RCA7591 Water Titration to get off BENZO - my doctor approves it

[fd11]

Ryan,

You told me to dry cut my pill every 4-6 weeks by ¼ .  I have been doing this and I am ready to cut down from 0.375 MG .25MG of the pill in 2 days and I still feel vertigo (off balanced), blurred vision, headaches and muscle pain.  I went to my doctor and explained that the withdrawals are still at a level that I can not tolerate.  I presented to him the water titration method and his first response was he never heard of it and my response was because it is not medically approved.  After he reviewed all the information on it; he decided that this was a terrific idea and that I should go ahead with it.  Now keep in mind that this doctor is the head of pharmacology for NYU Medical, one of the top hospitals in the United States.  Ryan, although you are very knowledgeable because of your book smarts, every one is different and what works for you may not work for everyone else.  Please stop being a know it all and let people do what they believe is good for them and stop discouraging them.  I personally know of 3 different people who tried dry cutting and it had a horrible effect and there is 1 person that it worked for.  Those 3 people turned to the water titration and they are feeling better then ever.  SO EVERYONE OUT THERE WHO IS TRING TO COME OFF OF BENZOS, DO WHAT YOUR BODY TELLS YOU AND DON’T LISTEN TO THIS FOOL ANYMORE.  

**Also remember that when you dry cut your pills you are not getting the exact cut every time and this shocks your brain.  Besides ¼ off the pill is too much, you should cut down at least 10% of the pill.**

[debaser23]

Hey, man, there's absolutely no reason to call that guy names or anything like like that.  A fool?  I hardly think so.  He helped a LOT of people on this forum including myself.  When you insult him, you insult me.

If the water titration works for you, that's great, but it's not cool to be throwing it in someone's face.

[spade22]

"You told me to dry cut my pill every 4-6 weeks by ¼ . "

I am sure you are aware that this is a patient-to-patient forum.  Medhelp CLEARLY states to: "Always seek the advice of your physician or other qualified health provider for any questions you may have regarding your medical condition, or prior to starting any new treatment" .

Ryan offers SUGGESTIONS based on his knowledge - as do the rest of us.  Ryan typically recommends you DISCUSS his recommendations with a DOCTOR however, this should be obvious.  In any case, anyone that asks a question in an unmoderated forum and follows that advice without talking to their health professional first does NOT have the right to call the person giving the advice a fool.

"Please stop being a know it all..."

If offering suggestions based on knowledge deems one a "know- it-all" then everyone that posts a reponse to a question asked in these forums is a "know-it-all".  If you do not want advice from "know-it-alls" then I suggest you dont post a question in a forum such as this.

"....and let people do what they believe is good for them......"

No one on this forum has the ability to force another individual to do something against their wishes as you clearly imply in this statement.  Ryan did NOT prevent you from doing what you thought was best for you - YOU need to take responsibilty for you own actions.

" I personally know of 3 different people who tried dry cutting and it had a horrible effect and there is 1 person that it worked for.  Those 3 people turned to the water titration and they are feeling better then ever. "

Why did you elect to use the dry cutting method instead of the titration method based on this evidence?

Fd11- rather than attacking another poster that is attempting to help, and has helped others, based on his knowledge why not set-up a positive post?  Prehaps you could explain what the water titration method is and what its benefits are to equip those with this knowledge as a possible tool they can use when tappering off benzo's.  Of course, this is something they should discuss with a doctor BEFORE commencing.

[tanns]

Fool?  Seriously, was it all that necessary to come back on to "attack" Ryan for YOUR decision?  He may have given advice but YOU chose to take it.  As the other posters have pointed out, this is not a doctor mediated forum and if you choose to read a post or ask for help/advice, you are responsible what you choose to do with that information.  Always, always ask your doctor.  

[Raine9]

If Ryan's suggestion didn't work for you, FINE!  But everyone here knows that Ryan is NOT a doctor.  He made that VERY clear.  So it was YOUR decision to take his advice.   You don't know Ryan well enough to be calling him a fool!    

[RCA7591]

"I presented to him the water titration method and his first response was he never heard of it and my response was because it is not medically approved.  After he reviewed all the information on it; he decided that this was a terrific idea and that I should go ahead with it.  Now keep in mind that this doctor is the head of pharmacology for NYU Medical, one of the top hospitals in the United States"

--end quote--

OK, let me get this straight:

You presented your proposed "water titration method" to the director of pharmacology at NYU Medical Center. He had never heard of it, he has no research or clinical trials to determine the efficacy of such a "method", but he reviewed your data. Magically, he deemed your idea as being "terrific", despite the fact that he had never heard of it before, and despite the fact that there is no documented efficacy to back this "method". He then suggested that you "go ahead" with it, despite all of those facts that I just outlined above.

