by Neil Bauman, Ph.D.
June, 2006
A lady explained:
“About 15 years ago I started having panic attacks and began taking Xanax (Alprazolam) at 1.5 mg/day and have been on it ever since. Two years ago I had some really bad panic attacks so my doctor doubled my Xanax medication to 3 mg/day.
Now everything is out of control for some reason. In the past year or two, in spite of the increased dose, things have been getting much worse to the point I don’t feel normal any more.
My hearing is a lot worse, I have vertigo and balance problems. I feel unsteady on my feet. My ears are ringing. They are also supersensitive to sounds. As a result, I can’t wear a hearing aid in one ear any more.
I feel like I am only 50% here—kind of like a bad head cold feeling, or living in a dream state. I feel shaky and out of sorts and panicky. I feel weird and feel like I am going to pass out. I can be fine one minute, then BAM—all of a sudden I feel this odd feeling coming on as if my hearing gets very quiet. I feel as if I am chilled. I get a tingly feeling in my head, and then I feel a sort of darkness and closed-in feeling about to happen. I start to shake and sweat, and I just feel as if I am drifting away.
I have always thought that my medications could be hurting me more than helping me. Why did the doctor do this to me? My neurologist feels I won’t be able to stop taking the Xanax as my body is now dependent on it. If I would go off this drug, he feels I would spin out of control—but I’m already out of control!
For some time I have wanted to try to taper down or get off the Xanax, but I am scared I will feel worse. How am I going to live my life without the Xanax? I want to be able to get through the day, but not like this! I would love to be free and be me again! What should I do?”—D. M.
Unfortunately, you are not alone. I have heard a number of similar stories from people who have been taking drugs of the Benzodiazepine (pronounced ben-zoe-die-AZ-eh-peen) class for a number of months or years. Eventually, like you, they realize the drugs are not really helping them, yet when they try to go off them, the nasty time bomb hidden in these drugs not only ambushes their ears, but also flips their lives upside down and leaves them worried about their ability to function in the future.
What are Benzodiazepines?
Benzodiazepines are a class of drugs commonly known as tranquilizers and sleeping pills. They are predominantly prescribed for anything associated with anxiety or sleeping problems.
In case you don’t know which drugs belong to the Benzodiazepine class, some of the more common Benzodiazepines include Xanax (Alprazolam), Valium (Diazepam), Ativan (Lorazepam), Rivotril & Klonopin (Clonazepam) and Halcion (Triazolam). (Brand names are in italics while generic names are in bold.) There are at least 20 different Benzodiazepines. The generic names as you can see above (with few exceptions) either end in “lam” or “pam.”
In addition to the Benzodiazepines, there are three other drugs that although not Benzodiazepines, have similar effects including the same horrible withdrawal problems. They are Sonata (Zaleplon), Ambien (Zolpidem) and Imovane (Zopiclone).
Here’s How It All Begins
When people go to their doctors and are prescribed one of the Benzodiazepines, the last thing on their minds is that years later they will be “hooked” on a horror drug. Here’s how it all begins.
Benzodiazepines are only meant to be taken for short periods of time. They are temporary solutions to problems such as anxiety and sleeplessness. In fact, safe and appropriate use of Benzodiazepines is for no longer that 2 to 3 weeks if taken daily. They were never meant to be the long-term solution to these problems. Unfortunately, doctors allow multitudes of people to stay on these drugs for months, and in many cases, years.
When you stay on a Benzodiazepine for too long, bad things begin to happen. First, the longer you take a Benzodiazepine, the less effective it becomes. For example, for problems sleeping, Benzodiazepines are only effective for about 1 to 2 weeks. When your symptoms begin to get worse, doctors typically increase your dose. This works for a few more weeks, then you begin to feel even worse.
This is because if you take Benzodiazepines for inappropriately long periods of time, not only does the drug become ineffective, it also induces drug dependency. What happens is that your body comes to depend on the drug to function. Thus you are “hooked” much as a person becomes addicted to certain drugs. (Note: technically, Benzodiazepines cause dependency, not addiction.) As a result, you will experience withdrawal symptoms when you reduce the dose, or stop taking it altogether.
“The biggest drug-addiction problem in the world doesn’t involve heroin, cocaine or marijuana. In fact, it doesn’t involve an illegal drug at all. The world’s biggest drug-addiction problem is posed by a group of drugs, the Benzodiazepines, which are widely prescribed by doctors and taken by countless millions of perfectly ordinary people around the world.”
“Drug-addiction experts claim that getting people off the Benzodiazepines is more difficult than getting addicts off heroin. The only genuine long-term solution is to be aware of these drugs and to avoid them like the plague.”
“It is more difficult to withdraw people from Benzodiazepines than it is from heroin. It just seems that the dependency is so ingrained and the withdrawal symptoms you get are so intolerable that people have a great deal of problem coming off. The other aspect is that with heroin, usually the withdrawal is over within a week or so. With Benzodiazepines, a proportion of patients go on to long term withdrawal and they have very unpleasant symptoms for month after month, and can go on for two years or more. Some of the tranquilizer groups document people who still have symptoms ten years after stopping.”
The above quotes were taken from the home page of benzo.org.uk, a web site dedicated to Benzodiazepine addiction, withdrawal and recovery.
At the same time, the result of this dependency actually makes your original symptoms worse. For example, Benzodiazepines eventually make your sleep problems even worse than they were before you began taking these drugs.
The same thing happens with anxiety. Initially, the Benzodiazepines help, but if you continue to take them for extended periods of time, the resulting physical dependency can actually cause an increase in anxiety—even while taking the same low dose!
Second, myriads of side effects begin to emerge. Taking Benzodiazepines can have several negative side effects on your ears. For example, those side effects that act on the cochlea include hearing loss, auditory hallucinations, hyperacusis (hypersensitivity to sound) and tinnitus (ringing or buzzing in the ears).
Those side effects that act on the vestibular system and affect your balance in one way or another include dizziness, ataxia (lack of coordination/staggering gait), loss of balance, vertigo (sensation of movement–usually a spinning sensation) and nystagmus (eyes jerking horizontally).
In addition to messing up your ears, taking Benzodiazepines can cause a number of other scary side effects such as anxiety, fears, feelings of unreality, hypersensitivity to light, insomnia, lack of concentration, loss of memory, nightmares, panic attacks, rapid mood changes, shaking, sweating, depersonalization (a feeling of not knowing who you are), outbursts of rage or aggression, paranoia, persistent unpleasant memories, feeling of pins and needles, rapid changes in body temperature, blackouts and a host of other symptoms.
When I mentioned to the lady in the above story that she likely would be shocked to learn that almost all of her symptoms, both ear-related and otherwise, were known side effects of taking Benzodiazepines, she replied, “I’m scared. Everything you have said about the drugs I take really hit home.”
Third, when you finally decide the Benzodiazepines aren’t doing you any good any more, and indeed are causing you much more harm than good, you try to go off them. That is when you discover to your horror that when you try to go off them, your existing symptoms intensify and still others appear.
For example, some people get hyperacusis (super-sensitivity to normal everyday sounds) when they try to go off Benzodiazepines. In one study of 22 people, 4 (18%) had hyperacusis. Fortunately, by 3 months, only one person of the 4 still had hyperacusis.
Other people end up with protracted tinnitus when they try to go off a Benzodiazepine. For example, one man who had taken Diazepam for 8 years for anxiety, got obnoxious tinnitus just 4 days after discontinuing Diazepam. His tinnitus persisted for 3 months. Fortunately, after 6 months, his tinnitus was only occasional and of short duration, and by 1 year it had completely disappeared.
Another man began to hear high-pitched ringing tinnitus in both his ears for the first time in his life as he reduced his Diazepam dose to a low level. Unfortunately, in his case, he still had tinnitus 1 year later but was learning to cope with it.
The withdrawal side effects can be so incapacitating that some people choose to stay on these drugs because they cannot cope with these horrible side effects when they try to stop taking Benzodiazepines. By doing so, they condemn themselves to a miserable existence for the rest of their lives.
For example, one man, after taking Diazepam for 12 years for anxiety had severe tinnitus upon discontinuing Diazepam. In his case, he discovered he couldn’t stop taking the Diazepam because of his incapacitating high-pitched intense tinnitus in both his ears which began each time he reduced his dose of Diazepam.
What’s the Risk?
Used responsibly and taken in the short term to tide you over a rough spot, Benzodiazepines can do some good. However, so often these drugs are abused. For example, according to one estimate, 1 person in every 50 people has been taking a Benzodiazepine for longer than 6 months!
Furthermore, research indicates that 30% to 50% of regular Benzodiazepine users will develop a dependency to these drugs. In addition, the longer you take a Benzodiazepine, the greater your risk of becoming dependent on that drug.
This makes it very difficult to get off Benzodiazepines. In fact, researchers estimate that between 50% and 80% of people who have taken Benzodiazepines continually for 6 months or longer will experience withdrawal symptoms when reducing the dose or stopping completely.
Getting Off Benzodiazepines
Getting on Benzodiazepines is easy, but getting off them once you have built up a dependence to them is very hard, and for some people almost impossible. You see, dependence to the Benzodiazepines is insidious and sneaks up on you without your even being aware of it—often until it is too late.
Therefore, your first line of defense is knowledge. You now know that Benzodiazepines are only supposed to be used for short periods of time—2 to 3 weeks at the most! Any doctor that prescribes these drugs for longer periods than that is doing you a disservice, and may be harming you. Thus, refuse to take any Benzodiazepine for longer than 3 weeks. By doing so, you will avoid all these withdrawal problems.
Once you finally decide to stop taking a Benzodiazepine, the range and severity of the withdrawal symptoms will likely take you by surprise. For many people, the intensity of Benzodiazepine withdrawal is overwhelming. Unfortunately, there are no predictors for who will likely suffer severe withdrawal, and who will likely have a mild withdrawal experience.
In order to go off any Benzodiazepine, you will have to taper off very gradually—under your doctor’s guidance, of course. Reducing the dose of the drug slowly minimizes the severity of the withdrawal symptoms.
However, overcoming the withdrawal side effects of Benzodiazepines can take many weeks or months, or, for some people, even years. Usually the length of time someone has been taking a Benzodiazepine and the amount they have been taking will have the most impact on how long it takes for their withdrawal symptoms to pass.
If you want to stop taking Benzodiazepines, read the excellent manual by Dr. Heather Ashton, one of the foremost authorities in the world on how to break free from these drugs.
Read her excellent manual “Benzodiazepines: How They Work and How To Withdraw”. Not only is it free, it’s easy to read and packed with the information you need to help you.
The good news is that if you persist through the agonies of the withdrawal stage—no matter how long it takes—in the end, as the lady in the above story expressed it, you will be free and be “me” again!
References
About Benzodiazepines. 2005. TRANX—Tranquillizer Recovery and New Existence. http://www.tranx.org.au/benzodiaz.html.
Ashton, Heather. 2002. Benzodiazepines: How They Work and How To Withdraw. http://www.benzo.org.uk/manual/contents.htm.
Bauman, Neil. 2010. Ototoxic Drugs Exposed. http://hearinglosshelp.com/shop/ototoxic-drugs-exposed/.
Busto, Usoa, et. al. 1988. Protracted Tinnitus after Discontinuation of Long-Term Therapeutic use of Benzodiazepines. New England Journal of Medicine 315:854-859. http://www.benzo.org.uk/busto.htm.
Steve says
Xanax [Alprazolam] is a really dangerous drug, physically and mentally. My wife lost hearing permanently while on them and I lost my wife permanently while she was on them. I would rank it on a par with heroin and crack, and worse than coke. Do not use it!
Nick says
I agree with Steve, they are a horrible drug. I used to abuse them and wake up feeling deaf in my left ear and my vision felt weird. and that’s after only one night of binging on them imagine taking them every day!!!!!
Jennifer says
I agree that Xanax and all drugs of it’s class are terrible. I suffer from G.A.D. and over the years I have been prescribed it so often I have been taking 8 mg. of Xanax for about 10 years. I tried withdrawing from it by lowering the dose in small doses. I am now doing a Valium taper and I feel worse than ever. I have ringing in my ears that is driving me insane. Also these drugs caused me to gain weight and lose my sense of balance seemingly permanently. I have had 2 bad falls this year and I am only 54 years old. I reccommend a person NEVER take any drugs of this class for any reason. If you do, don’t let a doctor give them to you for longer than 2 weeks. How I could be prescribed this for 10 years seems like medical malpractice to me.
Rod says
I am very aware of the dangers of these and every big pharma med…pure crapola. A few years ago I started getting ringing in my ears because my moron Dr left me on Valium for too long…over two years and I found out this should only be taken for two weeks!!!! After I read this page a few years ago I panicked and took myself off the Valium without talking to my idiot Dr.
Started getting withdrawals three weeks after stopping and didn’t realize it was withdrawals. I told my Dr I needed something for my anxiety…he never asked about the Valium. He gave me Xanax and you CANNOT go on Xanax after Valium…never.
I started get interdose withdrawal symptoms and the idiot prescribed a dangerous combo of meds and I nearly died two weeks later. Brain, muscle, nerve and kidney damage. My life is done at this point and it’s all from taking big pharma meds that don’t work anyways. The Dr admitted it was his fault. Meds are an easy way to ruin your life permanently.
Peace
Mark says
I had my life destroyed by these horrific drugs too.
Took sertraline which I had a bad reaction to, ended up having a fit and sexual dysfunction and weird neurological problems going on following one tablet…
This sent me into a massive anxiety state… Complained to my doctor who ignored the problems and told me that they not possible…
Went to ER feeling ill and they offered me a psych ward voluntarily. I wish I’d said no because then I was forced to take mirtazapene, quetiapine and lorazepam in massive doses.
