Suicidal

[Chinmoku]

Great post Chinmoku and glad you made it. Of course. On this forum in fact, common knowledge and gets written about all the time. However going in...and yet, you started meds in the first place...and I did the same thing. I have treaded very carefully for all the reasons you have eloquently enumerated.

So will ask you. You are on medication for some level of fear of withdrawal, and I am on Clonazepam 'as needed' which is sparingly and a huge help for me with little fear of stopping but when I need it, I need it or start looking for the ladder to that high place like Allan and Pete.

So you need to prescribe a roadmap Chinmoku. You with all your experience are now the signature advisor to both Allan and Peter....both of whom are tettering on the edge and thinking about jumping. I may have jumped off the ledge had it not been for Clonazepam. Can't speak for you. I live a relatively normal life now. Yes, my tinnitus is intrusive and bugs me and I take a Clonazepam as needed, resisting as much as possible understanding the pitfalls you discuss.

You have noted the slippery slope of meds, their tradeoffs, the trap of dependency and withdrawal, and possibility of tinnitus spiking.

Please advise Allan and Peter down off the ledge without medication. Or, if you believe this is a bridge too far, advise how they should proceed with medication.

We are all here to learn, I agree with everything you wrote however, tinnitus is a brain disorder, the brain operates on neural chemistry and basically the only game in town is to tweak this if nature is falling short with all the peril you identify. Can't modify behavior with profound mental illness placing people at the brink.

Please advise.

John I am not a medical doctor. Allan tried venlaflaxine and fluoxetine in the past if I recall correctly. Pete has been on amitriptyline. What I am trying to say is that, apart from the short term effects of clonazepam, there is little clarity on what would straighten their brain chemistry. They could try cbd oil, alternative therapies, taurine, L-theanine, valerian... but they should decide whether they wish to work with a psychiatrist or not. There are people who prefer naturopaths. There are hundreds of possible choices. What I wanted to challenge is the idea that psychiatric medication is always a solution to our problems. In retrospective, in my case, CBD oil would have worked much better than pregabalin. Unfortunately I can't take it now because it spikes my tinnitus and at the time I started pregabalin for anxiety and pain it was not available

 

[John Mahan]

John I am not a medical doctor. Allan tried venlaflaxine and fluoxetine in the past if I recall correctly. Pete has been on amitriptyline. What I am trying to say is that, apart from the short term effects of clonazepam, there is little clarity on what would straighten their brain chemistry. They could try cbd oil, alternative therapies, taurine, L-theanine, valerian... but they should decide whether they wish to work with a psychiatrist or not. There are people who prefer naturopaths. There are hundreds of possible choices. What I wanted to challenge is the idea that psychiatric medication is always a solution to our problems. In retrospective, in my case, CBD oil would have worked much better than pregabalin. Unfortunately I can't take it now because it spikes my tinnitus and at the time I started pregabalin for anxiety and pain it was not available

What I am hearing from you is...no approach. You don't know a path. If not a psychiatrist to help than who? A family doctor? An audiologist? Your uncle? The tooth fairy?

And where I would differ from you is...while you are trying to invent the wheel, Rome burns. That is the problem.
The science is crude as you say. And my counterpoint to you is, paralysis through analysis is no good, CBD oil does nothing for me...my niece is a Dr. in Homeopathy and has no viable solutions. Her herbal suggestions do nothing. Lipstick on a pig. Snake oil doesn't help or singing kumbha or making post cards. Nobody has a long term prognosis or a crystal ball of ill affects to just about anything from a knee to heart valve replacement. Subjects in question are trying to make it to tomorrow is the point.

This a great conversation to have. Many people try different things even with consequences you note. They almost don't have a choice. They are desperate. Perhaps you weren't. Sending people on wild goose chases will make people sicker and more hopeless than they are. Sedatives are generally a good thing for tinnitus. Benzo's overall. SSRI's have been know to cause spikes. They help some people.

But doing nothing substantive to help somebody mentally ill is as cruel as tinnitus itself. Your so called 'hundred of possible choices' you can't decide upon and have no tangible proof will work may in fact be more cruel than choosing the wrong med.

My sense with you is, you are somewhat bitter you have been hemmed into your particular box of being stuck on a med you don't want to get off of for fear your tinnitus would worsen. I get that. Reality is, we don't have a lot of options in spite of what you write.

