Naltrexone as a Tinnitus Treatment

Hey, I tried Clonazepam today, 0.25 mg, it did nothing lol.

 

What's a high dose? More than the recommended one?

 

I'd say up to 2000 mg or more.

 

Wait 12-24 hours.

 

Nothing happened lol, I dunno.

 

I stopped Naltrexone after 8 weeks because it had no effect on my tinnitus.

 

Then perhaps your issue isn't GABA.

Have you considered the possibility that it might be neuro/cochlear inflammation and/or potassium channel involvement?

 

I'm sorry to see this didn't help you.

Are you going to try higher doses?

 

I take almost ten times that dose, and it bioaccumulates substantially (30 hour half life) such that taking 2 mg a day ends up equaling a blood level similar to a ~10 mg single dose.

I'm not encouraging anyone to use benzos, but 0.25 mg of Clonazepam would do very, very little for me even before I had a significant tolerance it took 2-3x that to feel any relief. And, again, I do think the Gabapentin seems to be an important part of this for me.

 

No. I don’t see any hope that a higher dosage would have any effect.

 

I'm thinking of trying MSM.

Maybe consider it?

 

I honestly do not know, maybe inflammatory, since I had this issue from age 3 or even earlier on.

VSS included. I'm quite skeptical since VSS seems to be majorly a GABA issue:

Visual Snow: Updates on Pathology

 

I'll try 0.5 mg over the next days. Maybe it will do something but who knows. If not, I'll try the Gabapentin.

 

Did the higher dose help this time?

 

How bad is your tinnitus without the current dosage you are on?

What time do you take the meds? And what is your dosage of Clonazepam and Gabapentin?

I am at the end of my rope with how loud and reactive my tinnitus is and I am trying to stay on this planet.

 

@linearb takes 2 mg Clonazepam and 600 mg Gabapentin. First thing in the morning with a glass of water.

Hope I saved @linearb some time as I see he gets asked this a lot.

 

Do you know how long he’s been taking it?

 

5 years.

 

How does Gabapentin help tinnitus? Is it not for pain problems?

 

Look for Abraham Shulman tinnitus protocol. He used Clonazepam + Gabapentin combo successfully on tinnitus patients.

 

@2noist, have you ever tried this protocol?

 

Thanks

Yes this comes up so much and I feel bad because I genuinely believe this drug combination is pretty dangerous and also statistically unlikely to help ~any given tinnitus sufferer~ as much as it helps me because of all the specific stuff about my backstory that feeds into that.

I will probably attempt to taper the Gabapentin soon and see what happens.

 

This is also what led me to this, combination, but, again it also has a lot to do with my personal medical history and history with benzos. That said, I would hardly say there's strong evidence.

We had this preliminary report in 2002 that put this on people's radar:

GABAA-benzodiazepine-chloride receptor-targeted therapy for tinnitus control: preliminary report

Interesting, but hardly equivocal. 30 patients, with a 30% dropout rate (inherently casting doubt on claimed efficiency by at least that amount). The duration of effectiveness varied wildly, with some people seeing the effect wear off within a couple months. No control group, no RCT.

Also Shulman, 2002:

Benzodiazepine receptor deficiency and tinnitus

It provides some evidence people with tinnitus may have less benzo receptors in critical places. Again, interesting, but if this is correct then the effect of treating such people long term with drugs that manipulate the BDZ receptor "needs much study", since chronic BDZ use triggers downregulation.

So, then in 2006 we got this:

Benzodiazepines and GABAergics in treating severe disabling tinnitus of predominantly cochlear origin
(PDF - Full Text)

Still only 30 patients, but somewhat better design, 10 control (group 1), 10 benzo (group 2), 10 benzo + gabaergic (group 3). This references the earlier Shulman work, it's literally an attempt to reproduce the results with a more sound methodology, and this is where it concluded:

Do these numbers look compelling enough for you to want to try a generally dangerous combination of controlled substances?

From "discussion":

So, sounds like a big wet fart to me. Also I am firmly in the camp of "preexisting anxiety disorders" which would make me look somewhat like Shulman's sample group, and not at all like someone with severe idiopathic tinnitus and no prior psychological discomfort.

All in all -- I'd say the evidence that this works in any general or broad way simply doesn't exist, and the existing data strongly implies to me that most people with tinnitus will NOT benefit from this combination.

It's also somewhat hard to get put on benzos long term, and if you do and then decide you want to get off that's even harder...

 

That’s interesting because I stopped taking Naltrexone the first time because I had a nasty spike, then hours later it was gone. It seems to keep doing that. I’m only on 0.5 mg, going to work my way up. Before I tried 1.5 mg. I get random spikes, then it goes away randomly. Trying it for noxacusis so let’s see if I get pain relief.

 

What caused your tinnitus? I am trying to ask my doctor about Naltrexone for tinnitus.

Thanks!

 

Ototoxic drugs and noise exposure.

 

So why aren't ENTs talking about it, why aren't we on it?

 

Because of the potential "side effects", some of which can be fairly catastrophic.

 

Lots of reasons:

• Dependence
• Tolerance
• Withdrawal
• Sustainability
• Side effects

They were not followed up for more than a year... tough choices.

 

Alcohol has some catastrophic side effects, and none of it potential. Should you drink a lot instead to help you cope? I'm not sure, I haven't had a drink for ages.