Clonazepam (Klonopin, Rivotril)

Eek. I just started taking a GABA supplement (GABA Calm). Will this cause the same reaction in the brain (even though most people say the supplement doesn't even cross the blood brain barrier)?
I don't think so. GABA supplements are much less specific and potent than benzos or gabapentinoids (although the molecules of gabapentinoids look very similar to those of GABA). Also, as you said the general supplement won't cross the blood brain barrier (BBB) unless you have a leaky one. Some people use this as a test on the BBB. If GABA supplements have an effect on calming the brain, then it means the BBB is not working properly.

Anyway, there are forms of GABA supplements that are designed to cross the BBB I believe, maybe PharmaGABA. As @grate_biff was saying, the issue is very nuanced. To get an idea on GABA supplementation, there is a good article here we posted in the past. It's very nuanced and confusing, because if your GABA-Glutamate conversion mechanism is compromised, in trying to increase GABA you'll end up increasing Glutamate instead. It's a mess. In any case, some people benefit from benzos, at least for some time, but tolerance is an issue and if you hit it, it can become a nightmare.

@grate_biff, how are you doing man? Still in worsening hell here.
 
It comes down to calming down the neurons in the DCN, called fusiform cells.

Benzos do a good job at this by opening the GABA-A receptors for influx of chloride ions in presense of GABA.

This is what inhibits or calms the cells down. The problem is, over time, continuing benzos, the receptors becomes un-coupled or down-regulated, thus one becomes tolerant to the drug.

Glutamate is also produced in excess to counteract the effect of benzos in an effort to seek balance. Glutamate affects the AMPA- and NMDA- receptors with lots of neuro-excitability effects. NMDA receptors are known to thrive where there is nerve damage. So there is that on top then.

The GABAergic and the Glutamatergic system out of balance is bad news for your CNS, your DCN and tinnitus.

I don't think there is any shortage of GABA in withdrawal. The body just can't make use of it.

It's very complicated and delicate systems.

To make things even more puzzling, GABA is synthesized from Glutamate :confused:
That's where I understand I don't understand :dohanimation:

In short, benzos are NOT a sustainable treatment for tinnitus imo.
Thanks. Awesome explanation.

Quick question:

Many report tinnitus worsening from benzo withdrawal is temporary.

Do you agree with this?

Once the system is back in balance, does the aggravation of the Fusiform Cells stop and normal function returns?
 
What's Tinnitus Talk's take on 0.25 mg Klonopin 1-2x a week? I was on it for 41 days total (including taper) until two weeks ago when I finished tapering and quit completely without too much issue.

I would be taking it for sleep, as it's been very difficult since the appearance of tinnitus.

I'm scared of developing tolerance / side effects / worsening tinnitus and hyperacusis, however.
 
What's Tinnitus Talk's take on 0.25 mg Klonopin 1-2x a week? I was on it for 41 days total (including taper) until two weeks ago when I finished tapering and quit completely without too much issue.

I would be taking it for sleep, as it's been very difficult since the appearance of tinnitus.

I'm scared of developing tolerance / side effects / worsening tinnitus and hyperacusis, however.
I've been taking anywhere from 0.25 mg 2x a week or 0.5 mg once a week for quite a while now. I do not seem to have developed any tolerance as I can still discern effect from as little as 0.125 mg sublingual (I try to take the smallest possible dose first). And 0.25 mg or 0.5 mg orally still has the same effect as it did when I started.

Whether this is wise or not is certainly debatable. For me, I don't have a problem with repeat dosing. The risk is whether even these small and ~infrequent doses can cumulatively impair neurological function.
 
I've been taking anywhere from 0.25 mg 2x a week or 0.5 mg once a week for quite a while now. I do not seem to have developed any tolerance as I can still discern effect from as little as 0.125 mg sublingual (I try to take the smallest possible dose first). And 0.25 mg or 0.5 mg orally still has the same effect as it did when I started.

Whether this is wise or not is certainly debatable. For me, I don't have a problem with repeat dosing. The risk is whether even these small and ~infrequent doses can cumulatively impair neurological function.
Thanks for the information. Do you use it for sleep? I'm experimenting with CBD and have a prescription for low dose Seroquel but do not feel comfortable resorting to antipsychotics as sleep aids.
 
Do you use it for sleep? I'm experimenting with CBD and have a prescription for low dose Seroquel but do not feel comfortable resorting to antipsychotics as sleep aids.
In effect I do as I take it in the evening. I've long had a slight anxiety disorder where the slightest stressor in life will wreck my sleep. It's no wonder tinnitus has happened.

