Impact of Benzodiazepines on TRT (Tinnitus Retraining Therapy) Brain Plasticity?

Dr. Jastreboff, inventor of Tinnitus Retraining Therapy states in his book and in this YouTube video presentation (fast forward to 6:46) that patients who take benzodiazepines are not good candidates for TRT because these drugs decrease brain plasticity, which is an essential element to the success of the therapy.

Pawel Jastreboff on Tinnitus Retraining...

He states that this phenomenon has been "very well proven", however, I cannot find and scientific studies that confirm this. It is also unclear if patients who have previously used benzodiazepines have permanently decreased their brain plasticity or if it is a temporary state while the patient is currently on the drugs.

Has anyone had success after TRT while taking benzodiazepines or after having taken them for a prolonged period of time?

 

You could email Jastreboff and ask for his sources. Then share with us what he said. He's a loser who kept tinnitus research back for decades.

 

I too was curious about that.

 

I can't answer for TRT but I can for hypnosis.

You can sometimes read that benzos would limit the benefit of the hypnotic state and would even prevent the brain from going into a trance.
I've been using benzos daily for 3 years, no issue with hypnosis.

Hypnosis is not TRT but still, I thought I could give this piece of info here.

 

@Contrast any valid claims to this statement regarding plasticity and benzos?

This study says it goes both ways with plasticity:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4243505/

This articles suggests, but doesn't conclude, that it can effect plasticity:
http://www.remedypublications.com/o...-development-and-adaptation-processes-291.pdf

I see nothing that shows it is "very well proven" though. Such a strong statement for something that doesn't have much research.

@GaryTH off topic, but I see you said the shingle vaccine caused your tinnitus. Can you go into detail about that?

 

The guy is a blow hard and made it up just like every other aspect of the theory he conjured into existence. There was a scientific vacuum and he took advantage by providing a plausible solution to everyone except tinnitus sufferers - no one wants to deal with our intractable problems especially when they are invisible - he made a hand wavey way for medical practitioners to feel good by codifying treatments but it doesn’t hold up to real scrutiny.

 

I don't know if the shingles vaccine was the cause, as I had many other factors coinciding (stress and Airpods sound exposure). The Shingrix vaccine is the newer shingles vaccine, which is supposedly safer because it doesn't use a live virus (which in the past had been shown to cause tinnitus in some people). However, I received the first dose of the two dose vaccine 2 weeks before my tinnitus onset. I never went back for the second shot, which is supposed to be taken 2-6 months later.

 

I wouldn't mind punching the good doctor right in the teeth. Pushing his garbage therapy while people suffer life altering symptoms for decades.

 

Not sure why so many people have such animus towards this Dr. Jastreboff. TRT unlike many other so called tinnitus 'cures or treatments' is considered a legitimate therapeutic approach to helping tinnitus sufferers habituate.

 

Because it doesn't actually treat the root problem. It's a band aid that has been pushed as legitimate treatment. It doesn't actually fix the root cause.

 

@Jrblovsky -- Wow, you just very succinctly described the (very limited) approach of virtually all of modern conventional medicine. I'm far more oriented toward naturopathic, holistic, alternative, etc. approaches that actually seek out and address the root of the problem.

That said, I'm not at all averse to using various palliative measures that treat symptoms so that a person can get a measure of relief. Whether Jastreboff's method(s) are a "bandaid" or not doesn't diminish the very real results some people seem to be getting from using his methods. My hat's off to the guy.

 

That's great. I'm glad some are helped. It's still a garbage treatment.

 

I guess unless you're the one that got helped. The young man in the videos I posted sure seemed to believe it did.

 

I believe when you have mild tinnitus it would help. However placebo is probably most of it.

 

@Lane, @Jrblovsky, @Marcuso22... It's not even a bandaid, it's a scam.

Effect of Tinnitus Retraining Therapy vs Standard of Care on Tinnitus-Related Quality of Life

 

The central precept of this treatment is that it is impossible for us to actually affect the tinnitus medically in any meaningful way, ironically aside from benzos, which the treatment expressly forbids. Every single person with tinnitus should pause and consider that fact.