A psychiatrist is the best place to start. This is my opinion. Heck if you have good enough mental health and a two year time window to see if owning a drone and singing bird will help, go for it. Meanwhile Rome burns for those very sick and suicidal.

Your presentation of a myriad of options helping somebody is a needle in a hay stack of actual help. Yes, with meds and tinnitus, is a precarious balance. But many are helped, self included.

 

[PeteJ]

@John Mahan, Autumnly is a nice and helpful person here. I believe her tinnitus is severe but she is always polite and civil in her posts. For your sake, stop embarrassing yourself.

 

[Chinmoku]

What I am hearing from you is...no approach. You don't know a path. If not a psychiatrist to help than who? A family doctor? An audiologist? Your uncle? The tooth fairy?

And where I would differ from you is...while you are trying to invent the wheel, Rome burns. That is the problem.
The science is crude as you say. And my counterpoint to you is, paralysis through analysis is no good, CBD oil does nothing for me...my niece is a Dr. in Homeopathy and has no viable solutions. Her herbal suggestions do nothing. Lipstick on a pig. Snake oil doesn't help or singing kumbha or making post cards. Nobody has a long term prognosis or a crystal ball of ill affects to just about anything from a knee to heart valve replacement. Subjects in question are trying to make it to tomorrow is the point.

This a great conversation to have. Many people try different things even with consequences you note. They almost don't have a choice. They are desperate. Perhaps you weren't. Sending people on wild goose chases will make people sicker and more hopeless than they are. Sedatives are generally a good thing for tinnitus. Benzo's overall. SSRI's have been know to cause spikes. They help some people.

But doing nothing substantive to help somebody mentally ill is as cruel as tinnitus itself. Your so called 'hundred of possible choices' you can't decide upon and have no tangible proof will work may in fact be more cruel than choosing the wrong med.

My sense with you is, you are somewhat bitter you have been hemmed into your particular box of being stuck on a med you don't want to get off of for fear your tinnitus would worsen. I get that. Reality is, we don't have a lot of options in spite of what you write.

A psychiatrist is the best place to start. This is my opinion. Heck if you have good enough mental health and a two year time window to see if owning a drone and singing bird will help, go for it. Meanwhile Rome burns for those very sick and suicidal.

Your presentation of a myriad of options helping somebody is a needle in a hay stack of actual help. Yes, with meds and tinnitus, is a precarious balance. But many are helped, self included.

Lane has posted many remedies that worked for his conditions above and there is no psychiatric medication. His path was quite different. Some people have success with curcumin, others with CBD oil (not you, understood), and others with nothing unfortunately. So there are many paths. The psychiatric medication is one of the few paths immediately available and the one that we may consider when suicidal, we can agree on that, but it is not the only one, and it is not well understood. That is all I wanted to say.

 

[Michael Leigh]

@John Mahan, Autumnly is a nice and helpful person here. I believe her tinnitus is severe but she is always polite and civil in her posts. For your sake, stop embarrassing yourself.

@PeteJ

I have just seen your post and thankfully not read the post of the undesirable person that you refer to, as he has been placed on ignore for some time along with others whom I regard as the same. I have a lot of respect for @Autumnly and always like to read what she has to say about tinnitus and in particular how it can affect an individual. Undoubtedly, she has a deep understanding of this condition far more than the person that calls himself a "scientist". Whilst science has some bearing on tinnitus from a theoretical point of view, it can never compete with one's personal experience of the condition especially when it is "noise induced" which the said individual has no experience of.

I wish you well.
Michael

 

[John Mahan]

Lane has posted many remedies that worked for his conditions above and there is no psychiatric medication. His path was quite different. Some people have success with curcumin, others with CBD oil (not you, understood), and others with nothing unfortunately. So there are many paths. The psychiatric medication is one of the few paths immediately available and the one that we may consider when suicidal, we can agree on that, but it is not the only one, and it is not well understood. That is all I wanted to say.

