Clonazepam (Klonopin, Rivotril)

Hello All,

I was hoping to gather as much of a consensus on Clonazepam as I can. My life unfortunately is continuing to spin further out of control and I am now looking at either being hospitalized which I cannot afford or starting Clonazepam short term. I have also purchased at my own accord Tofisopam/Grandaxin hoping that it may be less intoxicating.

As a Type A personality this is a real struggle for me as I’ve never been one for medication that alters me in anyway as far as cognitively, motor skill or sedatively. I plan on starting on the 0.125 mg dose but was curious if any of you can tell me the following:

How does Clonazepam make you feel? Is there a point where you just feel normal as opposed to high/confused/out of it?

I’m hoping to only do this short term but unfortunately with no change I don’t know how that will be the case due to the severe reactivity and lack of ability to mask my high frequency central tinnitus at all. I have become a panicked prisoner in my home even on Propanolol. Has anyone worsened while on Clonazepam long term?

I’m thinking less than one year (yes I am basing this off of Susan Shore, hoping for the best and preparing for the worst in my very fragile mind state at this point).

Has anyone with reactivity had their reactivity reduced on this?

I'm also inquiring to see if there’s a regimen anyone experienced recommends to mitigate tolerance and/or severe withdrawal. I’ve seen the Ashton Method on here.

I’m highly distressed and attempting to sift through what pharmacological info I can and appreciate your experienced insights.

 

I was on 1 mg Clonezpam for my ear muscle spasms. I definitely think it helped keep me calm and more relaxed during the worst of my MEM.

I have now gone from 1 mg Clonezapam to Diazepam equivalent 20 mg and reduced to 11 mg so far. 4 mg in morning and 7 mg in evening.

I feel that Clonezapam is good if you have spasms, but perhaps consider a long acting benzo like Diazepam 2/3 times a day at say 2 mg to see if that helps as Clonezpam is more powerful and has a shorter half life, and therefore will be harder to withdraw.

Also, for sleep, if it is an issue, consider 7.5 mg Mirtazapine. Works really well for me.

 

Hi @Padraigh Griffin,

Thank you kindly I great appreciate the feedback and sleep is absolutely an issue. How do you feel about Nortriptyline?

How does the Diazepam make you feel? Do you feel altered throughout the day or just calm? Curious how Clonazepam made you feel as well.

That’s very helpful to know about the half-life. I’m looking for the longest acting medicine for sure.

Obviously I know this is subjective but has your tolerance increased? Hopefully your tinnitus has not worsened?

 

@IntotheBlue03, Diazepam has a longer half-life than Clonazepam. Because of this, it can be great for sleep. For me, it does have an effect on my fatigue, so I end up sleeping too much - it works. Clonazepam seems to be the most widely used for tinnitus, but there do seem to be some horror stories on here about its addictive capacity. It is also combined with the neuroleptic Gabapentin in what is called the Shulman Protocol, which has been used to alleviate some of the ringing.

Short-Term Effect of Gabapentin on Subjective Tinnitus in Acoustic Trauma Patients.

But that is pretty heavy, so I would not go down that route just yet.

There is, obviously, no correct answer on which benzo is "better" for you, as we all vary. Also, note that Clonazepam is, essentially, stronger than Diazepam in that 1 mg of Clonazepam = c. 15-20mg of Diazepam I believe. Diazepam comes in 2 mg tablets (and 5 mg and 10 mg) (as well as in liquid form in some places), so it is easy to experiment with small doses and build up to see where a therapeutic dose lies for you. I cannot comment more on Clonazepam.

Best.

 

A lot of people take Clonazepam for years with no issues. If you come off gradually, then there really isn’t an issue. It’s when you stop cold turkey that it’s a problem and even then, if you’re only taking like 1 mg, nothing will happen.

