Clonazepam (Klonopin, Rivotril)

It's all over google how bad they are for you.

"Tinnitus is often associated with a degree of hearing loss and is not uncommon in people with partial nerve deafness who have never taken benzodiazepines. Nevertheless, it often makes its first appearance during benzodiazepine withdrawal in people who have had hearing loss for years."

 

Ahh yes, Dr. Google.

 

Tinnitus Worse During Clonazepam (Klonopin, Rivotril) Taper

Spike in Tinnitus After Tapering Off Clonazepam (Klonopin)

 

Both those people posted once and never mentioned it again.

Clonazepam Quiets tinnitus: a randomised crossover study with Ginkgo Biloba

 

Links between neuroplasticity and benzodiazepine use, if not yet completely understood, is being discussed in the neuroscientific community.

No fact/evidence doesn't necessarily mean nothing's happening; neurosciences are very recent and there are tons of things we are learning each year in this field.

You'd be surprised by how science is currently taking a huge step in understanding why the general consensus regarding our previous ways of treating depression, anxiety, stress, traumas, etc. and the systematic use of antidepressants and anti-anxiety meds is being reconsidered.

A few hospitals with top-notch researchers in neurology, psychiatry, psychology, in Europe mostly (Switzerland, Germany, UK), but also in the US, are currently gathering pretty decent information on how our modern society has probably completely effed up with treating anxiety/depression disorders.

I wouldn't be surprised the bold claim made by the previous poster that "benzos will make things worse in the long run", while being maybe a bit dramatic, is not that far from the truth.

But again, each one of us should be humble regarding what we think is safe and what we think is not, because really, we still don't know much. The only thing we know is that today, in 2022, we're still in the stone age of neuroscience.

 

Long-term, high-dosage, constant/daily use of benzos can make a lot of things worse. The key is to use low doses and not take them daily. I've used Clonazepam for situational anxiety for maybe 20 years now and have never had any issues with it. Sometimes I'll take 0.25mg a couple of times a week, sometimes I go for weeks without any, sometimes I'll take a 0.5mg dose.

As I type this I'm planning on taking 0.5mg tonight because my tinnitus is in rare form. With 0.25mg I haven't experienced any reduction in its severity and I haven't taken a 0.5mg dose since my tinnitus spiked to its current level about 2 months ago so I'm hoping it will help. Will also be taking a half-dose of Mirtazapine and 300 mg Gabapentin. It's about the only way I think I'll be able to sleep tonight.

But if doctors try to push daily benzos on you, I'd be very cautious. I've seen family members end up in that situation and their withdrawal was horrible. My own father was put on high daily doses of benzos, Seroquel and a bunch of other stuff and it totally fucked him up. He eventually had to be hospitalized and ended up on intravenous Ativan and sent to a rehab facility.

But 0.5mg or 0.25mg once or twice a week doesn't sound too bad to me.

 

Interesting take.

Y'all's opinion?

I wonder why...

 

Is this still your current regime?

 

Were you asking for my opinion or someone else’s? Either way, here's my opinion on that. Keep in mind I'm not a medical professional and this is just the opinion of someone who has had some experience with benzos, both direct personal experience and seeing the effects they have had on family members, but is not a medical opinion or advice.

For me, those doses are way too high. They will absolutely lead to a dependence for most people. There might be a tradeoff there though. If whatever condition you're treating with Clonazepam resolves with those high doses AND you don't experience any unwanted side effects AND you're willing to remain addicted to it for life, I suppose some people will be willing to trade severe tinnitus or other conditions for a lifelong addiction to Clonazepam. But, if you experience a problem or situation that requires you to stop taking Clonazepam, you are going to be royally screwed and may end up in the hospital or dead.

And that's assuming those high doses actually fix the problem. If they don't, you could end up making things worse while also adding a dangerous addiction to your list of problems.

That is a choice each person should make for themselves and shouldn't be left to a doctor or anyone else.