I never said that there weren't other paths to psychiatric medicine. I stated my position very clearly. I will tell you misdirected experimentation with anecdotal remedies if suffering profoundly is a poor direction. I said psychiatric medicine is the first and principle path to recovery. Tinnitus is a brain disorder. Mental illness many times if not most is the biggest impediment to recovery. The heterogeneous nature of tinnitus interacting with a person's very specific brain physiology and chemistry makes it IMPOSSIBLE for any one stop shopping panacea. My advice has been that a psychiatrist is the best place to start. None of the things you have suggested has helped me and medicine prescribed by a health care professional has profoundly helped me which agrees with 'most' of the accounts here.
Many wouldn't be here if it weren't for psychiatric medicine as imperfect as it is.

PS. Lane is a brilliant guy btw and few can wade through the tedious task of self analysis and trial of different substances, interpreting the literature etc as well as he can. By contrast, Michael is as dense as a door nail...lol...and Autumnly doesn't have the balls to defend her floundering path to recovery. Both however are very 'nice'. As nice as a tinnitus spike. The shoe fits. Isn't that right Spike?

 

[GoatSheep]

 

[John Mahan]

A brief intermission for some comic relief:

 

[John Mahan]

And a bit more. The incomparable genius and tribute to one of our own who knows who he is while I listen with headphones. Btw, Sam is a screamer and nobody does it better so watch your volume:

 

[GoatSheep]

It's a murkle!

 

[John Mahan]

Oink.

 

[Chinmoku]

I never said that there weren't other paths to psychiatric medicine. I stated my position very clearly. I will tell you misdirected experimentation with anecdotal remedies if suffering profoundly is a poor direction. I said psychiatric medicine is the first and principle path to recovery. Tinnitus is a brain disorder. Mental illness many times if not most is the biggest impediment to recovery. The heterogeneous nature of tinnitus interacting with a person's very specific brain physiology and chemistry makes it IMPOSSIBLE for any one stop shopping panacea. My advice has been that a psychiatrist is the best place to start. None of the things you have suggested has helped me and medicine prescribed by a health care professional has profoundly helped me which agrees with 'most' of the accounts here.
Many wouldn't be here if it weren't for psychiatric medicine as imperfect as it is.

But does it? I can't really find any studies on AD effectiveness for tinnitus except for two very old studies on sertraline and amitriptyline. If we leave tinnitus aside and focus only on depression per se, even the recent most cited meta-analysis confirming AD efficacy for depression has been challenged by several psychiatrists. What is more, there is a recent study in "Cell" suggesting that serotonine, the most targeted neurotransmitter in AD drugs, can worsen tinnitus. The psychiatrists I talked to didn't know about this, and their prescription algorithm typically starts with serotonine SSRIs. Severe tinnitus was poorly understood by psychiatrists I talked to, who would basically disregard it, focusing on the depression and risking to make tinnitus worse even when the depression is originated by tinnitus in the first place. Liam Cairns here has been ruined by Agomelatine, that was supposed to be one of the most tolerated ADs. As I said, if one is to jump off a bridge quick action is needed and a good psychiatrist may be the best shot but seeing psychiatric medication as the main solution to tinnitus is dubious in my view, there simply is not enough systematic analysis to confirm this. But if you have references I missed I would be glad to see them.

 

[Autumnly]

Antidepressants
European guideline for the treatment of tinnitus

• No drug can generally be recommended for the treatment of chronic tinnitus. However, psychiatric comorbidities associated with tinnitus (anxiety depression) may need drug treatment. Antidepressants should not be prescribed to tinnitus patients without the diagnosis of depression.
• Side effects were commonly reported including sedation, sexual dysfunction, and dry mouth. Nonetheless, antidepressants are often successfully applied in the treatment accompanying depression and anxiety, not for improvement of the tinnitus.

Therapeutic Approaches to the Treatment of Tinnitus
Berthold Langguth, Ana Belen Elgoyhen, and Christopher R. Cederroth, Jan. 2019

• Nevertheless, while there is insufficient evidence to say that antidepressants improve tinnitus (21), available data provide converging evidence that tinnitus patients with depression and anxiety may benefit from interventions using antidepressants. It should also be noted that the onset and worsening of tinnitus have been reported as side effects of both treatment with and discontinuation from tricyclic and other antidepressants (86).

Benzodiazepines
European guideline for the treatment of tinnitus

• Thus, they concluded that benzodiazepine use for subjective tinnitus does not have a robust evidence base and that these drugs must be used with caution because of serious side effects.

