Suzy asked
I am currently on .25 mg of clonazapam OD. I want to taper off, what would you suggest to be a safe taper?
Answer
While there is no set in stone way regarding how to taper off benzodiazepines (of which clonazepam is a part of), there certainly are recommendations on how to go about doing it. Most commonly it depends on the length of time you have been taking the medication, the dose you are on and the withdrawal symptoms you are experiencing. I do recommend asking your doctor for advice on how to taper off as well as they probably have a good amount of experience regarding the matter.
Having said that, there are recommendations that I can share with you. The common recommendation I see in practice is the following:
Try decreasing your dose by around 25% the first week, then by 25% the second week, then by about 10% every week thereafter. You may have to taper more slowly than this based on your withdrawal symptoms. As I mentioned previously, there are a lot of factors that go into how to taper this medication appropriately. The biggest factor is how long you have been taking the medication so you always want to adjust the taper based on how you are feeling. Since you are taking the dissolving tablet, you can easily split the tablet to get a more appropriate dose.
Having mentioned withdrawal symptoms a few times, I want to quickly go over what they could be and risk factors for them.
Anyone has a chance of getting withdrawal symptoms after being on benzodiazepines but it appears the greatest risk is for people taking them consistently for greater than 6 month, taking high doses of them, or taking ones that last a short amount of time in the body. Fortunately, 0.25 mg would not be considered a "high" dose" and each dose can last days in the body. The fact that it does last longer in the body usually makes it easier to taper off.
The possible withdrawal symptoms are the following: Sweating/nervousness, fast heart beat, trouble sleeping, agitation, nausea/vomiting and in severe cases hallucinations and seizures. This is really a list of ALL the possible problems and typically people really only experience a few of them.
So, the taper method I described above is but one possibility for you. The most important thing is try the taper and then adjust based on your symptoms. I do recommend getting your doctors advice as well as they may have recommendations for you and could monitor possible side effects.