Damaged my hearing, eyesight and balance all nerve damage or ototoxic. I’m screwed now, can’t see properly due to eyes wobbling (oscillopsia), hearing loss, tinnitus, no doctor cares. All my career, hobbies, interests, LIFE GONE, just struggling now, wife left, can’t see well enough to have interest in things even watching TV appears double vision. I also have weakness in my limbs etc due to the antipsychotics…totally destroyed.
No doctor cares in the slightest…
Lynne says
Hi mark this is Lynne..I have everything that you have and I totally get it insane!!!! I also have static vision hearing issues double vision I’ve spoken to the doctor and I cold turkeyed big mistake but like you I had no help..I suffer every day for YEARS!! But we will heal one day as I’ve been told. It’s a nightmare but hang in life will get better…I couldn’t of dreamed this stuff up but yet like people who suffer illnesses or other major problems we need to go on the best we can..have faith it got me this far…hang in!!!
Paula says
I am on Sertraline due to my high anxiety with my Meniere’s Disease. I will also say without explanation that I have many other stressors in my life though leaving a highly stressful job should help but there are more stressors. Plus, I am on Valium 2 X’s per day (2.5mg) to help with the side effects I have from Meniere’s and hopefully make my spells less severe. ???
Chene Bodrero says
I was institutionalized because of a crisis already going on with my ears. The nasty psychiatrist put me on klonopin and nobody warned me that it would effectively destroy my nervous system. I am losing my hearing, my autonomic nervous system is breaking down, my senosry integration is getting worse and worse, and on top of that I now have a tremendous number of physical disabilties….all developed within a year. I am only 23 but nevertheless this is the year I will see my grave because of the murderous evil that is big pharma. The people who market drugs as harmless are committing mass murder for profit and should go to jail for life.
joanna says
valium was great at first but then started to gave me nightmares and i could hear voices in my head, made me begin to think i was crazy.
John c says
Horrible stories of destruction by bjg pharmacy and their agents in psychiatry posing as help when anothing but.
Stay away from ativan and Xanax. These drugs and all the other benzos are killers – they destroy lives!!!!
Medecine in general has been corrupted long ago we’ve been taught to put our faith entirely on medicines magic pills when you find out the truth it’s too late!!!!
Neil Bauman, Ph.D. says
Hi John:
They are bad sure enough. One time I was looking through drug side effects and to my surprise I found that suicide/thinking about committing suicide is the most common side effect of most benzodiazepines. And for those that it wasn’t the most common side effect, it was the second or third most common side effect.
That is why you need to be most careful if you are considering taking any of these drugs and only stay on them for a maximum of two weeks or so–and even then there are no guarantees they won’t “get” you.
Cordially,
Neil
Evelyn M Bell says
Thank goodness I have only been on 1 mg of xanax a day for one month due to panic attacks from sudden tinnitus. What can be safely taken instead? So what herbal can we take that is safe and effective?
Neil Bauman, Ph.D. says
Hi Evelyn:
First off, there’s no reason to panic just because you have tinnitus. You can learn to calm down and relax even though you have tinnitus. Trying to drug your tinnitus into submission doesn’t really work as it will still be there when you try to get off the drug.
If you want to calm down a bit, the herbal Valerian helps numbers of people.
You might also want to try Arches Tinnitus Formula and see whether this ginkgo formula helps bring down the volume of your tinnitus. Expect to take Arches for 3 months before you evaluate it and decide whether it is working for you or not. Typically, herbals don’t work overnight–you need to take them for some weeks to get the effect.
Cordially,
Neil
Shamim says
Hi, It’s about three years now I am on Xanax half of 0.25 mg daily, I have developed tinnitus and other related problems, I tried to taper it off many times but could not because of severe insomnia and headaches though I was tapering very slowly. Please guide me and it’s difficult to cut this half tab in many pieces, request for help thank you
Neil Bauman, Ph.D. says
Hi Shamim:
I agree it’s hard to cut pills into many pieces–and make them the right size too since you are wanting a constant taper.
A better way is to get yourself 3 things, a mortar, pestle for grinding the pills to a fine powder and a tall 100 ml graduated beaker (marked off in 1 ml increments).
When you want to taper you take a whole pill, grind it up and dissolve it in 100 ml of water. If you want to do a 100 day taper, the first day you pour out 1 ml and drink the 99 ml left. The second day, do it again, but pour out 2 ml and drink the remaining 98 ml. The third day, pour out 3 ml and drink the remaining 97 ml and so on. If you want a slower taper, you could do the same thing, but drink the 1 ml for 3 days, then 2 ml for 3 days, etc.
And if you want to taper faster, your can pour out 2 ml or 3 ml each day rather than just one.
That’s the easiest and most precise way to taper gradually.
Cordially,
Neil
Daniel says
I’ve been on clonezapam for three years. .5 mg twice daily, I break them in half though. Trying to get off it. I am beginning to see signs of hearing loss. As a avid audiophile this concerns me. Is the damage reversible?
Neil Bauman, Ph.D. says
Hi Daniel:
If you’ve built up a dependence on Clonazepam, then you want to do a slow taper, meaning reducing the dose by 1% every 3 days. That will take you 300 days to come off it. If you taper too fast, you may find you get loud tinnitus and other side effects. So in this case, slower is better.
If you haven’t built up a dependence, then you probably can taper much faster.
I understand your wanting to get off fast to try to preserve your remaining hearing. Hundreds and hundreds of people have reported hearing loss from taking Clonazepam so hearing loss certainly does occur.
I don’t have any information that indicates whether hearing loss is temporary or permanent. I suspect it can be either, so hope that it is temporary, but be aware it may not be.
Cordially,
Neil
Maria Burkhardt says
Hello Dr. Bauman
I have tinnitus and hyperacusis and its severe. It started in Jan 2018 on my left ear I saw the audiologist in April of that year said the cause is from some hearing loss then got it on my right ear. Ive been taking xanax 2 1/2 to 3 daily, I started with 1 a day and that had been since 2017 close to 3 years. I have read on some of your replies for other sufferers to taper slowly. I started this weekend and I need your help. I have side effects. I’m. Started by taking 1 1/2. Should I take less and how much?. I know it should be for 6 mos. to a year for tapering. Furthermore last year my tinnitus shifted to pulsatile and I notice recently before it shifted. I had sound sensitivity to loud sounds only. But now I can’t handle any sounds. I only could listen to Tv to a certain volume.
I forgot to mention, other than my pulsatile tinnitus and hyperacusis, I also suffer from insomnia for for years that’s the reason why I started on Xanax in the 1st place. I started in the valerian root extract today. I hope it will work on me. Because the only thing that really help me sleep was the xanax. When I started having sleeping problems I took unisom and it worked for years until they stop working in 2013.
Neil Bauman, Ph.D. says
Hi Maria:
If you are trying to taper of the Xanax, then you should do a 10% taper (a safe taper rate). Assuming you are taking 3 0.25 mg tablets per day for a total of 0.75 mg/day, then a 10% taper would be reducing that dose by 0.075 mg for the first step in your taper. You’d stay at that level for a month, then taper 10% of the remaining balance. etc.
If you tapered by 1 and a half pills per day for the first step, that would be a 50% taper–much, much too fast. No wonder side effects showed up.
Is your hyperacusis from the Xanax? It is known to cause hyperacusis, as well as hearing loss and tinnitus, etc.
Are you saying that the Unisom stopped working for you back in 2013, so you had to switch to something else?
Cordially,
Neil
Maria Burkhardt says
Yes. I switched to trazadone and temazipan which worked for 2 mos. So unfortunately back in May this yr. when I wrote to you I went back to my regular dosage of xanax. Dummy me I didnt handle the side effects because it was making both my tinnitus and hyperacusis worse. Since July 28th I tapered down to two by my psychiatrist because I went up to 3-1/2. Today Aug. 12
Per my Dr. wants me to go down to 1mg. But I thought that was too low so I’m going down to 1-1/2 mg. I’m going thru horrible side effects because the tinnitus and hyperacusis is so bad. I regret taking xanax so much. But since I have insomnia it worked so well. I’m taking melatonin 2-1/2 mg to sleep and it only helps a little, like 2 hrs sleep. I need to sleep. My Dr. suggest that dosage even though I have them in 5 mgs. Back in 2018 the audiologist told me the tinnitus was from some loss of hearing on my left ear. It really isn’t that much. I started to think it was the xanax because as time went on it shifted to pulsating tinnitus and hyperacusis which it’s severe.
I’m also taking Cymbalta per my psychiatrist. To help me with the anxiety and try to program my brain.
I apologize. I didn’t make myself clear. Just to make a point. In 2018 I only had Tinnitus until towards the end Nov or Dec. I notice that loud noise was bothering me so 2019 started and my tinnitus switched to pulsatile then both hyperacusis + tinnitus progressively got worse by May I went on medical leave and I had to resign from my job in October Because everything I was doing from the audiologist to medicine from Dr’s. wasn’t working. And week to week just kept on getting worse. Now Aug 2020 and tapering off its really really hard. The point being is both the tinnitus and hyperacusis got worse by itself before I tapered off the first time this past May.
Thank you
Maria
Neil Bauman, Ph.D. says
Hi Maria:
When you have severe ototoxic and other side effects, you have to taper off slowly–and that takes 10 or more months.
You seem to be jumping all over the place. That is NOT the way to taper without problems.
The first thing you should do is switch from the Alprazolam (Xanax) to a drug that has a long half-life such as Diazepam (Vallium) according to Benzo expert Dr. Heather Ashton. You can do this quite fast. Once you are stable on the Vallium, THEN you SLOWLY taper off it.
A safe taper according to her is a 10% taper per month on the descending balance.
Adding and changing drugs all the time sure isn’t helping you get stable.
Cordially,
Neil
Deb says
I disagree. I have taken a low dose of Xanax for over 20 years and I have never had the need to increase it in order to get the benefit of preventing panic attacks. It has been a lifesaver for me. Is it possible that there is something else going on that is causing the dizziness and that is why the Xanax is not helping?
Neil Bauman, Ph.D. says
Hi Deb:
Everyone is different, so how a specific drug affects you is different than how it would affect me. Obviously, you have not formed a dependence on this drug, but many do. Thus, I have to warn people about the potential problems since no one knows in advance what kinds of side effects they may or may not experience.
The Xanax can be helping you in one area (panic attacks), but cause problems in another area (dizziness, for example). You may choose to put up with certain side effects because of the help it is giving you. In another person, the side effects may be worse than the good it was supposed to do, so they stop taking it.
If you have been on Xanax for 20 years, how do you know you still need it? And if you try to come off it, will you get more side effects?
Cordially,
Neil
joel isom says
Coming off of Alprazolam I went completely bonkers. People speak of seizures and whatnot I wished In had seizures instead of what happened to me. A week after cold turkey I was admitted to the local Shands ER. I didn’t even know my own name. Babbling incoherently about the scenarios that played out in my head. Hallucinations not like LSD but like real life , you couldn’t tell the difference it was real . Real as real can be. The most troubling part about it is I could feel myself slipping deeper and deeper and deeper into insanity and nobody could help.
When they shot me up with I guess it was diazepam, for acting like a nut job in the ER and causing a ruckus I came up out of it real quick-like. When I found out what caused it I weaned myself off very very slowly. good riddance
Rick says
I didn’t know the side effects of withdraw. It’s been 10 days cold turkey off Xanax. Should I get back on them or stay the course?
Neil Bauman, Ph.D. says
Hi Rick:
That’s a hard one to answer. If you have not been on Xanax for very long and have not built up a tolerance to it, and the side effects are not too bad, then you might want to just “hang tough” until the side effects go away.
However, if you have been on the Xanax for a long time, and/or have built up a tolerance to it or if the side effects are too great to bear, then getting back on and doing a slow taper would probably be a wise course of action.
Cordially,
Neil
Jan Dennis says
4 years ago I was prescribed clonazepam 2mg for sleep worked for couple of monts by then I got addicted to it. Then I was given Zoplicom and tried many times since to get of clonazepam without success. Now 4 years later after being on almost every drug you can get I am living wreck my head is hissing badly almost daily and physically i lost 20 years of my life.
I am just coping probably 50% at the best time. Doctors don’t care anymore and i don’t know what else to do. I know for long time that benzos are not helping me in anyway but i cannot get of them. Is there any hope for me?
Neil Bauman, Ph.D. says
Hi Jan:
As long as you are still breathing, there is always hope. But you need to take charge of your life and have the will to make the necessary changes to get you back to being the old you again.
What drugs are you taking now? That is the place to start. I’ll help you get pointed in the right direction, but you’ll have to do the “work”.
Cordially,
Neil
Patricia says
I have had tinnitus and hyperacusis from an MRI I received in July. I have had a terrible time sleeping as I have severe anxiety because of my injury. The anxiety and insomnia have irritated my colitis. I desperately needed to take something for sleep so have been taking 0.5 mg and some nights added half of a 0.5 mg Xanax at bedtime for 1 month. In the last few days my tinnitus escalated and now my hyperacusis is worse. I want to get off this drug now. My Dr. says it will be a two week taper. My age is 73 if that makes any difference. What time line taper do you advise for me? Do you think the hypercusis and tinnitus will get better or is this elevation permanent?
Neil Bauman, Ph.D. says
Hi Patricia:
If you’ve only been on the Xanax for 1 month, maybe a two-week taper will be sufficient. If it is too fast and side effects begin to appear, then pause the taper until the side effects go away, then resume the taper, maybe a bit slower this time. You have to listen to your body for the correct speed.
Both tinnitus and hyperacusis are very sensitive to anxiety. So do all you can to get your anxiety under control and you will find it goes a long ways towards getting your tinnitus and hyperacusis under control.
