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
poster:SLS
thread:498386
URL: http://www.dr-bob.org/babble/wdrawl/20050424/msgs/498878.html