Clonazepam (Klonopin, Rivotril)

[erik]

Clonazepam quiets tinnitus: a randomised crossover study with Ginkgo biloba

Abstract​

Objective
To assess the effect of Ginkgo biloba and clonazepam, a γ-aminobutyric acid (GABA)-receptor agonist, upon tinnitus.

Methods
This was an open-label, randomised, crossover study. 27 men and 11 women (aged 16-80 (mean 58)) with tinnitus for more than 2 months were enrolled. Participants were randomised to either clonazepam or G biloba for the first 3 weeks. For the next 2 weeks of washout no medication was taken. For the final 3 weeks, subjects were given the other drug. The initial dose of clonazepam and G biloba was one tablet daily (clonazepam 0.5 mg; G biloba 40 mg). Subjects were instructed to increase the dose by one tablet every 3 days to a maximum of four tablets daily until they perceived a satisfactory decrease in tinnitus loudness or intolerable side effects. Tinnitus was assessed with pitch and loudness matching, tinnitus handicap inventory, and visual analogue scales of loudness, duration and annoyance.

Results
Comparing before and after each drug, clonazepam significantly improved tinnitus loudness (74% of subjects), duration (63%), annoyance (79%), and tinnitus handicap inventory score (61%), whereas the G biloba showed no significant differences on any of these measures.

Conclusion
Clonazepam is effective in treating tinnitus; G biloba is ineffective.


Not surprising about Ginkgo...

Anyone had luck this good with Clonazepam?

 

[mock turtle]

erik

20 years ago i took clonazepam when i first got tinnitus (ototoxicity exacerbated by noise exposure)

it was a big help as i not only perceived a moderate reduction in tinnitus "loudness" but as important my emotional response to T was greatly diminished. i stopped taking clonazepam about a year after i started (to be honest my memory is far from perfect I might be off by several months but about a year later)

quitting clonazepam was moderately stressful, on a scale from 1 to 10, with 10 being excruciatingly difficult id put it at a 4 or 5. i used exercise, and a little beer and wine to take the edge off… but after a month or two i was back to what had passed for normal, in terms of anxiety- stress level, many years before T and before clonazepam.

i quit the clonazepam because i found i had become used to (habituated to) my tinnitus, and really, by 5 years after that i didnt hear my tinnitus unless i "listened for it" and then , yes it was plainly there, but hey, i found that if i dint listen to it, and i didnt look for it, then i just wasnt conscious of tinnitus at all !

ok fast forward two decades

major shit storm hits my life, major medical problems, family crisis and 3 minor operations with all the attendant stress and medications, especially antibiotics...so then guess what..yep the tinnitus comes back in full force

so starting last november im back on clonazepam, same dose .5mg bid and yes once again it helps

but this time there appears to be a bit of an extra price to pay…I noticed I have less energy (not falling asleep during the day or anything like that but slowed down,, and I experienced a significant decrease in sex drive (libido)…ok no big deal at my age, 59, married with three adult children and my wife (same age) isn't exactly banging down the door for attention these days, so hey…it's a price I can pay

6 months later I begin to taper off as I feel im passed the crisis stage once again.

over a period of about a 2 months I get down to near zero use of clonazepam. once in a while when the T flairs up I take half a pill, but more and more this happens less and less often. working with my doctor ive reduced the prescription by half, and a month later half again. knowing that i got some clonazepasm "in my back pocket" if I need it , has significantly helped to handle T even when i don't take any…just having the option, lets me feel sure im not going to get pushed with my back all the way up against the wall

none-the-less clonazepam has its risks, especially for someone like me, a hyperactive type "A" personality who experiences a higher level of stress day to day than the "normal" person, so i have to be careful

people experience varying degrees of difficulty cutting back and quitting clonazepam. for me clonazepam exerts a "pull" significantly stronger than chocolate or caffeine (coffee) …but not quite as strong as alcohol… but much less than cigarettes which I quit in my late 20s…and I also quit coffee for several reasons…T and others

playing a musical instrument at low volume, (yeah im not very good but who cares!) helps a lot because it because it forces my brain to focus on "good sounds" and shifts my attention away from the tinnitus…keeping busy and focused on activities and other things is very important

exercise has been very important as well for reducing reliance on clonazepam AND dealing with T

and finally support here and from family and a caring doctor has been a big plus

i hope this response hasn't been toooo long; best wishes to you, from mock turtle

