Klonopin Tapering/Weaning Schedule
Medically reviewed byIsaac Alexis, M.D., AAMA, AMP-BC
February 20, 2019
A Klonopin tapering/weaning schedule helps individuals who are dependent on the drug to slowly and safely decrease their dosage, reducing the severity of withdrawal symptoms.
It is possible to develop a physical dependence on Klonopin (clonazepam) after a few weeks, even if it is taken as prescribed. This may be accompanied by mental dependence (addiction), especially if the drug has been abused.
When someone is dependent on a drug, they have symptoms of withdrawal if they stop taking it. Doctors generally taper patients off of benzodiazepines like Klonopin to avoid or reduce withdrawal symptoms.
Klonopin Tapering/Weaning Schedule
Tapering means gradually reducing dosage of Klonopin (clonazepam) until a person is able to stop taking it without experiencing severe or life-threatening withdrawal symptoms. Doctors work with patients to make a Klonopin tapering/weaning schedule, which may be adjusted depending on how a patient reacts.
Examples of a Klonopin tapering/weaning schedule:
- Decrease dosage by 0.5 mg every two weeks until 1 mg is reached, then decrease by 0.25 mg every week.
- Decrease dosage by 25 percent during week one and 10 percent each following week.
- Decrease dosage by 0.25 mg per week until no longer needed.
- For a slower taper, decrease dosage by five to 10 percent every two to four weeks.
The size of an individual’s regular dose affects the length of time needed for tapering. If someone is taking a very high dose (as is often the case with individuals who abuse Klonopin), it will likely take them longer to taper off of it. If someone is taking a low dose, they may be able to wean off of it more quickly, but they may decrease their dosage in smaller increments because the effect could be more drastic.
The slower the tapering process, the less intense and varied withdrawal symptoms are likely to be. Some people are more sensitive to withdrawal symptoms and may need to taper more slowly. A weaning schedule must be tailored to the individual, and it is never recommended that someone adjust their dosage without first consulting a medical professional.
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Substitution Taper Vs. Direct Taper
When someone undergoes a substitution taper, they transition from a drug that leaves the body quickly to one that is expelled more gradually. This allows them to take a lower or less frequent dose while preventing withdrawal symptoms.
Long-acting benzodiazepines like Klonopin (clonazepam) may be used as a substitution taper for short-acting drugs like Xanax (alprazolam). Valium (diazepam) is a long-acting benzodiazepine that replaces many other short-acting drugs during the tapering process.
A direct taper involves a measured reduction of dosage for the primary drug (in this case, Klonopin). This is more commonly used for long-acting benzodiazepines, as they stay in the body for a prolonged period.
Why Taper Off Klonopin (Clonazepam)?
Benzodiazepines like Klonopin (clonazepam) can cause severe withdrawal symptoms. Since these drugs affect brain activity, stopping use can cause electrical disruption in the brain, which may be serious enough to cause seizures. Klonopin withdrawal symptoms may also include psychosis and suicidal thoughts or actions.
Severe withdrawal symptoms prompt many individuals to continue taking Klonopin, which fuels drug abuse, dependence, and addiction. Tapering may be the only way some people are able to stop taking Klonopin. Though withdrawal symptoms may still occur with tapering, they will likely be much milder.
For many individuals, benzodiazepines are significantly less effective after several weeks of treatment. The body quickly develops a tolerance to these drugs, and continuing to take them may do more harm than good.
How Does Tapering Work?
Klonopin (clonazepam) increases the effect of gamma-aminobutyric acid (GABA), which slows down brain activity. This calms the central nervous system and helps the body relax. The body naturally regulates GABA, but when Klonopin is used long-term, it may stop doing this and depend on the drug instead. This weakens the normal functioning of the body and mind, which is why withdrawal symptoms occur once dependence or addiction develops.
Usually, the body and mind can resume proper functioning once the drug is out of the system, but this takes time. When someone abruptly stops taking Klonopin, the harshness of withdrawals can cause additional harm and make mental and physical healing more difficult.
Tapering off Klonopin reduces the stress of the withdrawal process, allowing the body to adjust incrementally to small changes in dosage rather than shocking it into severe withdrawal.
Can You Self-Taper Off Klonopin?
Some people may try to self-taper off Klonopin, thinking that if they reduce their dose gradually, they will be successful. This is a dangerous process. Most individuals struggling with Klonopin dependence are probably not trained in safe tapering practices. It is difficult to measure an appropriate dose reduction and determine safe increments in which to reduce it.
If an individual cuts down their dose too much or too quickly, they may experience some of the severe withdrawal symptoms they are trying to avoid. These symptoms could be deadly, and could be avoided or reduced by working with a medical professional.
Conversely, if someone tries to self-taper and decides it is not working, they may return to their original dose. The purpose of tapering is to allow the body to adjust to lower doses. Depending on how long a person has been tapering off Klonopin, their body may no longer be able to tolerate their original dosage. This can cause overdose and other adverse reactions.
Klonopin Tapering In A Medical Detox Program
Many medical detox programs for Klonopin (clonazepam) dependence provide an inpatient setting for individuals to wean off the drug. These programs are staffed by medical professionals who monitor vital signs and set up a tapering/weaning schedule.
During medically assisted detox, individuals receive adequate nutrition and hydration. They may participate in counseling and behavioral therapy that set a foundation for addiction recovery. Medication may also be administered during this process if needed to help with withdrawal symptoms.
These programs are especially helpful for individuals who have a severe physical dependence on Klonopin, likely accompanied by addiction. Once the drug is out of the body, a person may choose to enroll in an addiction treatment program to prevent relapse.
Drug rehab programs may take place in an outpatient capacity that allows the individual to live at home, or an inpatient environment that eliminates distraction and negative influences. The most effective programs use a wide range of therapies that help recovering individuals to regulate their emotions, cope with stress, and create an overall healthier life.Article Sources
Benzodiazepine Information Coalition - Benzodiazepine Tapering Strategies and Solutions
Drug and Therapeutics Bulletin of Navarre - Spain—Strategies for discontinuing benzodiazepines
U.S. Food and Drug Administration - Klonopin Tablets (Clonazepam)