor for over a year.
>
> > Sorry for all the tedious detail,but it helps to hear from someone like yourself who's dealt with this sort of thing. You'd think those people would be the Pdocs. Thanks for the reassurance that I won't be wearing a crash helmet.
>
> Perhaps the people here can help you go through the process of withdrawal and suggest ways to adjust your regime as you go through it. Yes, the difference between 2.0mg and 1.5mg is quite a large percentage - 25%. Surprisingly, most taper plans suggest in the literature ask for an initial dosage reduction of 40%, followed by a 10% per day reduction thereafter. No way. This way of thinking might be influencing your doctor's decision on how the 25% reduction should be reasonably well tolerated.
>
> What I do:
>
> I like using a flexible dosing strategy that allows the patient to determine dosing times and amounts based upon the rate at which the body accomodates the changes in daily dosage. Ultimately, I ended up biting off minute pieces of Klonopin as a PRN whenever I felt the withdrawal syndrome coming on - almost like using aspirin to treat a headache. The thing is, you must be sure not to exceed the total daily dosage that you had already worked down to. My general rule of thumb is to take as much medication as will allow me to make it 6-8 hours before the withdrawal syndrome re- appears. At this point, I take my next dose. It takes some experimentation to determine dosage amounts. Obviously, you will need to split the tablets. You don't have to be very precise, though. You will also need to become very familiar with what your withdrawal symptoms are to be able to judge the reappearance of the syndrome. It is important that you not take any more Klonopin until you are sure the symptoms are clearly present. Just don't allow them to persist for more than 30-60 minutes before taking your next dose.
>
> I've probably done a better job at explaining this in prior posts. Maybe you can take a look at some of them.
>
> It would have been interesting to see how the presence of Zyprexa would have affected your withdrawal experience. Do you have any Depakote lying around?
>
>
> - Scott
>
Hi Scott,
First of all,I'm doing well.This is the second day I'm down to 1.5mg of Klonopin from the 2.0. I'm taking .5mg before bed,and split the other two into halves,and do what you suggested,taking them when I notice withdrawal symptoms,which is working out to .25mg every 4 hours. I'm trying to identify the withdrawal symptoms--mostly dizziness,anxiety,tremor,and pressure in my jaw and ears. But this initial wd is simpler than I thought. Thanks to you and the others that reassured me.
In answer to your question about my experience withdrawing from the Zyprexa,I may repeat some things I've mentioned in previous posts,so bear with me.
I was on the Zyprexa for 5years,10mg,because I had a severe manic episode that landed me in the hospital--ironically,I'd stopped the Xanax I was on cold-turkey(now I know that with bipolar disorder,mania is a common symptom of sudden cessation of Xanax and Klonopin.) Zyprexa,as you know,is a nueroleptic (anti-psychotic). I gained 80lbs on this drug,I was slim before,and I was having a problem with edema. My Dr. at the time said I would have to be on this drug the rest of my life. Thank God I found a counselor,who knew my history,and being that I'd been stable on Klonopin,Zoloft,and Lamectil( a mood-stabilizer)plus the Zyprexa,it was time to find a supportive Dr. to get me on the minimal amount of drugs to control my condition.
So,I weaned off the 10mg of Zyprexa over a 5month period,but I admit I kind of messed around with the doses,some nights I'd take less,some more. I think I'd been on the 2.5mg a week when I stopped it cold.
First,I had horrible insomnia. Since Zyprexa is a major tranquilizer,I expected this. The stuff knocks you out,yet you feel alert the next day. The insomnia lasted over 2 weeks,though,and I don't think I would have been able to continue without it if my Dr. hadn't prescribed a small dose of Trazodone(Desyrel) with the Klonopin before bed.
I was extremely nauseous. This lasted for a couple weeks.
I had a weird "numb" feeling in the back of my head. I often had a feeling of being removed--of being an observer,what's it called? Disassociating? I don't know. I was hypersensitive to light and noise. But the fatigue was the worst.
I also had a flu-like thing that wouldn't go away--for months. I was tested for everything. Nothing showed.
Today,amazingly,I got an email from a person on a withdrawal site I belong to,and she said she couldn't believe that I'd had the exact same symptoms she had--for months afterwards. Her Dr. suggested Antivert for the dizziness and nausea,which you can get over the counter. I got some today and it seems to help with the Klonopin dizziness too.