Cordially,
Neil
Lynn Meyers says
I, too, am on 2 mg. clonazepam. I’ve been on very low doses for most of the 3 years, but last 6 months at 2 mg. Am trying a slow taper, but don’t know what you would consider a safe, slow taper. I am very sensitive.
No other drug use. Never used any in my life. This is from surgery. They never said it was dangerously addictive.
Neil Bauman, Ph.D. says
Hi Lynn:
To me a slow taper would be 1% reduction every three days–which would take you 300 days to come off.
You could always go faster if no untoward side effects appear, or go even slower if side effects begin to show up.
You can read my article on Tapering Off Citalopram Safely Without Side Effects at http://hearinglosshelp.com/blog/tapering-off-citalopram-safely-without-side-effects/. It explains how to do a 10% taper if that will work for you. If that is too fast, you can do the 300 day taper.
Here is how to do a SLOW taper.
If you have built up a tolerance to a Benzodiazepine, you have to taper off very slowly or you can cause new and worse side effects. A common problem is tapering off too fast, and like you said, it is hard to cut pills to smaller and smaller sizes. Getting smaller pills is one solution but even so, that will mean you taper by 25% or more with each size of pill reduction. This is MUCH too fast in many cases. I’ve heard from too many people that followed their doctors recommendations and tapered off too fast.
A much better way, according to Dr. Heather Ashton, is to taper off slowly over a period of 300 days. This means you would reduce your dose by 1/3 of a percent per day. That way you can almost guarantee you will not make things worse as you wean your body off this drug.
“How do you do that,” you ask? One way to precisely reduce the dose is to get yourself a mortar and pestle and a tall 100 ml beaker marked off in ml. Use the mortar and pestle to crush the pill to a fine powder, then fill the beaker with exactly 100 mL of water and dissolve the powdered pill in it and stir it well. Now, the first day, pour out 1 mL of the solution and drink the rest. Do this for three days. Now you have reduced your dose by 1%. On the fourth through sixth days pour out 2 mL of the solution and drink the rest. Thus, every three days you pour out one more milliliter of the solution and drink what remains until finally on the 298th day to 300th day you are pouring out 99 mL and drinking 1 mL. After that you are free from the drug!
Cordially,
Neil
Michael Frey says
With regard to klonopin what would be the best solution to use? Is milk the appropriate on? I take 1 mg 4 times a day so would it be best to put the solution after mixing it in the beaker into 4 smaller containers?
Neil Bauman, Ph.D. says
Hi Michael:
I’ve never thought of which solution to use. I just assumed that everyone would use water.
The way I’d do it is to disolve the Klonopin in 100 ml of water, then pour out what you don’t need (based on your reducing taper) and drink the rest. Do this each time you are to take your medicine.
Cordially,
Neil
gaye says
i believe klonopin and valium are fat soluble so I use 5mls of milk to dissolve and when certain that it is dissolved add an appropriate amount for the taper
Lynne says
Hi my name is Lynne..I cold turkeyed clonazapam seven years ago in about three months..I started with getting double vision and static vision and every other thing imaginable too many to mention including ear problems not hearing clicking I ears and some lose of hearing…I’m better now to a point but still have the vision problems and now it’s hard to cope..I went to nine eye doctors and they find nothing..I know it’s brain damage from this drug…I just hope it goes away soon..hope and pray ..!!!have you heard of this? I know dr Ashton talked of this but wow!!! How long? I heard of a man woke up after six years vision clear..hope it’s me seven years gives me a lot of anziety and depression. But not sure what’s what anymore…thx..
Neil Bauman, Ph.D. says
Hi Lynne:
Your story is a tragic example of coming off benzos too rapidly. The fastest you should go is 10% per week of the descending balance. This would take you 10 to 12 months. Another way is to reduce the dose by 1/3 of 1% each day which would take 300 days–roughly the same time frame as the 10% descending balance method. And for some people even this slow taper is too fast.
However, what is done is done and there is nothing you can do about what you did. Now you need to focus on getting back as close to normal as possible.
Unfortunately, I don’t have much insight into what you can do now that will reverse the effects you have experienced. You have experienced reduction in some symptoms–and this is good. Your brain is plastic and can largely fix itself over time, especially if you now practice a healthy life-style. Learn to relax and calm down your anxiety and deal with your depression without taking prescription drugs (or you can just get back on the old treadmill and make things worse).
Cordially,
Neil
Lynne says
Thank you..I hope and pray it’s soon..I panicked and had no help trying to get off doctors told me I was depressed because my husband died…no one cared..I went to so many doctors and ER and they basicly thought I was nuts!!! Boy did I learn not to trust some doctors..more needs to be done to make people aware of this drug!!! I know there’s a movie comming soon called (as prescribed…)..about awareness..I do my part telling everyone I can…thx again!!!
Lynn says
I have been on Xanax for over 30 years. My last daily dose was 12 mgs a day. Well my doctor is no longer in practice and with the new laws in affect I can’t find a doctor to give me any Xanax. I’m in withdrawals. My chest hurts my head is driving me crazy. Ringing headache. The ringing is driving me insane. I have never felt this in my life. My feet and hands or asleep, I CANNOT sleep. I’ve been up for 4 days and want be sleeping tonight. I’ve been to Er and they want do anything. One stupid doctor gave me 3 days of Librium and said take this and you will be off of benzos for good. WRONG I want to know if I can sue him because it can’t be done in 3 days. IDIOT. I just want my life back. I don’t know how much longer I can take this.
Neil Bauman, Ph.D. says
Hi Lynn:
If you have been on Alprazolam (Xanax) for 30 years, then there is no way you can just quit cold turkey and not expect some awful side effects. You NEED to taper off slowly–over a period of a year or so.
You need to find a source of Xanax so you can taper off properly. Can you get the drugs from another country so you can do a proper taper if you can’t find a doctor that is willing to work with you to get you off safely?
Cordially,
Neil
Lynn says
Where can I find someone from another country? I will try anything right now. Thanks
J.C Butler says
Hi Neil, I have been on Alprolozam ER 6mg per day for over 20 years prescribed by my doctor. in 2012 I had a serious work related accident and have sustained a serious work accident with cervical degenerative disease and severe back pain and neck pain but because of the length of time am not a candidate for surgery. I went to a psychological therapist and he recommended that I see a psychiatrist as he claims I am clinically depressed. I have been on/off xanax since 16 being diagnosed with chronic anxiety. Now I am afraid the psychiatrist will take me off the Alprolozam which I don’t think I can handle. I am scared and considering cancelling the psychiatrist fearing she will force me off alprolozam. If I forget a dose, within 3-4 hours I get pretty sick. I am also noticing the anxiety over time is getting more noticeable. So I feel like I may be caught between the devil and deep blue sea. I have no idea what to do. What do you suggest? Thank you for your time
Neil Bauman, Ph.D. says
Hi JC:
First, benzodiazepines drugs of which Alprazolam is one should only be taken in the short term. Short term means 2 weeks or less according to knowledgeable doctors. 20 years on this drug is ridiculous. That is not the way to treat anxiety. And it doesn’t work as you can see–here you are 20 years later and still have your original anxiety and now even more anxiety as a side effect of this drug. This is no way to live.
Like you say, you are between the devil and the deep blue sea–if you try to go off the Alprazolam your side effects will get worse, and if you don’t the side effects will get worse.
I’m not sure why you think the psychiatrist will take you off the Alprazolam? Actually, it would be a good thing–but you’d have to taper off VERY slowly after being on it so long. A slow taper would take a least a year. At the same time you need to find a counselor that can help you deal with your anxiety so it won’t be a problem any longer–ferret out the basic cause of your anxiety/depression and help you deal with it. Then you won’t need drugs any longer.
You could substitute the herbal St. John’s Wort for the Alprazolam. It is not ototoxic and is not habit forming. So that is a good alternative if you need a substitute for the Alprazolam.
To get off the Alprazolam, Dr. Heather Ashton has writen a comprehensive manual of how to do it. It is a two step process. First you need to transfer from a short-half life drug like Alprazolam to a drug with a long half-life such as Diazepam. Then you need to begin a taper of Diazepam. You can read the pertinent section of her manual at https://www.benzo.org.uk/manual/bzsched.htm#s1 .
Cordially,
Neil
Pam says
I have a serious problem. I was on Klonopin 0.5 mg PO QHS for 8 years, for insomnia. The doctor who ordered it left the practice and it became increasingly difficult to get the prescription filled. Finally, last May, I was told to stop taking it all together. Cold turkey. I knew that wasn’t safe so I weaned myself off over a period of two months and thought I was doing okay until one night last July when I woke up and could not move my arms. I literally could not put a cup to my mouth. My BP was through the roof and my husband took me to the ER. $20K worth of tests were ran, and nothing. I missed a week of work due to extreme dizziness, feeling like I couldn’t walk or was on a boat, vertigo. Eventually I learned to live with those symptoms. Went to an ENT for chronic ear stuffiness, he put tubes in, didn’t help. Went to a neurologist who ordered an MRI that showed nothing was wrong.
It’s been 8 months since that ER visit and the dizziness, chronic clogged ears, clogged sinuses, popping in my head & sinuses, neck pain, jaw pain…has gotten worse. I still work but it’s hard. I also have terrible headaches.
I really think its the damage the clonazepam did to my ears/brain. My question is, what do I do now? Do I just resign myself to starting klonopin again and take it forever in order to have quality of life? Do I do a better/longer taper?
I really need help as I am at the end of my rope. I have a demanding job and need to continue working.
Neil Bauman, Ph.D. says
Hi Pam:
First, I don’t think that going back on the Klonopin will really help. If there is damage done, it’s done and going back on it won’t really help since so much time has gone by. If it was only a week later, I’d suggest going back on it and then doing a slow taper over about a year. I really don’t know whether this would work in any degree now, but I don’t have any expertise in that.
I can’t say whether all your symptoms are from quitting the Klonopin too fast or not. But what sticks out to me is that the various symptoms you are experiencing could also be from something totally unrelated to this drug, namely that your upper cervical spine is out of proper alignment. That could account for your vertigo, balance problems, dizziness, headaches, clogged ears neck pain, jaw pain, believe it or not.
Since your doctors can’t find anything wrong, if I were in your shoes, I’d go to an upper cervical spine chiropractor (NOT a conventional chiropractor) and have them check if my C1 and C2 vertebrae are out of proper alignment. These people are able to work wonders for certain ailments and they are very gentle–not the bone cracker kind. They focus mostly on your top two vertebra (C1 (Atlas) & C2 (Axis). If this joint is “off” then you could have all/most of the symptoms you are experiencing.
You can find an upper cervical chiropractor at http://www.upcspine.com/ and clicking on “Practitioners” and then clicking on your state/province/country. Here is the URL.
There is a lot of good information on upper cervical chiropractic on this website.
Let me know how it goes.
Cordially,
Neil
Michael Freier says
Well, first of all I am very sorry to hear that you’re going through so much turmoil. It sounds like an absolute nightmare and I wish the very best for you and your “recovery.” As to your question though, l cannot see how Clonazepam (which is on the weaker side of benzodiazepine scale) could attribute to such health effects as The ones that you’re describing. Especially considering that the dose of .5 mg is very low. Theoretically, it’s possible that the drug may have triggered something completely unrelated to what you are experiencing; but then again — maybe a can of soda pop or a bagel was the culprit. The fact of the matter is that all too often, individuals will automatically assume the worst and contribute everything to a medication (placebo effect). Even worse, they also isolate turn to the internet in search of answers, only to be mislead by a number of people who don’t have a clue what they are talking about. As the doctor above mentioned, I’d look elsewhere for the origin of your medical condition.
Best Wishes
Pam says
Thank you for the response. There is one doctor from your link list that is within 100 miles from where I live, and she takes my insurance. I will definitely make an appointment with her to see what she says.
I’ll keep this post updated with progress!
Lynne says
Pam I wanted to tell you I have the same thing comming Off my ears dizziness vitrigo and I knew it was from that because when I took one it went away..going to get it checked is a good thing but if they find nothing that’s the cause..headaches pain in ears popping and I lost hearing in one ear on and off..this drug is so bad I hope it’s banned one day…anyway hang in it just takes time to heal…Lynne
Victoria says
I was prescribed oxazepam within around a week of taking it I started having vertigo, nausea, difficulty breathing, and strong heartbeat,confusion and even difficulty speaking. It seemed to me that these were side effects of the medication but my doctor said these were symptoms of anxiety and that I should increase the dose of oxazepam. I ended up having tinnitus and hypersensitivity in certain sounds. It is difficult to know if all these symptoms are side effects of oxazepam use or anxiety related. My question is if the tinnitus and sound sensitivity are caused by oxazepam will it go away after I stop it or is it most likely permanent? Do I need to get a hearing test?
Neil Bauman, Ph.D. says
Hi Victoria:
As far as the benzodiazepines go, Oxazepam is not as ototoxic as some of the other benzos, but some people have reported various side effects from taking it. For example, some people have experienced hearing loss, tinnitus, dizziness, vertigo and balance disorders.
So far, I don’t have any reports of oxazepam causing sound sensitivity (hyperacusis), but that is not to say it can’t cause this since other benzos do cause it.
I certainly wouldn’t categorically say that your symptoms are all due to anxiety (although some could be) and not due to oxazepam (because some almost certainly are). I think your doctor is ignorant and sweeping the drug side effects under the proverbial carpet like so many of them seem to do.
I wouldn’t be surprised that your symptoms stem both from your anxiety and from the Oxazepem. The easy way to see would be to stop taking the Oxazepam and see which side effects go away. Then you’d know that those at least were caused by the drug.
I have no information that specifically indicates whether these side effects are permanent or temporary.
I’d get your hearing checked. If you have some hearing loss it could be due to the drug. And since tinnitus almost always accompanies hearing loss, you could have gotten tinnitus as a result of the hearing loss, or it could be due to your anxiety, or some of both.