 

I honestly don't know anything about medication that I have not been on bar a few. I feel the Clonazepam gave a more instant effect but the Diazepam I hardly noticed. I am in the process of tapering the meds and using alternative strategies. I am using the Ashton Manual for withdrawal and switched from 1 mg Clonezapam to 20 mg Diazepam and am currently on 11 mg. I would think Diazepam is a less risky choice and 0.125 mg of Clonezapam will get you through a sticky patch, say a couple of hours, but 1 mg/2 mg of Diazepam might be better for consistent levelling out of the anxiety. Remember I am not a doctor though. This is just personal experience.

In the meantime I really hope you improve. I feel for you reading your messages.

 

@IntotheBlue03, I never took any drug before my tinnitus. It took me much doubting until I accepted benzos. I have been taking Oxazepam and Zopiclone (for sleeping) on and off for the 10 last years. I do not regret it and I believe it helped quite a lot.

If you do not have any addiction problems in your history, it should be very safe. I stayed on very low dose the entire time. Once my tinnitus is not too bad, I can stop taking it for a month. Once your tinnitus is better, it is typically quite easy to taper in a few weeks.

I might be in deep water here but most people that struggle with benzos took them prior to tinnitus.

Benzos for me is like drinking a glass of wine or two. It just calms me down. If I take too much, I lose a lot of creativity so I try to take it 3-5 times per week.

Oxazepam is the first choice of benzo to be prescribed here in Sweden.

Do you trust your doctor? I think it is wise to follow his recommendations.

 

Hi David,

Thank you so kindly for your reply and I am happy to hear you have had a good experience over the past 10 years with your medications.

You are correct I do not have any addiction issues or previous history with drugs of almost any kind and I’m definitely not the addictive personality type. I had to work myself into quite a state to give in to taking just 0.125 mg of the 0.5 mg Clonazepam I was prescribed and even that hit me pretty hard. I will say I definitely will never understand those who love the feeling of being on benzos like this, I absolutely hate it and only welcomed the quieting of my tinnitus and the calmness it delivered to the physical symptoms I am experiencing of extreme distress including chest pain and panic. Other than that it will be a struggle for me to continue to use this everyday but I feel I have no choice. I do however feel much better about my outcome and hopefully reduced likelihood of addiction and tolerance.

Do you typically taper off your medications from time to time? I think you mentioned month to month. I’d like to get into a routine if I could of cycling on and off but that’s at least a few weeks down the line at this point.

Believe it or not I actually came across the only compassionate ENT you’d find in the USA. He listened to my every concern and prescribed these to me knowing my concerns and felt because of my personality that I would have a less likelihood of addiction. After an onslaught of terrible ENTs I was shocked he existed.

 

Thanks @Gb3, I cut the 1 mg I was prescribed down to 0.125 mg and I was struggling to take that, still hit me like a ton of bricks. Appreciate the feedback.

 

Hi Padraigh,

I greatly appreciate your feedback and compassionate words. At this point I am very concerned about not just surviving this day to day but hopefully keeping my job and healthcare. I never realized tinnitus could be so severe and the more I read the more it seems that is the camp I am in with it being centralized, high frequency and reactive. I hope this can at least help me function in the meantime while we wait for treatments like Susan Shore's

Thank you for the info. I will definitely ask about Diazepam as I am looking for the lowest dose long acting anti-anxiety medicine that I can find for now. I am also looking at Grandaxin since it seems like it may have a better safety profile, being less addictive and less intoxicating.

 

Thank you kindly @Uklawyer, this has all been desperately needed information as I’m looking for the longest acting benzo that I can find. This has at least brought me down from total panic to being able to somewhat function again. Appreciate your knowledge always as another user has mentioned the long acting effect of Diazepam over Clonazepam. It was indeed much stronger than I cared for as well. I have Grandaxin that will be delivered tomorrow so I will follow up on that as it’s not widely used here in the USA that I know of but I believe it is elsewhere.

BTW even though it’s not my focus right now, I am on the LDN 4.5 mg daily.

 

Does anyone know if benzos slow down neuroplasticity/the ability to habituate? I still feel at this point habituation may not be possible with severe reactive tinnitus but still curious.

