Alcohol Relapse Combined with Benzo Abuse Resulting in Really Loud Tinnitus

[Liam_Cairns]

Hey guys. I wrote back in November about tapering off Benzos. I went from 15 mg of Valium down to 7.5 mg of Valium. Doing so, I had a bit of loud tinnitus but nothing crazy.

However, around the start of March I had several family members die and a vengeful ex causing chaos in my life and so I just kind of lost it. I completely derailed my taper, I was taking opiates with huge doses of Clonazepam and just binge drinking most nights. I was mentally in a really bad place. On the 14th of this month I decided to get myself together. I stopped drinking, I stopped taking opiates and was only taking 7.5 mg of Valium.

I just want to make clear this entire time I maintained taking the 7.5 mg of Valium every day without fail. I had a really frank discussion with my psychiatrist about my drug abuse and he was very understanding. However, about 3 days after my last dose of Clonazepam my tinnitus became incredibly loud.

I had 0 other withdrawal symptoms strangely enough (I normally experience pretty violent physical symptoms before my tinnitus spikes). So for two weeks I just kind of left it in hopes that it would subside, however, it hasn't. It has stayed just as pissed off.

Tonight, after speaking with my psychiatrist, I decided to up the Valium to 20 mg and then go down to 15 mg the next day, and then 10 mg, and see how my tinnitus reacts. He thinks I just might need to start my taper a bit higher and he is trying to find the lowest possible dose that quietens my tinnitus so that I can start the taper from there. I took the initial Valium dose of 20 mg tonight and my tinnitus has been much better.

I just wanted to ask is this a good idea or should I just stick to the 7.5 mg of Valium I was at and just keep going from there? I feel so fucking stupid and like such a failure,

I hate these drugs so much. I just want them out of me, but I know if I rapid taper I will just destroy my CNS. Any advice would be much appreciated. By the way, when I said I had gone sober, I mean absolutely everything except Keppra 1500 mg and Melatonin 20 mg.

Thanks,
Liam.

 

[Jebbis]

I am no expert in these drugs, but I do know that something as "benign" as nicotine withdrawal can skyrocket tinnitus volume and intrusiveness for a pretty long time. I had a bad spike from about March 28th to April 20th that started 2 days after I cold turkey quit vaping.

My best guess is that you should probably follow your doctor's advice. Also, don't beat yourself up or call yourself a failure. There's a saying that has really helped me in all of this, and it's this: "Start where you are at."

You can't dwell on past events, if you messed up or not, whatever. This is where you are now. Start there. Don't feel like you went backwards. Life happens, to everybody. Start the higher taper, focus on other aspects of healing such as sleep, eat good foods, cut down on inflammation, do anything active you can do take your mind out of your brain if that makes sense.

Again, I am no expert. Sounds like your doctor wants you to be comfortable, but I also think any spike you are experiencing is likely to go back down to baseline with some lifestyle changes.

 

[linearb]

@Liam_Cairns, super sorry to hear you're going through this.

Clonazepam is a bit of a unicorn; all the benzos have GABA-A receptor activity but Clonazepam also hits GABA-B (which is what non-racemic baclofen hits, which is why I thought it might help my tinnitus -- I've taken 2 mg/day for years now along with Gabapentin).

I suspect the 7.5 mg Valium isn't actually covering for whatever your benzo tolerance/dependence is. If you can tolerate life then I would try to stick at 7.5 mg and see if things level out over a period of months. If you can't then I would think about trying to do something like get on 1-2 mg/day Clonazepam, ditch the Valium completely, ride that out and see where it goes.

Another thing to keep in mind -- you may never find a "slow enough" taper to prevent tinnitus worsening at least temporarily, because withdrawal sucks and impacts you no matter how slow you do it. I've done two sixteen month tapers off benzos and my tinnitus was excruciating at the end of both of them (and the first time was pre-worsening, before my tinnitus in general was much of a problem).

Good luck, this stuff is complicated chemically and when you also get bombed with a ton of shitty life circumstances and other stuff like narcotics, it's that much more insane.

I wish I could be more helpful, I have a pretty good idea of exactly what you're going through.

 

[Liam_Cairns]

@Liam_Cairns, super sorry to hear you're going through this.

Clonazepam is a bit of a unicorn; all the benzos have GABA-A receptor activity but Clonazepam also hits GABA-B (which is what non-racemic baclofen hits, which is why I thought it might help my tinnitus -- I've taken 2 mg/day for years now along with Gabapentin).

I suspect the 7.5 mg Valium isn't actually covering for whatever your benzo tolerance/dependence is. If you can tolerate life then I would try to stick at 7.5 mg and see if things level out over a period of months. If you can't then I would think about trying to do something like get on 1-2 mg/day Clonazepam, ditch the Valium completely, ride that out and see where it goes.

Another thing to keep in mind -- you may never find a "slow enough" taper to prevent tinnitus worsening at least temporarily, because withdrawal sucks and impacts you no matter how slow you do it. I've done two sixteen month tapers off benzos and my tinnitus was excruciating at the end of both of them (and the first time was pre-worsening, before my tinnitus in general was much of a problem).