If you tinnitus is related to hearing loss, then it typically will go away if your hearing returns.
If you stop taking the Oxazepam, it may take a few months, but I’d expect your sound sensitivity to return to normal unless it is due to recruitment from any hearing loss.
You may also find that your symptoms are not as bad if you reduce your dose back to the original dose.
Personally, I wouldn’t take any benzos as the longer you take them, typically the less effective they become and the more likely they are to increase your anxiety, not reduce it. Then it is almost impossible to get off these drugs. Better to never get hooked in the first place.
Cordially,
Neil
Victoria says
Thank you Neil for the very detailed and informative reply. I wish that my doctor had warned me about the potential side effects and that he had given it more thought before ruling out oxazepam as the cause of my symptoms as they were not there before I started taking the drug. I will try to stop taking the oxazepam asap.
Ric W says
Hi Dr. Bauman, I’ve read a lot on this site about ototoxic drugs, and I’m trying to get a handle on just when to suspect drugs as culprits for permanent hearing loss/tinnitus/hyperacusis. On one hand, I appreciate being informed, though on the other hand, I don’t want to just blame things on potentially ototoxic medications (as you caution elsewhere on this site).
In my case, I experienced sudden loss of hearing (not deafness) in one ear, followed by tinnitus/hyperacusis, then another sudden loss of hearing in the other ear a month later, also followed by tinnitus/hyperacusis.
I appreciate that I will likely never know the cause of the hearing loss, and I’ve come to terms with that. However I’m also mindful of not becoming a hypochondriac about every last little thing that might have contributed.
In my case, I have been wondering about the possible contribution of medications since I seem to have been on quite a few from the list. My question is about dosages. I was on Xanax 0.25 twice daily for 3-4 years for panic attacks — a small dose that always worked, and I was never compelled to increase dosage. However, prior to my hearing loss, I had been using it a few times a month, though at half a 0.25 pill — 0.125 I suppose. Could such small doses have had a cumulative effect that could have contributed to sensorineural hearing loss?
Prior to the hearing loss I was also taking Ibuprofen regularly — about 400mg a day for another condition, for a few months. I’ve been advised by ENT’s that at this dose, hearing loss is very unlikely.
Here’s another one: for several years I’ve been using a Benzoyl Peroxide/Clindamycin topical gel for acne. The amount of clindamycin is small, and administered to the skin, but again in this case could accumulation over years have had an effect?
I know there’s no certainty of any of this, and the answer is always going to be “of course it COULD”. But I’m trying to gauge ballpark ideas of what sorts of drug usages might still be safe. My dentist would love me to take a bunch of Advil again to try and treat inflammation of TMJ, and I’d love to have the small Xanax doses available for those random times when it’d really help out (plane trips, MRI etc). At the moment I’m just avoiding all of it, but I’d like to be not quite so uptight about it 🙂
Thanks so much for what you do.
Ric
Neil Bauman, Ph.D. says
Hi Ric:
I rather doubt that the Alprazolam (Xanax) was the culprit. When you take very low doses, typically you fly under the ototoxic side effect radar and no symptoms show up. However, as you increase the dose, somewhere you fly above the “magic” threshold and ototoxic side effects appear.
I’d put my money on the Ibuprofen though. The longer you take it, the greater the chances you will have of ototoxic side effects showing up. Hearing loss is one of them. Tinnitus is another. So taking a lower dose for several months may have caused your hearing loss and tinnitus/hyperacusis.
You don’t even have to take 400 mg. One doctor reported, “I developed tinnitus after taking only 200 mg. and after only one dose.” So, although many people report problems with Ibuprofen when taking it in higher doses such as 1,600+ mg per day, it can cause permanent ototoxic side effects at MUCH lower doses.
Clindamycin can definitely cause hearing loss and tinnitus–hearing loss about 3 times as often as tinnitus. Drugs are adsorbed through the skin, so it is also a possibility.
But of the three, I’d say the Ibuprofen is the most likely culprit. I think you should be ok taking a very low dose of xanax occasionally like you want to do without any ototoxic problems–unless you see some reason to suspect the Xanax.
Personally, if I were you, I’d stay away from any dose of Ibuprofen in the future.
Cordially,
Neil
Benzowithdrawal Mom says
I’m currently tapering off of clonazepam at .5 mg and it’s going to be a long taper (doctor saying 1-3 years) because of such severe acute tolerance symptoms (many) that have developed – was previously on a higher dose, reduced dose and held too long. One of my worse symptoms is now severe hyperacusis and tinnitus. I had no idea how painful these conditions could get, among many of the other painful symptoms. I’m a 41 year old mother of 7 children so this has been devestating. I’m wondering in this case what the best course of action is – since this is going to take a while to get off, and then for things to heal (which I pray that they eventually will), what kinds of things should I be doing to ease the pain of the hyperacusis/tinnitus and make it more tolerable so I can get off of the medication. A human can only endure so much suffering. I’m finding even regular talking/household noises the past few days are making my ears burn so bad and make me want to jump out of my skin. I’m assuming I should not try any sort of therapy at this point – that it would be a mute point until off the medications? But just wondering what I can do besides ear plugs, noise machines, and noise cancelling headphones? Many say that these things can heal in time, after the receptors start to reuptake and I’m praying it’s so but this is going to be an agonizing withdrawal process – had no idea how painful this all could be. Do you have any suggestions in the meantime? Can my ears heal/get better over time from this, during a slow withdrawal and after cessation, even if it takes many more months?
Neil Bauman, Ph.D. says
Hi Benzo Mom:
When tapering off any of the benzo’s, Dr. Heather Ashton recommends that you first switch to the benzo that has the longest half-life which happens to be Diazepam (Valium). This allows you to have a smooth withdrawal experience. The shorter the half-life the more choppy the withdrawal experience.
Another reason to switch to Valium is that you can get lower dose pills so it makes it easier for you to do the taper. For example, a 0.5 mg Clonazepam tablet is approximately equal to a 10 mg diazepam tablet. And since you can get diazepam tablets in 1 mg size, you can do a more smooth and precise taper.
You can learn a lot more about this in Dr. Ashton’s manual that is freely available online. The two sections I would recommend you read first are found at https://www.benzo.org.uk/manual/bzcha02.htm#11 and https://www.benzo.org.uk/manual/bzsched.htm#s6.
One of the nasty things about tapering off benzodiazepines too fast is that you can get tinnitus and hyperacusis, which you have done.
However, don’t give up hope. Your ears can get better over time. As you realize, it will take some months or a year or two but you should notice a marked improvement as time goes by.
When you have both tinnitus and hyperacusis, you want to treat the hyperacusis first. When you do that, often the tinnitus comes under control at the same time.
You want to expand your reduced tolerance to sound. This is a slow process and you may have a number of setbacks, but don’t let that discourage you. Just keep on with the program and slowly your ears will get better. For example sudden loud noises may set you back so it may be two steps forward and one step back, but even so you are making progress one step at a time.
The normal treatment for hyperacusis is to surround yourself with sound both day and night. This should not be loud sound but loud enough for you to hear, but not so loud that it causes your hyperacusis to flare up. Over time as you can stand the background sound, you increase the sound a bit again to just below where it’s causes you problems. Over time this helps you expand your reduced tolerance to sound.
At the same time you need to protect your ears from loud sounds, so having your protectors handy is always a good idea. The trick is to not over protect your ears because doing that makes your hyperacusis worse. So you need to learn when to wear your ear protectors, and when not to. The goal is to wear them as little as possible in order to expand your collapsed tolerance to sound, but at the same time to protect your ears from loud sounds that make your hyperacusis worse.
To begin with you may find you need to wear that your protectors a lot more than you will later. I’ll bet your house gets noisy at times, likely lots of times, what with seven kids living there, which is not an ideal situation when you have hyperacusis. Thus, there will be times you need to wear the ear protectors just to keep yourself from jumping out of your skin all the time.
I wish you well going through this difficult period in your life.
Cordially,
Neil
Benzowithdrawal Mom says
Thank you so much for responding- unfortunately, not able to tolerate diazepam so using clonazepam wafers and cutting/weighing and micro-tapering. Not ideal but it’s the best solution we have right now and the taper at my current rate will be 9-12 months because of the hold and such severe symptoms. As you said, trying to find the balance between protecting and not overprotecting has been extremely difficult. It seems like the hyperacusis varies throughout each day now and day to day – same with tinnitus. I will have a good day, think all is well and then the next day is terrible and this is now without kids (they are currently at aunt’s) at home the last week, without any sort of “reason”. Sometimes, putting dishes away is too “loud” and sometimes not. Do ordinary sounds such as putting dishes away cause the hyperacusis to be worse or is it just my sensitivity at that time? I have come to realize that I can no longer vacuum, use blow dryer, etc, at least for now, something that caused me no trouble only a month ago. But normal talking voices? So when the kids do come back home, do I wear earplugs frequently if it feels better or only when it seems like it’s way too loud (even when it’s truly not harmful)? Will I even have a possibility of this getting better while tapering? I know you can’t forecast but just wondering if you have experience with that. Are my ears now more susceptible to noise damage because of the benzo tapering or is it just my tolerance to sound that has decreased because it seemed to go from mild to severe within just days? And could the hyperacusis also be due to noise events or just random in this case as I said? The audiologist told me not to protect from everyday noise but I don’t know that a home with 7 kids is everyday noise. Are slamming doors or a dog’s bark every day noise? A kid stomping down the stairs? A daughter singing? A 3 year old with a shrill voice? Kids fighting? Kids singing and playing while you are pushing them on the swings (chains clinking)? It seems like sometimes these bother, sometimes, not so….. then I’m kind of caught off guard.
Should I buy a decibel meter? If I don’t protect, am I less likely to get better and cause more permanent damage? Or am I just more likely to be feeling very uncomfortable? Also, I’ve been in touch with an audiologist who mentioned some low gain hearing aids in which the frequency and volumes could be adjusted (this is an audiologist who specializes with kids who have autism and some hyperacusis and sensory issues). She also said they would have masking noises which could help cope and desensitize. I could try them for 6 weeks but clearly no guarantees. Is this a bad idea? I know it would be quite expensive but if it would work and help me cope and get through and live in this home, I would do it. If it’s no better than wearing earplugs and having brown noise playing in headphones close to my ears in the long run, maybe not worth it. Sorry for more questions.
Neil Bauman, Ph.D. says
Hi Benzo Mom:
Sorry to be so long in getting back to you.
I understand about the Diazepam, so it looks like you are doing the right things in your Clonazepam taper–taking around a year to taper. You can go faster if your body tolerates a faster taper. But on the other hand, you may have to do an even slower taper. If, at any point, the side effects are getting worse, then pause at that level for a time (could be a week or a month or two) until they get under control, then continue the taper–maybe at an even slower rate. Go that rate that your body allows. This is not a race–but the goal is to complete the taper without bad side effects.
You will have good and bad days. Recognize that this is happening, so don’t be discouraged on the bad days. The next day may be a better day. Hopefully, as time goes by, the good days will be more frequent and the bad days less frequent.
I know what you mean about putting the dishes away, or cutlery clinking, etc. Typically, I have to take my hearing aids off to do such tasks. In your case, those activities that really bother you, wear your ear protectors then. The goal is not to torture yourself with sounds you find difficult to tolerate as you are healing.
I don’t think such sounds make your hyperacusis worse–but it sure feels like it. So wear your ear plugs when you’re having a tough time with noise–from whatever the source–just try to wear them as little as possible overall.
It’s going to be tough to get better while tapering, but not impossible. Just realize that you have two issues going on at the same time, so you need to allow extra time for your body to be able to adapt to both of these. Again, there is no rush (although you want it to end NOW!)–slow and steady wins the race in this case.
I don’t believe you are are more subject to real noise damage at this stage, even though it feels like it. It is really your perception that is heightened.
Your audiologist is right in that you should not protect from everyday noise–but that advice needs to be modified to what is tolerable for you. When these “everyday” sounds get to be too much for you, then wearing ear plugs for a bit so you can tolerate it is not wrong. So when the dog is barking, the kids fighting, etc., etc. you may want to put those ear plugs in for a bit until things calm down a bit. I get hyperacusis when I wear my hearing aids and I can’t stand a dog barking–so off come the aids at that point. You can’t do what I do, but you can put in the ear plugs for a bit.
Getting a sound meter isn’t really necessary. The everyday sounds aren’t going to physically damage your ears–apart from kids screaming in your ears. (That could be damaging for sure and will set you back when it happens.)
I don’t have experience in the low-gain hearing aids, but my first reaction is that you don’t want that. You’ve already got enough noise in your life! However, wearing sound generators that have masking sounds–white noise, brown noise, fractal music, other sounds, etc.–is not a bad idea, but I’d stay away from hearing aids. In my opinion wearing ear plugs and having the brown or pink noise playing in earphones would give the same effect and be much cheaper.
Cordially,
Neil
Charlie says
Hi Neil,
I use Lorazapam occasionally to prevent panic attacks in predictable circumstances, going to the dentist, job interviews etc. I have used it for about 5 years but only every now and then, maybe once or twice a week on average, 1mg and sometimes only 0.5mg. I developed tinnitus just over a year ago and I’m wondering if there could be a link even though my use of the benzo is only every now and then. The tinnitus can flare up to a very loud level for a few days then calm back down again to a quiet bearable level for a few more days then go up again etc in a cycle.
Does occasional use of a benzo over many years count as being dependent in the same way as someone who takes it daily for months or years? It is very effective at preventing panic attacks but I wouldn’t have thought I’m dependent in a physiological sense – I can go for weeks without needing it and only use ‘as needed’. Can you let me know if you think this could be the cause of my tinnitus?