Therapeutic Approaches to the Treatment of Tinnitus
Berthold Langguth, Ana Belen Elgoyhen, and Christopher R. Cederroth, Jan. 2019

• Even if these studies indicate a potential short-term benefit of benzodiazepines, the available data are not sufficient to recommend the use of benzodiazepines for the treatment of tinnitus given the range of side effects and especially the risk of drug dependency (92). Moreover, caution is warranted since protracted tinnitus has been reported after discontinuation of benzodiazepines (93).

There's an important difference between saying "you just need to find the right pill" and "many people are helped by anti-depressants".

 

[Star64]

Antidepressants
European guideline for the treatment of tinnitus

• No drug can generally be recommended for the treatment of chronic tinnitus. However, psychiatric comorbidities associated with tinnitus (anxiety depression) may need drug treatment. Antidepressants should not be prescribed to tinnitus patients without the diagnosis of depression.
• Side effects were commonly reported including sedation, sexual dysfunction, and dry mouth. Nonetheless, antidepressants are often successfully applied in the treatment accompanying depression and anxiety, not for improvement of the tinnitus.

Therapeutic Approaches to the Treatment of Tinnitus
Berthold Langguth, Ana Belen Elgoyhen, and Christopher R. Cederroth, Jan. 2019

• Nevertheless, while there is insufficient evidence to say that antidepressants improve tinnitus (21), available data provide converging evidence that tinnitus patients with depression and anxiety may benefit from interventions using antidepressants. It should also be noted that the onset and worsening of tinnitus have been reported as side effects of both treatment with and discontinuation from tricyclic and other antidepressants (86).

Benzodiazepines
European guideline for the treatment of tinnitus

• Thus, they concluded that benzodiazepine use for subjective tinnitus does not have a robust evidence base and that these drugs must be used with caution because of serious side effects.

Therapeutic Approaches to the Treatment of Tinnitus
Berthold Langguth, Ana Belen Elgoyhen, and Christopher R. Cederroth, Jan. 2019

• Even if these studies indicate a potential short-term benefit of benzodiazepines, the available data are not sufficient to recommend the use of benzodiazepines for the treatment of tinnitus given the range of side effects and especially the risk of drug dependency (92). Moreover, caution is warranted since protracted tinnitus has been reported after discontinuation of benzodiazepines (93).

There's an important difference between saying "you just need to find the right pill" and "many people are helped by anti-depressants".

Very valuable information, IF ONLY I had known about the risk of protracted tinnitus on withdrawal I would have never taken clonazepam. My tinnitus has been deafening since I hit tolerance on this drug at the lowest dosage.

I was told this was safe to use for tinnitus as many individuals were given this benzo long term for epilepsy. If used intermittently it probably is safe, but if it gives you relief and you continue to use it you are playing Russian roulette so to speak. It is unknown territory how quickly one will gain dependence on this drug... I know for a fact some people have suffered for years from 4 to 5 weeks use of benzos, others can take a benzo for years and never have any trouble. I am not one of those people, and this drug has put me on the wanting to climb that higher ladder at times as @John Mahan refers too, I know everybody means well when they recommend taking a benzo...

I am sorry I do not have the answers on what works best to get relief from tinnitus, it is trial and error. I am not anti medication, but after my experience I just do not want anyone to go through maybe more suffering if it can be avoided. @Lane has helped me enormously, he has sent me so much information on natural therapies, sure they might not be a quick fix but they have helped me cope so much better.

 

[Michael Leigh]

Benzodiazepines
European guideline for the treatment of tinnitus

• Thus, they concluded that benzodiazepine use for subjective tinnitus does not have a robust evidence base and that these drugs must be used with caution because of serious side effects.

A great post as usual Autumnly and I agree wholeheartedly with it. I and others that have experienced and live with severe tinnitus, know this condition is largely mental as it is intrinsically linked to our mental and emotional wellbeing. I know some people are adverse to taking medications to help cope with this condition. However, when it reaches into the realms of being severe and unrelenting, if they are not careful they can find themselves slipping into a vortex of confusion and severe depression. The Benzodiazepine, Clonazepam helped saved me from such a fate back in 2010 when my ENT consultant prescribed it. I was told of its addictive nature and unpleasant side effects but was advised it can help some people with severe tinnitus. I was advised to only take it when the tinnitus was severe. 2x 0.5mg tablets usually reduced the tinnitus to complete silence or at a comfortable level that I could cope with over a 12 to 24hr period.

