Clonazepam (Klonopin, Rivotril)

I was prescribed Clonazapam/Klonopin in 2010 because my tinnitus changed to severe variable tinnitus. My ENT consultant advised that I only take it when the tinnitus is severe. Two 0.5 mg tablets. It helped a lot reducing the tinnitus over 8 to 12 hours to complete silence or to a more manageable level.

Fortunately I haven't had any problems with Klonopin in 12 years and still have it on prescription from my doctor. I take it about once or twice a month for one or two days, then stop.

If you are around loud sounds as a musician, even wearing the best hearing protection will not necessarily stop your tinnitus getting worse. If external sound is loud enough it will pass through the head and transfer to your inner ear, by bone conduction and could spike the tinnitus. If you are fortunate the spike might reduce, or it could increase the tinnitus to a new permanent level.

Anyone that has noise-induced tinnitus risks making it worse if they listen to audio through any type of headphones even at low volume. This includes earbuds, AirPods, headsets, bone conduction and noise-cancelling headphones. Some people that have noise-induced tinnitus are able to use headphones without any adverse affects. However, many people that have this type of tinnitus do get adverse effects.

Type headphones in the search box at the top of this page and read the posts.

Michael

 

I think it has much more to do with how well it reduces anxiety or it is literally calming down DCN activity. If it was purely neck/tension, Valium would be the better option, as I believe it is much better in muscle relaxation, but it isn't as great for tinnitus. Guessing because it isn't as good as reducing anxiety. Don't know if Klonopin is better at reducing nerve impulses than Valium.

Also if you look at benzo withdrawal, it would appear tinnitus from withdrawals hit people using Klonopin worse than Valium.

I think benzos are the devil. Yes some can use 4 mg forever but that is a high dose. Dementia as an outcome of long term use has to be understood. Many people hit tolerance. Accidental addiction is also high.

 

That is a pretty jaw dropping amount of benzos.

 

Do you still take this dosage every day and, if so, for how long have you been taking it?

 

I’m a 63-year-old musician with left ear only tinnitus originally resulting from a onetime gunshot exposure when I was 26. My right ear is fine.

I had a really bad flare up in 2004 playing one gig with a loud drummer and it caused me to stop playing music for over a year. The last 10 years have been great as I either completely habituated to it or it was gone. I never thought about it. Since 2004 I’ve always worn a -25 dB ear filter in that ear in a loud environment.

Unfortunately, the tinnitus is back louder then ever after doing some vocal recording with headphones a couple months ago at a volume I’ve been recording at for years with no issues.

It’s very intrusive causing me major grief and anxiety. The only thing that masks it is taking a shower with my head under the faucet.

The baseline tinnitus sounds like a hose bib running - constant high frequency ring.

A month ago I finally got into seeing an ENT who was pretty clueless about tinnitus but did give me a prescription for 10 tablets of 0.5 mg Klonopin with one refill. Since that appointment on April 24, almost a month ago, I’ve taken 10 of the tablets usually at night to help me sleep.

I keep thinking my tinnitus is improving or I’m habituating to it as the volume and sound change to a mild hissing and I have several days in a row where the volume is something I could easily live with.

Unfortunately, I’ve now come to the realization that 0.5 mg Klonopin is suppressing my tinnitus for approximately 96 hours! It reduces the tinnitus from an intrusive 8-9 volume to a mild hissing 4-5 in volume and I actually forget I have tinnitus if I’m active. I last took a 0.5 tablet Tuesday night at 8 pm and I had relief until I awoke this morning (Sunday) at 2 am to the sound of the the loud hose bib tinnitus.

I was under the impression that the actual effects of Klonopin on the nervous system only lasted 12-16 hours yet it’s suppressing my tinnitus for up to 4 days! Anyone else get that much relief from just one 0.5 mg pill?

I have an appointment with an audiologist tomorrow so I’m not going to take any Klonopin as I want the baseline tinnitus for the hearing tests.