Neil Bauman, Ph.D. says
Hi Charlie:
It’s certainly possible that your tinnitus is from the Lorazepam, but I’m not sure how likely it is in your case.
One way would be to track the tinnitus flare-ups. If they follow taking the Lorazepam that day or in the next 2 days, I’d say your tinnitus is drug related. If there is no relationship, then your tinnitus could be from other factors.
Since the half life of Lorazepam is 12 or 18 hours–depending on the exact compound used–I doubt you are building up any dependence if you use it only once a week on the average. If you were using it 3 times a week, then I might wonder. And if you can go for weeks without taking in and without any side effects, then I’d say you don’t have any dependence on it.
Cordially,
Neil
Isabel says
Hi Neil,
I have had 2 times accident with alarm exposure this year the first one in January the 2nd one in may 2019. I got rid off the first tinnitus completely but only for 2 days then the 2nd alarm exposure with the 3rd one end of August an accident in a MRI scanner in the hospital so Extremly loud tinnitus.They put me on Serenase 1mg from April which did the job to get until I got the 2nd alarm dammage and tinnitus . To recuperate the hearing I had 2/heavy Medrol cures (Methylprwdnisolone)which worked and I tried to taper down the serenase eversince end of june with a table of tapering down of 10% every 3=weeks I got so nervous I lost 20 kg in 2 months my autonervous system went through the roof. Since I lost too much weight I My dr switched suddenly from 3/4 tablet of 1 mg to 1/2 mg wit 5 drops rivotril 2,5 mg/ml and 1 tab deaxit for 4days then He prescribed the above without the serenase for 7 days , I got terrible withdrawal effects and started to see new psychatrist he dedcided to stop all the medication all together disn’t sleep for days and terrible withdrawal effects with high pitched tinnitus and auto nervous system broke down after putting me for 3 days on Loramet 1tab of 2mg I ended up in the emergency. There they put me back on Rivotril since 23/9 8 drops for 15 days for 13 Day and felt really well that period also the noice og the tinnitus dropped a bit.
Under pressure of my new MD who said Rivotril to be really bad for you he tapered too quickly to 4 days of 6 drops ,7 days of 5 drops and 7 days of 3 drops. Already the last 2 Days of 5 drops I felt the nervous acting up and day 5of 3drops everythig out of control superloud spiking sound in my ears. My psychiatrist told me to continue taking 3 drops of rivotril but all day every hour I have withdrawal effects. My question is do I get less side effects if I go back to a higher dose of 4or 5 drops and taper much slower (need some help on how you taper a drop in smaler doses or should I sit out for the next 6weeks this hardly unbarable side effects.
Will the noice of tinnitus go on for longer than 4 months . Have a real hard time coping with the extreme loudness of the tinnitus which flared up since the rapid taper. Could I please have your opinion on this. I cannot switch to valium they say. So how do I taper the drops of rivotril into microdose? Since continuing with rivotril or any other benzo will maintain the tinnitus? Switching to valium not an option according to my Dr since I am already at a low dose of rivotril. I read the study you refer to from prof. Heather fron The University of Newcastle. uk.on how to reduce and taper down benzo’s. W Any other way to reduce this high pitched tinnitus. Thank you for your time and hope you can help me how to tackle this. My life has literally stopped this year, am at the end of my rope due to the lack of sleep. I sleep now + – 2 to 3 hours sometimesv1,5h with 3drops of rivotril and the rest of the night I am awake or sleep very lightly, in my dreams I can still hear the high pitched noise. So exhausted!
Neil Bauman, Ph.D. says
Hi Isabel:
It’s a hard decision whether to go back up to a higher dose and hope your side effects go away–then start tapering more slowly, or to assume you have already gone through the worst of it, and hold the present dose until you feel ok, then continue with a slower taper.
If you can’t manage where you are now, then you might want to increase the dose again and wait until you stabilize and then start tapering.
The easy way to taper when you have drops, is to get yourself a 100 ml beaker marked in 1 ml graduations.
Then if you want to taper using a 3 drop dose, put 3 drops into the beaker and then fill it to exactly 100 ml. Stir it up well. Then pour out the amount of the taper and drink the rest.
For example, for a 10% taper, pour out 10 ml and drink the 90 ml. Do this for a week or month or whatever length you choose before the next taper step.
The next time pour out an additional 10 ml so pour out 20 ml and drink the 80 ml. Do this for the week or whatever time frame you have chosen. Then repeat increasing the amount poured out by 10 ml each time. This will taper you off in 10 steps. If you want to go much slower, you could pour out in 5 ml steps or even 1 ml steps for a very slow taper.
Cordially,
Neil
Van meeuwen Isabel says
Hi Neil, many thanks for this very useful information. This is really very helpful since I asked two doctors how to taper slowly with drops non of the two knew the answer. Thank you again for coming back to me explaining the method how to taper drops.
Cordially, isabel
Georgie says
Hi Neil ..I’m glad I found this website!! I had been taking Alprazolam (Xanax) .5 3x day for years …then I took it down to .25 3x day for a couple more years Last year I went down to .25 2x/day but couldn’t get it down any further . (At this point on them 10 yrs). I recently asked my doctor if I could switch to Valium and perhaps get off it all together . She switched me to 2mg Valium 2 x day .. by the 4th day my ears were ringing and it’s now been 2 -3 weeks with same ear ringing …. What did we do wrong ? Is this withdrawal? Side effect? I don’t know what to do … I need help please!
I am a small 62+ female . I don’t understand at these small doses why I’m having ear ringing/withdrawal but where do I go from here as I really don’t want to go backwards ..thank you
Neil Bauman, Ph.D. says
Hi Georgie:
I’m not sure what went wrong. Is 2 mg of Valium equivalent to 0.25 mg of Alprazolam? I don’t know the drug equivalencies. You could ask your doctor, and your pharmacist as a second opinion. If the action of the 2 mg of Valium is not as much/strong, then it would be the same as withdrawing too fast. So that would be the first things I’d double-check.
It may be that you need a bit more Valium to start with to get stabilized on it before you begin to taper.
I sure understand your desire not to go “backwards”. But you have to find the equivalent dose of Valium that works for you, then start the slow taper off it.
Cordially,
Neil
Georgie says
Thank you for responding. I did check and of coarse they say that .5 Xanax a day is about equivalent to 4mg Valium a day. But the fact that I’m withdrawing…I take the ear ringing is just that .. I’m not sure that was best dose to start with for me .. :(. It’s about 3 weeks which is why I didn’t want to go backwards I was hoping I was thru the worded of it and that it would improve. But I see your point . I can try discussing with my doctor to see if she would be willing to just increase it to 2mg 3/day instead of 2 x day. But not sure she would comply. Either way I’m hoping this passes !
Thank you again for responding!
Georgie says
Hi. I did speak to my doc and she did increase. To 2mg 3/day and things were great for about 5 days and now it’s back to ringing. Now I’m confused … ? She was only willing to do this till January and then have me cut back 1/2 pill (1mg) a day ..but now that ringing is back ..I’m totally confused as to why? And..I know she won’t increase it again if that’s even the answer?? Your thoughts? Suggestions?
Neil Bauman, Ph.D. says
Hi Georgie:
Good question–is the ringing back because of the increased drug dose, or because of the change of drugs and your withdrawal schedule? It’s hard to know the right answer. If you choose to do so, you might want to stay on this increased dose until January, then continue your taper whether or not your tinnitus changes. Only time will tell what’s going to happen. The other alternative is to drop the increased dose now and see what happens to your tinnitus. I don’t really favor one over the other, so the choice is up to you since you know your body the best of anyone.
Cordially,
Neil
Georgie says
Ya I think I will stay with it till January then I have to cut 1/2 pill .. I’ll tackle the tapering when I get there
Thank you!
Bobby says
Hi Georgie.. give us an update. How did the plan/ reinstatement go? I’m considering doing same.
Georgie says
Hi I had to go up a dose and I’ve had a few days of ringing but overall it has worked up to this point ! Sometime in January I will start 1/2 mg decrease …and see how it goes from there . But I think the increase was right choice for me given it’s short term and it helped
Sarah says
I was on Xanax for 8 yrs or more had no clue of the dangers took 8 months or so to taper 3 yrs altercation battling symptoms.Ears eyes bladder muscle and joint soreness hand foot pain headaches dizzy fatigued sleep still disturbed heartburn power back hips ache .I try to keep dress out of my life exercise eat right rest cannabis magnesium warm baths with salts lots and lots of rest positive thinking seeing symptoms disappear sometimes also over all s lot less intense apparently my body needs more time .If I have to suffer with some for life it would be better then being on any benzo they were making me very ill when on them .Thanks everyone take care do a lot of deep breathing meditation and remember it will get better .
Patricia van Wagoner says
I wrote you earlier about tapering down from taking Xanax for a month. My Dr. recommended a two week taper which I completed. To transition after the taper I began taking 3mg Lunesta as I have insomnia. After 5 nights of taking it my hyperacusis and tinnitus had elevated. Found out Lunesta is ototoxic so have quit that. Then Dr. put me on Ramelteon which is a melatonin receptor agonist. It worked great the first night but subsequent 2 nights have not slept at all. Now Dr. wants to try Bellasamra which targets and inhibits the action of orexin and is suppose to not be ototoxic. I’ve had chronic insomnia on and off since my audio injury from MRI. The only time I’ve slept well was the month I took Zanax. But, of course, it’s ototoxic too and elevated my H&T. I have to sleep or I can’t heal. Do you have any recommendation for a sleeping pill I could take that isn’t ototoxic? If I could sleep better maybe I wouldn’t have anxiety. I have considered taking a low dose of Klonopin at night as I’ve heard it’s not ototoxic. But from what I’ve read here that might be an awful idea. At 73 I just want to sleep well as I think that’s key to my healing. My audiologist says my brain is in flight or fight mode because of my injury so even after these last 2 sleepless nights I’m exhausted but can’t even nap as I have that wired feeling all the time. Thank you for being here to help. You are a real humanitarian
Neil Bauman, Ph.D. says
Hi Patricia:
Eszopiclone (Lunesta) is mildly ototoxic as is Ramelteon, so if either work for you, you could use them–just be aware of what is happening to your ears and if any ototoxic side effects begin to show up, I’d dump them immediately and report to your doctor.
I don’t know Bellasamra–are you sure you spelled it correctly?
Unfortunately, all prescription pills are ototoxic to some degree. If you want to try alternative things, the herbal Valerian is useful for calming you so you can sleep better. Have you tried it?
Lack of sleep and anxiety feed off each other. So you want to get both under control. Have you tried exercise to burn off the nervous energy before you hit the sack? And be sure your B vitamins are up, as well as your vitamin D3 levels. Many people are grossly low in these and this exacerbates anxiety.
Practicing breathing exercises is also a great way to help control anxiety. You can practice it any time you are feeling anxious.
Personally, I’d stay away from Clonazepam (Klonopin). It is quite ototoxic.
I’m sure you are stuck in “fight or flight” mode. You need to identify the “threat” that is causing this and then work with a counselor to face this threat down so it has no hold over you. Then you can learn to relax and get out of the fight or flight mode.
Cordially,
Neil
Bobby says
You don’t need a threat when you go through benzo withdrawals. every aspect of existence becomes threatening, light, dark, food, people, water, thoughts, body functions.. every little thing. Only time will heal this Patricia, just have to be patient. Going on a anti depressant can dial the dread down a bit. It helped me.
Samantha says
Hi Neil! I’m new to this website so i hope you can clear my doubts! I’m a 24 years old female. On Thursday night suddenly i started getting a ringing in my right ear out of nowhere. No hearing anything with high volume and i rarely hear music and wear headphones. Rarely go to concerts too. I thought it would eventually go away in 24 or 48 hours because i have had ringing on my ears on rare occasions but usually get away in minutes, hours or maximum a couple of days. I suffer from chronic insomnia since May last year and been on 1 1/2 pill of mirtazapine and estazolam each night since December prescribed by a psychiatrist. (One night i take mirtazapine and other estazolam). I saw online that sometimes very rarely one of estazolam side effects is tinnitus. I asked my psychiatrist about this but she said is not for the medicine because if it was, i would have got the tinnitus right away. Do you know wether it could be for the benzodiazepine or not? Also since yesterday, started noticing some pain on my both ears. 5/6 out of 10 in terms of pain. No hearing difficulties. Only the ringing on the left and some ear pain on both. Could it be excess of wax? Ear infection? Should i go see an ENT? Please enlighten me! I’m so freaking scared and hope it goes away. I have enough with the insomnia already. 🙏😣
Neil Bauman, Ph.D. says
Hi Samantha:
You are correct that tinnitus is a relatively rare side effect of Estazolam. But tinnitus is much more common in people taking Mirtazapine.
Your psychiatrist is wrong if she thinks that tinnitus has to start right away. It may start soon after you take a drug, but it may be days, weeks, months or longer before tinnitus starts. And for benzodiazepine drugs such as Estazolam, the tinnitus may only start when you STOP taking the drug.
Ear pain is another side effect of Mirtazapine. It is only reported about half as much as is tinnitus. Ear pain is rarely reported for Estazolam.
For my money, your ear problems are from taking the Mirtazapine. I’d get off them and see whether the pain goes away and hopefully the tinnitus will get less and less in the future.
Since you have trouble getting to sleep, have you tried the herbal Valerian? It helps calm you down so you can fall asleep.
You may also be low on B vitamins. Here’s the link to a good article on the subject I was reading just yesterday. https://everlast.mercola.com/r/?id=h2fd8cbce,1fa8779d,1fbc8e12&et_cid=DM450905&et_rid=802737102
Here are other good articles on sleep by the same author. https://search.mercola.com/results.aspx?q=Fixing%20this%20Vitamin%20Deficiency%20Can%20Help%20You%20Sleep%20Better#stq=Fixing%20this%20Vitamin%20Deficiency%20Can%20Help%20You%20Sleep%20Better
I’d certainly use supplements and natural means rather than take drugs.