 

[erik]

Thanks Mock T for the thorough explanation. I guess it comes down to the fact that I am worried about addiction and the fact that all benzos are ototoxic and it might make my T worse.

 

[mock turtle]

erik

some drugs are ototoxic, permanently destroying hearing cells...an others like aspirin irritate the outer hair cells, but when one stops taking aspirin the tinnitus decreases

i may be wrong, but my doctor told me that moderate doses of clonazepam for short periods of time were low risk for permanent hearing damage and what ive read seems to indicate that after a tim of discontinuing clonazepam, if the tinnitus is aggravated by benzo withdrawal , it greatly decreases in time...but i could be wrong about this, and you are right to be concerned

keep in mind the vast majority of medications are ototoxic for somebody, some where out there...very idiopathic condition

i used to take a very common "proton pump inhibitor" for acid reflux..something easy to buy at the corner store...it caused hearing damage and is reported to do so in 2% of the population..very small percent but unfortunately im part of that small small group

so i dont encourage you or anyone to take clonazepam, cause, who knows for sure??....i sure dont

best wishes
mock turtle

 

[Louise]

My T has progressively been getting worse lately. I've realised what might be the cause. My realisation has come about because of the worsening of my eye floaters. I've been taking Clonazepam ad-hoc for about a month. I have taken 0.5mg once or twice a week. I've read on the net that common n=benzo withdrawl symptoms are eye floaters & tinnitus. Could it be that by taking just one pill a week has had the effect of me 'coming off Benzos' each time? My floaters are definitely worse.

Just putting this out there to see what people think.

 

[Lesky]

You are not supposed to get withdrawl symptoms from 1 pill, correct?

Please someone with experience tell us for sure, but I can not imagine this to be the reason for your worsening tinnitus.

 

[Louise]

Its been one pill sometimes then some weeks its been 1 pill and then half a pill the following night. I know it sounds like only a small amount. Its the fact that my eye floaters have got worse that's made me realise it could be the Clonazepam. I wish there was someone to ask. The doctors wont know.

 

[Markku]

You are not supposed to get withdrawl symptoms from 1 pill, correct?

Please someone with experience tell us for sure, but I can not imagine this to be the reason for your worsening tinnitus.

I agree. Plus Clonazepam builds up tolerance slower than other benzos, so I think Louise's worsening condition can't be attributed to Clonazepam. But... who knows. No one can say for sure!

However, it's interesting Louise, that you have floaters too. I have too. And a pretty bad case, lots of them. But I've had floaters since the age of 15, and tinnitus only came about 10 years later. I've even at some point considered Floaters Only Vitrectomy (FOV). But the risks (retinal detachment, infection, cataracts) have been a bit too much for me. I've been a member at FloaterTalk for years.

Yet I didn't know that withdrawal from benzos could cause / make floaters (/tinnitus) worse. Permanently I mean. I would think that the perception* of both floaters and tinnitus could become more of a problem after stopping benzos, but that the withdrawal able to cause permanent changes (in the vitreous, for example, causing more floaters) is something I haven't heard.

*Yeah, floaters are very much physical particles and not some imagination, but the nuisance of them depends a lot, at least in my case, on my mental state. If I'm feeling anxious or stressed, floaters tend to suck a lot more. Same goes for tinnitus I think. Tinnitus and the amount of floaters can stay constant, but the annoyance level of both of them can vary a lot depending on mood.

