Can Benzodiazepine Withdrawal Lead To Tinnitus?
January 28, 2022

In today's world, it seems like more people than ever are anxious. When you take the time to stop and look around, it is easy to understand how more and more people are becoming anxious. The constant bustling of traffic, the increase in work hours,  the social isolation experienced during the pandemic, and the anxiety of the future are all valid. 

Luckily more people in today’s day and age are seeking care for their anxiety. Mental health is much more normalized today and is becoming less of a taboo topic allowing an easier time seeking care.

There are a number of different treatments that can be offered to individuals that are anxious. Benzodiazepine is one of those potential treatments. While this drug is able to help with anxiety, it could have a number of different unintended side effects, such as tinnitus. 

Below is a closer look at everything you need to know about benzodiazepine, how it relates to tinnitus, and what can be done to help. 

What Are Benzodiazepines?

Benzodiazepine is a class of drugs that acts as a sedative within the body. Benzodiazepine, also known as benzos, is a widely prescribed drug that can help with severe anxiety and other health problems. While they have a therapeutic purpose, the effects of benzos can have the potential to be addictive and potentially dangerous. 

Below is a closer look at what exactly benzos are and how they affect the body. 

How Benzodiazepine Affects the Body

The human body has hundreds of different chemical messengers that are flowing throughout it at any given time. These chemical messengers play a very specific and important role in ensuring the body is working as it should. While the body is an extraordinary conductor of all of these messengers, sometimes it needs the assistance of medication. 

Benzodiazepine is a medication that impacts the chemical messenger GABA within the brain. GABA is a neurotransmitter within the brain that acts by suppressing nerve activity. GABA plays an essential role in allowing you to calm down.

In the case of those with anxiety or sleep disorders, the brain may have a difficult time settling down. This is where benzodiazepine comes in. 

Benzos work within the body by increasing the effect that GABA has on nerves. Essentially they make GABA more effective and, as a result, can allow people with anxiety or trouble falling asleep a more calm state of mind. 

Types of Benzos

Benzodiazepine is a term utilized to describe a whole class of drugs, but more specific examples of benzos include Klonopin, Xanax, Halcion, Ativan, and Valium. These medications all act by increasing the action of GABA but differ in how fast they act. 

Benzodiazepines can be broken down into two categories. This includes fast-acting benzodiazepines and slow-acting benzodiazepines. Both have their specific use case and also carry a unique set of potential side effects. 

Fast-acting benzodiazepines can have a propensity to increase the chance of feeling withdrawal symptoms after use and are more likely to contribute to an addiction. Slow-acting benzodiazepines, on the other hand, work over a longer period of time and may reduce the chance of developing withdrawal or addiction.  

What Is Benzodiazepine Used For?

According to the FDA, benzodiazepines are approved to treat anxiety disorders, insomnia, social anxiety, panic disorders, and some seizures. In addition to treating these specific disorders, benzodiazepines are also approved to be used before a medical procedure to help in sedation. 

Precautions

Like any drug, benzodiazepine has the ability to be misused. Benzodiazepine has a potent effect on the brain. As a result, the body can develop a tolerance to the drug making it easy to become addicted to it. 

Because of the fact that the body can develop a tolerance to the drug. Benzodiazepines tend to only be prescribed for relatively short periods of time or are closely monitored under the supervision of a doctor. This ensures that the drug is not being abused and that a high tolerance isn’t developed.

Another vital precaution to note is that benzodiazepines are not something that you should cease taking on your own. If you need to get off the medication for whatever reason you should first discuss this with your doctor so they can slowly wean you off the medication to avoid some nasty withdrawal symptoms. 

How Are Tinnitus and Benzodiazepines Related?

Tinnitus and drugs that act as a sedative may seem completely unrelated, but they are linked in a very specific way. As discussed previously, benzodiazepine use can lead to a tolerance of it by the body. Essentially a tolerance is a way that the body copes with a drug. 

Take a substance like caffeine as an example. Caffeine works by inhibiting a neurotransmitter known as adenosine from binding. Adenosine binding helps you to feel tired and by blocking it you feel more awake.

In response to adenosine not binding, the brain produces more adenosine receptors. This allows adenosine to bind even when caffeine is present. When you suddenly take caffeine out of the equation the brain is left with all of these open receptors without enough adenosine to fill them. The result is a bad headache and caffeine withdrawal. 

The same sort of concept applies with benzodiazepine but it carries its own unique set of withdrawal symptoms that are much more serious. Some withdrawal symptoms can include insomnia, nausea, seizures, irritability, depression, anxiety, and even tinnitus. 

Withdrawal Associated Tinnitus

The fact that the medication benzodiazepine can cause tinnitus is not unique and there are actually a number of different medications that have the ability to contribute to tinnitus. What is unique about benzodiazepine and tinnitus is that tinnitus tends to emerge upon discontinuation of the medication. 

Another aspect of benzodiazepine withdrawal associated tinnitus that is unique is the fact that the tinnitus can be lasting. Many cases of medication-associated tinnituses will dissipate upon cessation. Yet, some case studies seem to show that tinnitus can be lasting with benzodiazepine withdrawal.

What Is Tinnitus?

Tinnitus is a condition that causes you to hear a sound that is not present in your immediate environment. The perception of a non-existent sound may not sound that severe, but it can negatively impact your overall well-being.

Imagine trying to go about your day getting work done and constantly having a high-pitched noise ringing in your ears. While the exact tone and volume of tinnitus can differ from person to person, the capacity to impact your wellbeing is common across all of them. 

Underlying Cause of Tinnitus

According to the American Tinnitus Association, nearly 50 million Americans experience some form of tinnitus. Even though there are millions impacted by tinnitus, there is still some level of unknown when it comes to the underlying cause of tinnitus. 

Tinnitus can be broken down into two distinct categories. The first form is known as objective tinnitus and this comes as a result of internal noises that become perceivable. One of the more common forms of objective tinnitus known as pulsatile tinnitus is caused by turbulent blood flow near the structures of the ear.

The turbulence emits a slight sound and because of its proximity to the inner ear, it becomes detectable and causes a form of tinnitus that pulsates. This form of tinnitus can come and go and can vary depending on the activity level, intracranial pressure, and blood pressure. 

The second and more prevalent form of tinnitus is known as subjective tinnitus. Subjective tinnitus has no external source of the sound. Subjective tinnitus is typically what is experienced with tinnitus associated with hearing loss, medications, and loud noise exposure. 

Treatments

When it comes to tinnitus a large majority of cases are unable to be directly cured. While this can be disheartening there are a number of different treatments that can help you to come to terms with tinnitus and live with it more effectively. 

One option that can help those that have tinnitus and hearing loss is hearing aids. Hearing aids are ideal to help with symptoms of hearing loss but hearing aids can also help with tinnitus by drowning the tinnitus with noise to make it less noticeable. 

Another option that can provide long-term relief from tinnitus is therapy. Tinnitus therapy tends to focus on how you react to your tinnitus as well as your thoughts and opinions about it. By coming to terms with tinnitus and going through tinnitus retraining therapy, individuals can live their day without tinnitus having as much of a negative impact. 

Medications and Tinnitus

In summary, benzodiazepine is a medication that is commonly prescribed for anxiety and sleep disorders. While it is effective, there is a potential to develop tinnitus when ceasing benzodiazepine treatment. Even though this potential is relatively low, it is a side effect that is important to be aware of before treatment. 


Sources

Benzodiazepine Drug Information | FDA

Understanding the Facts | American Tinnitus Association

Tinnitus associated with benzodiazepine withdrawal syndrome: A case report and literature review | NCBI

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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