One other point I'd like to make - I've seen people mention on this forum that benzos with longer half-life are more prone to lead to tolerance and dependence. This is backward. Benzos with a longer half life are less likely to create addiction/dependence because since they clear out of your system more slowly, they give your body more time to adapt to their absence rather than just disappearing quickly. This is why benzos like Xanax are more dangerous than Clonazepam in that respect.

BTW, my own experiment last night was only partially successful. About an hour after taking the Clonazepam/Gabapentin/Mirtazapine mix my sensitivity to the tinnitus tone was greatly reduced and made it so it didn't really bother me although it only produced a minimal, yet still noticeable, reduction in the perceived volume. It also helped me fall asleep without having to play any masking noises but when I woke up in the middle of the night I did have to turn on the masking noise to go back to sleep and this morning the tinnitus tone is back to normal.

So, while I'm willing to continue the Gabapentin+Mirtazapine combination, I won't be using Clonazepam for this on a regular basis unless the ENT I'm scheduled to see in September has a different opinion, and even if that's the case, I will use my own experience and common sense to determine the right dose and frequency of use. But if I absolutely need to sleep, I will use last night's full combination again, but no more than once a week. The rest of the time will just be Gabapentin, Mirtazapine, and maybe something like Doxylamine or Melatonin (yes, I know those can be ototoxic but so can pretty much any medication if you believe everything you read).

 

Well I went to my doctor today for my annual checkup and asked him what he thought about me giving Clonazepam a go. I have no panic response to tinnitus anymore, no existential trauma, just pain, pain I've learned to live with but still I go around wincing most days for a couple of hours a day.

So I'm going to give this a try, do it for 3 months, and see if it improves my QoL. The doctor seemed to think tapering, if I want to get off, wouldn't be that big of a deal. I know on Tinnitus Talk we are covered with people that had a lot of bad times from benzos but we are also a bit of a self-selected group.

Only additional thing is that I am due to go back for a week of study on my brain at NIH in a couple of weeks (read my back story if you dare, but I'm part of a five year study of people that had unexplained health incidents) and might want to hold off starting until after they do their follow-up study to keep their data clean.

Question to the group, if I do this for a week just to try it out before going back for the study, do I need to taper or am I pretty safe just stopping?

 

How much are you taking?

 

I'd steer clear of it if anything and preserve your current QoL.

 

I agree.

 

Why wouldn’t I try it? I don’t get any special award for living in pain but benzo free. Super not concerned about it getting worse, I don’t believe that functionally it can be much worse.

Why?

 

Just worried for you to get worse but yeah, based on what you said, I can understand now.

 

It can always get worse.

 

None yet but 1 mg 3x a day if I want. I guess I'll start at 0.5 mg once a day and keep increasing until I get a positive response or it sucks too bad.

Back to my original question, can I do 0.5 3x a day for a week as a trial run to see what it does for me, then stop without a taper and clean up so that the NIH can get a clean apples to apples comparison as to how whatever happened to me affects people over time?

My condition is currently severe enough that it doesn't make life worth it for its own sake about 80% of the time. The only reason that I bother staying on this plain of existence with this ridiculous condition is for my family. It's the loudest thing I hear 99% of the time, never gets masked, fluctuating endless cascades of various piercing shrieks and squeals, and I don't know all the sounds I try not to focus my attention to it... and then there are rare hours when it is loud, still unmaskable, but a steady sound which I could get accustomed to, but that is what passes for a rare good hour or two. I've been on this ride for more than 3 years so it's not going to get better. If it got "worse," whatever that means, I'd still stay around for my family. I don't mind pain, I'm not afraid of it, it is like my shadow, a part of me that I can never leave behind.

So my attitude after trying everything else, having been clinically certified as not depressed, not anxious, not stressed, not suffering from any mental illness aside from bearing endless experience of pain, why not try this to see if it lightens my load?

Again my doctor didn't think it would be too hard to taper if I want to.