I found it immensely helpful and have never had a problem with it nine years. I take it approximately once or twice a month now for one or two days.

Michael

 

[Allan1967]

In amongst the in fighting I'm here and getting closer to a successful attempt. Tried again today, but failed. Hurt my throat in the process.

I'm assured this latest spike/increase will settle but I'm just not convinced. My auditory nerve has taken a shock from the alarm, is irritated and needs to settle. Told a week or two but I reckon more like months at my age.

People say hang in for your family but my own suffering is now outweighing this in my mind.

 

[John Mahan]

Antidepressants
European guideline for the treatment of tinnitus

• No drug can generally be recommended for the treatment of chronic tinnitus. However, psychiatric comorbidities associated with tinnitus (anxiety depression) may need drug treatment. Antidepressants should not be prescribed to tinnitus patients without the diagnosis of depression.
• Side effects were commonly reported including sedation, sexual dysfunction, and dry mouth. Nonetheless, antidepressants are often successfully applied in the treatment accompanying depression and anxiety, not for improvement of the tinnitus.

Therapeutic Approaches to the Treatment of Tinnitus
Berthold Langguth, Ana Belen Elgoyhen, and Christopher R. Cederroth, Jan. 2019

• Nevertheless, while there is insufficient evidence to say that antidepressants improve tinnitus (21), available data provide converging evidence that tinnitus patients with depression and anxiety may benefit from interventions using antidepressants. It should also be noted that the onset and worsening of tinnitus have been reported as side effects of both treatment with and discontinuation from tricyclic and other antidepressants (86).

Benzodiazepines
European guideline for the treatment of tinnitus

• Thus, they concluded that benzodiazepine use for subjective tinnitus does not have a robust evidence base and that these drugs must be used with caution because of serious side effects.

Therapeutic Approaches to the Treatment of Tinnitus
Berthold Langguth, Ana Belen Elgoyhen, and Christopher R. Cederroth, Jan. 2019

• Even if these studies indicate a potential short-term benefit of benzodiazepines, the available data are not sufficient to recommend the use of benzodiazepines for the treatment of tinnitus given the range of side effects and especially the risk of drug dependency (92). Moreover, caution is warranted since protracted tinnitus has been reported after discontinuation of benzodiazepines (93).

There's an important difference between saying "you just need to find the right pill" and "many people are helped by anti-depressants".

Finally you had the decency to post your push back.

So let's be clear. Meds can break the suicidal stranglehold tinnitus can wreak and you categorically dismiss all medication because of unknown long term consequences.

A person can't walk and only path to that person walking is a knee replacement. But you dismiss a knee replacement because you don't know in 10 years if the mechanical knee will interact with the immune system and make that person sick. Is that right?

Rome burns but you don't want to put the fire out, because if you do or at least retard it, you are concerned what the future will bring.

Btw, studies do indicate a short term benefit of benzodiazepines, add, myself, Daniel... I begrudgingly add Michael's name because he doesn't know which way is up but him too...and countless others to the list. I take them so infrequently to ward off long term consequence or dependency. Michael has had tinnitus for 23 years and began Clonazepam 9 years ago.

Since you have decided to participate and you categorically throw all medication under the bus because meds are the boogie man with unknown consequences, you need to tell us Autumnly in your profound wisdom, Allan is contemplating taking his precious life. By all accounts, he is a very good person and his cry for help deserves a substantive response. Without medication, to bring him down off the ledge, what do you suggest? Group hug? Sing puff the magic dragon in harmony? Drink plenty of green tea?

That is your next post Autumnly and if you don't respond, not only does this do a disservice to Allan but completely negates the veracity of your 'sky is falling' first post. All meds have consequences. Some can't take an aspirin.

 

[Michael Leigh]

People say hang in for your family but my own suffering is now outweighing this in my mind.

Have a word with your GP or ENT doctor and ask whether they will prescribe clonazepam, it might help you and offer some temporary relief.

