Member@Cmspgran, I'm thinking of following suit. My concern is that if I take it at night, I might start to feel agitated by the afternoon. Since I tend to suffer more during the day, it seems like a better option to take it then. Could @linearb chime in and explain why they decided to take it during the day?
Clonazepam (Klonopin, Rivotril)
- Thread starter erik
- Start date
I switched to this approach because I was tired of the high-to-low depression swings caused by sporadic use. The sedative effects have long since worn off for me, as documented in the literature, so it's no longer an issue.
Often, I wake up at 5 a.m., and if that happens, I'll take it then and go back to sleep for a few more hours. I liked and respected @linearb, even though I never interacted with him. I appreciated his attitude of "take the medication to cope, because life must go on as best it can." That's how I try to approach things as well.
RunningMan
Member
- May 8, 2023
- 604
- Tinnitus Since
- HiFrq ~2000, Increased 2022, LoFrq ~2020
- Cause of Tinnitus
- Loud noise - clubs, stereos, cycles, headphones, engines,etc
That's what I usually do when I take Ativan, but I don't normally take it more than once per week. I'll wake up around 5 AM and take 0.5 mg along with a piece of a Zolpidem tablet (1 to 1.5 mg) hoping I'll get another 2 hours of sleep. This way, Ativan is still working when I get up, but I have a chance of the benefit of additional sleep as well, which I typically don't get enough of.
Thank you for the interesting discussion.
I'm not typically an anxious person, but a severe tinnitus spike can definitely make me anxious. I've experienced so many spikes that now I mostly just:
I'm not typically an anxious person, but a severe tinnitus spike can definitely make me anxious. I've experienced so many spikes that now I mostly just:
- Suppress it with Clonazepam.
- Ride it out.
- Hope for the best, since there's not much else to do.
RunningMan
Member
- May 8, 2023
- 604
- Tinnitus Since
- HiFrq ~2000, Increased 2022, LoFrq ~2020
- Cause of Tinnitus
- Loud noise - clubs, stereos, cycles, headphones, engines,etc
I use a pill cutter. Starting with a 10 mg tablet, I aim to cut it into 8 pieces, though I often end up with 7. The pieces aren't all exactly the same size, but I get them as close as possible. Usually, after taking one piece sublingually, I can fall back asleep fairly quickly. However, I might wake up again within an hour.
Do you take Clonazepam regularly? Does it actually help with tinnitus?
I've considered it as well, although doctors in our country are very reluctant to prescribe it.
Doctors are correct to be cautious with Clonazepam; the problem is, no one fully understands tinnitus or is eager to treat it. I found myself in a critical situation with my career in a different city when I experienced a severe spike in symptoms and went days without sleep. Fortunately, I knew someone who could vouch for the fact that I am not a drug addict, so I described my urgent situation, and he prescribed Clonazepam over the phone without an in-person visit. He instructed me not to take it until I returned to my apartment, but I was getting absolutely no sleep, which was not sustainable. Just like air, food, and water, you need sleep. So, I took 1 mg, and the next thing I knew, I had slept four hours. My first thought was, "Oh, I slept," and my second was, "Where did the tinnitus go?"
After a few weeks, I started sleeping too much, which is also not good, so I decided to stop. Being in a university town, I visited an ENT clinic, but the ENT specialist was unhelpful, even suggesting a shot of whiskey would be just as effective. As if I would risk showing up to work hungover. Fortunately, Dr. Farnell, one of the city's top family doctors, was far more supportive.
Now, I reserve Clonazepam for managing severe spikes. Once, I had shingles and was prescribed some 5 mg Morphine tablets. Morphine is rarely prescribed, so I guard it closely and only use it sparingly, maybe two tablets a year. The challenge with Clonazepam is building tolerance, but if I have a spike, I need to suppress it, even if it means spending a couple of days in bed. Some people experience migraines and need similar rest. I have not found many doctors as competent and supportive as Dr. Farnell was for me. That was ten years ago, and now I am on 0.5 mg, which I try to taper down slowly. I am probably somewhat dependent on it.
My doctor is cautious about prescribing Clonazepam because it is a controlled substance, but I am fortunate to have a 1.5 mg prescription. I save what I do not take so that if I need 2 mg to manage a spike, I can take it for a short period, around three to four days, and then quickly taper back down. My job requires clear thinking, and if I drive impaired, it is a criminal offense that could cost me my career. Clonazepam is incredibly useful, but nothing can completely make this condition disappear. When I am sleep-deprived, my tinnitus intensifies, and I cannot function.