This is analogous to Stockholm Syndrome - "Yes we are trapped here, but if you just embrace this new reality, it's not so bad!" - Jastreboff has gone full Colonel Kurtz and HE DOESN'T EVEN HAVE TINNITUS.

 

It's only because it came out at a moment where there wasn't anything else, and it could claim a certain improvement in the majority of sufferers that may very well have been the result of the time that had passed. As such, it's as much an observation of a naturally occurring phenomenon (habituation) rather than the treatment doing anything. In the absence of any objective marker for tinnitus TRT could get away with getting the credit for said improvements.

Jastreboff has built his career on it and still believes it to be the best and only treatment available. He also fails to acknowledge the need for ongoing research saying TRT is really all anyone could ever need. He has gone on record saying people who don't improve may actually have an economic interest (disability) in their prolonged suffering.

And for all the above reasons, I find him a total prick.

 

I'm sure any person suffering from tinnitus wants to be disabled. What a fuckin idiot.

Only a person with no brain cells would think that way.

 

I don't believe it's a scam because it isn't promoted as a cure or guarantee that everyone who takes TRT will be a success story. They seem honest about their internal studies & TRT has been subjected to many studies showing in some cases that it is at least equal to or better in most cases what is considered the standard of care. The standard of care being entirely focused around specific counseling to help improve one's perception of the tinnitus distress. Whether this placebo effect with the use of sound generators was performed without controversy i don't know but keep in mind many of these studies do end up at some point being contested by newer studies pointing out flaws in the way they were conducted.

The problem which many ignore here is that casual observers reads the titles and summaries of these studies taking no more than a couple minutes while ignoring other pertinent information throughout the body of the study, i.e. Eligibility Criteria - who is eligible for these studies! In this study all participants had subjective distressing tinnitus of at least 1 year duration & no prior treatment for their tinnitus. Well for me and many others waiting one year to begin a treatment is far too long to wait! That doesn't prove TRT is superior to rest of treatments but if a participant in this study can go for one whole year without any form of treatment then they are already in far better shape than me & probably have already experienced some habituation to their tinnitus.

 

My audiologist wanted to send me down his path but I read that white noise causes cognitive impairment.

I'm not at all up with the research only being new to tinnitus myself but I am interested to know more.

Unintended Consequences of White Noise Therapy for Tinnitus—Otolaryngology's Cobra Effect

 

If you click on the related articles you will find two responses from different Ph.d's who disagree with their conclusion which is entirely based on animal studies. Dr. James A. Henry is a well known respected audiologist.

I do however think there is some merit to what they are saying. If you're going to listen to only one type of broadband sound for 10 hours a day for many month's or years you're going to deprive your auditory system of everyday sounds which are numerous & differ in quality therefore you can end up becoming more hypersensitive to natural sounds in our surroundings. But that can be avoided even with the use of ear level sound generators as long as the volume level of the broadband noise is not overwhelming to the point they mask the sounds around you. When you wear BTE ear level sound generators/hearing aids strictly for tinnitus and not hearing loss as well as tinnitus you should still be able to have conversation with someone where the broadband sound isn't interfering with your ability to hear what the other person is saying & other noises in the background. This is suppose to be the great advantage of wearing BTE sound generator/hearing aids over wearing ear buds connected to your smart phone or mp3 player which apparently cause occlusion.

 

@GaryTH I'm guessing you got better?

 

I must then be screwed because acoustic trauma triggered my tinnitus during benzo taper. And I have used benzos long term.

ENT suggested TRT if my tinnitus symptoms continue to bother me. I don't know whether to laugh or cry after reading this. Maybe I shouldn't waste my money on this. What makes this situation even more desperate is that there is no TRT available anywhere near the city I live in.

And even the founder of TRT wouldn't see me as a good candidate for this therapy because of benzos . What treatment options are left then...

I would like to say my opinion about this though. I have gone to therapy during benzo taper and have got a lot of help from the therapy and have learned a lot of new stuff and changed my emotional responses. I believe benzos can make therapy more challenging though.