 

[John Mahan]

A great post as usual Autumnly and I agree wholeheartedly with it. I and others that have experienced and live with severe tinnitus, know this condition is largely mental as it is intrinsically linked to our mental and emotional wellbeing. I know some people are adverse to taking medications to help cope with this condition. However, when it reaches into the realms of being severe and unrelenting, if they are not careful they can find themselves slipping into a vortex of confusion and severe depression. The Benzodiazepine, Clonazepam helped saved me from such a fate back in 2010 when my ENT consultant prescribed it. I was told of its addictive nature and unpleasant side effects but was advised it can help some people with severe tinnitus. I was advised to only take it when the tinnitus was severe. 2x 0.5mg tablets usually reduced the tinnitus to complete silence or at a comfortable level that I could cope with over a 12 to 24hr period.

I found it immensely helpful and have never had a problem with it nine years. I take it approximately once or twice a month now for one or two days.

Michael

In your ignorance you denounce Autumnly. You are the gift that keeps on giving. A veritable disinformation campaign. Autumnly dismisses Benzodiazepines in her post. God you are dense.

You just wrote:
Benzodiazepines , Clonazepam helped saved me from such a fate back in 2010 when my ENT consultant prescribed it. I was told of its addictive nature and unpleasant side effects but was advised it can help some people with severe tinnitus. I was advised to only take it when the tinnitus was severe. 2x 0.5mg tablets usually reduced the tinnitus to complete silence or at a comfortable level that I could cope with over a 12 to 24hr period.
---------------

Ironically, I couldn't agree more. Clonazepam is/was a life saver for me as well with same effect. Only as needed only your dosage is likely too high for the average person. You are a small person and I am bigger. I take 1/2 that dosage and it helps immeasurably.

Autumnly either supports the use of Benzodiazepines or she denounces their usage, 'with caution or otherwise'. What is 'with caution'? What is sparingly? Once a week? Once a month? Twice a week? Does it vary by person, body weight, brain chemistry, level of mental illness? Of course.

Autumnly hides behind her qualitative BS because she can't see the forest through the trees.

 

[John Mahan]

Have a word with your GP or ENT doctor and ask whether they will prescribe clonazepam, it might help you and offer some temporary relief.

Finally. What I have been saying all along. That is your first cogent post I recall.

 

[John Mahan]

But does it? I can't really find any studies on AD effectiveness for tinnitus except for two very old studies on sertraline and amitriptyline. If we leave tinnitus aside and focus only on depression per se, even the recent most cited meta-analysis confirming AD efficacy for depression has been challenged by several psychiatrists. What is more, there is a recent study in "Cell" suggesting that serotonine, the most targeted neurotransmitter in AD drugs, can worsen tinnitus. The psychiatrists I talked to didn't know about this, and their prescription algorithm typically starts with serotonine SSRIs. Severe tinnitus was poorly understood by psychiatrists I talked to, who would basically disregard it, focusing on the depression and risking to make tinnitus worse even when the depression is originated by tinnitus in the first place. Liam Cairns here has been ruined by Agomelatine, that was supposed to be one of the most tolerated ADs. As I said, if one is to jump off a bridge quick action is needed and a good psychiatrist may be the best shot but seeing psychiatric medication as the main solution to tinnitus is dubious in my view, there simply is not enough systematic analysis to confirm this. But if you have references I missed I would be glad to see them.

Now you are lumping SSRI's with clear jeopardy to tinnitus as often reported here to Benzodiazepines which are completely different. Of course some psychiatrists are ignorant. The world is replete with poor practitioners.

You need your car fixed. Don't take your car to a mechanic because some are bad and ignorant.
Solid advice.

 

[John Mahan]

In amongst the in fighting I'm here and getting closer to a successful attempt. Tried again today, but failed. Hurt my throat in the process.

I'm assured this latest spike/increase will settle but I'm just not convinced. My auditory nerve has taken a shock from the alarm, is irritated and needs to settle. Told a week or two but I reckon more like months at my age.

People say hang in for your family but my own suffering is now outweighing this in my mind.

Hang in there Allan.

 

[JohnAdams]

I'm assured this latest spike/increase will settle but I'm just not convinced. My auditory nerve has taken a shock from the alarm, is irritated and needs to settle.

How long did the alarm go off before you got your ears covered?

 

[John Mahan]

Very valuable information, IF ONLY I had known about the risk of protracted tinnitus on withdrawal I would have never taken clonazepam. My tinnitus has been deafening since I hit tolerance on this drug at the lowest dosage.