I'd be curious to try Seroquel, just because I'm in to trying things.
 
In effect I do as I take it in the evening. I've long had a slight anxiety disorder where the slightest stressor in life will wreck my sleep. It's no wonder tinnitus has happened.

I'd be curious to try Seroquel, just because I'm in to trying things.
Seroquel at 12.5 mg does not work as an antipsychotic and will only touch histamine receptors and not go near dopamine.

Mirtazapine at 7.5 mg has a similar effect.
 
What's Tinnitus Talk's take on 0.25 mg Klonopin 1-2x a week? I was on it for 41 days total (including taper) until two weeks ago when I finished tapering and quit completely without too much issue.

I would be taking it for sleep, as it's been very difficult since the appearance of tinnitus.

I'm scared of developing tolerance / side effects / worsening tinnitus and hyperacusis, however.
Don't do it. Stay off of all drugs.
 
Don't do it. Stay off of all drugs.
Totally agree with this.

At onset I would have probably taken any antidepressant drugs I could have got my hands on. I'm happy that it's pretty tough to get them prescribed over here (Denmark) - so never went down that rabbit hole. If I had been back living in my other home (London, UK) at the time, not sure if thy would have been easier to acquire?

I think it's just the unknown of taking them that it can get worse and you don't know if it's the drug or just natural worsening. I might not have ever got 90% better like I am today compared to onset just over 2 years ago. I really feel for those that have not had any improvement :(
 
You have made a wise decision, benzos are dangerous drugs and should not be taken long term for this reason.

Unfortunately my tinnitus has not settled back to its baseline but I am only 11 weeks off the benzo and still have many other horrible symptoms due to withdrawal.

Things are slowly starting to improve with some symptoms, so I am still hoping that my tinnitus will eventually settle some more.

Withdrawal can go on for lengthy periods, some people experience symptoms for years after ceasing. Do a slow taper and hopefully you will not experience any problems.

You can contact me anytime if you need any further help with your taper :huganimation:
Hi Star,

Going through a similar situation to you.

When you switched from Clonazepam to Valium, did your tinnitus get worse or stay about the same? I am split between switching over or direct tapering from Clonazepam.

Do you mind me asking how long your total taper was?

Have things improved since you posted about it last?

Thanks and hope you are feeling better.
 
I don't know why anyone in the tinnitus community would advocate to take benzos.

I'm amazed at how many doctors and people push for benzos to help cope with tinnitus. Why would anyone suggest any drugs that mess with the brain when tinnitus is already messing with things enough once you got it.

Screenshot_20220918-123328_Reddit.jpg
 
Why would anyone suggest any drugs that mess with the brain when tinnitus is already messing with things enough once you got it.
Because short term benzos work wonders.

I remember in the beginning, 5 mg of Diazepam would give me relief for a week. Sometimes 10 mg would totally mute it for two days. How can one resist that? But eventually, you will have to pay for it :cry:

Listen, I'm a veteran when it comes to this issue and I don't believe for one second that benzos and withdrawals do any kind of permanent damage. I'm sure your reactivity will improve. Patience is key, although hard.

Actually, I have a theory that through withdrawal, we can fool the brain to let tinnitus go away in the end.

Here is why (trying to be simplistic):

1) Nerve damage to the inner ear. The brain, with DCN being the central part, is actively occupied searching for the lost input. For me this was quite obvious because I had a constant rhythmic tinnitus going through a constant loop at the octave intervals where my dip in hearing lies (8 kHz - 12.5 kHz). Drrrrrrrrrrrrr (upwards in frequency) and it would end on a zing (very high pitched that was painful).

2) Now this goes on for a while. Then the brain stops searching for lost input and then either the tinnitus goes away, gets better or worse, but somehow it changes and this is where it becomes "a brain thing". The brain is not really bothered by the loss of input anymore, but the (hyper) activity in the DCN remains, but now because of mechanisms similar or exactly like "phantom limb pain".

For me, the rhythmic loop ended and I was left with a high pitched squeal. Not pleasant, but more stable, a less organic feel to it. I could also feel a change of perception switching from my ears to my brain. It was subtle and I could be biased as this is following the theory I have learned to believe.

And bear in mind, this was my process. I know it can be a totally different story/process for others.

