Benzo — Mechanism of Action

[Lisa88]

Hi Dr. Nagler,
Just to recap, I have been on Lorazepam for six weeks a@ .5mg per night. It has helped me to sleep, cut my sounds by 50%, and somewhat evened out the reactive side/fluctuations of my t. I intend to be on it for a while longer. Extensive audio testing including high freq. audiogram and OAE's, shows normal hearing. My t was triggered 5 months ago by local anesthetic Lidocaine, administered at the same time as a menstrual migraine. I have been told that for me, t is more likely change in brain chemistry than an inner ear disfunction. So here is my question:
With the theory that t is excitatory neurotransmitters overfiring, and Lorazepam then gating that with inhibitory gaba mechanism of action - then surely tapering off Lorazepam will cause my t to recede back to where it was, or become even worse, as my natural gaba will be even weaker?
What is your medical opinion on this?
Thanks, as ever, Dr. Nagler!
Lisa

 

[Dr. Nagler]

So here is my question:
With the theory that t is excitatory neurotransmitters overfiring, and Lorazepam then gating that with inhibitory gaba mechanism of action - then surely tapering off Lorazepam will cause my t to recede back to where it was, or become even worse, as my natural gaba will be even weaker?
What is your medical opinion on this?

Lisa, your question brings up an interesting point.

You ask my medical opinion on a conclusion you have drawn based on (1) a theory about the nature of tinnitus and (2) a mechanism of action for a medication that has never been established in vivo. So I guess I should answer your question with a question of my own: How can I possibly give you a responsible medical opinion to a question founded upon such tenuous supposition?

Instead, I will give you a responsible medical opinion of a different sort: Since in 2014 we do not yet have a predictable way to lastingly mitigate the tinnitus signal itself, I respectfully suggest that you would be far better off focusing on the established effective approaches for lastingly mitigating your reaction to that signal.

Best regards -

Dr. Stephen Nagler