Do We Understand How Benzos Affect Tinnitus?

Every time I take a Xanax and try to listen for my tinnitus, it’s basically gone. My distortion/dysacusis where I hear whistling noise over lots of external noises is also gone. Even my pain hyperacusis is mitigated - I just went and stood under a vent that usually makes my ears hurt and now it just sounds like it used to - a normal air vent with a gentle flow of air.

So basically Xanax makes my life 80% - 90% back to normal.

Do we understand the mechanism by which this works? Is it similar to Trobalt/Retigabine? I’m asking because it’s amazing to me that a single pill could do this, and I wonder if there are other things that can affect me similarly, without the extremely high risks of benzos.

 

Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA).

 

I think it’s simply because it’s a sedative. It lessens the neural activity in your central nervous system so tinnitus is less intrusive and maybe not even there at all. I believe most forms of tinnitus would cease if there was a healthy way keeping the central nervous system activity in relation to the auditory process down. For me, and from what I read on here, many people don’t have tinnitus when they initially wake up and then after a minute to an hour after waking up it sets in showing it has something to do with neural activity excitement. Another example would be the avoidance of caffeine (a stimulant) because it makes tinnitus worse. I don’t know any drugs you can take everyday long term that would do this though and don’t have really bad long term side effects.

 

I think benzos, as other posters have written, enhance the effect of GABA.

I'm not sure if Retigabine has gabernergic effects, but I do know it's a potassium channel opener (kV2/3).

I've been tempted to take GABA itself but concerned about providing an external source, which might impact on my tinnitus long term.

I've opted to taking precursors to GABA such as Magnesium L-Threonate, Taurine, Glycine...

Someone correct me here, but I think I recall Ashwaghanda can help generate more GABA receptors?

I drink linden and chamomile tea too.

 

It seems extremely multi factorial. Benzos can affect any or all of the following:

1) Counterbalances the hyperactivity of excess glutamate in both the brain and cochlea.

2) OHCs themselves have GABA receptors which contribute to normal function:

Functional Role of GABAergic Innervation of the Cochlea: Phenotypic Analysis of Mice Lacking GABAA Receptor Subunits α1, α2, α5, α6, β2, β3, or δ

3) Brain calming/ sedative effects.

4) Other effects I am probably missing.

Most people regardless of etiology or damage seem to initially get at least some effect from benzos.

The problem is that if tolerance is reached or withdrawal happens without an appropriately slow taper, these same initially helpful receptors become down regulated.

Tagging @Star64 too because she knows a ton about benzos.

 

Problem is that gaba is linked with glutamate (glutamate is a precursor of gaba) and if one person has the gaba-glutamate conversion mechanism compromised some gaba enhancing drugs or supplements may become dangerous and do the opposite of what they are supposed to do. L-theanine is one example. This is good article on balancing gaba and glutamate, I posted it yesterday on a different thread

https://www.holistichelp.net/blog/how-to-increase-gaba-and-balance-glutamate/

Benzos increase gaba in a quite specific way. They do not attach to gaba receptors from what I gather. They may work short term, some people are able to stay on them long term without reaching tolerance or withdrawal, but some other people do and it's hell. It's a lottery and varies across individuals.
I tried L-theanine, taurine, gaba, and all sort of gaba-enhancing supplements and gaba-modulators in the past, and NAC that should turn glutamate into glutathione, but this didn't even scratch my tinnitus. Perhaps this stuff does not have the potency and selectiveness of gabapentinoids and benzos. Clonazepam initially was able to make me ignore my tinnitus (not to quieten it) but as I remained on a constant dosage it totally lost power and I suspect the worsening I keep experiencing might be partly due to tolerance withdrawal. I tried Lamictal to reduce glutamate but it backfired. So I think the relationship gaba-glutamate is much more nuanced than we would think.

The Holy Grail would be a drug acting on gaba without tolerance or dependence. Initially we thought gabapentinoids were like that, like "good benzos", but some harm reduction specialists I talked to told me people struggle to quit pregabalin more than benzos very often, with horrid withdrawal symptoms (including tinnitus). So it is a no-go. There is a very promising drug in phase III that regulates gaba but is not addictive, vistagen ph94b (Greg Sacramento mentioned this to me). This is very encouraging and could be the solution to finally avoid benzos but we have no idea of its effect on tinnitus. There are other gaba-acting drugs like acamprosate that seem to have no effect on tinnitus according to some studies (but do according to others) and there are quite a number of glutamate antagonists but they don't seem to help. So it's a little of a mystery why some gaba enhancing or glutamate reducing drugs and supplements do nothing while benzos seem to be generally effective. Maybe it's potency. Who knows. More research is desperately needed here, as in all things tinnitus.