The Zyprexa withdrawal was so intense I couldn't even get up the energy to go to my job. I won't go on anymore,but anyone withdrawing from a nueroleptic had best do it extremely slowly. It's been since January that I stopped,and it's only been the past week that I feel somewhat better.
Hope this explains things. You weren't serious about the Depakote,were you? I was joking about the heroin.
Thanks again(are you a Dr.?Or is this a hobby?)
Hlar
Posted by Dr. Bob on May 17, 2005, at 23:58:40
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 16, 2005, at 11:52:40
> I know some of the references were in 'Your Drug May be Your Problem'
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book, movie, or music without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by SLS on May 18, 2005, at 7:38:11
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 17, 2005, at 21:23:10
> You weren't serious about the Depakote,were you?
Actually, I was serious. There is some support in the medical literature that some anticonvulsants might help make withdrawal from certain drugs easier. I'm sort of taking a head-count to see if it really works.
> I was joking about the heroin.
Phew...
:-)
That's good. I wouldn't have judged you anyway, but I would have been a bit concerned as to the place such a habit would have in your treatment goals.
> Thanks again(are you a Dr.?Or is this a hobby?)
Neither. Like most of the others here, my failure to respond to the treatment of multiple doctors forced me to gather more information about my illness. People like me are not necessarily smarter than the average bear, but are driven to find some way to relieve pain, regain function, and find a path back to mainstream society. Fortunately, this website has attracted caring and nurturing people who are willing to share their knowledge and experiences, along with mutual support.
- Scott
Posted by Hlar on May 18, 2005, at 8:38:35
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by SLS on May 18, 2005, at 7:38:11
Regarding Depakote--I had a terrible reaction to the drug--really doped me up,made me nauseous,I had to stop taking it after a couple doses.
I am on a mood stabilizer called Lamictal--an anticonvulsant recently approved for bipolar disorder(takes the place of Lithium,Depakote,etc),I've been on it for 4 years,no side effects, and works really well controlling the mood swings. I was wondering as well if maybe that was helping me through the severity of withdrawal. This may also be the reasoning of my Dr. feeling I can do without the daily Klonopin eventually. I'm on 200mg of Lamictal a day.
So you can't include me in your Depakote head count,sorry.
Take care,
Hlar
Posted by Hlar on May 19, 2005, at 11:06:25
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 18, 2005, at 8:38:35
It's funny how wd symptoms vary day to day,unless they're just getting progressively worse.
Yesterday,I was up at 9:30,only got about 7hrs of sleep(and this was only be. my Pdoc temporarily added 15mg of Restoril to get me through)and felt fine til the evening,when I almost fell asleep at a hair appt.,and had the ears blocking and tightness in the jaw and dizziness. I got home around 8,took the dose of Klonopin I'd worked out,and conked out til 10. Then couldn't get tired again until 2. Up again at 7:30,back to bed at 9:30. Now up again at 12. And I'd saved most of the 1.5mg of Klonopin I'm taking now(.75) with the Restoril at 2. Is this normal when you change your dose?
Also,has anyone heard of something called the Ashton Manual--lots of sites refer to it in regards to getting off benzos,but I'm afraid to even look at it.
And,is there anything you can do about the blocked up ears and pressure in the jaw? I feel like I've been on a 12hour plane trip.
Hlar
Posted by ed_uk on May 19, 2005, at 13:25:56
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 19, 2005, at 11:06:25
Here is the Ashton Manual......
http://www.benzo.org.uk/manual/index.htm
Professor Ashton used to run a benzo withdrawal clinic in the UK.
Regards,
Ed.
Posted by SLS on May 19, 2005, at 16:17:23
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by ed_uk on May 19, 2005, at 13:25:56
> Here is the Ashton Manual......
>
> http://www.benzo.org.uk/manual/index.htm
>
> Professor Ashton used to run a benzo withdrawal clinic in the UK.
>
> Regards,
> Ed.I've seen this website before. The taper schedules suggested seem to me to be inordinately long. Perhaps I don't fully appreciate how difficult the discontinuation process is for some people. I guess it's wishful thinking on my part that there must be a better way. The other thing that I wonder is if diazepam really does fully substitute for a triazolobenzodiazepine like alprazolam. I read something the other day indicating that it did not. Perhaps using a tiny dose of desipramine (10mg) would be helpful in addition to the diazepam.
