I really admire your guts Jack. Because that is what it is.
On Monday I took 10 mg of Diazepam, woke up on Tuesday with tinnitus gone all day. My painful sensitivity to sound also alleviated. Today it´s blasting super high pitch fucking crazy in my right ear, spreading across the brain. It´s an excruciating feeling.
I know benzos will help like magic, but I´m so skeptic to its sustainability. I don´t dare taking it every day or even every week. I should make aware that I have a problematic history with benzo addiction and withdrawal in the past and maybe even present so I´m well aware of the consequences.
Well, your tinnitus is relatively fresh, so you still have a window where that is a possibility. But I´m afraid taking a healthy dose of benzo, like you are, hoping it will get better, and then taper off, is wishful thinking IMO.
The way this drug works and how it affects the brain, in our case a brain with local hyperactive activity (tinnitus) it just doesn´t seem viable.
So how does it work in regards to tinnitus (as I have come to believe at least):
1) Benzo binds to GABA-a receptors in our brain, this prompts a biochemical reaction on a cellular level and has a calming (inhibitory) effect on our neurons/cells.
2) Tinnitus often originates in a part of our reptile brain called Dorsal Cochlea Nucleus (DCN). It´s these hyperactive neurons called Fusiform cells that spreads to the brain from the DCN and we perceive it as sound/noise. Like the rest of the brain, the DCN has many GABA-a sites, thus this inhibitory effect will occur and alleviate or remove our perception of tinnitus completely as long as we keep up with the benzo. It it a powerful drug to filter tinnitus away from our conscience.
The problem, however, is that the brain will always seek balance. In this case, after affecting the GABA-a receptors, over time, it will increase the flow of Glutamate. Glutamate does the exact opposite of GABA. It has an excitatory/stimulative effect on our neurons. An important neurotransmitter for learning and keeping attention, but not so good when in excess and in controlling the activity of the DCN and to keep tinnitus under control.
When one stops taking benzos the gabaergic/glutamatergic system is out of balance. No more calming effect, as your GABA-a receptors would be downregulated in addition to the heightened stimulative/hyperactive effect of the Glutamate.
This can take a long time to balance itself out naturally and there is no real way to speed up this process. We have talked about Flumazenil on this forum, but not sure it would help as a way to upgrade your GABA-a receptors.
I have thought long and hard about this, both because I am in protracted withdrawal and I want to make this way of treatment viable. Maybe benzos and a strong NMDA- receptor (binding site for Glutamate) antagonist like Ketamine, to cover for the excess glutamate would do the trick? I don´t know and nobody really seems to do real research on the subject. Ketamine, though, is in the limelight at the moment for treating depression.
I dont´t mean to startle you, but better to be informed if you are not.
I see quite a few people going this benzo route now, many with added Gabapentin.
I have not been able to make a choice so I end up taking it sparingly, getting short time relief and probably upholding my protracted withdrawal.
If one only knew how long it would work, how long can one keep up-dosing when tolerance kicks in and you would need more to keep tinnitus & hyperacusis suppressed?
Will our GABA-a receptors eventually be completely depleted? How many years to reach that point?
Some people take benzos for a lifetime without up-dosing. Why is that?
In (my) reality it´s a question of killing myself now or take benzos for a "no way to know how long", but enjoy life and kill my self when it becomes futile in suppressing tinnitus. Or what if a cure comes along and you get rid of your tinnitus, but now you must get off benzos again, which is "hell on earth" and something I don´t think I would survive going through again. Maybe even the glutamate storm in my brain and ears will kill off my newly regenerated hair cells. Then what?
I am in a middle of an AD (Venlafaxine) withdrawal right now. I´m on two kinds and feel poisoned already. Not in a good place at all and can´t make a decision about anything right now. And the question of going all in on benzos, or not, is the hardest one to make ever in my life. Long term thinking it's the choice between two evils.
All I am is anxiety, tremors and screaming ultra high pitched tinnitus and so broken by my noxacusis. I have all the reasons to take benzos, but as I´ve said, I don´t have the guts.
Somebody tell me, what is the right decision?
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