 

[Louise]

I did a lot of googling about clonazepam & benzos in association with floaters yesterday and yes, a lot of reports and info saying that floaters & T are known problems when coming off Benzos. You wouldnt think one pill would do that but then again, it has such a prfound effect on me (really reduces the noise) that maybe I do get a strong reaction from just one pill. I really wish it wasnt the case.

I've had floaters for as long as I can remember. They hardly ever bothered me at all over the years.
They have really gone up in number now though and are bothering me. Something has caused that. Its only after I've noticed the increase that I researched it and found out about Benzo withdrawl causing them.

Do you know that there is laser vitriolysis (sp?) for them now so you dont have to have the vitreous replaced. It sounds a much less dangerous procedure. Its expensive but at least there's an option to do something about them, unlike T.

 

[click]

I have floaters too - sometimes they are a real problem. I thought most people had them but many of my friends haven't got any - so I've wondered 'why me' for years.

 

[Louise]

I've had them since I can remember, why did you gets yours?

 

[click]

I've had them since I can remember, why did you gets yours?

I don't know the reason why. I had a problem with one eye almost 10 years ago and saw a consultant eye surgeon (privately - because the NHS said there was nothing wrong! - found out at the appointment that he was also head of the NHS eye department). Finally discovered that the tiny blotch that was worrying me was a pre retinal membrane. I thought it was the start of something serious but he assured me it wasn't. Anyway - I asked him about the floaters and he expained what they were and just said 'some people have them - some don't'. So I suppose it's another area that doctors know very little about?

Mine are always worse in bright light - especially sunshine. Sometimes they also stop me programming because they just get too much in the way! Normally flicking my eyes from side to side moves the larger ones sufficiently to carry on.

 

[Louise]

Sorry I meant 'when' did you get them not 'why', my brain isnt working properly anymore

It is another area they know little about I think. At least there is a procedure or two to get rid of them though they will carry risks. Those procedures arent available on the NHS as they are not deemed serious. It seems that after paying in for 30 years there isnt much the NHS will do for my problems. If I wanted IVF though they'd be willing to shell out a fortune on that.

Mine are now getting in the way or me reading on the laptop, that wasnt happening before last week. Just what I needed.

 

[RaZaH]

My Tinnitus started after I quit Rivotril/Clonazepam cold turkey after realizing I had been wrongly diagnozed with epilepsy. Two days after stopping the meds my hearing dropped severly , Im an audio engineer and I noticed immediately. Two weeks after that my T started.

Of course I have been told that it was caused by noise exposure by doctors as soon as I mention that Im an audio engineer,but I have always taken very good care of my ears and never mixed at live venues , in fact my clients used to complain about my low levels when mixing.

I'm absolutely confident that my tinnitus was caused by these medications and in fact when talking to others that have discontinued benzos it seems to be a common theme to get tinnitus.
It seems logical to me that since doctors prescribe Clonazepam to alleviate tinnitus it is having an effect on the ears , so it isnt all that farfetched that they might be causing damage as well .
I would not advise anyone to use those drugs as they *in my opinion* will kill your ears and they are highly addictive as well. Stay away from benzos at all costs ....my advice.

 

[Louise]

Hi RaZaH,

Possible tinnitus increase is a known effect of coming off Benzos. Its the brain which is affected by the Benzo not the ears directly. Clonazepam inhibits hyperactivity by its effect on GABA and this quietens tinnitus, if your tinnitus is caused by hyperactivity in the auditory cortex. When the Benzo is stopped the neuronal inhibition ceases and you get 'rebound dis-inhibition' where the neurons go back to the previous hyperactivity.
However, it can be worse than just the rebound disinhibition, as if you've been on the Benzos long enough, the body reduces the GABA receptors (or stops them working) to counteract the Benzo's effect. So then when you come off the Benzo you actually have fewer GABA receptors and so more neuronal hyperactivity. Apparently it can take months for the body to increase the GABA receptors again and put you back to where you started.