 

@IntotheBlue03, Jastreboff claims they do (particularly with respect to his TRT), but there is no explanation of why this might be the case, nor has anyone else, so far as I am aware, said the same.

At the moment I would try not to worry about these things. The aim is not to be on benzos forever - it is to get to a safer place in the short term and then move on when in a calmer state.

Glad to hear you are feeling a bit more assured. That's good progress so quickly.

 

Thanks @Uklawyer, that’s the impression I get too and I question the potential conflict of interest/motive behind it for now. I appreciate that you always get back to my posts and questions, it’s the one thing that is keeping me going day to day.

The tinnitus has toned down quite a bit on Clonazepam even with me microdosing it but I struggle with the intoxicated feeling it brings, tinnitus is definitely not for high strung Type A personalities which is what I am lol.

Hoping to achieve this calmer state in the next few weeks and I’ll take any suggestions you have in the short term. I attempt to do the things I know I cannot do off of Clonazepam which is to watch movies or listen to music but the reactivity is still there to a certain degree. Susan Shore really cannot deliver soon enough.

 

From what I understand, benzos can only mask the pain and the reactivity. If you keep exposing yourself, your condition will have become worse once you come off. You will probably also find that there comes a point where they start to lose their effectiveness, because they can no longer keep up with the damage that you’re causing / no longer mask it. This seems to be the case with every one who has gone this route. I could be wrong. I’m sorry you’re suffering.

 

Hi @IntotheBlue03, you are very welcome. We have all been there and know it is a very hard thing to deal with. You are doing well and you must tell yourself that. Be indulgent, be kind to yourself during this time and try to let go of the demands you are placing on yourself. If you feel a bit lighter on medication, take it in, accept it. It's hard with this condition, when you are frantically seeking out answers, but try not to fight, however unintuitive or illogical that may seem.

Essentially, you would expect to feel a bit mellow/drowsy on any benzo, but people react differently to these things. I know that Diazepam gives me that drowsy or lighter feeling more than Alprazolam (Xanax), but I cannot speak to the effect of Clonazepam (nor to how these drugs will affect you).

Have you spoken to a Psychiatrist or just your PCP? How much Clonazepam are you taking?

 

Hi Daniel,

I’m sorry I might be misinterpreting but what damage am I doing exposing myself? Do you mean the use of benzos or the fact that I’m doing things that would normally spike the reactivity?

I had prior been in 6 weeks of near silence which is an added torment and I have not improved as far as reactivity goes. Do you mean I should be continuing to limit sound/protect my ears? I’ve heard 2 schools of thought regarding this and honestly am not sure which to follow.

 

I took a lot of Oxazepam and Zopiclone for almost 2 years daily. Then once my tinnitus improved, it was not hard at all to taper them out. Benzo is a very safe drug for most people and been on the market for 60-70 years. It really helped me a lot with insomnia and anxiety. I still take it every now and then. This is my very personal experience.

 

Thanks @Uklawyer, I know a lot of this most likely has to do with retraining my mindset which is incredibly difficult. At the moment I feel like I’m caught between 2 places - dealing with the tinnitus or being intoxicated to quiet it. I know with my personality that’s making me feel trapped in a sense so I am starting to panic and take less of the Clonazepam which is counterproductive. Today I am taking half of 0.125 mg which is far less than what I’ve been prescribed and even that was a struggle to take. I am difficult and the absolute worst person to develop what feels like such a severe tinnitus. I am practicing breathing as we speak as it’s starting to wear off I believe and I am considering trying the Grandaxin that has just arrived.

I can at least say the Clonazepam has been very effective in quieting my T-basically down to a 1-3/10 as I was worried it might not be effective. I know this is short term though and hope the less addictive safer profile of the Grandaxin will help and if anything get me out of what feels like fight or flight again.