Well, pal, I'm no fool, and find your story to be a bit absurd. Firstly, doctors don't generally suggest bizarre or unapproved methods for their patients. Secondly, this particular doctor, is, as you claim, the "head of pharmacology". If that's a true statement, then he would've known a few basic facts that would contradict the use of "water titration" to taper a Benzodiazepine:

5-(2-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one (Klonopin), is in the class of drugs known as the 1,4 Benzodiazepines. Klonopin is NOT WATER SOLUBLE, it is lipophillic (dissolves in oil, but not water). Since Klonopin is not hydrophillic (doesn't dissolve in water), water is an incomptabile.

What does that mean? Exactly what it says, that Klonopin is not water soluble, and will not dissolve in water. Therefore, using water as a vehicle to titrate Klonopin (and all Benzodiazepines) is invalid. The soultion would contain excessive precipitate or particulate matter, and it would be impossible to accurately mesaure the amount of the drug in which you were intending to ingest. You could accurately measure the solution itself with a calibrated graduated cylinder or syringe. You could not, however, accurately measure the amount of Clonazepam in the solution. I don't care what you do to the solution you've made (shake it, blend it), you will never be able to accurately measure the amount of Clonazepam in milligrams contained within. The tolerance is +/- 50% if not greater. You will, however, be receiving some "X" amount of Clonazepam (X is unknown, and is not measurable as the soultion is not homogeneous).

To make Klonopin compatible with water, it must be combined with an organic compound that is both *hygroscopic* (ability to attract water molecules by absorption) and *miscible* (property of two liquids to mix and form a homogeneous soultion). The organic compund (vehicle) must possess these two properties. The organic compound that is used to accomplish this is Propylene Glycol, which is a Diol Alcohol (an oily substance). Klonopin is soluble in oil (lipophillic).

To prove this point, if 1/8 (0.125 mg) of Clonazepam were to be dissolved in 10 milliliters of physiologic saline solution and injected intraveneously, there would be no pharmacological effect. The drug would not be absorbed, as Clonazepam and saline are incompatible. The particulate matter formed would cause venous thrombosis and tissue necrosis to the affected area(s) of the injection site.

To make Clonazepam suitable for IV injection, it is combined with a high percentage of Propylene Glycol, making the solution stable and homogeneous. The drug would now be compatible in its new vehicle, and readily absored by tissue lipids.

The main purpose of this presenation is to demonstrate that Clonazepam is lipophillic, and not water soluble. Water is an incompatible, and thus the water titration method is invalid due to the high degree of error involved.

As far as dry cutting Klonopin, there is no reason to. Wafers are available (even in generic form) to help facilitate you during the process of tapering, and to remove any user error that will inevitably occur by cutting the tablets on your own. Simply ask the doctor for 1/8 mg wafers.

When tapering Klonopin properly at the suggested 1/8 mg (0.125 mg) increments every four weeks, there is little to no withdrawal phenomena involved. However, as the drug is discontinued, your original symptomatology may reappear. You were originally placed on the drug for a purpose, and you cannot expect to discontinue Klonopin without also anticipating a return of your original symptomatology. Therefore, it is unfair to blame every little sensation that you may encounter solely on the Klonopin, when the vast majority is almost certainly of a psychogenic origin.

As always, there are exceptions. Everyone is indivdualized, and I can appreciate that fact. Should difficulty arrise, Diazepam should be utilized instead of Clonazepam. The Diazepam is withdrawn in 2 mg increments every four weeks until it is discontinued. The initiation of Diazepam is only required for folks who took Klonopin multiple times daily, and even then, it is very, very rarely required.

For multi-dosing of Klonopin, only one dose should be altered at a time. For b.i.d dosing, the morning dose is tapered first by 1/8 mg. The morning and night dosages are alternated between every four weeks until the drug is discontinued. The key here is to alter only *one dose* at a time. In the case of an 0.5 mg tablet, this is 25%. For a 10 mg Valium tablet, 20%. 10% is not practical. These percentages DO NOT reflect the *total* daily dosage, as most folks take Klonopin or Valium two-to-three times daily. The percentages reflect a single dose, not the total dosage. Only one dose is to be altered at a time.

If I'm not mistaken (correct me if I am), you are the person who took Klonopin only once daily (at night). In your case, the drug never reached a steady-state plasma level. I don't know who you've been conversing with, but you are highly suggestible, easily manipulated, and have been brainwashed into believing that this "water titration method" is actually valid, when it is in fact, quackery. The vertigo, visual disturbances, headaches, and muscular tension are, in my opinion, a figment of your imagination. I have no strong suspicion that Klonopin withdrawal is causing any of your symptoms. I do not attribute them to withdrawal phenomena.