I've been on Clonazepam now for 3 weeks (I really had no choice) and am now looking to taper off before this reduction of the GABA receptors starts/gets worse.

 

[RaZaH]

Yes, I have read that for people that actually get Tinnitus from benzo use , it can take months and even years but usually it gets better. I have had T for 10 months now and I can't say that it has gotten any better at all

In my case benzos actually caused hearing loss but I was on Rivotril for almost a year , many will try and dispute that but what can I say ...? Two days after quitting...bam! I could hear that my upper range was severely lowered 10-17 Khz, as well as the presence range around 4-6 Khz . I'm a mastering engineer and very familiar with the upper range 10K and upwards which im sure a lot of people sort of disregard.

Don't mean to scare you , should be fine If you don't use benzos as long as i did and dont stop cold turkey.
3 weeks should be fine if you start to taper off soon.
Funnily enough my doctor said it was fine to just quit ...big mistake on my part.

 

[Louise]

Your doctor should be struck off for that information. You have to taper off a Benzo very, very slowly.

So it caused hearing loss because you quit so suddenly. I wonder what the mechanism could be that would cause that? Terrible for that to happen.

I will be stopping mine very slowly and its only 0.5mg each night which Im told is a small dose. I am going to reaearch how to taper properly.

 

[Joel]

Yes, I have read that for people that actually get Tinnitus from benzo use , it can take months and even years but usually it gets better. I have had T for 10 months now and I can't say that it has gotten any better at all

In my case benzos actually caused hearing loss but I was on Rivotril for almost a year , many will try and dispute that but what can I say ...? Two days after quitting...bam! I could hear that my upper range was severely lowered 10-17 Khz, as well as the presence range around 4-6 Khz . I'm a mastering engineer and very familiar with the upper range 10K and upwards which im sure a lot of people sort of disregard.

Don't mean to scare you , should be fine If you don't use benzos as long as i did and dont stop cold turkey.
3 weeks should be fine if you start to taper off soon.
Funnily enough my doctor said it was fine to just quit ...big mistake on my part.

WOW .. I don't think I will ever touch that stuff after reading this.

RaZaH, sorry if this is a little off topic. (I can start a new thread if you want) Have you had to make any adjustments to the way you mix?

I also have some loss in the 4k - 6k range (left ear) and was starting to ask myself questions like "Do I need to compensate for the loss in my mixes?" Or in other words .. mix normally ..and then boots the 4 - 6k range a db or two just because I'm probably not hearing it correctly.

Thank you guys for the useful info on this subject (benzos)

 

[RaZaH]

Yeah man ..stay away from that stuff. It works for some to alleviate T but that is because it messes with your ears , and not in a good way ...trust me.
As for mixing , yeah ...I slap on a slight boost in the 4-6 range on the master while mixing so it does not disturb me as much and then I take that down when finished. I make sure to listen to music all the time to try and readjust my ears but its tough. Mastering is done for me ...too much damage.

I used to have perfect hearing , now I can only hear up to about 14khz. . if that..
Of course most ENT's do not measure that high which is a shame as thats probably where the damage starts.
I personally think that most measurements ENT's do are next to useless , tell you next to nothing about the bandwidth of damage or range. I did find an online hearing test that measures at 24 bands , I could find it again if you are interested?

On a sidenote ... A few months ago I noticed that I could hear 3khz pretty good but 3.1 Khz was gone , Incidentally that's exactly the freq of my T. As well as higher freq T that I attribute to my Hi freq loss , havent pinpointed that freq though.

 

[RaZaH]

You are more likely to have protracted withdrawal symptoms if you quit cold turkey , I was sort of expecting that but thought it would be mental issues rather than physical ones . I was wrong.

I would like to add that on Benzo forums people refer to Benzos as "The devils pill" . I hate benzos , turned me into a vegetable , but , each to his own.

