Alprazolam and Tinnitus
Question:
Another thought-provoking post, thanks, Bob. We really are all adrift in boats, aren’t we? One man’s drug is another’s horror. So we can go with stats (which, as you observe are paltry, and don’t exist for comparison purposes) or on personal observation. For what it’s worth, I’ve never been on Klonopin, so cannot compare. I’ve been on Xanax about 6 years, have absolutely no trouble getting going in the morning (perhaps because that early morning T high point is best relieved by getting going). Do I dream? Intensely! I would hope so! Drowsy? Occasionally, but more due to fatigue accompanying hearing loss and FAR less than before taking Xanax for sleep deprivation from T. Did Xanax lower my T? Not appreciably, but I have a severe case, with deafness. It seems to lower T for some people, but that’s no sure thing; it’s no miracle drug, and most assuredly not the cure we are all hoping for. Wish you luck. It seems we must each skipper our own boat…Mary
Response:
In article <NE685.6287$4C4.112…@news2-win.server.ntlworld.com
, "John
Goddard" <john.godda…@virgin.net
writes: Can anyone tell what’s so special about Xanax for treating tinnitus when it’s only one of a large group of benzodiazepines? Why not diazepam itself (cheap generic drug)? John
As I recall, Dr Jack Vernon, now semi retired is the person who popularised Xanax as a tinnitus treatment. I recall him saying that if he was young enough to continue in research he would like to research onther drugs in the same group. So I think he would agree with your point. Tony J
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On 08 Jul 2000 15:46:10 GMT, tonyjef…@aol.comTonyJ (TonyJeffs2) wrote: – Hide quoted text — Show quoted text -
In article <NE685.6287$4C4.112…@news2-win.server.ntlworld.com, "John Goddard" <john.godda…@virgin.net writes: Can anyone tell what’s so special about Xanax for treating tinnitus when it’s only one of a large group of benzodiazepines? Why not diazepam itself (cheap generic drug)? John As I recall, Dr Jack Vernon, now semi retired is the person who popularised Xanax as a tinnitus treatment. I recall him saying that if he was young enough to continue in research he would like to research onther drugs in the same group. So I think he would agree with your point. Tony J
Tony: Has the Doctor (or anyone else) stated a position on long term use of Xanax ? I’ve been using it for 19 years now — the only trouble I ever had over it was when I read Dr. Jastreboff’s quote that he felt it "inhibited the habituation process". I tried to taper off it over the 3 months before my visit to him — absolute disaster — I couldn’t believe T could get so loud and irritating. It took another 3 months of little sleep to restore my ‘charma’ of T treatment. I haven’t corresponded with many people who have taken X for a comparable time period. Bob D. Long Island, NY dimarco_…@mindspring.com
Response:
- Hide quoted text — Show quoted text -TonyJeffs2 wrote:
"John Goddard" <john.godda…@virgin.net writes: Can anyone tell what’s so special about Xanax for treating tinnitus when it’s only one of a large group of benzodiazepines? Why not diazepam itself (cheap generic drug)? John As I recall, Dr Jack Vernon, now semi retired is the person who popularised Xanax as a tinnitus treatment. I recall him saying that if he was young enough to continue in research he would like to research on ther drugs in the same group. So I think he would agree with your point. Tony J
—————– Actually, Tony, I spoke to Jack Vernon last week, and he was unwillingly to extrapolate the benefits of any benzo other than xanax, as there has never been a controlled study on their benefits. Having read a report on the 1991 study on xanax itself, it’s hard to figure out anything conclusive. It may well be that certain benzos do the job on tinnitus better than others, for whatever unknown reason–or that some people have better success with some than others. Despite Vernon’s very professional attitude in not applying information on xanax to other benzos, I was just reading the book that Vernon edited himself: "Tinnitus: Treatment and Relief," where, on p. 14, Dr. Ross Coles of the Institute of Hearing Research, University Park, Nottingham, UK, says that he "personally favor[s] clonazepam (klonopin) since it is less addictive [apparently rather questionable] and seems to work in a very low dosage (0.5 to 2 mg a day)….Xanax has been used for this purpose in the United States but is banned for use in the United Kingdom [is this still true, Tony?] because of its highly addictive properties." In reading the report on the original xanax study in the US, there were considerable problems with daytime drowsiness, difficulty with "getting going" in the morning, as well as an increase in dreams [strangely, my doctor told me that benzos tend to suppress dreams, while I have found that neither extreme is true for me]. I’m on klonopin, and have found that while 0.75 mg seems to cause some depression and "droopiness," a tiny reduction to 0.625 mg solves this. Very strange. I must be very sensitive to this. I was wondering whether to switch to xanax since so many people have reported good success levels with it, and I haven’t heard a word about klonopin (clonazepam), nor has it been especially wonderful for my tinnitus, but now I’m not so sure that any benefit would be gained. Thoughts, folks? Bob Seletsky <mem…@sprintmail.com
