Benzodiazepine's Effect on Tinnitus

Hello,

I was recently prescribed Lorazepam for helping me deal with tinnitus. When I take the lorazepam, tinnitus becomes much less of a problem - but I cannot figure out if it is because the signal has abated or some affected part of my brain that the lorazepam affects has dampened down my reaction. Another possibility is that because I'm less anxious, I am not stuck in that intrusive tinnitus feedback loop that Jastreboff describes in his TRT model.

What is actually going on here? This drug helps me a lot, but I am afraid of being on it for too long. Thank you for reading.

 

There's no biochemical mechanisms by which lorazepam would intervene directly to reduce tinnitus. As you suggest, then, the most likely explanation is that lorazapam reduces anxiety, which reduces your hypervigilance to tinnitus. The result is that the perceived, or "subjective" volume of the tinnitus is reduced.

The good news is that lorazepam, and other benzodiazepines, act on a part of the nervous system -- the parasympathetic, or PNS -- commonly called "the relaxation response." Taking a benzo is the easy way to engage your brain's relaxation response, but there are many natural ways to do so, for example: progressive muscle relaxation, diaphragmatic breathing, certain styles of yoga and meditation, even taking a hot bath! These non-medication forms of inducing the relaxation response take longer because they require learning and practice, but in the long run, can be equally as effective as benzos.

Historically, relaxation training was a standard part of CBT for tinnitus distress. It has given way to mindfulness, which both facilitates relaxation and teaches control of attention.

Best Wishes!
Dr Hubbard