Cordially,
Neil
Samantha says
Hi again Neil! Besides the ringing and the ear pain, now since yesterday my ears hurt whenever i drink something too. Do you know if that can be caused by the mirtazapine too? I just went to an ENT today and got my ears checked. She said my ears look okay and i got wax removal but the ringing and ear pain remain. She send me some anti inflammatory medicine for 10 days and said if it doesn’t get better, i will probably need an audiology. What do you think? Still think it could be the mirtazapine? About Valerian root, vitamin B and every natural supplement or herbal for sleep, sadly it doesn’t help my sleep at all.
Other doubt Neil. The ENT prescribed me loratadine for 10 days and paracetamol for 3. I’m now scared of all medicines. Do any of the two have the risk of making my ear problems worse? What should i do?
Neil Bauman, Ph.D. says
Hi Samantha:
I can’t say for sure, but it could be some side effects of the Mirtazapine.
Did you read ALL the articles under the links I sent you? They explain there are a lot of things you can do besides take vitamins and supplements in order to get better sleep. I encourage you to read them all and seriously think on each of them whether one or more could help you sleep better. Try them and see what your results are.
I don’t know whether Loratadine will help you–but it is ototoxic. I rate it a 3 out of 5 so you need to be careful. Paracetamol (Acetaminophen over here) is an anti-inflammatory drug. It is also somewhat ototoxic–especially in higher doses and for longer times. But taking a low dose for 3 days probably won’t affect your ears (but there is still a chance so be careful).
Cordially,
Neil
Melissa says
Hello, I have been taking Seroxat for 7 years. I have tried many times to lower to dose from 20 mg but failed. At the 7 year I desided to finally get through simtomps and reduse it from 20 to 10 mg. I stayed about half of year on that dose and in November I reduce it to 5 mg for a week and then stopped. Now after three months I developed tinitus and insomnia at same time. My doctors say they never heard of it that it happens 3 months after stoping medication . Now they have given me lorazepam and mirtazapine to sleep. I see they also have horrible side effects . What do you suggest,do I go back to Seroxat and taper more slowly ? It’s been three months since I have been off. I take lorazepam for sleep but I refuse for now mirtazepane.
Neil Bauman, Ph.D. says
Hi Melissa:
Why did you stop after only 1 week at 5 mg? Why didn’t you give it half a year like you did the previous drop?
Why do you suspect that your tinnitus and insomnia are from stopping the Paroxetine and not from some other cause? 3 months does seem a long time to pass for withdrawal symptoms to show up. That’s why I wonder if some other factor is to blame.
Personally, I wouldn’t go back on the Paroxetine and taper more slowly. You’d be taking a step backwards doing that and I don’t think it would help at this point.
Taking Lorazepam (a benzodiazepine) or Mirtazapine (a tetra-cyclic antidepressant) is leaving you open to more ototoxic side effects. Of the two, Lorazepam is actually the worse choice, but neither is a good choice.
The real question is why can’t you sleep? Go back to the fundamental cause and address that rather than trying to drug it away.
Here are some links to good articles that can help you sleep better.
https://articles.mercola.com/sites/articles/archive/2011/02/04/17-ways-to-improve-your-sleep-hygiene-tonight.aspx
https://articles.mercola.com/sites/articles/archive/2018/03/29/why-do-you-need-sleep.aspx
https://articles.mercola.com/sites/articles/archive/2016/05/26/16-chronological-tips-to-improve-sleep.aspx
I’m sure some of the tips in these 3 articles will help you in the long run and you won’t be drugged in the process.
Cordially,
Neil
Melissa says
I have read numerous posts from people who stopped Seroxat after long use,and some experiences were that ototoxic side effect appeared months after stopping medication. Do you know can it be progressive,permanent,or temporary? Can it lead to hearing loss? I read also about various neurological damage from this types of drugs (antidepressants and benzos) and I am really worried about it. Could my insomnia be linked to some neurological damage from this drug since it appeared at same time as tinitus? Or insomnia is linked to appearence of tinitus?I am scared of taking any medication now,but my insomnia is only getting worse,and with all this my depression and anxiety.
Neil Bauman, Ph.D. says
Hi Melissa:
Paroxetine (Seroxat) certainly can mess up your ears. Side effects may show up right away or not be noticeable for some months or years after you start taking it. I wouldn’t be surprised if the same is true for withdrawal symptoms, although I’d expect most side effects to show up shortly after the drug finally leaves your body.
As far as I know, any hearing loss is not progressive, but it may be permanent. Hundreds upon hundreds of people have reported hearing loss from taking this drug.
I’m no expert on what neurological damage these drugs cause, but I know there can cause permanent neurological damage.
Insomnia could be linked to tinnitus insofar as when you don’t get adequate sleep you are under more and more stress and anxiety and depression–and those three can each cause tinnitus.
Rather than taking drugs that have all these harmful side effects, have you tried psychological counseling to learn how to effectively deal with your depression and anxiety and insomnia? This is what I would do. The trick is finding a good counselor.
Cordially,
Neil
Patricia van Wagoner says
Hello Neil,
Thank you for your help in the past. As you and my audiologist suggested I am getting CBD therapy to address my anxiety and insomnia. I’ve had 5 visits which have now ceased for the time being because of the corona virus and my anxiety level is much improved, however, insomnia still a problem. I’ve tried many supplements including valerian but nothing really helped. I am not seditary. Even with little sleep I keep up with housework and meal prep. I’m also outside each day walking my dog and light gardening. I live on one of the smaller Hawaiian islands so lots of sun and weather mostly good. But big drawback is not many doctors to treat tinnitus and hyperacusis.
I had a visit with my primary care physician recently on 2/24. She was alarmed at my continuing insomnia. She was aware I was seeing a psychologist for CBD therapy and she asked if I was depressed. The therapist and I talked about that and I think I do have some degree of depression because of my health issues. So she thought maybe an anti depressant might help me with sleep as well. We couldn’t find one that was not on the ototoxic list. So I ended up with a prescription for 2.5mg Klonopin as it is not listed on the ototoxic list. I knew the dangers of benzos but desperate for a decent nights sleep. I have taken one every 3 nights since 2/24 which I thought would be reasonable. It was great I slept and felt like myself again. This last week the three I took don’t seem so effective now. I assume I’ve built up my tolerance and my brain wants a higher dose. I’m tempted to take one every night or go to a higher dose but common sense tells me otherwise. I’m not sure how to taper off taking it only 3 nights a week. What do you advise as I don’t want to end up worse because of a mistake in tapering. Also, I realize you are not an MD and don’t prescribe drugs but to your knowledge is there any prescription anti depressant that won’t elevate my tinnitus.
Thank you so much for being so helpful. People like me who have these multiple complicated issues don’t often get the best advice from doctors. Not because they don’t care but they just don’t have a magic bullet, a surgery or a drug that will cure us.
Aloha and best,
Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
I don’t ever remember recommending CBD to anyone.
Clonazepam (Klonopin) has had hundreds and hundreds of reports to the FDA database of tinnitus from taking this drug, so I’d be very careful of it.
If you want a non-ototoxic antidepressant, I’d suggest the herbal St. John’s Wort. It is not ototoxic, is available without a prescription at many drug stores, health food stores or On-line.
A number of studies have shown that it works as well as, or better, than prescription drugs for mild to moderate cases of depression.
If you choose to get it, just be sure it says on the bottle “standardized” and then give what it is standardized to. You want something that says, “standardized to 0.3% (or up to 0.7%) hypericin” which is the active ingredient.
When you are not taking a drug every day, its hard to know how to taper off it. Fortunately, Clonazepam has a long half-life of 30 to 40 hours so you should be able to do a relatively slow taper anyway.
A slow safe taper is considered to be a 10% taper on the descending balance.
Cordially,
Neil
Patricia van Wagoner says
Hi Neil,
Oh, I meant CBT or cognitive behavioral therapy from a Dr. of clinical psychology.
What is a reasonable time frame for this tapering? If it’s 10% off each time I take one it could be a long taper which is ok as I do not want to further damage my hearing. This is so confusing as I was told by an ENT doctor and an audiologist that Klonopin un like other benzos is not ototoxic. But I am noticing an elevation in both H&T so I’d like to get off of it sooner rather than later. It’s obvious Drs. I’ve seen here have no idea how to help me through this so I maybe writing you for further advice on tapering.
I will look for some St. John’s Wort. I have to be careful with supplements as some can cause my colitis to flare up. I had a problem taking valerian because of that. I read the Mercola article you advised about the importance of certain B and D vitamins for sleep we may be lacking. I’m taking the ones advised in the article. Once again thanks for the valuable info.
Best,
Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
Oops. CBD and CBT are entirely different animals. Gotta be careful with the alphabet soup!
If you have developed a dependence on a drug, in my estimation, a reasonable safe taper would be 10 months or more. But depending on your body, etc., some people can taper off much faster. Watch for side effects appearing. If they do, you know you are tapering too fast–so you pause the taper there until the side effects go away, then resume the taper but at a slower speed.
I’d take anything a doctor tells you about the ototoxicity of drugs with a big grain of salt as they don’t know much about the ototoxic side effects of drugs. They take a minimalistic view of ototoxic side effects.
I’ve written quite a bit about tapering off drugs. See my article on tapering off Citalopram and all my comments below that article at https://hearinglosshelp.com/blog/tapering-off-citalopram-safely-without-side-effects/
Cordially,
Neil
Patricia van Wagoner says
Hi Neal, I took a 0.25 dose of Klonopin the night before last, but last night I didn’t sleep at all. Since 2/24 I’ve been taking that dose about 3 or 4 times per week. This last week I’ve had to take that dose almost every other night. I think I have become dependent and my body wants it every night now.
The reason I began taking this was for chronic insomnia so very difficult for me to lose a nights sleep. Do you think it would be reasonable for me to take the dose every night and taper. If so, you mentioned a 10% taper is that still the right course? Was that taper each night 10% or 10% each week? I would think that since I’ve only taken a total of 20 doses since 2/24 that I could do a faster taper but maybe I’m too dependent now. Please advise.
Thank you,
Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
You can try taking a dose every night–do that for a couple of weeks or more, then try tapering.
The 10% taper on the descending balance is normally done monthly, but you can do it faster, every two weeks or every week if no withdrawal side effects appear. I think daily would be much too fast. You have to listen to your body for the right taper speed.
Cordially,
Neil
Patricia van Wagoner says
Hello Neil, In my post on April 4th about my first taking Klonopin I wrote I was taking 2.5 mg. That was a typing error. I’ve only been taking 0.25 mg. As I stated the first month beginning Feb. 24, I only took 2 or 3 doses a week. The following 2 weeks I took that dose every other night. Since then I’ve taken one every night. I can see I’m becoming dependent and only sleeping 4to5 hours. I want to taper off. I have reduced my dose by 10% as of last night. How many weeks should I stay on 10% taper before I can reduce another 10%. Does the fact that I am on such a small dose mean that I will be able to taper faster? I have tinnitus and hyperacusis if that would be a factor. I just need to know what you think the best time frame for taper. Two weeks or a month each reduction? I know you are busy but I need advice as my Dr. is no help. Also I read in Dr. Ashton’s book about switching to Valium do you think that would be a good option for me? I’m concerned it might make my tinnitus worse.
Thank you,
Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
The slow taper route is you taper 10% each month, but if you have no withdrawal side effects appearing, feel free to taper faster. You could try every 2 weeks and if that causes problems, slow down to 3 weeks or 4 weeks (or even longer if you need to). If everything goes well at two weeks and the next two weeks as well, then you might want to try to go 1 week, but again, listen to your body. This isn’t a race.
Just because you are on a low dose doesn’t mean you can taper faster. You have to listen to your body.
I’m not sure you need to switch to Diazepam (Valium) first with its long half life of 20-50 hours, since the half life of Clonazepam is still quite long at 18-39 hours. You’ll have to decide whether you want to switch or not. If you are going to switch, now is the time to do it–before you begin the taper. You’ll have to give your body time to adjust to the Diazepam (maybe a month or more) before you begin the taper if you decide to switch.
Note: if you did switch, a 0.25 mg dose of Clonazepam is equivalent to a 5.0 mg dose of Diazepam.
Switching shouldn’t make your tinnitus worse. If anything, Diazepam is easier on the ears than Clonazepam and actually has around 20% fewer reports of tinnitus.
If you want to know the equivalent dosages and half-lives of the Benzodiazepines, there is a good chart at http://www.vhpharmsci.com/VHFormulary/Tools/Benzodiazepines-comparison.htm .
Cordially,
Neil
Patricia van Wagoner says
Hi Neil, I began 10% taper on 4/18. Already having issues these last 4 nights. The first night I slept maybe 1or 2 hours. Next night I slept 10 hrs. Woke up several times but went back to sleep. Following two nights same pattern. Should I decease taper by 5%?Maybe 10% taper is too much for me. If I switch to Valium I would completely stop the Klonopin cold right? I am able to get liquid Valium at my pharmacy which would make the taper easier. Also like that it would be better for tinnitus. I can get a prescription for 5mg Valium tomorrow. Can I begin with a 5mg. Valium right away and take for a month and begin 10% taper again or is the taper I’ve begun with the Klonopin a problem? Thanks, Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
You could reduce the taper if you want, or tough it out for a while and wait for things to normalize. Then you can continue the taper.
You should ask your doctor or pharmacist about stopping cold turkey on the Klonopin and switching to Valium–or if you have to taper a bit. That is not my area of expertise.
If you switch to Valium, I’d start the taper over again once you have stabilized on it for a month or more.