 

[Louise]

I used to have perfect hearing , now I can only hear up to about 14khz. . if that..
Of course most ENT's do not measure that high which is a shame as thats probably where the damage starts.
I personally think that most measurements ENT's do are next to useless , tell you next to nothing about the bandwidth of damage or range. I did find an online hearing test that measures at 24 bands , I could find it again if you are interested?

I couldnt agree more. ENTs/audiologists only have kit to measure up to 8khz as that range covers speech and they are only interested in hearing aids to help people understand speech. This testing only goes part of the way for tinnitus sufferers. We need testing right up to the limit its possible to hear. And also need hearing aids up to that limit too. Then we may have a chance of hearing aids helping to mask the T when being worn and also reorganise the tonotopic map again and reduce/eradicate the T.
Audiology and hearing aid wise there is nothing for us!! Alright, some aids go to 12khz but you cant find an audiologist with kit to even measure that high so what is the point of them? At least you cant find anyone in the UK.
All the hearing aid manufacturers bother to do for us is put some masking sounds in the hearing aids.

Rant over!

 

[Louise]

You are more likely to have protracted withdrawal symptoms if you quit cold turkey , I was sort of expecting that but thought it would be mental issues rather than physical ones . I was wrong.

I would like to add that on Benzo forums people refer to Benzos as "The devils pill" . I hate benzos , turned me into a vegetable , but , each to his own.

Yep, you cant come off them quick.

I actually like the feeling I get from them, which was actually stronger at first. Never turned me into a veg, it actually did the reverse. I was so paralysed with fear over T that when I took a Clonazepam it relieved that fear and I was (almost) me again. I'd take them forever if they didnt build a tolerance. If you are in a very bad place with panic and anxiety then they do wonders. But, you have to understand what you are taking on and be responsible.

Definitely better if you can cope without them but if you cant then do go in with eyes open.

 

[RaZaH]

Yeah it's the equivalent to going to see a optometrist and having one large A and a small B on the wall and deducing your eyesight based on that ...the resolution is just not sufficient.

 

[Louise]

Nope. Also, they only measure at octaves or half octaves, like 1khz, 2khz, 4khz, 6khz 8hz. What about all those frequencies in between? The hearing could be going up & down like a yo-yo in the frequencies they dont measure. I suppose a rough measurement like that is ok for a hearing aid setting to allow a little old lady to hear speech again, (no offence to little old ladies, Im not that young myself), but its not precise enough for what T sufferers need it for. We need to give back to the brain exactly what it lost through the hearing loss, no more no less. So we need very accurate readings!! Like I said, there's virtually nothing for us in audiometry/hearing aids.

 

[RaZaH]

Yeah indeed , I loved being on that stuff, felt great ..in fact , never felt better. Got some much stuff done that couldn't believe it , my career really took off ?It was just annoying to go the the store 4 times to buy the same stuff...in a row. At the end of it I couldnt remember anything at all , lucky to find my way home after going out. I guess it's fine for short period but after a year I was a fruit.

In fact I might consider reinstating If I wouldn't know that it sucks longterm and it kills your ears.

 

[Louise]

Yeah indeed , I loved being on that stuff, felt great ..in fact , never felt better. Got some much stuff done that couldn't believe it , my career really took off ?It was just annoying to go the the store 4 times to buy the same stuff...in a row. At the end of it I couldnt remember anything at all , lucky to find my way home after going out. I guess it's fine for short period but after a year I was a fruit.

In fact I might consider reinstating If I wouldn't know that it sucks longterm and it kills your ears.

So it was ok at first and then long-term turned you into a veg? How much were you on?
Maybe I shouldnt tell you this but I have read loads about Benzo withdrawl and they say that if you get T from stopping them........ if you go back on them the T stops!!

I know you wouldnt risk it as it damaged your actual ears. Just checked my Ototoxic book, it doesnt list hearing loss as a possibility for Clonazepam. Are you sure it was that and not the music? Just asking!!