I will just add that it took three acoustic traumas for my tinnitus to become chronic. The first two times (2001 & 2008) my tinnitus lasted for some months and then went away. I thought this was the nature of tinnitus so sadly I did not learn much from it, taking care of my ears. From 2014 it has stayed with me :sour:

3) To the interesting part regarding benzo withdrawals and how the brain can be fooled to slow down the fusiform cells in the DCN. If I am right in that the brain eventually disregards the hearing loss (bad news for inner hair cell regeneration as a possible treatment, not that I disregard this AT ALL!).

But it makes things a little easier, because it falls more on brain chemistry. Easier, but by no means easy, as I believe all our voltage-gated pathways, neurotransmitters and hormones could play a part in upholding but also curing this fucking senseless affliction. It also means thousands of different approaches could work.

As far as I know, maybe apart from some very specific voltage gated channels, GABA and GABA-receptors, Glutamate and NMDA-receptors plays the high ranking role regarding inhibition and hyperexcitability of the CNS and the DCN.

4) So to my optimistic view/theory then. When in benzo withdrawal, you are causing even more havoc to the part(s) of your brain already in hyperactive mode because of this "phantom limb" effect where many seem to believe Glutamate plays a role in the first place, thus making tinnitus even worse (reactivity, louder, higher pitch and a more electrical feel are all things that I have felt/is feeling during withdrawal). Well, what if then, even though a drawn out and terrible process, when we eventually heal, maybe the brain forgets about its initial hyperactivity and we end up better off than before we threw benzos at it :wideyed:

I've read a lot of stories of people who initially became dependent on benzos because of anxiety and panic disorder and went through hell getting off it, but came out the other end free from the former problems and felt better than ever (y)

This is also my experience. I´ve been through 2-3 wd´s in my life. In 2018 I was free from benzos after a long withdrawal. I remember two evenings in the summer where my tinnitus would just fade down to nothing. That has never happened before or after in that way because I fucked up again and got back on it, chasing tinnitus free days. If I had remained absent, god knows where I would have been today. Benzos are a sickness for me. Been on/off since 1993.

I must add I was also down and stable on 7.5 mg from 30 mg of Mirtazapine at the time. I think boosting our serotonin levels artificially is not good news for tinnitus, as it is a stimulant. But antidepressants will relieve you of stress and depression so it's a tough choice.

That's it from me. Hope you like my theory? I have written this whole post with my virtual keyboard (too sick to sit in an upright position and use a keyboard). It took me around 3-4 hours to write the bloody thing ;)
 
Because short term benzos work wonders.

I remember in the beginning, 5 mg of Diazepam would give me relief for a week. Sometimes 10 mg would totally mute it for two days. How can one resist that? But eventually, you will have to pay for it :cry:

Listen, I'm a veteran when it comes to this issue and I don't believe for one second that benzos and withdrawals do any kind of permanent damage. I'm sure your reactivity will improve. Patience is key, although hard.

Actually, I have a theory that through withdrawal, we can fool the brain to let tinnitus go away in the end.

Here is why (trying to be simplistic):

1) Nerve damage to the inner ear. The brain, with DCN being the central part, is actively occupied searching for the lost input. For me this was quite obvious because I had a constant rhythmic tinnitus going through a constant loop at the octave intervals where my dip in hearing lies (8 kHz - 12.5 kHz). Drrrrrrrrrrrrr (upwards in frequency) and it would end on a zing (very high pitched that was painful).

2) Now this goes on for a while. Then the brain stops searching for lost input and then either the tinnitus goes away, gets better or worse, but somehow it changes and this is where it becomes "a brain thing". The brain is not really bothered by the loss of input anymore, but the (hyper) activity in the DCN remains, but now because of mechanisms similar or exactly like "phantom limb pain".

For me, the rhythmic loop ended and I was left with a high pitched squeal. Not pleasant, but more stable, a less organic feel to it. I could also feel a change of perception switching from my ears to my brain. It was subtle and I could be biased as this is following the theory I have learned to believe.

And bear in mind, this was my process. I know it can be a totally different story/process for others.

I will just add that it took three acoustic traumas for my tinnitus to become chronic. The first two times (2001 & 2008) my tinnitus lasted for some months and then went away. I thought this was the nature of tinnitus so sadly I did not learn much from it, taking care of my ears. From 2014 it has stayed with me :sour:

3) To the interesting part regarding benzo withdrawals and how the brain can be fooled to slow down the fusiform cells in the DCN. If I am right in that the brain eventually disregards the hearing loss (bad news for inner hair cell regeneration as a possible treatment, not that I disregard this AT ALL!).

But it makes things a little easier, because it falls more on brain chemistry. Easier, but by no means easy, as I believe all our voltage-gated pathways, neurotransmitters and hormones could play a part in upholding but also curing this fucking senseless affliction. It also means thousands of different approaches could work.