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I’m just bewildered to think of any child on Xanax. Surely there was no double-blind study on children. If children are on Xanax, their learning problems may stem from other problems besides neuroplasticity concerns. I wish someone would reassure me there really are not a lot of kids on Xanax. Mary
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- Hide quoted text — Show quoted text -e…@my-deja.com wrote:
I am presently undergoing TRT. When I began TRT I was on Xanax and upon the recommendation of my clinician, I slowly tapered off. It was difficult and my tinnitus did get worse during this process– but it sure was worth it. My habituation did markedly improve, once I was off Xanax. Dr. Nagler is WRONG (yes folks, Dr. Nagler can be wrong also) when he states that it is only theoretical that benzodiazepenes inhibit neuroplasticity. It is well documented, for example, that learning is adversely affected in children who are on drugs such as Xanax. Learning occurs as a consequence of neuroplasticity and I have heard of recent studies that have demonstrated that benzodiazepenes do indeed inhibit neuroplasticity. In addition, once the brain adjusts to a new homeostasis, the Xanax has no effect upon tinnitus and then the patient is faced with two choices: a) slowly going off Xanax and the consequent increase in tinnitus or b) permanently staying on Xanax without any benefit.
………… Well, I’ll stand by my original statement. So now you have two opinions! And I most certainly CAN be wrong. (Just not this time.) smn
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I am presently undergoing TRT. When I began TRT I was on Xanax and upon the recommendation of my clinician, I slowly tapered off. It was difficult and my tinnitus did get worse during this process– but it sure was worth it. My habituation did markedly improve, once I was off Xanax. Dr. Nagler is WRONG (yes folks, Dr. Nagler can be wrong also) when he states that it is only theoretical that benzodiazepenes inhibit neuroplasticity. It is well documented, for example, that learning is adversely affected in children who are on drugs such as Xanax. Learning occurs as a consequence of neuroplasticity and I have heard of recent studies that have demonstrated that benzodiazepenes do indeed inhibit neuroplasticity. In addition, once the brain adjusts to a new homeostasis, the Xanax has no effect upon tinnitus and then the patient is faced with two choices: a) slowly going off Xanax and the consequent increase in tinnitus or b) permanently staying on Xanax without any benefit. Sent via Deja.com http://www.deja.com/ Before you buy.
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dimarco_…@mindspring.com (Bob DiMarco) wrote:
Has the Doctor (or anyone else) stated a position on long term use of Xanax ? I’ve been using it for 19 years now — the only trouble I ever had over it was when I read Dr. Jastreboff’s quote that he felt it "inhibited the habituation process". I tried to taper off it over the 3 months before my visit to him — absolute disaster — I couldn’t believe T could get so loud and irritating.
……… Dr. Vernon has absolutely no problem with recommending Xanax for long term use. stephen nagler
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On Sat, 08 Jul 2000 17:22:54 GMT, nag…@tinn.com (Stephen Nagler) wrote:
……… Dr. Vernon has absolutely no problem with recommending Xanax for long term use. stephen nagler
Doctor: Thank you — it’s reassuring to hear. My wife also has T now along with Meniere’s and participates in the MDG Meniere’s group. LOTS of folks there think of xanax as the ‘medicine from hell’. Since T is a small portion of the Meniere’s problems, I guess I’m not seeing a complete picture. Thanks again, Bob D. Long Island, NY dimarco_…@mindspring.com
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Hi T-people, Ive read your thread about Xanax and cant but wonder. I have been on Valium about 20 yrs (started with 4 times 10 mg per day, after 10 yrs: 6 times 5 mg per day, trying to get that down on my own -works best for me- to right now 2 1/2 pills of 5mg per day). Valium is diazepam. So is Xanax. What is so special about Xanax? Why does anyone think it works for T? BTW: I started to cut down my diazepam by myself with little bits about 6 yrs ago, so no ’sudden’ changes have been made. I have T + H since 3 months, do I have to take MORE diazepam??? (If I get it at all…) Maya. PS Diazepam is addictive. Takes long to get ‘off’ it. So??? Maya. "Stephen Nagler" <nag…@tinn.com
wrote in message
news:39676334.421252924@news.mindspring.com… – Hide quoted text — Show quoted text -