I was told this was safe to use for tinnitus as many individuals were given this benzo long term for epilepsy. If used intermittently it probably is safe, but if it gives you relief and you continue to use it you are playing Russian roulette so to speak. It is unknown territory how quickly one will gain dependence on this drug... I know for a fact some people have suffered for years from 4 to 5 weeks use of benzos, others can take a benzo for years and never have any trouble. I am not one of those people, and this drug has put me on the wanting to climb that higher ladder at times as @John Mahan refers too, I know everybody means well when they recommend taking a benzo...

I am sorry I do not have the answers on what works best to get relief from tinnitus, it is trial and error. I am not anti medication, but after my experience I just do not want anyone to go through maybe more suffering if it can be avoided. @Lane has helped me enormously, he has sent me so much information on natural therapies, sure they might not be a quick fix but they have helped me cope so much better.

Hi Star,

In fairness, you don't know about the relationship between Clonazepam and tinnitus. You are 'assuming' there is a correlation because you happened to be taking it and your tinnitus grew worse.

Guess what? People have tinnitus spikes all the time without medication. Please read that again. Countless people come to this forum with a tinnitus spike they can't make sense of. All they drink is mineral water so it must be the mineral water causing their spike. Tinnitus can grow worse for reasons they haven't considered and perhaps few could ever understand.

It is somewhat analogous to Michael categorically throwing headphone use under the bus when people using headphones call him crying and Michael immediately assigns the cause of headphones to a person's spike which is rubbish. Of course if listening too loudly this could cause a spike. Loud sound with hearing damage is a slippery slope.

So that is the problem with a condemnation of a given substance. If there is a definitive trend as reflected here, it is SSRI's can be dangerous to some. Yes, they help some too.

So caution is the order of the day. Maybe you were as cautious as you could be. You took a low dosage for a long period of time. I opt for the 'add needed' approach and also very low dosage which works for me.

Cool that Lane is helping you. He is a very diligent student of tinnitus and I like his thinking about the linkage with OCD which many seem to have with chronic tinnitus.

 

[Allan1967]

How long did the alarm go off before you got your ears covered?

10 seconds? Ran down stairs, looked for earmuffs that I know are nearby & shoved them on.

Sounder is muffled too.

 

[Agrajag364]

In amongst the in fighting I'm here and getting closer to a successful attempt. Tried again today, but failed. Hurt my throat in the process.

I'm assured this latest spike/increase will settle but I'm just not convinced. My auditory nerve has taken a shock from the alarm, is irritated and needs to settle. Told a week or two but I reckon more like months at my age.

People say hang in for your family but my own suffering is now outweighing this in my mind.

Allan, this is very worrying. I do understand how you feel. But if you give up, you will never know if things could have got better. As someone once posted here the only 100% certainty in life is that we are all going to die one day and we will be dead a long time. It sounds trite but given that there's a big impetus to hang on and just see if life can turn around for us. I don't know why so many have to suffer so much but I do know life can turn around and surprise us and improve.

Can't you hang on and see if this Lenire spike goes down? Have you tried TMJ techniques like a jaw splint?

PLEASE confide in your family how bad you feel.

 

[Mathieulh]

Great post Chinmoku and glad you made it. Of course. On this forum in fact, common knowledge and gets written about all the time. However going in...and yet, you started meds in the first place...and I did the same thing. I have treaded very carefully for all the reasons you have eloquently enumerated.

So will ask you. You are on medication for some level of fear of withdrawal, and I am on Clonazepam 'as needed' which is sparingly and a huge help for me with little fear of stopping but when I need it, I need it or start looking for the ladder to that high place like Allan and Pete.

So you need to prescribe a roadmap Chinmoku. You with all your experience are now the signature advisor to both Allan and Peter....both of whom are tettering on the edge and thinking about jumping. I may have jumped off the ledge had it not been for Clonazepam. Can't speak for you. I live a relatively normal life now. Yes, my tinnitus is intrusive and bugs me and I take a Clonazepam as needed, resisting as much as possible understanding the pitfalls you discuss.

You have noted the slippery slope of meds, their tradeoffs, the trap of dependency and withdrawal, and possibility of tinnitus spiking.

Please advise Allan and Peter down off the ledge without medication. Or, if you believe this is a bridge too far, advise how they should proceed with medication.

We are all here to learn, I agree with everything you wrote however, tinnitus is a brain disorder, the brain operates on neural chemistry and basically the only game in town is to tweak this if nature is falling short with all the peril you identify. Can't modify behavior with profound mental illness placing people at the brink.