 

I've been wondering about that, too. I don't think a 0.5 mg has ever lasted 96 hours for me but I do get 18-24 hours of benefit from Klonopin. I try to take no more than 1 mg per week. I don't think that amount can make me dependent but I do worry about the positive effects wearing off over time.

I think I read where Dr. Nagler stated that benzos can possibly inhibit habituation so that's something to consider when taking them.

 

I decided to cut the 0.5 mg doses of Klonopin into half. On Monday night (May 23) I took 0.25 mg as I was having trouble sleeping. I ended up sleeping well and the next day the tinnitus had reduced to a mild hissing just like before.

Several days went by with the lower volume less bothersome hissing tinnitus. I was again fooled into thinking wow! I must be getting better or habituation is occurring as I could easily live with this level of tinnitus and there’s no way it could be that small dose of Klonopin I took as it’s been three days!

Disappointingly, I awoke Friday morning (May 27th) to the sound of the louder intrusive hose bib running tinnitus in my head. I couldn’t believe that 0.25 mg of Klonopin lowered my tinnitus substantially for over 72 hours!

I'm going to try and not take any Klonopin for a week and see if the tinnitus level changes at all. If it remains at this loud intrusive level and pitch, it’s going to be difficult to not taking the easy way out and just take 0.25 mg of Klonopin every 4 days and hope no dependency forms from that low amount!

 

So the last two weeks I have started to experiment with taking 1 mg dose of Xanax, once a week because I figure that is a safe enough spacing. I’ve noticed that the next day I don’t experience my tinnitus as intensely. Previously I used it as needed to just kind of get me through a horrible night but lower doses like 0.25 mg didn’t really have that effect when I tried them.

Seeing that I’m consistently experiencing a positive effect, I am considering working with my MD to start me on a more regular moderate dosing of Klonopin (Xanax clearly isn’t what I want to form a dependency to), every day or every other day, accepting that I will develop a dependency and see whether it helps improve QoL until a real treatment gets developed.

How bad is long term use for your overall health? How bad is getting off Klonopin when I eventually want to?

 

My own experience is that Klonopin is the only prescription that I have taken and produced significant clinical improvement in my tinnitus.

Unfortunately, it only works when it is taken from time to time. It is best to reserve it for spikes or really bad days. It helps with sleep as well.

What you are doing taking it once weekly seems OK, but I doubt that you will get more benefit from taking it more often. I rarely take more than 0.5 mg Klonopin. You will hear similar comments from other old timers like @papu and @Michael Leigh.

 

You have explained the best way to use Klonopin for maximum benefit to help with tinnitus management @InfiniteLoop. My ENT prescribed it in 2010, with the advice to only take it when the tinnitus is severe. I was told of potential side effects if taken too regularly and therefore take it for a brief period, then it is stopped.

I have found Klonopin very helpful over the last 12 years and never had a problem with it. I take it once or twice a month 2x 0.5mg tablets for 1 or 2 days then stop. My tinnitus is variable from complete silence, mild, moderate, severe and can reach very severe levels.

When the tinnitus is severe, Klonopin can reduce to a more manageable level by itself but this doesn't always happen. If it is severe for more than three days, the level of intrusiveness becomes too much even for a seasoned veteran such as myself, it is then I need to take Klonopin to calm things down. It usually reduces the tinnitus over 12 hours to a more manageable level, complete silence, mild or moderate.

Some people might think I haven't habituated but this is not the case. Habituating to tinnitus is all about being able to manage it by any means possible without harming one's health. I am able to do this with the occasional help of Klonopin and continue living my life.

Michael

 

I just went 5 days - 123 hours - of low mild hissing tinnitus of a 4-5 level (which I have habituated to and can ignore) after taking one 0.5 mg Klonopin pill ast Monday night June 6 at 11 pm.

I had a great 5 days of relatively low manageable tinnitus and a normal lifestyle. All day yesterday I was so hoping I had turned a corner using my new hearing aids and listening to violet noise at night with the hearing aids boosting those high frequencies that I haven’t heard in a while where I have hearing loss in hopes that maybe the brain would turn down the volume of those frequencies thus lessening the tinnitus.

