Benzodiazepine Withdrawal and Worsening Tinnitus: I Fell for the Benzo Trapdoor of Hell

I am almost 4 months from my sudden onset of tinnitus (August 30). It took about a week to go into freak out mode and on September 8 my GP prescribed Xanax (0.25 mg 2x/day) and Ambien 6.5 mg CR for anxiety and sleep.

At first the Xanax seemed like magic and literally stopped my tinnitus for hours. This effect lasted for a few weeks but started to decline, so I upped the dose to 0.5 mg 2x/day. I did that for about 3 weeks but the effect of reducing my tinnitus loudness waned even at the higher dose.

Understanding the dangers of benzos, and unwilling to updose again, I started tapering in early October, cutting back from 1.0 mg/day to 0.75 mg/day. In November I cut this again to 0.50 mg/day.

Throughout October and November I noticed I was becoming very depressed (fleeting suicidal ideations) and even more anxious. Although I really didn't have any other physical withdrawal symptoms, my tinnitus was worsening, becoming louder and higher in frequency. My mild hyperacusis became worse as well. I started doing some internet research and stumbled onto benzo withdrawal syndrome, and then everything made sense. I had overdone it with the Xanax and became physically dependent, and my big cuts were causing withdrawal symptoms, including worsening tinnitus and sound sensitivity, which are well-documented symptoms (Ashton Manual).

I am now on a slower taper plan, for both Xanax and Ambien, and things are still not going well. In addition, I am enormously angry at myself for falling into the benzo trapdoor of hell, especially when I really did know the dangers of benzos and Z drugs. If could wind back the clock I would have used those drugs sparingly and weaned off of them after a few weeks; and would have found other ways to deal with tinnitus distress (CBT, mindfulness, whatever). But the damage is done and now I have to slowly work out out of this hole slowly.

And the cruel irony of this is that my tinnitus is far worse than it was in the beginning, and I have no doubt that it is due to benzo withdrawal. I have read other posts on Tinnitus Talk that other have experienced worsening tinnitus after weaning off benzos, and am looking for some hope that the huge spike this has caused may decline in the future once my brain settles down from the benzo injury.

I ask others here to share their experiences with benzo withdrawal and tinnitus/hyperacusis.

 

Don't blame yourself. This has happened to so many people.

How are you doing now a month later?

 

Also I'd recommend looking at alternatives such as CBD oil or L-Theanine in the management of your anxiety. I'm using both and I actually prefer them to Xanax, because they achieve anxiety reduction without causing sedation. There are many other anxiety/insomnia meds mentioned on the forum which are much safer than benzos. So you don't have to go without pharmaceutical aid.

 

Thank you for helping relieve some of my guilt about getting myself into this mess. As for how I am doing - I have successfully weaned entirely off Ambien without any insomnia or other withdrawal effects. And I converted my Xanax over to 5mg/day of Valium, which I am now tapering off via the Ashton protocol (planned completion in April).

However, my tinnitus and sound sensitivity is worse than ever, and I have nothing else to blame but the benzo/Z drug withdrawal. Tough times.

 

I'm sure you know this already, but it's probably good to hear anyway:

The tinnitus is spiking because of your withdrawal.

Once it's over, and it will be over, your tinnitus will settle down.

 

I'm pushing past a month on benzos (Lorazepam) and just started third week of SSRI. I know the benzo will be problematic the longer I take it, but what problems can long-term SSRI use have?

 

I can relate. My right ear tinnitus started in January 2020. My first issues were sleep so I was prescribed Ambien first and then Lunesta to sleep.

Early September I was prescribed Klonopin 0.5 mg a day to further help with sleep and then bumped up a few weeks later to 0.25 mg 3x day. I almost immediately wanted to updose the Klonopin so I told my ENT and he said stop.

Two weeks later I had to reinstate for bad withdrawal. So I started a lower slower taper and got down to .1125 mg Klonopin until December with acoustic trauma event. I went back up on Klonopin and now tapering again. I phased out the Ambien but still take Lunesta plus Melatonin plus Klonopin to sleep. I split my Klonopin dose and am tapering my daily dose.

Doctor wants to start me on a SSRI but I have been putting it off in fear.

 

Update on my status. I cold turkeyed off the Ambien on January 6 and haven't touched it since. Also converted from Ativan to Valium on January 4 to begin tapering off the benzo. After quitting the Ambien several of the symptoms I was feeling just stopped. In particular, the brain fog and feelings of doom stopped within a few days. I thought I would have big time insomnia, but converting to Valium and taking the full 5mg dose at bedtime really helped me with sleep. I have been cutting the Valium by 0.5mg/week and am now down to 2.5mg/day. So far I have had no other benzo withdrawal symptoms. If things continue on this trajectory, I will be done with benzos in early April.

As for my tinnitus, I keep a daily log and since I quit Ambien and started tapering I have logged about a half-dozen days where I scored my tinnitus/hyperacusis at a 3 out of 10. On bad days I am 7-8/10. So, there have been some improvements. Once change that I have noted is that on the bad days my tinnitus is super high-pitched, like a freaking laser beam in my brain. But on the good days its like cicadas, and not horribly unpleasant. Also, on the good days, the reactivity of my tinnitus seems to be much less or even gone.