dimarco_…@mindspring.com (Bob DiMarco) wrote: Has the Doctor (or anyone else) stated a position on long term use of Xanax ? I’ve been using it for 19 years now — the only trouble I ever had over it was when I read Dr. Jastreboff’s quote that he felt it "inhibited the habituation process". I tried to taper off it over the 3 months before my visit to him — absolute disaster — I couldn’t believe T could get so loud and irritating. ……… Dr. Vernon has absolutely no problem with recommending Xanax for long term use. stephen nagler
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On Sat, 8 Jul 2000 23:39:31 +0200, "Maya Zuiderweg" <ma.zuider…@planet.nl
wrote: Hi T-people, Ive read your thread about Xanax and cant but wonder. I have been on Valium about 20 yrs (started with 4 times 10 mg per day, after 10 yrs: 6 times 5 mg per day, trying to get that down on my own -works best for me- to right now 2 1/2 pills of 5mg per day). Valium is diazepam. So is Xanax. What is so special about Xanax? Why does anyone think it works for T? BTW: I started to cut down my diazepam by myself with little bits about 6 yrs ago, so no ’sudden’ changes have been made. I have T + H since 3 months, do I have to take MORE diazepam??? (If I get it at all…) Maya. PS Diazepam is addictive. Takes long to get ‘off’ it. So??? Maya.
Maya: To my totally unprofessional knowledge, Valium (V) and Xanax (X) are chemically similar. I read an article about X about 20 years ago and my ENT has been prescribing it for me ever since. It HAS helped with T reduction and relaxation. For the first few years, it was also a sleep aid — long term use has greatly diminished this benefit. Is this an addiction ? — Good question, don’t really know — It is certainly a dependency at this point. How similar are X and T ? — Another good one — I’ve corresponded with a number of folks in this NG who also take X and are pleased. When my wife and I have mentioned X in the Meniere’s group where she participates, we found that MANY of the participants greatly prefer V for combined T and balance problems. I couldn’t even begin to guess the effective dosage for T & H — This is definitely a question for your Doctor(s). Good luck witgh your treatment, Bob D. Long Island, NY dimarco_…@mindspring.com
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Are you aware of any studies on the combination of T with significant hearing loss ?
No. The factor of signficant hearing loss and the treatments for tinnitus are nor presented as correlates in any studies I have read. I was particularly looking for
TRT results with combined hearing loss — Do those 80 % success numbers hold up, .
Yes. In this clinic they do, anyway. Biggest problem group is actually the folks with perfect or near perfect hearing, horrible tinnitus, and profound hyperacusis….regardless of what they doing to help themselves…….. Just my 2 cents. Marsha Johnson, M.S., CCC-A, FAAA Clinic Director/Audiologist, TRTA Member since 1997 Oregon Tinnitus & Hyperacusis Treatment Center (503) 233-5925 -clinic (9-5 PM), (503) 203 5858 voicemail (24 hours) www.tinnitus-audiology.com
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On 02 Jul 2000 20:52:02 GMT, oreg…@aol.com (Marsha Johnson) wrote: – Hide quoted text — Show quoted text -
Are you aware of any studies on the combination of T with significant hearing loss ? No. The factor of signficant hearing loss and the treatments for tinnitus are nor presented as correlates in any studies I have read. I was particularly looking for TRT results with combined hearing loss — Do those 80 % success numbers hold up, . Yes. In this clinic they do, anyway. Biggest problem group is actually the folks with perfect or near perfect hearing, horrible tinnitus, and profound hyperacusis….regardless of what they doing to help themselves…….. Just my 2 cents. Marsha Johnson, M.S., CCC-A, FAAA
Marsha: Thank you — your $0.02 is always of great interest to me. When I went to see Dr. Jastreboff in ‘97, these were 2 (of the many) questions that I asked him. I have no useful hearing but LOUD T in one ear and 55 dB average loss in the other — the main question was "Could I benefit sufficiently from TRT to be worth trying" ? – He decided not to treat me. I tried self TRT for about 2 years and got some benefit. Currently, I’m more pleased with digi BICROS. Thanks again, Bob D. Long Island, NY dimarco_…@mindspring.com
Response:
I go with Bob. I’ve had T close to half a century. In my thirties, the sleep deprivation became a real danger to me; I was teetering close to falling asleep driving kids to soccer games and school, etc. Dr. Vernon corresponded with me and started me on Xanax, which I’ve now taken for 6 years with no problems. My sleep patterns are completely normal. Far from being detrimental, Xanax has enhanced the quality of my life immeasurably. For people with really severe T, Xanax deserves some respect and consideration under a physician’s care. It’s not a cure; it’s certainly not the first thing to try, but for some people Xanax is a tremendous help.
