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how do i titrate down from 4.5 mgs of klonipin without horrible withdrawals?
Hello everybody. I am prescribed 6mgs of klonipin daily. I titrated down to 5mgs right away, my psychiatrist told me i would have no withdrawals. so that was all fine and dandy. Then i titrated down to 4.5 and stayed there for two weeks. I was still having no withdrawals. Then i went down to 4mgs and all hell broke loose, i was a mental wreck, crying a lot, having panic attacks during the day, and getting EXTREMELY irritable and angry, then i would start crying again. I want off this stuff, or at least to the point where i take a 1/2 a mg or 1mg 2-3 times a wk. I tried going up to 4 and one quarter of a mg, but that did NOT help at all. I feel stuck at 4.5 mgs. I broached my psychiatrist that i wanted to taper down and he basically said no. that was months ago. any advice or help would be very much appreciated, thank you, snowflake
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Read a book called the Antidepressant Solution by Glenmullen.  This will give you a general guide to when it's time to stop a drug and how to do it.  But this is the general guidelines I discovered when researching this (too late, my psychiatrist was clueless and left me broken):  the schedule for tapering off a drug is as long as it takes you to do it without suffering a horrible withdrawal.  You don't say how long you've been on klonopin, but you've been on a very high dose, and you're experience so far shows it will be very hard for you to stop.  So do it very very slowly.  If it takes a year, it takes a year.  Maybe you'll never be able to stop and feel good enough so maybe you'll stay on it, but if you want to try, again, as slowly as it takes you to do it.  Don't follow any schedule arbitrarily set by a psychiatrist; follow one that suits you.  Also know that, at some point, you're probably going to suffer withdrawal and will have to push through it, but what you don't want is one that lasts a long time or forever or that gives you emotional problems you didn't have before you went on the drug in the first place.  So, you know that going down after two weeks was too fast for you -- you go back up to the last dose at which you felt fine, and taper off more slowly every time it gets really bad.  So maybe take a month before you taper down more.  You can also cut your pills to titrate down very very slowly.  Your psychiatrist won't want to do this -- it takes too much time and he's got patients to make money off of.  Doesn't want to spend all his time with you.  You have to make it clear he works for you.  You have to set the schedule, because most of what doctors know about drugs they learned from the pharmaceutical companies that made them and paid people to write the textbooks, and they lied.  Take it into your own hands, you're the only you.  Some do this very easily, some don't.  You don't.  Have patience.  If it doesn't work, the worst that happens is, you stay where you are now,  but with enough time, exercise, relaxation exercises, therapy and the like to help you, you should make it through.  Peace.
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And also, make darned sure you're ready to come off the drug.  If you've never worked on your problems through therapy, if you still think the same way, you may simply not be ready to quit.  Only you know the answer to that one.
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thank you so much for your reply paxiled. It is not what i wanted to hear, but what i needed to hear. Yeah Ive tried to break down my 2mg pills and the most i can do with the pill cutter is get 0.5 mgs. Soooooo.....I already asked my psychiatrist months ago to wean me down and he basically said no. But your right he works for me. I am going to see him this week and be very assertive and explain why I want off. Why do I want off? Thats a good question. I better come up with something that is better than just "im tired of being on them" im going to tell him once i get through the withdrawals and while im in withdrawals ive learned ways to calm myself, like running, mediation, breathing exercises, and im ready to come down to one mg a couple times a week. I need him to write me out two partial scripts. 32 2mg pills/month, and 15 0.5 mg pills/month. I called the pharmacist and she said all the klonipin types are the same size. then im going to break the 0.5mg into fours with my pill  cuttter and take 3 of the pieces for two wks, then two for two wks, ect, try to go as slowly as i can. im a prettty stubborn person by nature. when i get a idea in my head its stuck. i just have to have my psychiatrist in the same boat. Which poses a challenge. im concerned about it. If he doesnt help me i dont know how to do it. :(
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Also i am in the process of counseling and have learned relaxation techniques and run five days a week so i am truly trying.
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Your psychiatrist might not believe you're ready to come off the drug.  Tell him what you've said here and you should get where you want with him.  
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You should try to get your psychiatrist to switch you to valium. Valium has a much longer half life than klonopin and is much easier to come off of. Klonopin's half life is around 34 hours while valium's is around 100 hours. If he still won't do that and you are desperate to come off, you should start shaving tiny amounts of the pill. When I say tiny I mean 10% of the pill. I know the pills are already so small so it is a very tedious process. If that doesn't work then start dissolve it in water and calculate with doses that way. But only start with 10% at most every two weeks. So if you are taking two doses a day only start with shaving just one of those doses. I would not use a pill cutter either, because you have a lot less control of where it cuts.

You could also just ask your primary care or another doctor for help. Most GPs are quite biased against benzos so they love the thought of taking people off of them. But your absolute best option would be to switch to valium and come off that way. If you tolerate klonopin then you can probably tolerate the valium because those two are very similar. I personally hate both of those and they actually make my anxiety worse. They are much different than xanax which is still the best for severe sudden panic attacks. Klonopin doesn't really work as well to take as needed so that's why doctors tend to like it better for long term use to prevent attacks before they start. It works better once you start taking it daily and it tends to be easier to come off of than xanax, but valium is easier to come off of than klonopin.
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I believe this is inaccurate.  As someone who has taken both, I believe klonopin works the longest of any benzo.  It also, because of this, starts working more slowly.  As for the best drug, that is completely dependent on the individual and how his or her body and brain react to the drug.  Xanax caused me more anxiety.  Valium worked somewhat, klonopin worked somewhat better and certainly for a lot longer.  But inasmuch as they're all addictive, the best way to take them is only when absolutely necessary to get through the moment.  And as for stopping, this also depends on the person -- for some it will be impossible, for others easy as pie.  As for a bias against benzos, it's not a bias, it's a fact -- benzos are addictive drugs first off and second off, much research especially in England has shown that regular use causes the brain to forget how to react to stress.  Research in England has also shown that benzos probably cause the most protracted withdrawals of any addictive drug, including alcohol and heroin.  They must be respected.  On the other hand, if that's the only thing that allows you to have a life, then I agree with Scared, you've only got one life and if all else has failed doctors shouldn't be so wed to generalizations.  But Scared, info on here should be accurate, and a lot of what you're printing goes against what I've researched over the years since Paxil withdrawal destroyed my life.  Doctors never told me any of this, and that's scary to contemplate.  And generalizing with these drugs is impossible -- our brains and bodies just don't utilize things the same as others do.  For some, a drug with a shorter half-life might give them longer relief than a drug with a longer one because the brain is utilizing it better or the liver isn't blocking its absorption as much.  Very complex stuff, not subject to simplification.  I'd also add, GPs don't know much about anything -- they're role in medicine today is to send you to someone who knows more.  Psychiatrists know more in general, though a good GP is better than a bad psychiatrist.  What GPs almost never know is how to help you quit taking a drug.  They don't study much in the way of mental illness in med school and they study very little pharmacology.  Problem is, they often act as if they know what they're doing when they don't because these docs are competing for your business.  Try to find a psychopharmacologist, at least with one of those you have a fighting chance they really did study these drugs and how they affect different individuals.  Peace, all.
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