As far as I know, maybe apart from some very specific voltage gated channels, GABA and GABA-receptors, Glutamate and NMDA-receptors plays the high ranking role regarding inhibition and hyperexcitability of the CNS and the DCN.

4) So to my optimistic view/theory then. When in benzo withdrawal, you are causing even more havoc to the part(s) of your brain already in hyperactive mode because of this "phantom limb" effect where many seem to believe Glutamate plays a role in the first place, thus making tinnitus even worse (reactivity, louder, higher pitch and a more electrical feel are all things that I have felt/is feeling during withdrawal). Well, what if then, even though a drawn out and terrible process, when we eventually heal, maybe the brain forgets about its initial hyperactivity and we end up better off than before we threw benzos at it :wideyed:

I've read a lot of stories of people who initially became dependent on benzos because of anxiety and panic disorder and went through hell getting off it, but came out the other end free from the former problems and felt better than ever (y)

This is also my experience. I´ve been through 2-3 wd´s in my life. In 2018 I was free from benzos after a long withdrawal. I remember two evenings in the summer where my tinnitus would just fade down to nothing. That has never happened before or after in that way because I fucked up again and got back on it, chasing tinnitus free days. If I had remained absent, god knows where I would have been today. Benzos are a sickness for me. Been on/off since 1993.

I must add I was also down and stable on 7.5 mg from 30 mg of Mirtazapine at the time. I think boosting our serotonin levels artificially is not good news for tinnitus, as it is a stimulant. But antidepressants will relieve you of stress and depression so it's a tough choice.

That's it from me. Hope you like my theory? I have written this whole post with my virtual keyboard (too sick to sit in an upright position and use a keyboard). It took me around 3-4 hours to write the bloody thing ;)
Thank you so much for the hope. I pray you are right and I can see some improvement. It is a bloody battle from hell to get off the benzos. I'm tapering down from 1 mg of Klonopin, currently down to 0.5 mg and I've never been worse. Loudness hyperacusis is off the charts and my brain and ears are on fire. I have read your words here over and over to keep hope alive in my mind. I must survive this somehow. I send good vibes to all that are suffering. We gotta make it. We just have to.
 
I take 300 mg of Gabapentin in the morning, then at night I take the other 300 mg of Gabapentin along with the 0.5 mg of Clonazepam. People have very strong opinions of Clonazepam but it has helped me tremendously.
@Carlos1, is your tinnitus of central origin? I was reading the literature of Gabapentin + Clonazepam. It states disabling severity of central type for this combo.
 
@Carlos1, is your tinnitus of central origin? I was reading the literature of Gabapentin + Clonazepam. It states disabling severity of central type for this combo.
My tinnitus has been stable for the last 2 years, thank God. Since then I have weened off Gabapentin and am just on Clonazepam. My tinnitus is unilateral; in the left ear only. It's been almost 10 years since I got tinnitus and I'm finally at the stage where I can say for the most part I can ignore it now. I still hear it loud and clear and still have my tough days but I can live my life. I never believed I could accept tinnitus but here I am 10 years later and I can say I've made peace with my tinnitus.

I wish you well my friend. Stay strong.
 
My tinnitus has been stable for the last 2 years, thank God. Since then I have weened off Gabapentin and am just on Clonazepam. My tinnitus is unilateral; in the left ear only. It's been almost 10 years since I got tinnitus and I'm finally at the stage where I can say for the most part I can ignore it now. I still hear it loud and clear and still have my tough days but I can live my life. I never believed I could accept tinnitus but here I am 10 years later and I can say I've made peace with my tinnitus.

I wish you well my friend. Stay strong.
Great to hear all this Carlos. Can you tell me how long you spent ramping down the Gabapentin and from what dose?

I want to get off that one I think.
 
My tinnitus has been stable for the last 2 years, thank God. Since then I have weened off Gabapentin and am just on Clonazepam. My tinnitus is unilateral; in the left ear only. It's been almost 10 years since I got tinnitus and I'm finally at the stage where I can say for the most part I can ignore it now. I still hear it loud and clear and still have my tough days but I can live my life. I never believed I could accept tinnitus but here I am 10 years later and I can say I've made peace with my tinnitus.

I wish you well my friend. Stay strong.
@Carlos1, that's great news for you. Thanks for replying.
 