Response:
"Mary Holmes Dague" <dag…@epix.net
wrote: I go with Bob. I’ve had T close to half a century. In my thirties, the sleep deprivation became a real danger to me; I was teetering close to falling asleep driving kids to soccer games and school, etc. Dr. Vernon corresponded with me and started me on Xanax, which I’ve now taken for 6 years with no problems. My sleep patterns are completely normal. Far from being detrimental, Xanax has enhanced the quality of my life immeasurably. For people with really severe T, Xanax deserves some respect and consideration under a physician’s care. It’s not a cure; it’s certainly not the first thing to try, but for some people Xanax is a tremendous help.
……….. I think that most of the objection to Xanax comes from two corners – first, TRT clinicians who have had it drummed into them by Dr. Jastreboff that Xanax theoretically inhibits neuronal plasticity and thereby (again theoretically) impedes tinnitus habituation … and second, from some medical professionals who are just not comfortable with making the type of long-range commitment to a patient sometimes required when placing a patient on benzodiazepines such as Xanax. In terms of the first, I have never seen any studies to support the theoretical contention that Xanax delays habituation. On the contrary, I have several patients in my own practice who never would have been able to get through TRT and ultimately succeed were it not for pharmacological assistance! In terms of the second, I agree with Marsha that Xanax has several potential side effects, but so does almost every single drug in existence today! The trick is for the person assuming responsibility for prescribing the drug to clearly understand both the indications AND the potential complications … and to assist the patient in weighing one against the other so that both the patient and the prescribing physician reach a satisfactory comfort level. And while it is true that there is only one study demonstrating Xanax’s efficacy in tinnitus (not a really great study at that), Xanax HAS withstood "the test of time," having been recommended for use in tinnitus patients for many years … and while not being anything close to a cure, having often been highly effective as an adjunct to treatment (as in Mary’s situation, for instance). In summary, while I feel that Jastreboff’s contributions to the "tinnitus scene" have been extraordinary, I feel that he has unwittingly put unnecessary fear into the minds of many tinnitus patients (and clinicians) who might otherwise consider a drug that can – when prescribed responsibly and judiciously – effect considerable relief. stephen nagler www.tinn.com
Response:
On Mon, 03 Jul 2000 12:59:21 GMT, "Mary Holmes Dague" <dag…@epix.net
wrote: I go with Bob. I’ve had T close to half a century. In my thirties, the sleep deprivation became a real danger to me; I was teetering close to falling asleep driving kids to soccer games and school, etc. Dr. Vernon corresponded with me and started me on Xanax, which I’ve now taken for 6 years with no problems. My sleep patterns are completely normal. Far from being detrimental, Xanax has enhanced the quality of my life immeasurably. For people with really severe T, Xanax deserves some respect and consideration under a physician’s care. It’s not a cure; it’s certainly not the first thing to try, but for some people Xanax is a tremendous help.
Mary: Apparently not too many people agree with us about Xanax. I’m not sure if there are any bonafide studies to back them up. I’ve only found 1 or 2 other people who have taken Xanax for T for as long as I have. We all felt that there was a significant difference between a long-term medical dependency and an addiction. Good luck with your treatment, Bob D. Long Island, NY dimarco_…@mindspring.com
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Can anyone tell what’s so special about Xanax for treating tinnitus when it’s only one of a large group of benzodiazepines? Why not diazepam itself (cheap generic drug)? John
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Bob, you have been on Xanax longer than anyone I know and it encourages me that you have been able to do so (at least until something better comes down the pike). Dr. Vernon and my physician both say that Xanax isn’t addictive, and I find that too–if I miss a dose it’s no big deal, no craving. Going off has to be done in steps over at least a month per the proper protocol, but I’ve never had to do that. After a year on Xanax, I contacted Dr. Vernon about Xanax and my concern that it was working too well. (What is it about the human mind that we second guess a good thing?) He said if it’s working for you it’s something you need and you can accept that exactly the same as a person who needs medication for other physical ailments. I really appreciated his compassion and common sense. Once, just once, I forgot I’d taken the meds and took it again, a double dose. Ahhhh….peace….tinnitus down to a whisper. Problem was, I was too spaced out to want to drive or anything. So I am content not to raise the level of medication, stay functional with tinnitus and sleep at night. Vernon saw that chance moment of incredible relief as a good sign that the dose I am supposed to take is a good choice for me. The neuroplasticity issue is for the scientists to work out, and I’m not a TRT candidate anyway. I feel a LOT better with a good night’s sleep than I did during the long decade of serious sleep deprivation, and my memory seems about the same as most people I know who are my age…now if only I could remember what my age is…:-) Best to you. Mary