Good luck, this stuff is complicated chemically and when you also get bombed with a ton of shitty life circumstances and other stuff like narcotics, it's that much more insane.

I wish I could be more helpful, I have a pretty good idea of exactly what you're going through.

Hi @linearb, I really appreciate the response. I know you have quite an extensive history with Clonazepam and so I don't mean this to come off as disrespectful at all, but are you sure that Clonazepam actually hits GABA-B receptors in humans? I know in rat dissections there is evidence but that doesn't correlate to humans directly (I do obviously understand why we use rats in science) as obviously measuring that kind of stuff is virtually impossible without killing someone.

Also, I stupidly left out something really important which is that on the 24th of April I started taking Guanfacine and I have a very strong suspicion that it aggravated my tinnitus, I noticed like the day after taking it my tinnitus was so pissed off. I think I just didn't realize it initially because the Clonazepam and alcohol were hiding the increase. It is hard to tell how much I was actually taking during that period and how frequently, I know that it was mainly drinking that I was doing pretty consistently, but there were periods there where I took like a week's break from Clonazepam and I was fine, but it is hard to honestly remember, the whole thing was a blur. I was just taking mega doses basically, I mean I went through 25 mg in about 2 months so obviously I was going way overboard. I will say though when I first had withdrawals and went from Clonazepam to Diazepam back in November I experienced like a tonne of physical symptoms, but this time around I get zero physical symptoms, like absolutely nothing which makes me think that my tolerance hasn't changed. Do you think that makes sense or is there possibly another reason for that? Like when I up my dose I get that high that I used to get when I first started taking it, but when I take 7.5 mg I just feel normal.

Also I just wanted to say thank you for your kind words man, that genuinely meant a lot to me. I am just glad I caught myself early. I am going to trial 1 mg of Clonazepam tomorrow and see if that changes anything but I have a sneaking suspicion that this is just the Guanfacine leftover effects, it works on a similar serotonin sub-receptor that Venlafaxine activates and that stuff absolutely wrecked my ears so it makes sense.

 

[linearb]

Hi @linearb, I really appreciate the response. I know you have quite an extensive history with Clonazepam and so I don't mean this to come off as disrespectful at all, but are you sure that Clonazepam actually hits GABA-B receptors in humans? I know in rat dissections there is evidence but that doesn't correlate to humans directly (I do obviously understand why we use rats in science) as obviously measuring that kind of stuff is virtually impossible without killing someone.

I have no evidence, and I've never even taken non-racemic Baclofen and witnessed it suppressing my tinnitus, so I am being extremely speculative here. It's also worth pointing out that the equivalent Diazepam dose to my current Klonopin dose (2 mg) would be 30-40 mg/day -- I never took Valium at doses even vaguely that high, it's possible that doing so would be as effective as Klonopin; I prefer Klonopin for various reasons that may not be entirely science based

Also, I stupidly left out something really important which is that on the 24th of April I started taking Guanfacine and I have a very strong suspicion that it aggravated my tinnitus, I noticed like the day after taking it my tinnitus was so pissed off.

Well, you just named a drug that I had to Google and then still not recognize and go read about, so that's something that doesn't usually happen on here

Guanfacine is a highly selective agonist of the α2A adrenergic receptor, with low affinity for other receptors. However it may also be a potent 5-HT2B receptor agonist, potentially contributing to valvulopathy.

I can't remember if α2A adrenergic drugs are linked to tinnitus spikes or not, but anything that's messing with the serotonin system can muck with how tinnitus sounds. I would not be particularly worried about long term damage, especially if you only took it short term, but once things get rattled it can take a while for them to settle.

I will say though when I first had withdrawals and went from Clonazepam to Diazepam back in November I experienced like a tonne of physical symptoms, but this time around I get zero physical symptoms, like absolutely nothing which makes me think that my tolerance hasn't changed. Do you think that makes sense or is there possibly another reason for that? Like when I up my dose I get that high that I used to get when I first started taking it, but when I take 7.5 mg I just feel normal.

This resonates with me; you would think that after being on 2 mg/day for years, minor dose variations would not really matter much, but I've definitely had days where things are especially shitty and I take an extra pill (my provider knows this) and it sometimes seems to hit me as hard as 1 mg did with no tolerance. But, it's variable.

Benzos are extremely weird and unpredictable, tolerance to them is likewise, and for every person who swears they had their lives ruined by them there's someone else who says they're a lifesaver, and someone like me who says "well they are super dangerous and I dislike them but prefer taking them to not, for the moment". It is pretty hard to predict; there are dedicated benzo forums where people have more experience, for sure, but like all chronic health forums those can be a trap.

Also I just wanted to say thank you for your kind words man, that genuinely meant a lot to me. I am just glad I caught myself early. I am going to trial 1 mg of Clonazepam tomorrow and see if that changes anything but I have a sneaking suspicion that this is just the Guanfacine leftover effects, it works on a similar serotonin sub-receptor that Venlafaxine activates and that stuff absolutely wrecked my ears so it makes sense.