I have not consulted a Psychiatrist but definitely will be looking to do so. Healthcare in America is so disjointed as I’ve had a never ending to do list of seeking out healthcare practitioners and dealing with limited questionable services and delays etc etc. There is no protocol here for tinnitus, it’s all guesswork and heavy costs left up to the suffering patient. I’ve spent nearly $7k already. Wondering what it would take for me to be able to see a tinnitus clinic in the EU?

 

The latter.

You may not improve with silence, but at least you’re not getting worse. I can’t see any other outcome with exposure. Clonazepam might still be a good idea though, lessening the torment of having to sit in silence until you find better solutions / treatment options. I’m definitely of the school of thought that thinks silence is the way to go. It’s what helped me. My reactivity took months to improve.

 

Thanks @David S! This is such valuable information. And you were able to continue to habituate somewhat during that period? That’s also a question I have even though I’m sure it can be subjective and the fact that I have reactive tinnitus makes me question habituation as a possibility at all.

I am of course stupidly hanging on to the idea that I won’t have to be on medications more than a year if Susan’s device becomes available. In my fragile state of mind I have to cling to something.

 

My issue was a conflict between wanting to CONTINUE to take a benzo for a while, with fear of building a tolerance and wanting to get on with habituating by not having anything. Initially, I was also concerned that taking anything ran the risk of making things worse. At that point, my psychiatrist said that if I didn't allow him to help he would have to have me sectioned. Not much choice! But I also had to give up some of this control in order to receive the benefit of the drugs.

And feeling "intoxicated" is not a bad thing. Obviously, that is what drugs do. If you are feeling bad, you have to do something to help. It is important, I feel, to acknowledge that if you want to help yourself, you have to commit to, at least, trying something. Do it, accept the need to do it, and let it do its thing. You have, yourself, acknowledged that Clonazepam is helping. Taking something for a month or two will not turn you into a drug addict.

You can, at least, control what you are taking. This might be sensible for you as a first step, in order to feel a bit calmer about taking these drugs. Try a quantity, see how it makes you feel. If necessary, try a little more. In my case, I was put on a high dose and just had to accept it. At the time, I didn't give a shit, as, for me, my life was as good as over anyway, so I just let go and did what I was told, come what may.

The fact that you are still concerned about quantities, types of drug, being able to function etc, shows that you are far from losing it like - which is a great sign. But please try not to get too hung up on finding the perfect way through. All you are doing is taking something to help make things a bit easier. I would, however, recommend trying to find a competent psychiatrist, preferably that has some experience with tinnitus.

If Clonazepam is helping in small quantities, it might be worth sticking with it for now. But if you have Grandaxin, you could always try that first and, if it does not work, you can think again about Clonazepam or maybe Valium. But if you are going to try the Grandaxin, I would leave a bit of time for the bit of Clonazepam to work its way through your system. Do not mix Benzos.

WTF have you spent that on?! I haven't been to a tinnitus clinic in the EU. I saw an audiologist in the UK and a psychiatrist and ENT in France. I think you would only get either sound therapy or be coached in mindfulness. You might be able to get a teleconsultation with someone if you really wanted to.

 

Thanks. It’s still mostly silence. I honestly only watch maybe a show a day because the reactivity while lessened is still there and it’s honestly distracted watching. What I’m really utilizing is the ability to leave the house for endless doctors appts etc without having to worry about my ears 24/7.

How severe was your reactivity? Are there any theories as to what causes this? Cochlear synaptopathy etc? I feel it’s the most tormenting aspect of tinnitus. Is your tinnitus centralized?

I really hope the reactivity improves just seems the ratio of stories I come across here is more often no improvement.

 

Mine was severe to the point where I couldn’t eat or walk without wanting to blow my brains out for the remainder of the day to the catastrophical spikes I would get

I think it’s some sort of trauma to the audiotory system, maybe coupled with inflammation, noise being ototoxic inflammation. The treshold for sound can diminish so bad that sounds as low as breathing can keep the system inflammed, making it almost impossible to come out of.

These are only some of my theories though.