 

[RaZaH]

What I also find interesting is the connection between Benzos and alcohol , I find that beer takes the edge of my T and getting drunk ...Silence ! Only time I have experienced silence is when I'm plastered , not too good.
Apparently alcohol and benzos are related in that you can actually prolong your Benzo withdrawal if you use alcohol ? So there's some kind of connection. Havnet studied that extensively though.

It seems that a lot of folks get T from being in a club and drinking alcohol. Maybe alcohol and benzos ruin your ears defence mechanisms ....as well as dulling your existing T ? Both seem to have some effect on your ears .

 

[RaZaH]

How much...can't remember ..haha ! Come to think of it though it was 5 x 1/2 mg of Rivotril per day for a year, so 2.5 mg. Fine for the first few months but then It got weird.

As for the music question. That's a perfectly fair question and one I have had a number of times. It's possible indeed .
Thing is , I don't listen loud at all and I in fact turned off my studio while I did the comedown.
Two days and .. bam ... I was just walking around my studio , on the phone and happened to bump into a cymbal and thought" that's strange sounding" and noticed that my hi freq were pretty much gone ?

I can't be sure but on the other hand , if it can cause T , why not hearing damage ? I have also read other peoples experiences that match mine , hearing damage and all . Also , I'm not entirely convinced that the majority of Benzo users would even notice Hi freq dropoff all that much , It certainly doesn't interfere with hearing speech.

And yeah I'm too scared of that stuff to reinstate.

 

[Louise]

What I also find interesting is the connection between Benzos and alcohol , I find that beer takes the edge of my T and getting drunk ...Silence ! Only time I have experienced silence is when I'm plastered , not too good.
Apparently alcohol and benzos are related in that you can actually prolong your Benzo withdrawal if you use alcohol ? So there's some kind of connection. Havnet studied that extensively though.

It seems that a lot of folks get T from being in a club and drinking alcohol. Maybe alcohol and benzos ruin your ears defence mechanisms ....as well as dulling your existing T ? Both seem to have some effect on your ears .

Interesting you should mention alcohol, especially that it could ruin the ears. Here's something I posted a while ago whilst wanting to find a connection between the two, makes for sobering reading! https://www.tinnitustalk.com/threads/alcohol.933/#post-7203

If you get silence from drinking then its because booze is a glutamate antagonist I would have thought. So, it reduces any excessive glutamate output or at least the effects of such. Excessive glutamate from the cochlear hair cells is purported to be a cause of T.

I read that if you like alcohol (well more if you're addicted) then you'll suffer coming off Benzos.

 

[Louise]

How much...can't remember ..haha ! Come to think of it though it was 5 x 1/2 mg of Rivotril per day for a year, so 2.5 mg. Fine for the first few months but then It got weird.

As for the music question. That's a perfectly fair question and one I have had a number of times. It's possible indeed .
Thing is , I don't listen loud at all and I in fact turned off my studio while I did the comedown.
Two days and .. bam ... I was just walking around my studio , on the phone and happened to bump into a cymbal and thought" that's strange sounding" and noticed that my hi freq were pretty much gone ?

I can't be sure but on the other hand , if it can cause T , why not hearing damage ? I have also read other peoples experiences that match mine , hearing damage and all . Also , I'm not entirely convinced that the majority of Benzo users would even notice Hi freq dropoff all that much , It certainly doesn't interfere with hearing speech.

And yeah I'm too scared of that stuff to reinstate.

That's quite a decent dose isnt it? Think I wouldve been out of it on that. I cant believe your doctor didnt tell you how important it was to taper from such a high dose taken for so long.

When you say "it got weird" after the first few months what do you mean?

I dont think most would notice the high frequency drop off like you did. Its interesting about the Benzos that people generally report T etc when they stop taking them. This leads me to think its neuronal dis-inhibition that causes problems. I dont know, I'm no scientist!