 

My question to you is at what dose is it working? I have had severe tinnitus for 30 years. Of the 30 years I've been on Xanax for 25 years. It doesn't stop me from hearing the tinnitus but it appears to change the pitch. I'm glad you found relief.

 

For me a .5 mg dose reduces things 50-90% - I also am on regular Mirtazapine and Nortriptyline so maybe it is synergistic.

I’ve only done this a handful of times for fear of tolerance or permanent change to my baseline.

 

I can only say do what helps get you through tinnitus. You sound like you have a handle on it. G-d bless.

 

If I had a guarantee I wouldn't develop tolerance or worse tinnitus I'd consider it a cure, but I feel like the opposite is far more likely given protracted usage. Have you been taking it regularly for 25 years without issue?

 

Do they help?

 

Benzos enhance the action of GABA, GABA in general decreases neuronal activity and firing rates. It is likely that it is reducing excitatory nervous system activity in some of the brain regions responsible for carrying the tinnitus signal through the whole brain -- tinnitus is not just a thing that's "heard", it seems to also directly activate emotional and fear related centers, in severe cases anyway.

There is also a thought that people with an abnormally light distribution of BDZ receptors in specific brain regions might be predisposed to tinnitus, and benzos are sort of duct tape for those people.

In my case, I was on Klonopin daily for 6 years from the age if 19-25, and I think that may have just wired bits of my brain to "want" it, if not "need". My experience with going back on at the age of ~36, specifically for tinnitus (and combined with Gabapentin and a cannabinnoid protocol), was that for the first month or two I had a significant suppression of volume, a "honeymoon period". After that the tinnitus seemed to "come back", yet, somehow, it's still vastly easier to live with than it was pre-medication and if I am not on this forum I often go hours or more without thinking about it. Any time I do it's generally super obvious 14khz EEEEEEEE cutting through everything. Sometimes it still seems "bad", especially if sleep deprived, at the end of a long day, or a couple hours after having an alcoholic drink, but it's very rarely "painful" and I do not believe I have missed any work on account of tinnitus since going back on daily benzos in 2018.

That's not very long ago so I'll get back to you in another 10-15 years about how that went. I have been through the long, slow, shitty withdrawal twice in my life, so I have some sense what I am into. Benzos are extremely dangerous, and may make tinnitus or cognitive problems worse over time in some cases.

Just eating GABA won't do too much as it cannot cross the blood brain barrier in any meaningful amount. (If it could, there are a lot of GABA-containing foods that would knock us out or kill us....)

 

@linearb I've been on Prozac and Xanax for 25 years. I found this to be beneficial for me to tolerate tinnitus. Even on the cocktail I do have spikes but I do stick with it. The formula has allowed me to keep a job, finish a career and deal better. I do not suggest this will work for everyone but it kept me above ground.

 

This non benzo medication, a non binding gaba NMDA receptor within their pipeline has a label for anxiety adjustment and Post-traumatic stress disorders. They have FDA Fast Track, the only non addictive medication within class, no taper needed, no known side issues and may help with excitotoxicity from other benzodiazepine use. Company won't discuss if it will help with tinnitus, just as benzo manufacturer's won't, because it's not label. I sent a video to Dan and the video does speak. They have many publications and they are based in San Francisco. Neuro team has very impressive backgrounds. They have a pain med in their pipeline that is also safe from toxicity.

 

I've had this conversation with my psychiatrist. I asked about tolerance then I said I don't want to know. What I have been taken for 25 years has helped so I do not think about whether it is a a placebo or tolerance. I know it dosen't affect my everyday life. I sure wish for better treatments.

 

Sorry if you have mentioned this elsewhere, but do you have any additional info so I can venture out onto the interwebs and educate myself? This is something I'd like to keep an eye on.

 

@GBB

https://www.vistagen.com/

https://www.vistagen.com/news-media/press-releases

https://www.vistagen.com/news-media/media-coverage

https://www.vistagen.com/news-media...shawn-singh-highlights-company-pipeline---wsm

https://www.vistagen.com/news-media/multimedia

https://www.vistagen.com/pipeline/av-101/major-depressive-disorder

 

Does Gabapentin do something similar, and is there risk to taking that long term? I’m on 300mg 2-3 times a day.

 

Need to consciously mention that VistaGen is not of investment quality. Company is not investor friendly as most small development stage bios are not. They may need to do a reverse spilt to obtain compliance so that a 180 day clock isn't ticking. 93% of the time with a reverse spilt and for years to come, stock value is hit hard. Also needed is more creative financing to fund developments that will continue to dilute shares. CEO with required ethics reporting recently stated this, and this is another reason why the stock trades for pennies. Much of the house is and will continue to be given away to firms that do marketing if and when a treatment is approved.