You are very welcome and I hope things level out for you soon. If 1 mg of Klonopin makes life seem livable or better, my personal best advice would be to stick with that for some period of time (months?) while also skipping alcohol and other drugs, and then if things are still fine you can try very slowly backing off the dose.

 

[Maria Francesca]

@Liam_Cairns, hope you are feeling better. Just want to comment that at least with benzo induced tinnitus there is always hope. I started taking benzos (Bromazepam, Lorazepam, Clonazepam) in June 2020 when my original tinnitus started in order to sleep, but I rapidly developed tolerance and benzo tinnitus added to the previous one.

Starting in December 2020 I spent 6 months tapering with Clonepazepam. After stopping, things started to improve and after two months I have benzo tinnitus approximately one day per week and not hard as before. Original tinnitus persist.

 

[GoatSheep]

@Liam_Cairns, hope you are feeling better. Just want to comment that at least with benzo induced tinnitus there is always hope. I started taking benzos (Bromazepam, Lorazepam, Clonazepam) in June 2020 when my original tinnitus started in order to sleep, but I rapidly developed tolerance and benzo tinnitus added to the previous one.

Starting in December 2020 I spent 6 months tapering with Clonepazepam. After stopping, things started to improve and after two months I have benzo tinnitus approximately one day per week and not hard as before. Original tinnitus persist.

How are you doing with tinnitus in general now? Has your benzo tinnitus continued to improve?

 

[dd314]

I've never even taken non-racemic Baclofen and witnessed it suppressing my tinnitus, so I am being extremely speculative here.

Wait, do you mean that Baclofen did in fact suppress your tinnitus?

 

[berdichevskyivan]

@Liam_Cairns, hope you are feeling better. Just want to comment that at least with benzo induced tinnitus there is always hope. I started taking benzos (Bromazepam, Lorazepam, Clonazepam) in June 2020 when my original tinnitus started in order to sleep, but I rapidly developed tolerance and benzo tinnitus added to the previous one.

Starting in December 2020 I spent 6 months tapering with Clonepazepam. After stopping, things started to improve and after two months I have benzo tinnitus approximately one day per week and not hard as before. Original tinnitus persist.

Hi Maria, how are you doing nowadays?

I'm tapering off 2 mg Klonopin and 1 mg Xanax in order to hopefully turn down the volume of my tinnitus and I hope I can get it to be like your experience. I know I will have to wait some time (months or years) until my GABA-A receptors return back to normal but it seems feasible.

 

[dd314]

Hi @linearb, I really appreciate the response. I know you have quite an extensive history with Clonazepam and so I don't mean this to come off as disrespectful at all, but are you sure that Clonazepam actually hits GABA-B receptors in humans? I know in rat dissections there is evidence but that doesn't correlate to humans directly (I do obviously understand why we use rats in science) as obviously measuring that kind of stuff is virtually impossible without killing someone.

Also, I stupidly left out something really important which is that on the 24th of April I started taking Guanfacine and I have a very strong suspicion that it aggravated my tinnitus, I noticed like the day after taking it my tinnitus was so pissed off. I think I just didn't realize it initially because the Clonazepam and alcohol were hiding the increase. It is hard to tell how much I was actually taking during that period and how frequently, I know that it was mainly drinking that I was doing pretty consistently, but there were periods there where I took like a week's break from Clonazepam and I was fine, but it is hard to honestly remember, the whole thing was a blur. I was just taking mega doses basically, I mean I went through 25 mg in about 2 months so obviously I was going way overboard. I will say though when I first had withdrawals and went from Clonazepam to Diazepam back in November I experienced like a tonne of physical symptoms, but this time around I get zero physical symptoms, like absolutely nothing which makes me think that my tolerance hasn't changed. Do you think that makes sense or is there possibly another reason for that? Like when I up my dose I get that high that I used to get when I first started taking it, but when I take 7.5 mg I just feel normal.

Also I just wanted to say thank you for your kind words man, that genuinely meant a lot to me. I am just glad I caught myself early. I am going to trial 1 mg of Clonazepam tomorrow and see if that changes anything but I have a sneaking suspicion that this is just the Guanfacine leftover effects, it works on a similar serotonin sub-receptor that Venlafaxine activates and that stuff absolutely wrecked my ears so it makes sense.

Anything that affects blood flow can affect tinnitus. Guanfacine gives people hypotension at first.

 

[linearb]

Wait, do you mean that Baclofen did in fact suppress your tinnitus?

No; my belief is that one of the isomers in Baclofen helps with tinnitus and the other competes with this effect. All prescription Baclofen I am aware of is racemic. I have seen studies done using material prepared for the studies, and I have seen people attempting to put together custom synthesis buy efforts of the desired isomer, but I have no other knowledge or experience.

I believe that importing a synthesized Baclofen isomer is a felony along multiple lines.