Therefore, I would recommend that you refrain from reading online horror stories, or conversing with those that would only add to your suggestibility, and would also recommend that you consult with a medical doctor for work-up and assistance in withdrawing the Klonopin. If the work-up is negative, referral to psychiatry would be indicated at that point to assess for a psychological component.



Ryan

[heartfluttersflyawayplz]

wow , ryan is a very smart young man and knows what he is talking about, its to bad you didnt listen to him because you would be better off by now , so do as you want to and let ryan help others who want his help and needs his help, read back on forum hes been there for many and did a great job, you need another dr. hgope you get help/ and can get off of it , but plz dont put down a young man who has been here for others and helped them get off the med.

[fd11]

Everyone has their own opinion and if he has helped you then great.  All I am saying is that he shouldn’t discourage procedures that are not medically approved, because everyone is different and what is good for him may not be good for someone else.

Ryan-

Yes I presented this water titration method to him and because the doctors follow a strict guideline of the FDA they would never hear of it.  After I presented him with the information, he did research it and thought in his exact words “it is a terrific idea”.  

Since you are so scientifically inclined, then you should know that your statement below is inaccurate.  Roche; the company that produces this drug (Klonopin) says that those are all physical withdrawal symptoms and/or side effects.  

"The vertigo, visual disturbances, headaches, and muscular tension are, in my opinion, a figment of your imagination. I have no strong suspicion that Klonopin withdrawal is causing any of your symptoms. I do not attribute them to withdrawal phenomena."

“That Klonopin is not water soluble, and will not dissolve in water”

The benzodiazepine particles are suspended into the water, therefore there is no need for the pill to dissolve or be water soluble; putting the particles into suspension is sufficient enough to insure an accurate cut.

Well I have nothing else to say and from the bottom of my heart I hope all of you can fine the proper help and get better.  

[michaxx2]

..There are always a better,nicer,respectable ways to express yourself....calling him a fool?....that was'nt nice at all......Ryan is a good guy trying to help as much as he can ...he does not force his opinion on anybody....if you dont like it its fine but dont be mean and rude to him...
Micha

[suzi-q]

Please let us know your doctor's name so we know to NEVER go to him!  How can a doctor who never heard of a procedure (especially a pharmacologist) recommend it without doing some investigating?  Also, the fact that he never heard of this method shows me that he is not a well informed, well read doctor.

Ryan is a very well read, well informed individual who helps where he can.  He never gives advice without statistics to back it up.  He also ALWAYS tells you to speak to your doctor.  You have the right to your opinion and he has the right to his.  Let's not make this a personal issue.  

I wish you well.

[JanaHill]

Titration is not the issue. Using water is the issue.

Titration is the change in dose of a drug by very small amounts until the desired result is acheived. Who is against that? What studies are needed to validate a definition?

It is obvious that Measuring very small amounts requires a liquid. It is also obvious that the agent cannot always be dissolved in water. A liquid suitable for the specific drug is necessary.

I am irritated by the term: water-titration. The most popular version of this relies on beating the Valium into a suspension and then measuring that.. I agree; this is not a reliable medium for measurement. Titrating a benzo does not depend upon using water. It depends on using a liquid that will either actually dissolve the substance or put it into a reliable suspension.

I am horrified at the suggestions of a liquid. Have you considered mixing the fat solubale benzos into some ewhyl alcohol and then adding glycerin? This method covers the bases.

The idea of titrating is an excellent one. It is the mixing method and liquid used that are in serious question.

If smaller doses used closer together produce milder symptoms, take the idea much farther and make the dose extremely small, and do it every day. Are controlled studies needed for something so logically useful?

[Kat10]

I have been glued to this site.. I really fine your info very good, I have been taking one sort of bezo for along time. Last year I finally was off of it for about 2 months, but w/d sympotms, thats what they were horendous, So about 9 month or more  I went back on clonzepam at one time it was .05 up to 3 times a day. I didnt take it that much, I had learned that much.. anyway I'm down to about to a 1/8 to 1/4  in the evening usually. but I have been dry cutting , but sometimes they crumble and  its not very exact.. I know u understand when I say I really really want to stop this stuff, and try and wait out what w/d's I'll have.    So I take the 1/4 for a month then go to a 1/8 and take a month and than ????  Also I'm going to check and see if the wafers our expensive. insurance does not cover beznos of any kind.. I really apprciate any feed back.. thanks    
Kat

[JSGeare]

Quite a zesty discussion we have going here. I implore the two of you -and everyone, really- to avoid statements or suggestions which might reasonably be interpreted as an attack on the person as opposed to a challenge to their point of view. This can be tough to do, sometimes and I fear that I have often crossed the boundary myself.