Cordially,
Neil
Patricia van Wagoner says
Hi Neil, I began with a 5mg Valium taper 3 nights ago. The first night I only slept 4 hours. Second night slept 4 hours, woke up, but went back to sleep a few more hours. Last night I slept 8 hours. So think the valium is beginning to work for me.
My Doctor’s taper schedule for me is as follows: 5mg at night for 2 weeks; then 2.5mg for 3weeks; then 1.25mg for 4 weeks. “Then we will see where you are at” I had explained to him about your recommended taper especially to accommodate my H&T. Because of social distancing I’m not seeing him in person so have to email or phone. Do you have any suggestions to make him understand how important slow tapering is for benzos. If it matters I am 73, 5’2” and weigh 102 lbs. I’m guessing age body size and weight don’t matter as it is the brain we are trying to accommodate. Again, thank you for working with me on this.
Best,
Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
It appears the Valium is working for you, so that is good.
Your doctors taper is a 50% taper which seems awfully fast to me. It may be ok in the sense that you haven’t and won’t have been on the Valium very long. However, remember, you have been on a benzo for a long time and are using Valium to replace this benzo–so you also have the effects of the previous benzo on your body, and I don’t think such a fast taper will look after it properly.
Personally, I’d go slower until you see how things work for you–maybe a 20% taper, but ultimately, the 10% taper is the supposed “guaranteed” safe taper rate.
Cordially,
Neil
Patricia van Wagoner says
Hi Neil,
What is your evaluation of TRT therapy for tinnitus and hyperacusis? I have a neuromonics I pod with ear buds. when I use it for as little as 10 minutes my left ear (in which I have a higher level of hyperacusis) becomes painful. It goes after a few hours and my right ear seems fine with it. I do notice my tinnitus can be elevated right after using it. Do you think that continuing the treatment is a good idea? My gut feeling is that if it hurts then maybe it’s not helping. My audiologist tells me that she has not had a patient whose hyperacusis and tinnitus were made worse by neuromonics. According to her this treatment cannot lessen the tinnitus but it may help the hyperacusis lessen. Also since I’m on the Valium taper is it wise to use the neuromonics while doing it or should I try again after the taper?
As always, thank you for your help.
Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
TRT therapy, when done correctly, is a good way to treat both tinnitus and loudness hyperacusis.
You never want sounds to be painful when treating loudness hyperacusis. When it is painful, you focus on the pain and this is counterproductive to successfully dealing with loudness hyperacusis.
If you have control over your sound device, turn it down. If not, have your audiologist turn it down NOW. There’s nothing wrong with the treatment as long as the volume is ALWAYS just below where these sounds cause you distress of any kind.
It sounds like your audiologist doesn’t understand how to properly treat people with loudness hyperacusis. I’ve heard from people that got worse because their audiologists thought they knew it all. She needs to modify the “book theory” to fit each individual person. It’s not “one size fits all” when it comes to the various kinds of hyperacusis of which loudness is one of the seven kinds.
How much counseling are you getting? The most important part of both TRT and Neuromonics is the counseling–yet this is where some/many audiologists give you the short end of the stick because it takes so much time. They typically want to give you the sound device and kick you out the door. Counseling without the sound device can do more good than the sound device without counseling, but both together definitely give better results.
When you have both tinnitus and loudness hyperacusis, you set the volume for your hyperacusis, NOT for your tinnitus. Typically, you focus on treating the hyperacusis and your tinnitus often gets better in the process.
I don’t see that being on a Valium taper precludes you treating your hyperacusis–but your nerves will tend to be close to being “on edge” so you never want the sound generator noise to cause you any discomfort, pain or annoyance. So set the sound such that it doesn’t do any of those things.
Cordially,
Neil
Patricia van Wagoner says
Hi Neil,
I took the 5mg Valium for a month and am now on the 10% taper every 2 weeks. I am now taking 4mg liquid Valium at night until next Friday when I go down to 3.5 mg. Because I also have colitis I had trouble taking the normal liquid Valium which contained sorbitol and made my colitis flare up. So my Pharmacy compounded the Valium in ethanol which doesn’t effect my colon so far. However, I seem to have headaches almost everyday now. I noticed from time to time with taking the Valium I’ve had occasional headaches but now they are almost everyday. I try to drink more water, get outside and walk etc. which gives some relief. but I’m wondering if this is a normal side effect of the Valium. I don’t want to continue having headaches throughout my taper. Do you have any insights or suggestions?
Thank you,
Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
Headaches are one of the side effects of taking Diazepam (Valium). I don’t know whether the headaches get more common/worse as a withdrawal side effect or not. Normally, if withdrawal side effects show up as you taper, you are tapering too fast. If that i the case, you temporarily stop the taper until the side effect goes away then resume the tape–probably at a slower rate of taper.
Cordially,
Neil
Kelly says
Dear Doctor,
I recently came off 10 mg of Valium which I had been taking for a long time, 25 years. But I had a successful withdrawal with no side effects rice years ago, unfortunately a year later went back on them. This time I did a slow taper and was down to 1mg. Then I had a rough day and took 5mg, then I forgot to take my pill for 3 days, and I then developed brain shakes with tinnitus. I had to go back on the Valium so I could sleep and the brain shakes wouldn’t let me sleep and I was going to start the taper all over again, but 2 months later I got hyperacusis. My hearing seems okay. But my main question is, does the tinnitus (and hyperacusis) get better over time after you finally get Valium out of your body? Can one have silence again? Do any of us recover given time or is this permanent? It came on overnight and now my whole life has changed. I had anxiety before, and I did have tinnitus one other time and it went away, but this came on dramatically after ceasing Valium and I really would like to know the prognosis of the tinnitus? If people recover to hear nothing but peace again? I am so scared! Thank you for answering all of our questions!
Kelly says
I should add at the same time as I forgot to take my dose of valium, my doctor gave me a 20mg pill for escitalopram, which I took, and the effects came on that night.
But regardless, I would like to know if there’s any hope for the tinnitus to get better with time?? And I guess I have caused the hyperacusis by going back on the Valium but wondering of the prognosis of that too after I am free of Valium? Either way, I’d like to know the real truth Of the tinnitus as all the doctors keep telling me they’ve never heard of tinnitus with Valium withdrawal. I can’t believe I caused this to myself by forgetting to take ONE pill. I never had a problem on the Valium the whole time I was on it. Thank you so much for your answers.
Neil Bauman, Ph.D. says
Hi Kelly:
I don’t know whether the Escitalopram had anything to do with your tinnitus or not. It may have been a combination of stopping the Valium and taking the Escitalopram at the same time, but maybe not.
I don’t know where your doctors get their information, but it is known that suddenly coming of any of the Benzodiazepines can result in horrible tinnitus. That is why I tell people to reduce very slowly. It can also induce hyperacusis. Doctors need to know these things.
I don’t think you brought all this on by forgetting to take one pill, but it certainly didn’t help. Benzodiazepine drugs should only be prescribed in the short term–2 weeks or so–not for 25 years! That’s where the real problem lies.
I’ll talk to you on Monday and we can discuss this further.
Cordially,
Neil
Neil Bauman, Ph.D. says
Hi Kelly:
You can get your tinnitus and hyperacusis under control. You don’t have to suffer from them for a lifetime–but you do have to do the right things. It’s not time alone that makes the difference, but what you do in that time.
I don’t know the long term effects of taking Valium for all those years (if any), but my first wife took it for years and was able to wean herself off of it. My expertise is in the effects to the ears, not how drugs affect your brain.
I know some people seem to have bad tinnitus from coming off a drug too fast and that can be hard to get rid of–but I don’t believe it is impossible to get it to a manageable level.
So much depends on your attitude towards your tinnitus. When you think of it as a threat to your well-being, you can’t do much with it, but when you change your attitude and no longer consider your tinnitus a threat to your well-being, but just another (useless) unimportant background sound that is safe to ignore, then you start making progress to it fading into the background.
Cordially,
Neil
Kelly says
By the way, that should have read that I went back on the Valium 5 years ago. Been on 10mg a day since. I am going to do the Heather Ashton taper this time. I am very scared though.
Maria Burkhardt says
Hello Dr. Bauman,
I have had terrible side effects before I tapered off the xanax in May. It let me to believe that it had to be the Xanax sine I’ve taken them for 3 yrs. but I left a reply to you that I went back to it in May and since then I continue to have these side effects like shock waves in my head and vibrating also. Plus tingling in my legs and rapid heart beat with palpitations even below my ears. I had been tapering off since July 28th now. And taking Cymbalta. I just hope that these side effects disappear. Both my T and H also had gotten worse before tapering off. I am down to 1.25mg a night. I want so bad to get off these xanax. Now I’m Scared about the Cymbalta today has been 3 wks since I taken them 30 mg twice a day. Any advise please. Once again side effects were before I tapered off.
Sorry. I forgot to add i can’t sleep either. Have tried melatonin per my Dr. 2.5mg didn’t work went to 5mg still didn’t since I have chronic insomnia for years. My Dr. Doesn’t want me on sleeping pills because I on xanax still.
Thank you in advance for your reply
Maria
Neil Bauman, Ph.D. says
Hi Maria:
Side effects like shock waves and vibrating and tingling, etc. are typically from tapering off a drug too fast.
I don’t know what you want me to do to help you. You have doctors putting you on drugs, taking you off drugs, making you taper too fast, etc. That is NOT the way to get side effects of drugs under control.
Cordially,
Neil
Maria Burkhardt says
Hello,
Thank you in replying.
I understand. But Once again unfortunately I had these side effects before I tapered off the first time in May. I’m confused because people are getting side effects while they’re tapering off the meds. For me has been before tapering off the Xanax. And Drs. can’t figure out why. I have had MRI, MRA, C-scans. And of course nothing shows up.
I will ask the Dr. I’m seeing to see if she will prescribe the valium. This one doesn’t usually prescribe Benzos. But maybe in this case she will. I will show her your reply. I thank you for your advise. You are very helpful. If any other advise even on the Cymbalta
please reply.
Patricia van Wagoner says
Hi Neil,
I am on the last of my 5 mg liquid Valium taper which I began in April (Ashton Method that you suggested) Thursday night I took my last of the 1/2 mg taper which I’d been on for 2 weeks. I asked my pharmacist if I could just stop and he said it was such a low dose that I could. However I got a little scared so the last 4 nights I took a half of a half mg. dose which was going ok until last night I couldn’t sleep all night and had anxiety. I still have it today. I’m trying to take a little nap now since I’m really tired but the anxiety is still happening. Should I just ride this out or go back on the 1/2 mg dose. Does this happen often after this very slow taper ? I’m a little scared but trying to stay positive that this will soon resolve. I do have lots of calming sleep supplements I’ve been taking as the taper lowered but nothing worked last night. Please advise
Thank you,
Patricia
Neil Bauman, Ph.D. says
Hi Patricia:
You might think that a small dose would be safe to just “jump off”, but actually, it is harder at the end where it is more important to keep tapering way down, especially if you are worried about “jumping off” according to Heather Ashton, the expert on tapering off such drugs.
You can “ride it out” if you feel you can handle it, or go back to the previous dose, wait until you stabilize at that dose, then resume the taper even if it seems a very small amount. At some point you will have to stop and “jump off”, but you can choose that point based on how you feel.
Cordially,
Neil
Marcus G says
I was exposed to extreme high pitch alarm for around 15 seconds. It caused me so much pain in my head from the loud tinnitus running through my head I became suicidal. If it were not for an emergency doctor prescribing Xanax to me few day’s later I would have ended my life. Now it’s been just over two weeks taking 1.5 mg Xanas throughout the day. It makes the tinnitus livable at best. I don’t know what else to take or do! I realize the dangerous effects of the drug but at same time I know I can not live with the extreme level of sound the tinnitus produces without taking medication for it that reduces the loudness. What am I suppose to do? I feel I am damned if I do and damned if i don’t.
Neil Bauman, Ph.D. says
Hi Marcus:
When you say you take 1.5 mg “throughout the day”, how much are you taking per day in total?
Is your tinnitus volume dropping as it is now 6 weeks or so since you began the Xanax? You want to get below 1.5 mg of Xanax per day so you can begin to habituate to your tinnitus. More than that prevents habituation from occurring. Thus you want to get off any and all benzodiazepines so you can successfully deal with your tinnitus.
Since tinnitus is a psychosomatic condition, a lot depends on your emotional/psychological attitude towards your tinnitus. You need to think of it as a totally unimportant background sound that is not worthy of even listening to. As long as you think of it as a threat to your well-being (like you are doing now), you can’t habituate to it so it fades into the background. So you need help with the psychological aspect of dealing with tinnitus.
An the same time, you can use pink noise or water sounds, etc. to partially mask your tinnitus. You don’t want to completely mask it (which you can’t if it is really loud), but the masking sound will make it easier to live with it while you habituate to it.
Cordially,
Neil
Beverly Crispi says
How can I taper off .50 lorazepam I’ve been taking for three months. I’ve gone from .75 in just one month. Having brain zaps and increased T. I’ve had the tinnitus for four years and I think it’s from Mirtazpine and lorazepam off and on during this time. This is my third time trying to get off the lorazepam. I’ve never been off for more than six months because some anxiety event always drives me back. I might need spinal surgery soon and am so scared of drugs for pain anesthesia and antibiotics. Not sure how to handle all this.
Neil Bauman, Ph.D. says
Hi Beverly:
Once you’ve formed a dependence on a Benzodiazepine drug such as Lorazepam, the safe taper rate is 10% per month on the descending balance. So if you are on .5 mg now, you’d taper to .9 (90%) x .5 = .45 mg for the 1st month, then .8 (80%) x .45 = .36 mg the second month, .7 (70%) x .36 = .25 mg the third month and so on.