I’m sure it will get better for you. Right now it’s just important that it doesn’t get worse.

 

Thanks Daniel. That's my concern too as I don't know how I would deal with worse.

How is your reactivity now?

 

@Uklawyer, I might have to start paying you for these sessions because if you were giving this type of counseling in the US Healthcare system you would be banging big bucks out of destressed people like me lol. I hit another wall unfortunately yesterday with my fight or flight from fearing having to take the Clonazepam again so I switched to Grandaxin at the end of the day and I can say it's definitely much better. It still lowers the tinnitus for me from 10/10 to 3/10 as long as I'm monitoring my environment and I feel no where near as intoxicated. You are absolutely right about everything you are saying as I'm very much at the point of needing to commit to medication or risk being hospitalized. That constant panic mode is exhausting as well and I didn't know how much more of that I could handle either. I will be committing to this hopefully moving forward and I agree I feel much more comfortable sticking on this for a month or two without a high risk of dependency occurring. Hopefully tolerance doesn't occur. That's my only concern.

I have thrown away that money and more at this point thanks to having high deductible healthcare which basically means I get the privilege of having to spend a fixed amount out of pocket for my healthcare to the tune of $3,000 annually before my healthcare will kick in and even at that point I have to pay co-pays and coverage is only up to 70%. I'm sure your head is spinning at this point. Of course alternative therapies I've been trying have been expensive and fruitless (electric acupuncture, dry needling, somatic physical therapy, craniosacral therapy, upper cervical chiropractic, hearing aids etc along with supplements and now medication). I'm now looking into psychiatry and maybe CBT if you recommend it. Too early for TRT, don't you think? Seems like the options for that are pretty limited in my area as well.

 

A lot better. The duration of my spikes last an hour now where as before they would last the rest of the day. Only thing that sets me back is overexposure to digital audio. I would probably be well on my way to recovery by now if I wasn’t so addicted.

 

Don’t feel badly. I’ve probably gone through $125,000. I started out with absolutely catastrophic tinnitus and hyperacusis about nine years ago. I lost something like 30 pounds going from 150 to low 120s. I was pretty much skeletal unable to sleep, unable to drive, unable to function.

Anyway in addition to craniosacral therapy, acupuncture, Ayurvedic treatment which has been helpful, hypnosis, TRT including the devices, and lots more, I also take 1 mg of Klonopin and 500 mg of Gabapentin.

I find the combination is somewhat helpful although more so my first time around using the Klonopin. I tapered down with no problem except for the fact that the tinnitus would increase each time I tapered and then settle back down to perhaps a 3/10. I did pretty well for about two months after stopping the Klonopin and then there was a resurgence of the tinnitus so I’m back on it. It all depends how sensitive you are to meds but in my case Klonopin was not hard to reduce.

Unfortunately now things are all over the place. Some days when I’m really lucky at 3/10, other days up to perhaps an 8/10.

Good luck with it

 

@slc, I am sorry to hear things are all over currently. Were you ever able to break the fight or fight cycle consistently? That is where I am and I feel like everyday it is getting harder despite medication. I am unable to go outside at the moment which is devastating.

 

So, figured I should add in here my situation.

I developed tinnitus after earwax removal (manual) from an ENT. It set in like 3 days later. Could it be from something else? Possible? But the timing is suspect. Anyways, it caused me all kinds of anxiety and was put on Lexapro by my general doctor.

I got to talk to a psychiatrist and he said to go ahead and start taking Clonazepam (0.5 mg) nightly. I am like on day 3, and surprisingly it's like it lowered the volume in a major way. It's still there... but a much more manageable level.

The good news is that this is just a nice break from what is now almost a month of usually high pitched tinnitus. Also, I can finally sleep... as waking up in the middle of the night is when my tinnitus is screaming the loudest.

So, reading this forum... sounds like I'm doomed because it sounds like this is a short-term thing? My doctor said to use this for 15 nights and see how it goes.

Don't want this dreaded withdrawal people are talking about. Ugh!