- Scott
Posted by Hlar on May 20, 2005, at 14:59:34
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by SLS on May 19, 2005, at 16:17:23
Okay,I'm starting all over with the Klonopin taper,and am going to do it Scott's way,as I found that the 2mg cut immediately to 1.5mg proved to be too much as of yesterday.
I was depressed,extremely tired but wired,jaw tight,ears plugged,anxious,etc. I decided this is enough--I just got off a 5year Zyprexa habit 4 months ago,stopped trazodone a week or two ago,then the Klonopin before I was even feeling back to normal from the former. Plus there's been alot of stress in my life that I hadn't really considered,my father died of cancer 7 months ago(bless his soul),I quit smoking a year ago.
So I called my Pdoc yesterday and after explaining all of the above,said it was just too much to ask right now. He represcribed the 2mg(.5mg 4x a day)again.
Now,I want to do this right. And I want as little wd as possible for the next month. So I was wondering,is tapering .125 a day a good start? I've also cut the Restoril to 15,since I only used it a few days.
Scott,can you help me out here? I feel so much better now,I was completely dysfunctional yesterday and the later the day before. It was frightening how going back to the original dose made me feel "normal".Thanks,Hlar
Posted by SLS on May 20, 2005, at 16:26:05
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 20, 2005, at 14:59:34
Hi.
I'm sorry that things didn't work out moving from 2.0 to 1.5mg (25% decrease) with the Klonopin. I was hoping it would.
> Now,I want to do this right. And I want as little wd as possible for the next month. So I was wondering,is tapering .125 a day a good start?
According to many "experts", reducing a BZD dosage by 10% at a time is prudent. 0.125mg certainly falls within this range. I think each person's withdrawal experience is somewhat unique and must allow for a certain amount of flexibility in the tapering process. You will learn how your body responds to dosage decreases along the way and become better able to choose when to take the next step downward, the amount of decrease, and for how long.
How long were you planning to remain at each dosage?
How many times a day do you plan to take it?
>It was frightening how going back to the original dose made me feel "normal".
I know. You must feel like you are to be chained forever to the stuff.
Don't worry, you'll make it.
- Scott
Posted by Hlar on May 21, 2005, at 7:34:08
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by SLS on May 20, 2005, at 16:26:05
Hi Scott,
I'm kind of foggy mentally right now--just got up,takes a couple cups of coffee...anyway,to answer your questions:
I plan on doing the .125 reduction for 2 weeks.
Then,if I'm ready,another .125 for two weeks,etc.
Yes,it'll take a long time to get off the Klonopin,but since I am bipolar,I have to be extremely careful about withdrawal.
Here's where the signifigance of my brain fog comes in: I cannot for the life of me figure out a dosing schedule for the day. I know I want to take .75-.85 before bed,around 2am.,so that leaves 2 5mg tabs. Is it wise to space these in two 5mg doses (every 8 hours),or .25 every 4 hours during the day? I want to take the higher amount at bedtime to minimize insomnia. Can you help me out here? Again? Please? I've no idea how long it takes for it to wear off. I guess that's the "half life"? I'll have my degree in pharmacology when this is over...
Hlar
Posted by SLS on May 21, 2005, at 12:55:19
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by Hlar on May 21, 2005, at 7:34:08
I think your plan is a great one.
Many times, the most difficult part of a taper occurs when a dosage of 25% of the original is reached. When you reach this point, it might be time for a flexible-dose strategy. Until then, it certainly makes sense to bias your intake of Klonopin towards bedtime and spread the rest of the dose at 8 hour intervals. It probably won't be necessary at this point in the taper to take it any more often than that as Klonopin has a half-life of 30-40 hrs. However, once you reach the lower dosages, it might make sense to dose more often. This will allow some flexibility in your ability to control withdrawal symptoms.
What is your sleep/wake schedule? When I was a patient at the NIMH, they were very adamant that one sleep between the hours of 11:00pm and 7:00am and avoid long naps during the day. There might be something important to maintaining this precise schedule built into our suprachiasmatic nucleus of the hypothalamus that serves to keep our circadian rhythm synchronized based upon environmental cues that we might not be aware of.
I'll be rooting for you.
- Scott
Posted by Hlar on May 21, 2005, at 13:40:44
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by SLS on May 21, 2005, at 12:55:19
> I think your plan is a great one.