I've been taking anywhere from 0.25 mg 2x a week or 0.5 mg once a week for quite a while now. I do not seem to have developed any tolerance as I can still discern effect from as little as 0.125 mg sublingual (I try to take the smallest possible dose first). And 0.25 mg or 0.5 mg orally still has the same effect as it did when I started.

Whether this is wise or not is certainly debatable. For me, I don't have a problem with repeat dosing. The risk is whether even these small and ~infrequent doses can cumulatively impair neurological function.
@blamingeverything, how long have you been at this?
 
Great to hear all this Carlos. Can you tell me how long you spent ramping down the Gabapentin and from what dose?

I want to get off that one I think.
Good to hear from you man! I have read many of your posts and you've been a great help to many people.

My Gabapentin was 300 mg x 3 per day. What I did at first was stop the mid day dose of 300 mg. I did this for about 4 months, then I proceeded to stop the morning dose. I stayed that way for another 4 months and then stopped taking it at night as well. I did not experience any withdrawal symptoms. As of now, I am on 0.75 mg of Clonazepam and plan to ween off of that very very slowly. Even if it takes years, I am in no rush.

Stay strong man.
 
After a 9 day hiatus, I took 0.5 mg of Clonazepam and felt normal again. What a sad state of affairs. Currently meeting an ENT to trial Gabapentin and Flupentixol with a view to trialling each for a few days, seeing if 1 or 2 of them work and if they do, sticking them in the tinnitus toolbox and developing a method of limited sporadic safe use without major interactions.

It's a minefield of working out ideas. These seem like the only 3 meds that offer a reasonable % some form of reduction in symptoms.

Xanax I wouldn't touch due to short half life and it's banned in the UK as seen as dangerous.

CBT with an audiologist is only available in limited areas of the UK. So with severe bilateral reactive tinnitus, what are you supposed to do? My logical mind says look at what a decent amount have success with + studies to back it up and trial them on an individual basis.

So it may be a weird conversation with the ENT asking for:

1) 6 mg Clonazepam/month
2) 6 x 0.5 mg Flupentixol/month
3) 6 x 300 mg Gabapentin/month

Report results & side effects.

Number 1 works for me. I've established it with sporadic use, so I figure trial 2 & 3 and keep any that work, report back and formulate a plan.

Current regular medicine is Mirtazapine 30 mg @ night.

The days are torture. I can't be sure whether this looks like an idiosyncratic idea of avoiding the regular Clonazepam/Gabapentin/Deanxit routine or a feasible but scattered plan.

@Mentos, you always write well and I enjoy reading your input. Any side effects with Deanxit? Does Flupentixol lower the volume or just make you not care?
 
After a 9 day hiatus, I took 0.5 mg of Clonazepam and felt normal again. What a sad state of affairs. Currently meeting an ENT to trial Gabapentin and Flupentixol with a view to trialling each for a few days, seeing if 1 or 2 of them work and if they do, sticking them in the tinnitus toolbox and developing a method of limited sporadic safe use without major interactions.

It's a minefield of working out ideas. These seem like the only 3 meds that offer a reasonable % some form of reduction in symptoms.

Xanax I wouldn't touch due to short half life and it's banned in the UK as seen as dangerous.

CBT with an audiologist is only available in limited areas of the UK. So with severe bilateral reactive tinnitus, what are you supposed to do? My logical mind says look at what a decent amount have success with + studies to back it up and trial them on an individual basis.

So it may be a weird conversation with the ENT asking for:

1) 6 mg Clonazepam/month
2) 6 x 0.5 mg Flupentixol/month
3) 6 x 300 mg Gabapentin/month

Report results & side effects.

Number 1 works for me. I've established it with sporadic use, so I figure trial 2 & 3 and keep any that work, report back and formulate a plan.

Current regular medicine is Mirtazapine 30 mg @ night.

The days are torture. I can't be sure whether this looks like an idiosyncratic idea of avoiding the regular Clonazepam/Gabapentin/Deanxit routine or a feasible but scattered plan.

@Mentos, you always write well and I enjoy reading your input. Any side effects with Deanxit? Does Flupentixol lower the volume or just make you not care?
Hey Nick, any chance for advice?

I'm meeting with my doctor and wondering what I should ask for. Obviously anti-depressants and sleep aid since I wake up at 2 am and can't get back to sleep till like 4 am. I stay in bed for 11 hours a day now.

I feel I will get referred to a shrink for possible benzos to help with anxiety attacks and coping to hopefully see my tinnitus fade in a year. I just really need something to help me get through it. I'm going to be brutally honest with him since I'm going bonkers on the inside. I've never taken a benzo or even SSRI.
 

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