Currently, I am experimenting with CBD, CBDV, CBG, and THCV, which are novel cannabinoids. THC used to help, but it no longer does, and accessing these newer cannabinoids is not easy. Thankfully, laws are improving, and prices and availability are becoming more favorable. Still, nothing compares to Clonazepam for suppressing a spike. I also take Seroquel, Mirtazapine, and Lyrica. Lyrica is also a controlled substance. My pharmacist, who knows I am not a drug seeker, is sharp and understanding. In the end, it is about finding the right balance of treatments that work for you.
@object16, do you take 0.5 mg of Clonazepam daily and use a higher dose during a spike? Also, do you take Carbamazepine as well?
I had a private conversation with Brian Fargo, who described Clonazepam as a "game changer," although he mentioned it doesn't work for everyone.
In the UK, I'm having a hard time getting a GP to prescribe Nortriptyline.
I'm currently on Clonazepam 0.5 mg, and my plan is to taper it slowly: first to 0.375 mg, then 0.25 mg, and finally to 0.125 mg. I hope to do this over about two weeks. Ten days ago, I had a spike and temporarily increased the dose to 2.0 mg, so getting back down to 0.5 mg feels like progress.
For Carbamazepine, I take 200 mg at bedtime, but I usually wake up around 2 a.m. and take another 200 mg then. My doctor has measured my Carbamazepine levels first thing in the morning, and they fall below the therapeutic range, likely because this medication induces hepatic enzymes that speed up its metabolism. Since Carbamazepine is used for chronic pain and I have a chronic pain condition, it's reasonable to stay on it, especially as it also helps me sleep. Some medications are more stable with dosing, but I prefer to keep Clonazepam in reserve for spikes.
It's currently 9:30 p.m. as I'm typing this, and my tinnitus is fairly manageable, likely because of my nighttime medication dose. Right now, I actually feel cautiously optimistic. I got plenty of rest today, had a full day at work, and the tinnitus wasn't too bothersome. In the middle of the night, I also took CBG 75 mg, CBD 75 mg, and a CBD/CBDV mix of 75 mg, all in a sublingual propylene glycol preparation. It's possible that's starting to take effect. These novel cannabinoids could promote neural plasticity, so I'm hopeful.
I'm also taking whole-food, probiotic-cultured black chickpea sprouts, which, according to research, are high in isoflavones. I use anything with a reasonable chance of promoting neural plasticity. Isoflavones are known to help prevent Alzheimer's and Parkinson's; they act like beta-estradiol and reach the cell nucleus, so this isn't just a trend for me—it has real potential. That said, I haven't noticed any dramatic effects so far.
Back in 2015, Dr. Farnell in Kingston prescribed Clonazepam 1.5 mg during a spike, and it was a game-changer. As I mentioned before, I now use it mainly to control spikes, though ideally, I aim to avoid them entirely.
Nortriptyline is a strong anticholinergic, and habituation is a known issue with it. Initially, everything works well, but then habituation sets in, so it's crucial to use sound immersion therapy alongside the medication. Medication is useful, but I also play music in my office during the day and in the bedroom at night at around 60 dB. This level is low enough to still hear the tinnitus but is slightly below its intensity, aligning with Tinnitus Retraining Therapy recommendations. It's also a safe volume for the hair cells.
@Alberte, Clonazepam reduces tinnitus in 66% of patients. For most, it takes 12–24 hours to lower the volume when taken occasionally.
It also helps reduce anxiety, typically within about 2 hours.
See my ancient post.
To be more precise: I had been taking 8 drops of Clonazepam for over a year, following the advice of my oto-neurologist, without any noticeable effect. So, with my oto-neurologist's approval, I decided to gradually increase the dosage. At 21 drops, I began to experience slight pain in my trunk area (chest and abdomen) but still noticed no effect on the volume of my tinnitus.
With further approval, I continued increasing the dosage up to the maximum allowed, 30 drops. At this point, I did feel a slight improvement in my tinnitus volume, but the trunk pain became unbearable. I then tapered down slowly, but the improvement in my tinnitus disappeared before the pain subsided.
In conclusion, taking Clonazepam was not worth it.
Note: In France, Clonazepam is administered in drops, but I am unsure of the exact mg per drop.
You can't get Clonazepam in France anymore. It's now prescribed exclusively for epilepsy, and only neurologists are authorized to prescribe it to patients.