>
> Many times, the most difficult part of a taper occurs when a dosage of 25% of the original is reached. When you reach this point, it might be time for a flexible-dose strategy. Until then, it certainly makes sense to bias your intake of Klonopin towards bedtime and spread the rest of the dose at 8 hour intervals. It probably won't be necessary at this point in the taper to take it any more often than that as Klonopin has a half-life of 30-40 hrs. However, once you reach the lower dosages, it might make sense to dose more often. This will allow some flexibility in your ability to control withdrawal symptoms.
>
> What is your sleep/wake schedule? When I was a patient at the NIMH, they were very adamant that one sleep between the hours of 11:00pm and 7:00am and avoid long naps during the day. There might be something important to maintaining this precise schedule built into our suprachiasmatic nucleus of the hypothalamus that serves to keep our circadian rhythm synchronized based upon environmental cues that we might not be aware of.
>
> I'll be rooting for you.
>
>
> - Scott
>
>Scott,don't you know that phrases like,"suprachiasmatic nucleus of the hypothalamus" trigger withdrawal symptoms like delusions of emailing Einstein,etc.? Time for my dose of Klonopin,geeeez.My sleep schedule is a bit weird right now. I've been staying up til between 12-2 and getting up at 8 or 9. I do take an hour nap during the day,I admit. I know I should go to bed earlier,but now that I'm just taking 15mg of Restoril(and I plan to stop that entirely,I've only used it for a week,initially at 30)I like to be exhausted so I'm guaranteed to fall asleep immediately.
Thanks again,and I'll keep you posted.
Hlar
Posted by EarthLover on May 22, 2005, at 15:40:20
In reply to Re: Need advice from someone knowledgeable(SLS?) » Hlar, posted by SLS on May 21, 2005, at 12:55:19
Greetings all: Since I just started Effexor and can't sleep at all, I have spent the last several hours reviewing the material on this site. A bit too early to be thinking about withdrawal I know, but I can't go further without embarassing Scott by stating that he might well be the most generous, intelligent, resourceful, and thoughtful contributor I have ever seen in any forum anywhere on the Internet. Moreover, he's an excellent writer. We are all fortunate to have him here. Please take a bow Mr. S? And forgive me for directing attention to you without your permission!
SLS wrote: "Like most of the others here, my failure to respond to the treatment of multiple doctors forced me to gather more information about my illness. People like me are not necessarily smarter than the average bear, but are driven to find some way to relieve pain, regain function, and find a path back to mainstream society. Fortunately, this website has attracted caring and nurturing people who are willing to share their knowledge and experiences, along with mutual support."
Posted by Hlar on May 22, 2005, at 15:52:42
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by EarthLover on May 22, 2005, at 15:40:20
I agree. Scott is the best.(on my feet applauding wildly) Thank God I found him!
Hlar
Posted by SLS on May 22, 2005, at 15:56:55
In reply to Re: Need advice from someone knowledgeable(SLS?), posted by EarthLover on May 22, 2005, at 15:40:20
Hi EarthLover.
I am overwhelmed to the point of tears. Thank you. It is nice to be appreciated.
- Scott
> Greetings all: Since I just started Effexor and can't sleep at all, I have spent the last several hours reviewing the material on this site. A bit too early to be thinking about withdrawal I know, but I can't go further without embarassing Scott by stating that he might well be the most generous, intelligent, resourceful, and thoughtful contributor I have ever seen in any forum anywhere on the Internet. Moreover, he's an excellent writer. We are all fortunate to have him here. Please take a bow Mr. S? And forgive me for directing attention to you without your permission!
>
> SLS wrote: "Like most of the others here, my failure to respond to the treatment of multiple doctors forced me to gather more information about my illness. People like me are not necessarily smarter than the average bear, but are driven to find some way to relieve pain, regain function, and find a path back to mainstream society. Fortunately, this website has attracted caring and nurturing people who are willing to share their knowledge and experiences, along with mutual support."
Posted by ed_uk on May 22, 2005, at 17:37:21
In reply to Re: Need advice from someone knowledgeable(SLS?) » EarthLover, posted by SLS on May 22, 2005, at 15:56:55
Hi Scott!
>It is nice to be appreciated.
Absolutely, you are very much appreciated :-D
Kind regards,
Ed.
This is the end of the thread.
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