There is no question that psych drugs effect tinnitus in big ways. When I first developed tinnitus Labor Day weekend of 2020, 1.0mg of Xanax would literally make my tinnitus and hyperacusis disappear for 3-4 hours. It was magical. But that effect started to wear off in a matter of a few weeks. And once I started cutting the dose and having inter-dose withdrawals, my tinnitus and hyperacusis got much worse. If you understand how benzos work, this makes perfect sense. The bottom line with benzos and Z drugs is that they should only be used for short periods of time - like 2-4 weeks. They were never designed to be used daily for months or years. Using them that way is clearly harmful for most people, and getting off of them once a dependency has been developed can be a living hell - much worse than getting off opiates.

The situation with SSRI's is more complicated. In October 2020 I started taking Lexapro, thinking I would be off the benzo quickly. I remember one day about a week after starting the Lexapro I woke up to complete silence, and I thought wow, this is the cure! Of course it didn't last but an hour or so, but that was the last time I had zero tinnitus and experienced total silence. I really can't say if Lexapro has helped or hurt my tinnitus, but I can say that it has helped a lot with my depression, anxiety, and overall attitude about my tinnitus. There are some studies that show that antidepressant that increase serotonin can exacerbate tinnitus because of more active neuronal activity; but then there are other studies that show no such effect. SSRI's, particularly Lexapro, are helpful in the long term management of anxiety, as well as depression, which I think helps people habituate to tinnitus. So, I think the record on SSRI's is mixed. They might help some, but not others.

In summary, if I could go back 6 months to the onset of my tinnitus, I would have used Xanax and Ambien only sparingly for a few weeks, just to the get through the initial freak out phase. I would also have started on Lexapro immediately, as it is a better long term drug for anxiety. Had I avoided developing a dependency on Xanax and Ambien, I believe my tinnitus would have been more manageable, and that I would be further along in the habituation process. Tinnitus distress is bad enough, but adding a benzo withdrawal problem to the mix just made it all that much worse. I am digging out of the benzo hole and feel more hopeful, but it has been the hardest 6 months of my life, and I am 66 years old and been through some shit in my life. My advice to others here is BE DAMNED CAREFUL WITH BENZOS AND Z DRUGS. They can help in the very short term, but long term use will only make your situation much worse.

 

I could not agree with you more. I am digging out of my Klonopin benzo hole and then will target my Lunesta z drug hole. I do feel like I need to be on an antidepressant (have Zoloft in the cabinet) but have been putting it off while tapering.

KWC

 

Everything I've read seems to indicate that yes, benzo tinnitus sucks, but it eventually (even if it's 3 years) fades or disappears... makes sense as the nerves aren't actually dead, but those receptors take a VERY long time to turnover (months) but they adapt very quickly to new situations like benzos (within days to a weekish).

 

Hey All: Update on me, the OP.

I quick tapered off Ambien in early January. I also converted from Ativan to Valium in early January and started a slow taper. I will be done and benzo free in about 3 weeks. So far the taper has gone well; no other symptoms to speak of other than loud, variable and reactive tinnitus. Maybe my tinnitus would have been like this had I not overdone it with benzos and Z drugs, but I have to think messing with my GABA receptors is not helping. I am hoping that as my brain chemistry recovers back to normal my tinnitus will maybe back down a bit and reach a new quieter equilibrium. But there is no guarantee of that.

 

I am right there with you. I tapered Ambien awhile back, just finished Lunesta this past Sunday and now working on getting off Klonopin. Keep us posted.

KWC

 

@DRobi, how is your benzo taper going?

 

My taper is going very well. I am down to 0.25mg of Valium, which is a like a crumb. This is my last week of that then I jump on May 2. I have had no symptoms other than up and down tinnitus, which could be what I am stuck with for good. However, I have had more frequent days when my tinnitus is pretty quiet (2-3/10 subjective scale), and I am hoping that this trend continues. I am still taking 5mg/day of Lexapro, as my psych advises I stay on for a while as I continue to habituate to my tinnitus. I don't think SSRIs like Lexapro have much of an effect on tinnitus, at least in my case. It does help with anxiety and sleep, and is a much better long term drug than are benzos and Z drugs.

I know that benzo use for tinnitus is somewhat controversial, but after this experience I would recommend trying to avoid benzos other than the occasional use - I mean 1-2/month - for extreme spikes and anxiety. It is easy to develop a dependence, and then getting off of these drugs becomes a real ordeal. Likewise for Z drugs like Ambien. They are probably OK for occasional insomnia, but dependence can develop quickly. For me, the daily combination of Ambien and Xanax for months really messed up my brain chemistry. I knew better, so I can't really blame my doctors. But tinnitus distress can be very scary and drive people to do things they normally would not do.

 

Yes I wish I had never gone down the Klonopin path. Currently at .3 mg and still have a while to taper. I have Zoloft but not sure if I will take it yet.