Unfortunately, I awoke at 2 am this morning (Sunday) to the sound of my louder (8-9) Intense open hosebib sound in my head that can’t be masked by violet noise. I ended up taking another 0.5 mg Klonopin at 2:30 am to try and sleep.

I’m now working with a psychiatrist to help figure out how I can manage the louder very intrusive tinnitus with Klonopin without building up a dependency if that’s possible.

I’ve now used 16 0.5 mg doses of Klonopin in 47 days.

I asked him if there’s a way to alternate every few months between Klonopin and an antidepressant that has been shown to lower tinnitus so you avoid building up a dependency on either one. He’s going to do some research on that.

 

@Karl Tallman, please keep us posted and sorry to hear about your spike.

 

Having only taken Clonazepam occasionally (0.5 mg once every 10 days) I can certainly say it's a useful tool. My concern is consistent use may be a slippery slope. It does seem to last 2-3 days. Many times 2 days after I thought I was turning a corner and it took a month to see the link. I always took the duration of 12 hours as gold standard.

 

As a former daily user of Clonazepam during 4 years, I can confirm it is.

It basically works reducing the perceived volume, until it does not anymore because your body gets used to it.

Then, you're end up trapped with a double issue: dealing with your tinnitus/hyperacusis + working on tapering off.

Being super cautious with benzo dependence would be the only advice I could give on this subject

 

You've summed up and confirmed my concerns. How long into it did it stop working for you? When in those 4 years did you start tapering?

 

For me it stopped working pretty quickly, I'd say 6 months after the first dose.

I kept taking it because I was afraid it would be much worse if I didn't take it.

I started tapering after 4 years

 

Well I last took a 0.5 mg dose of Klonopin on Monday night and the tinnitus was a mild 4-5 all week. This morning the Klonopin must have worn off as the tinnitus is back to the more intense open hose bib sound which I subjectively rate a 7-8 at best.

I actually was on a Zoom call last week with a psychiatrist and after telling him my whole ordeal for the past three months and the anxiety it was causing me, he agreed with my choice to use Klonopin but thought I should utilize the Klonopin more consistently and take a 0.5 mg dose every other day. He prescribed me 30 pills.

But after reading all the nightmare stories about benzos, I’ve decided I’m going to try and go at least a couple weeks without taking any Klonopin and see If I can get used to the louder baseline tinnitus and keep my anxiety in check.

I’m actually pretty calm this morning and in the past week I have found on YouTube, through Dalesnale’s channel, a 10 hour tinnitus masking noise at 14,000 Hz called “tinnitus smoother 14 kHz” that actually masks my tinnitus. I do have to wear my new Widex 440 hearing aids for it to effectively mask the tinnitus but that’s not a problem.

But knowing I can successfully mask it and be able to sleep is huge psychologically.

I may ask the psychiatrist for a good sleeping med Rx. I’ve been taking two Benadryl at night but would like to alternate with something so I’m not overdoing the Benadryl. I’ve tried melatonin, CBD, THC gummies but they are just not as effective as the Benadryl in inducing a solid 6-7 hour sleep.

I’m going to forgo the Klonopin and hope that by constantly wearing the Widex 440 hearing aids that boost my 6000 Hz to 10,000 Hz hearing loss, that maybe my brain, over time, will turn down the volume of the tinnitus and I can habituate someday.

 

@Karl Tallman, Trazodone has been really helpful for my sleep, in fact haven't slept this well in a long time (still not amazing) even pre-dating tinnitus.

 

Thanks for the tip blamingeverything!

I read online that it is widely prescribed for insomnia instead of depression and due to its short half-life, not much of a chance on becoming dependent. Does it reduce your tinnitus severity like Klonopin?

I'm trying to stay away from anything that temporarily reduces it so I can hopefully eventually habituate to it.

 

I've also been prescribed Trazodone for insomnia. It's been instrumental in getting me to sleep, and it's had no effect on my tinnitus.

