Need advice on how weaning off of Clonazepam

[Christa04]

I went to my Dr. today and Had a physical and informed him that I would like to wean off of Clonazepam because I not only would like to stop taking it but am also trying to get pregnant. He said to just stop taking it all together. That because I only take 1MB every night my symptoms shouldnt be bad and its the safest route if I am pregnant or become pregnant. Everything I have read tells me I should not just stop taking this medication. I have been on it for almost 3 years now and like I already stated I take 1MG a night. How should I go about weaning myself off of this medication quickly and in a safe way?

[Paxiled]

Your doctor is an idiot.  You should always wean off benzos, not quit abruptly.  Wait to start trying to become pregnant until you wean off; that solves that problem.  Abruptly quitting a benzo can, in some occasions, cause seizures, since they're also anti-seizure medications, and withdrawal can be significant.  So take it easy.  See a psychiatrist for these meds, not a regular doc, and make sure they understand this stuff before you settle on one.  You'll find tapering schedules on this forum by Ryan several times, and if you go on the Mental Health forum Dr. Gould will give you one.  I think tapering should be more individual -- you taper according to how you feel.  If it goes easily, swell.  If it doesn't, you take it easy.  Why go through what you don't have to?  And tell your doc he's a moron.

[RCA759I]

Clonazepam - a long acting Benzodiazepine, works on the principal of accumulation. This agent carries an average half-life of thirty-six hours, and upon repeated dosing, accumulates. When it is dosed only once daily, it does not accumulate to adequate levels, and this results in abrupt peaks and troughs in the plasma level.

When dosed two-to-three times daily, Clonazepam accumulates substantially in the plasma. Each dose you take overlaps the last up to a certain point, as you will see. Over a span of five half-lives (7.5 days), the drug accumulates to steady-state. Steady-state simply means that the blood plasma level is held at a consistent level, without significant peaks or troughs. Over an additional five half-lives (7.5 days), Clonazepam accumulates between 1.5 - 3 times that of the steady-state plasma level, at which point the accumulation stops.

To taper off of one milligram of Clonazepam, one should utilize the full accumulation potential of the drug, as this will allow for a very gradual decline in the plasma level, and hence, minimize or eliminate the possibility of severe withdrawal symptoms. In your case, perhaps the worst symptom will be rebound insomnia.

*Taper Schedule for 1 mg Clonazepam, q.h.s.(abbreviation for "every night")...

Weeks 1-2: Take 0.5 mg of Klonopin in the morning and nightly. Separate the doses 12 hours apart. Over a span of two weeks, the Klonopin will have reached most of its accumulation potential.

Weeks 2-4: Take 0.375 mg of Klonopin in the morning (3/4 of an 0.5 mg tablet), and 0.5 mg nightly.

Weeks 4-6: Take 0.375 mg of Klonopin morning and nightly.

Weeks 6-8: Take 0.25 mg of Klonopin in the morning, and 0.375 mg nightly.

Weeks 8-10: Take 0.25 mg of Klonopin morning and nightly.

Weeks 10-12: Take 0.125 mg of Klonopin in the morning, and 0.25 mg nightly.

Weeks 12-14: Take 0.125 mg of Klonopin in the morning and nightly.

Weeks 14-15: Take 0.125 mg of Klonopin every other morning, and 0.125 mg nightly.

Weeks 15-17: Take 0.125 mg of Klonopin in the afternoon.

Week 18: Take 0.125 mg of Klonopin every other day (in the afternoon), then stop.

*It is imperative that any drug discontinuance schedule be initiated only under the direct supervision of a medical doctor. If you attempt to taper any faster than what is outlined above, you would not be utilizing the full accumulation advantage of Klonopin, and this would defeat the benefit.

Good luck,

Ryan