In my opinion, few to almost no companies have any investment or staying quality where they have any association to tinnitus, hearing, somatic physical issues or emotional input. Frequently Therapeutics may be an exception over the longer term.

 

No worries - I won't invest in my employer for fear of over concentrating my resources in life - I DEFINITELY WILL NOT invest in a tinnitus-related company. Imagine the condition leading not only to your mental degradation but your financial ruin...

I just want to consume their product like candy is all

 

I was curious. What was your experience with Lamictal?

 

Not good, it made my tinnitus sharper and louder. Now I'm in agony

 

I am so sorry to hear that . I hope it will lower for you. Are you saying that you took the Lamictal and are off it now but that the Lamictal made it louder even after you stopped?

 

Yes, I hope it calms down but so far it hasn't.

 

So I'm just an idiot trying to parse this "non-binding GABA NMDA receptor". I did a little googling and have educated myself on agonists vs antagonists, and that benzos bind to a separate GABA site and activate as positive allosteric modulators, but what exactly does the vistagen drug do? Is it an NMDA antagonist, similar to Memantine or Ketamine? I've read through their investor literature on AV-101 but it's still not entirely clear to me (again, relative idiot).

 

@GBB -- Synthetic neuroactive steroids called phorones, increase levels of serotonin which activate the hypothalamus, limbic amygdala, prefrontal cortex, and frontal gyrus via chemosensory neurons. It is said by many researchers that drug delivery needs to turn on chemosensory neurons starting with basal forebrain structure. They believe that channel blockers will not depolarize. They have electrodermal results from first study of volunteers. The FDA recently black box all benzos. AV-101 is not a benzo.

 

May I ask, have you had to adjust your dosage at all or experienced a perceived drop in efficacy of the Xanax?

 

Hi! Can you please tell me what is your daily dosage of Klonopin and Gabapentin?

And what cannabinnoid protocol do you use?

I knew that Gabapentin can have bad side effects but maybe your dosage is not so high.

I would really need your answer as my tinnitus is severe enough at this moment and disturbing my life.Thank you so much!

 

Before I answer this, I'm just going to comment that you've been dealing with this for about 2 years, which sucks, but it took me nearly a decade of living in frequent suicidal ideation and daily misery before I was willing to entertain the idea of daily benzo use again, exactly because I have been on and withdrawn from Klonopin in the past, and I know that both the addiction and the withdrawal process are dangerous and hellish. So, this wasn't a road I was willing to go down until "all else failed". Additionally, I suspect that my earlier (and fairly extended, and youthful) exposure to Klonopin, might have done weird things to my developing brain that cause these drugs to affect me differently than they might if I hadn't been on them when my brain was still developing.

Disclaimers aside...

2mg a day Klonopin, 600-900mg Gabapentin. Neither of these things is good but I personally find the benzo more concerning, even if Gabapentin is a generally "weirder" drug.

Growing and processing weed is legal here so I do it all myself and therefore can't tell you very much with certainty. If I assume the oil I produce is in the realm of 70-90% pure cannabinoids, which is probably reasonable, then I'd guess on average I use something like 100-300mg per day, mostly THC but with enough CBD/CBG in the mix to be synergistic.

Cannabis was much less helpful (and sometimes intolerable) before being back on benzos.

I don't really know what is doing what, but, if I had to say what I think each of these things is doing:

* Klonopin - generally lower stress levels, generally lower distress response to stressful input, generally better able to ignore stressful inputs.

* Gabapentin - this may actually be lowering volume and pitch, but if so, it's doing it through some weird synergy with the Klonopin, because taking Gabapentin by itself never seemed to do very much. Attempting to taper back off it now, I can maintain 600mg no problem but once I start cutting from there, the "machine shop" high pitched brain drill seems to come back within a few days. This is all subjective, though.

* Cannabinoids - severe reduction in time to sleep onset; generally sleep longer and with less waking. Better sleep == less cranky.

 

Thank you so much for your answer. I'm from Romania which I think is already giving me a bad spot since THC is illegal here. I was thinking to try CBD only, which I heard can give some anti-anxiety relief. I take 0.5 mg Klonopin for sleep only. At the beginning this dosage could easily quiet down my tinnitus, after 2 months this advantage was lost. I didn't want to increase the dosage. It has some effect on sleep.

Yap daily misery would be exactly my description. I had no history of nothing that could have brought up my tinnitus, it just came after an external ear canal infection. That was taking care off, but the inflammation, untreated, gave me tinnitus. The doctors just dismissed it from the beginning by saying that will resolve by its own.

I have no hearing loss up to 16,000 Hz, at least on the audiogram, but regardless have very fluctuating bad tinnitus. Reactive to noise. Now in both ears even though my infection and the clogged stuff were in one ear only.

I can't clear my head around how this could have gave tinnitus.