If you experience brain zaps and increased tinnitus you know you are tapering too fast. In that case, pause the taper until the symptoms go away and then continue at a slower rate–perhaps every 6 weeks or 2 months per taper step.
If you want to stay off psychotropic drugs, you need to learn how to control your anxiety. A good anxiety counselor (psychologist) can help you control your anxiety so you no longer need drugs to help you deal with it.
Depending on your spinal surgery, you may not even need any drugs for pain. I didn’t even take an Aspirin after my spinal surgery–just cold packs and rest did the trick (and tough out the bit of pain I had). It was ever so much less pain than I’d had before. I didn’t need antibiotics either. Don’t worry about what might be as it may never happen.
Cordially,
Neil
Carrie says
Hello Dr. Bauman! First off thank you for helping people like us! The extra time you take to answer to people like me on these posts is truly awesome. Thank you! I have a question, about 5 months back I developed a blood clot in my arm (surgery related) anxiety that it was gonna break off and kill me was pretty high for a solid 3 months. Gave in to my doctor and took 1 single Prozac. I was pretty nervous as I didn’t want to take any medicine that could affect my clot or anything. Was pretty paranoid, felt even more anxiety taking the pill but also felt I was not coping so I took it. After about 20 min I felt this weird heat feeling go up the back of my neck but thought nothing of it maybe it was the Prozac “kicking in” anyways fell asleep shortly after. Woke up to ringing in my ears which caused a panic, immediately felt it was the Prozac. Never took anymore. It hasn’t stopped here almost 6 months later. Is it possible one pill can cause it? Or did my over anxiety trip the wire? Thank you very much.
Neil Bauman, Ph.D. says
Hi Carrie:
Fluoxetine (Prozac) is one of the SSRI class of drugs. I do not have any reports that a single dose caused permanent tinnitus, but exactly that can and does happen to people taking Citalopram (Celexa). What can happen to one drug in a chemically-related class can happen to others in that same class.
Thus, it is quite likely that that one pill caused your permanent tinnitus. And it probably was exacerbated by your high levels of anxiety. Your anxiety can keep the tinnitus “running”. I hope you have your anxiety under control now. If so, you can work on habituating to your tinnitus and bring it under control too.
Cordially,
Neil
Pam Nieblas says
Dr. Bauman…I don’t know how I happened upon this site searching for help on damaged gaba receptors, but I couldn’t leave it without saying you are the absolute BEST for taking the time to respond to people and help them. I was given lorazepam from my doctor to help me sleep. Not researching right away, it already did it’s damage short term. I tapered off from start to finish 6 months maybe a total of 85 pills. I am still suffering 6 years later and never touched that evil med again. I have yearly setbacks that are worse than withdrawal and they last months…every symptom in the book. Right now I’m in an absolutely hellish evil tortuous setback (4 months long so far) and am fighting for my life everyday. We sufferers truly need someone like you with your care, compassion and knowledge to help those of us suffering with protracted injury that lasts for years and years.
Neil Bauman, Ph.D. says
Hi Pam:
Thank you for those kind words. I’m sorry you’re having such a difficult time with the aftereffects of the Lorazepam you took. That is why I keep telling people to take it easy with drugs. You never know what effect they will have on you. When you take drugs for small problems, you risk having even bigger problems in return. You can choose to take a drug or not, but, unfortunately, you can’t choose the consequences.
I wish I knew what you could do to get your life back together again, but that is not my area of expertise.
Cordially,
Neil
Mari says
Hello Dr. Bauman,
I wish I had seen your site before I started my Lorazepam taper. I was taking 1mg a night for severe insomnia for about 3 months…then started to taper. I did 25% taper for about 2 weeks, then another 25% taper for 3 weeks, and now I am at half a 25% taper–down to .375 mgs per night…and two days ago I developed very loud tinnitus. I had low-grade tinnitus from being a musician in many loud bands..but this is MUCH worse. I don’t want to go back up to a higher dose…I want to stay the course and taper–I am working with a psychiatrist who wants me on this dose for another 2-3 weeks…then down to .25 for the same, then half of that, then off….but I am worried now–will the tinnitus be permanent? I’ve done some research and and it seems for many folks it goes away (or gets much better) eventually-even if it’s a year later. I am taking L-theanine and N-Acetal Cycsteine and Ashwaganda and Valerian. They are helping with the insomnia. As a musician/singer and someone with chronic insomnia…it’s very disconcerting. I appreciate your time in reading and look forward to your response. Thank you.
Neil Bauman, Ph.D. says
Hi Mari:
The problem with tapering off a benzo is that you don’t know how slow you have to go to be safe. Some people can taper off relatively fast, and others need to go VERY slowly–and take a year or so to get off.
Since you have tapered off to about 1/3 of your original dose and now have tinnitus and don’t want to go back up, I’d suggest that you stay at this level until your side effects go away, then begin tapering at a “safe” rate of a 10% taper per month on a descending balance. I’m afraid your doctor is asking you to still taper too fast, and considering you are now fighting tinnitus, it may be much too fast. There is no way to know ahead of time whether your tinnitus will be permanent or not, but by tapering very slowly starting now will give you the best chance of your tinnitus fading away in time. That, and not focusing on your tinnitus, but on the loves of your life. If you focus on your tinnitus and treat it as a threat to your well-being, tinnitus can take on a life of its own. So remain neutral towards your tinnitus and basically ignore it as much as you can.
The supplements and herbal you are taking are good. They should help you in the long run.
I wish you well.
Cordially,
Neil
Sheri says
HI Dr. Bauman…I just want to say how extraordinary you are for sharing so much of your wisdom with everyone! I just stumbled upon this page as I developed tinnitus 2 days ago after being on .5mg Lorazapan for 2 months every other night or every 2 nights, 30 pills total. Although I have the ringing in my left ear, I don’t feel I have developed a dependency on them, just for occasional sleepless nights. After reading nearly every one of these posts I want to stop taking them immediately. Do you feel I should tapper if I’m not dependent? Thank you again for your time and such care for everyone…
Neil Bauman, Ph.D. says
Hi Sheri:
Since you are only taking a pill every other day or two and have, as far as you know, not developed a dependence on the Lorazepam, you can probably stop cold turkey. Note that since Lorazepam has a half-life of 12 hours, and you take it every second day or every third day, the concentration is down to 25% or 12%, by the time you take the next pill, so essentially you have been tapering off the drug after every pill. So you should only have minimal withdrawal effects (if any).
Cordially,
Neil
Sheri says
Thank you Dr. Bauman for your reply! I just want to add the tinnitus has increased since stopping a few days ago and I have about 75% hearing loss in the same ear. Could this have happened with such a short term use of Lorazapan? With much gratitude and appreciation…Sheri
Neil Bauman, Ph.D. says
Hi Sheri:
Anything is possible when you take drugs, especially the Benzodiazepines. So much depends on your body chemistry AND your psychological state of mind. If you are worried or anxious about this, it could make your tinnitus worse. If this is what is happening, as you calm down, I’d expect your tinnitus to do the same.
Cordially,
Neil
Sheri says
I understand! Thank you again for taking the time to respond, truly grateful! Sheri
RS says
Amazing that I stumbled into this situation with almost no awareness from medical professionals about the long-term implications. I took Adderall daily for 12 years, Ambien to sleep the last 6 – both prescribed by the same doctor. “I have lots of patients that do both.”
5 months ago I stopped 30mg daily Adderall and 10 mg Ambien cold turkey and started taking 2mg of Xanax 5-6 days a week 1X daily to help me sleep.
I realized this was an issue as I would wake up tired – ears were ringing, hearing seemed reduced in one ear and just mentally nowhere near the prior me. I have reduced to 1mg a day (for 2 +weeks now) – barely got out of bed 2 days but exercising and eating well.
But, I know this is going to be hard. Doing a silent retreat in a week and would like to drop to .5 1X daily at that point. Meditation, Exercise, Yoga, Reading and keto-focused diet.
The ringing was worse 2 weeks ago, my hearing is better, but I’m wondering if the taper to .5 is too quick – and how many weeks I should stay with that. I don’t feel like I need to switch to valium and would like to move to .25mg then .125 mg in the next 2 months.
Based on the above history – is my approach reasonable – knowing it’s different for everyone and nothing is without risk?
Neil Bauman, Ph.D. says
Hi RS:
If you can stand the side effects until they finally go away, you can do what you are doing and risk whatever may happen. Only you know how bad the side effects are and whether you want to put up with them or not.
The fact your tinnitus and hearing are improving is a good sign. If you follow your suggested taper and either one of these symptoms begins to get worse, then slow the taper down or freeze the taper at that point until your symptoms go away, then continue on the taper.
That is what I’d probably do.
Cordially,
Neil
RS says
So far, so good. Going slower than plan – down to .25 with no negative impacts. Still have “clicking” in one ear and reduced hearing in the other – but not worse. Hopefully just another month.
Neil Bauman, Ph.D. says
Hi RS:
Sounds like you are tapering at a correct speed now. That’s great. No rush–just keep on and you’ll be off the drug as your body slowly adapts.
Cordially,
Neil
Larry says
Hi Neil
I develop tinnitus a wk after I stop taking clonazepam 1.5mg for insomnia for a period of 3 wks ( not consistent taking nightly ) .. can I re instate again the drug and taper so it will stop my tinnitus ? hoping for your reply
Neil Bauman, Ph.D. says
Hi Larry:
You can try this, but unfortunately, there are no guarantees it will work. In my experience, it probably won’t work. That’s one of the nasty things about getting of the Benzos. You have to do it right the first time. So I always suggest a slow taper. Better to be safe than sorry.
Cordially,
Neil
Kristina Koehler says
Dearest Dr. Baumann
Thank you from the heart for all the support and information.
Had I just known…..
I experienced a burnout with a Hyperacusis (loudness). I went to a psychosomatic clinic I thought I could heal there. I was so wrong. They put me on Tavor for 5 weeks 1.5 mg/day. I developped strange sounds in my ears at night that time thinking I was juat stressed. I got not better and changed the clinic. In the new clinic they said they were shocked I was on Tavor such a long time and told me I was a addict now and we had to taper. They went too fast. I developpedevek more strange sounds in my ears that started to persist also during the day. And they got higher in their sound level. My whole body got extremely stressed out by the tapering – I even started to have heart problems (I was always so happy that my heart was so healthy).
Now I am in a horrible state regarding also my ears. One ear developped today a very high frequency sound and it feels like I am hearing less. My hyperakusis is so much worseand it also changed to be a dysakusis also that I dont know how I am going to live my life again as before. I am a journalist travelling a lot but taking trains or riding in a car feels so loud and strange now?
I AM SO SCARED that I ve ruined my ears and my life. Can my ears heal? I am tapering too fast I guess. I am on 0.25 mg daily now…tapering since 5 weeks…
What do you think?
🙁
With kind regards,
Kris
Neil Bauman, Ph.D. says
Hi Kris:
When you say you were put on Tavor, I assume that the generic name of this drug is the benzodiazepine, Lorazepam, correct? (I need to check because there are 4 totally different drugs that all have Tavor as their brand name–depending on the country.) The common brand name over here is Ativan.
Unfortunately, Lorazepam can cause a whole host of ear problems including hearing loss, hyperacusis and tinnitus as you have experienced.
Once you have developed a dependence on this drug, you have to taper slowly. Typically doctors taper far too fast. The safe way to taper is a 10% taper per month on the descending balance. You may be able to taper faster (or may need to taper slower) depending on your body. Thus, the taper could take you 10 months to a year or longer–again depending on your body.
The correct taper rate is one that doesn’t cause withdrawal side effects to appear–or just very mild ones that you can easily handle. If more severe side effects begin to appear, you need to stop the taper at that point and wait until the side effects go away, then resume the taper but now at a slower rate.
One of the nasty things about benzodiazepines is that you can develop hyperacusis if you taper too fast.
Since you are experiencing bad side effects, you need to stop tapering and wait until your body adjusts to the level you are at now before you resume tapering. This may take weeks or months.
You need to calm down. Anxiety and fear just make matters worse. Only time will tell whether you will have any permanent ototoxic side effects or not. But you can be hopeful that they will go away in time.
Cordially,
Neil
Anita says
I have taken .25 mg of Xanax off and on for over 30 years. I would take 1/2 of .25 when I felt and bad headache coming on and the other half if the first didn’t help.
I have recently learned that Hyperacusis can be a side effect from Xanax and have stopped my occasional Xanax usage. Since my life has been disrupted by my Hyperacusis, I never want to take Xanax again.
My question is: Since my .25 Xanax usage was maybe once a week or less, do you think I will have any withdrawal symptoms? I have daily headaches anyway that I treat with OTC meds, ice and heat, therefore, I’m not sure if I would notice a “withdrawal headache”. Any insight would be greatly appreciated. Thank you!
Neil Bauman, Ph.D. says
Hi Anita:
I doubt you will notice any withdrawal side effects if you stop taking the Xanax “cold turkey”. Here’s why.
The half life of Xanax is an average of 11 hours (The range is from 6 to 27 hours). This means that the Xanax concentration in your blood is reduced by 50% at 11 hours, 75% at 22 hrs, 87.5% at 33 hrs and 93.75% at 44 hours. So if you don’t take another Xanax for 4 days, you’ve basically already withdrawn from the Xanax. Then you wait 3 or more days (once a week or less) before you take the next one.
Thus, as I see it, you never got hooked on Xanax. You’ve basically already “suffered” withdrawal every week before you take the next pill. Thus stopping completely won’t be any different to your body than just taking 1 pill a week like you are doing now.
I doubt your hyperacusis is the result of taking Xanax at such a low dose and taken less than once a week, although I suppose it could do so.
I’m curious, what caused your loudness hyperacusis? Do you also have tinnitus?
Cordially,
Neil