Please advise.

Tinnitus is not just a brain disorder, it starts with cochlear peripheral neuropathy, and unless someone or something fixes that root cause, I am afraid you aren't going to fix your tinnitus anytime soon, at best you will "habituate", but everyone here knows that's no real cure.

 

[Mathieulh]

I never said that there weren't other paths to psychiatric medicine. I stated my position very clearly. I will tell you misdirected experimentation with anecdotal remedies if suffering profoundly is a poor direction. I said psychiatric medicine is the first and principle path to recovery. Tinnitus is a brain disorder. Mental illness many times if not most is the biggest impediment to recovery. The heterogeneous nature of tinnitus interacting with a person's very specific brain physiology and chemistry makes it IMPOSSIBLE for any one stop shopping panacea. My advice has been that a psychiatrist is the best place to start. None of the things you have suggested has helped me and medicine prescribed by a health care professional has profoundly helped me which agrees with 'most' of the accounts here.
Many wouldn't be here if it weren't for psychiatric medicine as imperfect as it is.

PS. Lane is a brilliant guy btw and few can wade through the tedious task of self analysis and trial of different substances, interpreting the literature etc as well as he can. By contrast, Michael is as dense as a door nail...lol...and Autumnly doesn't have the balls to defend her floundering path to recovery. Both however are very 'nice'. As nice as a tinnitus spike. The shoe fits. Isn't that right Spike?

Tinnitus is NOT a brain disorder, it's a neurological condition tied to the inner ear (and to a lesser extent, the auditory cortex, but that again is tied to the inputs (or lack thereof) of the cochlear, which chronic exposure of, can eventually deregulate (among many other things in the brain), while the brain does have part to play in the perception of tinnitus, it's not the root cause of tinnitus and thus is only part of the equation, it is in fact quite likely that fixing the inner ear and its surrounding nerves and synapses would, over time, fix tinnitus as the auditory cortex, should it have been deregulated would likely eventually revert to its proper state without any external intervention required.

 

[Mathieulh]

How long did the alarm go off before you got your ears covered?

Depending on how badly your ear is damaged, it can take but a second to further increase permanent damage, considering dead ear cells don't regenerate in humans, that's quite likely, this is why we need medicine to provide us with ways to restore our hearing, hopefully, this won't be as difficult as restoring eyesight.

 

[Mathieulh]

But does it? I can't really find any studies on AD effectiveness for tinnitus except for two very old studies on sertraline and amitriptyline. If we leave tinnitus aside and focus only on depression per se, even the recent most cited meta-analysis confirming AD efficacy for depression has been challenged by several psychiatrists. What is more, there is a recent study in "Cell" suggesting that serotonine, the most targeted neurotransmitter in AD drugs, can worsen tinnitus. The psychiatrists I talked to didn't know about this, and their prescription algorithm typically starts with serotonine SSRIs. Severe tinnitus was poorly understood by psychiatrists I talked to, who would basically disregard it, focusing on the depression and risking to make tinnitus worse even when the depression is originated by tinnitus in the first place. Liam Cairns here has been ruined by Agomelatine, that was supposed to be one of the most tolerated ADs. As I said, if one is to jump off a bridge quick action is needed and a good psychiatrist may be the best shot but seeing psychiatric medication as the main solution to tinnitus is dubious in my view, there simply is not enough systematic analysis to confirm this. But if you have references I missed I would be glad to see them.

It's not effective per se, it lowers your perception of tinnitus (to a degree) and your response to it, by targeting and acting on your brain's GABA receptors, this somewhat "works" short term, but the tradeoff is a very high risk of 1. Addiction 2. Severe and lengthy withdrawal symptoms, including inducing or increasing tinnitus. Not worth it in my opinion, and by a long shot.

Fun fact, noise induced mild and severe tinnitus are one and the same, as in, they share the same cause, the main difference being the extent of damage your ear/ears has sustained, the more damaged it is, the louder your tinnitus becomes, of course your response and distress is indeed directly correlated to the perception (or loudness) of your tinnitus.

If someday we manage to fix noise induced mild tinnitus, chances are we can also decrease quite substantially severe tinnitus as well, if not fix it (depending on what becomes available in the future, if anything).