I know that I am the aberrant one on Tinnitus Talk, but I don't do fear, it's not in my psychological makeup. My stress/fear response got all burned to the ground working for years in war zones and more years running international disaster response operations. I should have already been dead a dozen times over, bullets have missed me, bombs hit the next building over, the mobs weren't quite able chop me with their machetes, I survived all through some bravery and luck; I am living on bonus time now. So could it get worse? Hard to imagine, but if it did it all that would happen is that I'd adjust my maximal threshold for pain. In either case my pain dial can only of up to 10 (all apologies to spinal tap), no matter what that 10 might be.

 

I strongly believe that my reactive electrical tinnitus is due to me re-instating benzos, not the noise trauma that I suffered in January. It is too erratic and random to be noise trauma, and comes from the head rather than my regular tinnitus that is in the ears.

I am tapering, every time I taper it gets worse for about 2 weeks, followed by a stretch of good days. I hope this nightmare I am in will be over once I am completely off benzos.

I cold turkeyed in 2020 after 4 years of 0.5mg/day, so I'm sure that has something to do with it.

Btw 3 mg/day is enough to knock out a small elephant.

If you choose to do it, which I also do not recommend, take 0.5 mg every other day, and not consistently. You will build up tolerance in 2 weeks.

 

So I popped 1 mg last night, sure did get sleepy. Didn't do a damn thing to my tinnitus.

I'm taking a 0.5 mg tonight.

How many days should I be taking this before it does anything but help me sleep?

 

You should be able to see right away if it does anything for tinnitus.

But a lot of people say to not take it more than once a week. The more you take it, the more tolerance you will build.

 

So here's a very limited anecdote with no statistical significance.

Monday night I took 0.5 mg Clonazepam. Tuesday my tinnitus tone was significantly lower in volume. So low I thought maybe it was resolving itself. Tuesday night I did not take any Clonazepam. Today my tinnitus is back to its normal annoying screech.

Based on one day I'm kind of hoping it really does have an effect.

Tonight I will be taking another 0.5 mg to see if the results are consistent with what I experienced when taking it Monday night.

For the record, I'm combining it with 300 mg Gabapentin.

 

If it's going to do anything for your tinnitus, it would be within a couple hours.

 

Dr. Levine says you will know within a few minutes to hours, not days:

https://www.tinnitustalk.com/attachments/how-to-use-clonazepam-for-tinnitus-pdf.51200/

 

That's about what I get in terms of duration of effect. 36 hours.

 

I guess I should increase the dosage.

 

I'd consult a doctor before taking more than 1 mg at a time. It won't harm you but if you take that much in a single dose every day you will increase the potential for developing a dependence/addiction. Some people even develop an addiction with 0.5mg twice a day for a couple of weeks.

 

So my Clonazepam experiment is working relatively well so far. Last night I took 0.5 mg and it reduced the volume by the time I went to sleep. The couple of times I woke up in the middle of the night, it was low enough that I didn't have any issues going back to sleep.

When I woke up this morning it was louder between approx 6:15 and 8:00 but by 8:00 the volume was back down quite a bit.

As I type this I'm on a Zoom call and with headphones on I can hear the whine but it's not a screech.

If my experiment goes how I expect it to, by tonight or tomorrow it will be back to the regular screeching. I have a few Clonazepams left from an old RX but it won't last me much longer even taking just one every two or three days. My ENT appointment isn't until September and I'm hoping he will give me a new RX, otherwise I'm going to be very miserable.

Since we're on the subject, does anyone have any suggestions for how to get an RX for Clonazepam in the event the ENT I'm going to see doesn't want to prescribe it? My old prescription is from a psychiatrist but I no longer live in that state and I really don't care to go doctor shopping.

 

My primary care physician proscribed mine.

Sadly it doesn't seem to do anything for me, other than giving me a good night's sleep, not enough benefit to justify prolonged use. I've used it 3-4 nights in a row, I guess 'll give it a rest for a week or two, and then give it one more try at heroic dosing levels to see if it can do anything for me under any circumstances.

Congrats on finding something that helps.

 

@Carlos1, was your tinnitus severe/reactive before you started this combo?

It's such a difficult decision to make when you read some people hit tolerance and it stopped working after 6 months.

Is the missing link the Gabapentin having some sort of synergistic effect?

 

Wasn’t your head tinnitus gone after Korea?