 

My tinnitus is indeed usually quieter after Trazodone. Could be the better sleep, could be the drug. But it does help! It is different than Klonopin, I don’t take Trazodone when I’m spiking like I do Klonopin. It’s different in that way. Klonopin always settles me.

 

I was thinking about this. It's good just knowing it's there for bad tinnitus days/spiking. Simply knowing it's effective and in the toolbox. My thinking is that the next 5-10 years may bring better treatment options for hearing loss and tinnitus.

That being said (and that tinnitus can be a side effect of benzo withdrawal), if new treatments arrive after several years of benzo use, will this inhibit effectiveness of these treatments?

 

No one can answer this. I think the answer will be that it depends... Best bet is simply to not become dependent if you can avoid it.

 

Can I ask which route you chose? What you have written match my current thoughts EXACTLY.

 

Well, since writing that post, I have had 3 attempts at tapering off. I even managed to stay off for 10 months in 2020, but could not take it any more. It´s the noxacusis that is killing me the most. Tinnitus bad too.

Tried again recently, tapered down slowly the whole of 2021. But I took rescue dose after rescue dose in the first few months of this year. It´s weird because then you need to take a lot. First you have to take like 20 mg Valium just to get out of the withdrawal, but with no real anxiolytic effect and then maybe the next day it will work. I took like 40-50 mg over three days to feel better, you regret it, the intellect takes control again and you stop. Record being 36 days off. I ended up at the ER several times with extreme pain and panic attacks. You get really scared when you have no control over your heart even though you are on a healthy dose of beta blockers.

As of May this year, after screaming suicide many a time, a doctor said I should take a benzo for the rest of my life and not feel ashamed about it. Everybody in the room bought in to it full of respect to the preach he held about it, me having a chronic condition and whatnot. Only I was sceptic as I´m so worried of tolerance. You must know I have a long history with benzos long before I destroyed my ears.

Anyway, I followed his advice, taking 15-20 mg a day.

Yes, it helped with both hyperacusis and tinnitus, but I got severely depressed and got this "brain zaps".

I´m on two ADs and it´s obvious to me that benzo inhibits serotonergic transmission.

Add to this, my main GP threatened to take my driving license if I took more than 10 mg a day. (One hour after I had agreed with a car dealer to buy the Ionic 5.) I was the one who stupidly brought it up. But it is a new law in my country now and it is his duty to inform as he said.

I´ve had some serious dental work lately, with a lot of drilling. You can imagine how fun that is when only flushing the toilet sends torturous pain trough my brain. Had to take lot of benzos and codeine to get through it. It dulls the pain.

So, I´m basically back to square one. I have rapidly tapered down to 10 mg and I am currently violently ill, but my goal is to start tapering further again even though I know I won´t be able to make it.

I might start taking Gabapentin to aid the withdrawal. I actually took 500 mg last evening. Passed out for 3 hours and when I woke up my tinnitus was totally gone. Not a tiny little beep even. Noxacusis seemed better too. But I fear, like with all the other medications I´ve tried, it´s short lived and hard to replicate if you don´t take a few days brake in between doses.

It´s really an evil beast we are up against. There is no way to win.

That´s all I can tell you, I have come nowhere really. I have hope for XEN-1101, that´s it.

I´m really sick of life. What keeps me alive is the love for a football team in England. But I feel soon that won´t be enough. I´ve lived in total isolation the last 3-4 years.

Sorry for the depressing comeback.

 

I took 0.25 mg but it does nothing for my tinnitus/Visual Snow Syndrome. Any ideas why?

 

It’s not a very big dose would be my first guess.

 

I'll take a 0.5 mg today. I'll keep ya updated.

 

Never ever get on benzos. Especially if you have any hearing conditions. Benzos will only make things worse in the long run. I believe they slow your healing and will make your tinnitus worse and worse. Being pushed on these by my doctor and family member is the nail in the coffin for me.

 

Do you have any facts/evidence that back your claims?