Response:
On 01 Jul 2000 21:10:54 GMT, oreg…@aol.com (Marsha Johnson) wrote in part:
I spoke with their director this week and he pointed out that in this study, the control group was given benedryl as their medication, versus the group that had the xanax. We agreed that it would have been a better study if there could have been a group that was given some sort of medication that does not induce drowsiness, as both xanax and benedryl do. [snip]
Marsha: I’ll submit myself as a case study of 1 (no placebo group). I’ve been taking xanax (0.5 mg 2x to 3x) for the past 18 to 19 years. I never found it to be detrimental to memory but I did find that it lost most of it’s sleep-aid benefit after the first few years. It was ALWAYS of great benefit for T relief. I didn’t appreciate how much until ‘97 when I read that Dr. Jastreboff felt it "inhibited the habituation process". My attempt to taper off xanax (over 3-4 months) was an unbelievable disaster which I won’t willingly repeat. I never knew or believed that T could be SO LOUD ! It took another 3 months to restore my theraputic level of xanax (and my peace of mind). Are you aware of any studies on the combination of T with significant hearing loss ? I was particularly looking for TRT results with combined hearing loss — Do those 80 % success numbers hold up, … continued success, Bob D. Long Island, NY dimarco_…@mindspring.com
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The Oregon Health Sciences University, Deparment of Otolarygology, published a double-blind study which outlined a protocol showing that xanax reduced the loudness of their tinnitus (measured by masking levels) in about 75% of the cases. I’m certain it reduced the anxiety in an even higher percentage. Their protocol considers the dependency nature of xanax and is designed to help reduce this effect. (Johnson, Brummett and Schleuning, Archives of Otolaryngology-Head & Neck Surgery, volume 119, pp. 842-845, 1993). Paul
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Please note that I don’t endorse nor oppose this protocol. Haven’t tried it. Just posting it for information. There are some notable researchers and clinicians who feel that xanax will slow down the process of habituation on the TRT protocol, if you are considering the latter. Paul
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John is correct. There is another advantage to Tai Chi. Studies have proven that this exercise prevents falls and hip fractures. Personally I think every health program should offer this to their members. The costs are negligeable – are about 1/10 of what a single fall costs. Murray Grossan, M.D. http://www.ent-consult.com
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I spoke with their director this week and he pointed out that in this study, the control group was given benedryl as their medication, versus the group that had the xanax. We agreed that it would have been a better study if there could have been a group that was given some sort of medication that does not induce drowsiness, as both xanax and benedryl do. I also think that with observing and evaluating over 500 people in the last 3 years, that the side effects of xanax type medications cannot be underestimated. If the effect is primarily attentional…..or in the relief of the anxiety….then the problem is that the person finds that same numbing or lessening effect in ALL aspects of their lives…including work, social, spiritual, etc. This is often unacceptable. One study does not a finding make…..there needs to be better designed, longer studies completed with ALL the medications physicians are throwing at people with chronic intrusive tinnitus—-mostly without knowing about potential side effects! MJ Marsha Johnson, M.S., CCC-A, FAAA Clinic Director/Audiologist, TRTA Member since 1997 Oregon Tinnitus & Hyperacusis Treatment Center (503) 233-5925 -clinic (9-5 PM), (503) 203 5858 voicemail (24 hours) www.tinnitus-audiology.com
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I have had tinnitus for the past ten years. I have found, purely by chance, that alprazolam(Xanax) substantially reduces the ringing. I am taking alprazolam to reduce anxiety and found a very,very good side effect. I hope this also works for you……..Lee
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This is a kind of wll known that a drug like Xanax helps T. I don’t think that Xanax is actually reducing the level of T, but just your attitude toward it. In other words, it lets you cope with it better. The question might be in your case as in many other people, is the T causiing your anxiety or is your anxiety increasing your T? (chicken /egg thing) Be careful not to get dependent on Xanax, My understanding is that this is used as a last resort for people with severe T that nothing else seems to help. I would try a non-drug alternative and I would try other non-drug things to reduce your anxiety such as Tai Chi, Yoga , exercise, etc. Regards, John
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