After all is said and done, look at the material you are preparing to post (or are thinking about) and ask yourself if it really contributes to the greater good, bearing in mind that the forum is open to all. If you are so possessed of a point of view that an eyeball-to-eyeball confrontation seems necessary or inevitable, then carry it out directly in PM's.

'Nuff said?

Thanks.

[abby10]

Use milk "piehole"

abby

[Ryan7591]

Pure cow's milk (straight from the ***, and unmodified by man) contains on average 87% water content. It also contains many phospholipids, of which Clonazepam is *sparingly* soluble in. The inactive compunds (binders and fillers) that comprise the bulk of a Clonazepam tablet are not soluble in milk due to its high water content.

*Sparingly* soluble is not adequate. Ideally, the drug should be fully soluble in the chosen vehicle so that it may then be titrated accurately. The entire concept of titration is to start with a KNOWN VALUE, and to subsequently subtract from it. When the proposed vehicle is not fully compatible with the agent that you wish to titrate (and in this case it is only sparingly soluble), you no longer have a known value, you have an "X" (an unknown value). And while it may appear to the untrained eye that two sides of an equation are present (Clonazepam and Milk, with values for each), under real world conditions, they cannot be expressed in equation form because they are NOT compatible. Hence, "X" remains unknown and variable depending on the sedimentation rate of the Clonazepam in the milk solution, as the resultant product is not homogeneous.

To further complicate matters, the bulk of the milk sold today is pasteurized and homogenized, and this changes the consistency to the point where less phospholipid binding occurs, and the water content is increased. For all practical purposes, Clonazepam is no more soluble in this type of processed milk than it is in water.

Those who are looking to discontinue Clonazepam would be best served using the wafers, which are available in values as small as 1/8th of a milligram (0.125 mgs). Both brand and generic wafers are available.

--Ryan

[abby10]

I am so sorry for you... for all your science you are blinded by it!  And I am sorry for the lemmings that follow you because they don't take the time to do further research.

The water titration works.  For those who have used it, it works.  You have to crush klonopin or valium to a very fine powder and mix it in the cylinder with water or milk. The particals will fall to the bottom very quickly, shake the solution and quickly remove the solution with a dropper that measures milliliters.  I quit the milk because I couldn't see the particals in it.  But the milk suspends the particals better. This is not a minute/exact formula, but extremely effective.  Much better than guessing on how much powder on the table to press up with your finger and lick off.

Your information on the klonopin waffers is excellent. I appreciate it. I just don't know how easily it would be for someone to find.

abby

[Ryan7591]

Your information on the klonopin waffers is excellent. I appreciate it. I just don't know how easily it would be for someone to find.

^quote

Drugstore.com carries them. Almost every Rite Aid retail pharmacy chain operates through them. If you have access to a Rite Aid, you can obtain these Clonazepam wafers. You can also ask almost any pharmacist to order them for you.

http://www.drugstore.com/pharmacy/prices/drugprice.asp?ndc=49884030602&trx=1Z5006

Or, one could opt to chase particles around in a glass of water. Ultimately, it's your call. As for physics, I've spent my life trying to defy it...didn't work out so well. Best to accept it for what it is.

You could also use a scale. Say for instance that you had an 0.5 mg tablet of Klonopin. Obviously, the tablet does not actually weigh 0.5 milligrams, it is much larger.
Only a small percentage of the tablet contains Clonazepam, the remainder is garbage.

As an example, say the tablet weighed 250 milligrams, and you are looking for 0.0625 mg (1/16 of a mg) of actual Clonazepam. You already know that the total Clonazepam contained within is 0.5 milligrams, so you now have everything you need to form a proportion...

0.5/250 = 0.0625/X

X = 31.25 milligrams of the tablet

What you could then do is crush the tablet, and measure out exactly 31.25 mg on the scale. The contents could then be placed into an empty capsule and consumed. In reality, you could make any dosage that you wanted. And the degree of accuracy is exceptionally high using this method - flawless for all practical purposes. You would know exactly how much Clonazepam you were taking.

A good scale with a 0.1% tolerance range or better can be costly. However, the cost for a one-month supply of the wafers would pay for it, along with the empty capsules. Clonazepam tablets are cheap ($20 on average) for 60 of them. In the end, you'd actually save money, and of course, you would have the power to make any dosage that you wanted.

Tools required:

(1) Brain
(1) Digital Scale, 0.1% accuracy or better
(500) Empty Capsules (ask pharmacist)
(60) 0.5 mg Clonazepam Tablets/Month

Weigh the tablet, use the above equation to determine dosage, place contents in capsule. Presto.


-Ryan

[abby10]

Maybe the scale could be rented. I would of done it a year ago when I needed it. Scary shaking the benzo up and drinking it fast. But it does work well. A pain in the arse to be sure.

abby