Permanent damage to GABA receptor?

Isn't there concern that benzos can cause permanent damage/changes to the brain?  In particular here is a quote...

 

"Still, it is a topic of concern, and deserves further research, whether chronic administration of benzodiazepines may in some way permanently alter the benzodiazepine-GABAergic system."

 

from this article,

http://www.acnp.org/G4/GN401000129/CH127.html

 

Thus, if my tinnitus, and other symptoms are caused by some permanent alteration in my brain from using Klonopin, then it won't go away.  :'(

 

I hate seeing quotes like that because it scares the hell out of me.  Still, don't we have to face the fact that this is a possibility?  I hope research is being done to find out the answer.

I could be wrong, and if so I'm sure I will be corrected, but I believe the risk of brain damage mainly exists in those who were on a benzo for a long period of time. I recall reading something similar to what you posted and it scared the hell out of me, I know you've been going through a difficult time and are looking for answers... but don't let your fears get the best of you.

Isn't there concern that benzos can cause permanent damage/changes to the brain?  In particular here is a quote...

 

"Still, it is a topic of concern, and deserves further research, whether chronic administration of benzodiazepines may in some way permanently alter the benzodiazepine-GABAergic system."

 

from this article,

http://www.acnp.org/G4/GN401000129/CH127.html

 

Thus, if my tinnitus, and other symptoms are caused by some permanent alteration in my brain from using Klonopin, then it won't go away.  :'(

 

I hate seeing quotes like that because it scares the hell out of me.  Still, don't we have to face the fact that this is a possibility?  I hope research is being done to find out the answer.

 

If you look for them, you can find plenty of stuff to scare the crap out of you about benzos and most other meds.  All they are saying is it ought to be researched, presumably because it has not been demonstrated that there is any permanent alterations of the brain due to chronic benzo use. I didn't read the whole article but did they even say what they considered "chronic use"?

 

That being said, I view my tinnitus as something that I have to accept and learn to live with somehow.  I don't know if mine will ever go away or lessen in volume even though, of course, I hope that it does.  I believe I'm supporting my body's ability to heal with my mental attitude as well as healthy diet and environment.  I plan on getting more exercise and to be involved in more outside activities this next year.  As soon as my mind is not occupied with something else, the tinnitus really gets to me, so I'm trying to keep my mind otherwise occupied.  It's another of those "focus on what you can control" things.

No, it didn't define what "chronic" use meant.  I am just assuming that it means any use longer than is recommended.  And we all know that they are only indicated to be used for 2 weeks.  I read that they have recently been recommending a duration of only 7 days.

I still can't shake what my previous doctor told me about some people "never healing" and needing benzos forever. God I am so scared I have ruined myself. :'( I am scared I will have to take Klonopin again if I ever am to function at even a minimal level.  Then, of course, I will need more and more of it as the years go on... and I will become more and more of a moron as a result. :'( 

 

Is it just me, or does it seem like a lot of the people who are having a very hard time month out are those who came off of Klonopin?  I know that there are others here who have had a difficult time long term coming off of other benzos, but it seems to me like there is a trend with protracted withdrawal and Klonopin.

I still can't shake what my previous doctor told me about some people "never healing" and needing benzos forever. God I am so scared I have ruined myself. :'( I am scared I will have to take Klonopin again if I ever am to function at even a minimal level.  Then, of course, I will need more and more of it as the years go on... and I will become more and more of a moron as a result. :'( 

 

Is it just me, or does it seem like a lot of the people who are having a very hard time month out are those who came off of Klonopin?  I know that there are others here who have had a difficult time long term coming off of other benzos, but it seems to me like there is a trend with protracted withdrawal and Klonopin.

 

I think all of us were told we would be on this drug forever.  I know I was.  And it was a lie!  The facts are that drs. really don't have a clue how these drugs affect us, they only know how to prescribe, prescribe, prescribe.

 

There's no doubt, Klonopin is one of the worst but it's not a death sentence.  As far protracted wd goes I've heard, and there are many theories, that protracted starts after being 18 months off.  You have a ways to go before you can be considered protracted.   

There is a study that found that people with tinnitus have a deficiency of benzo receptors.

Here is the abstract:

http://www.ncbi.nlm.nih.gov/pubmed/14689626?ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

 

Okay, with that being known, think about this... It is common for the brain to "down-regulate" and prune receptors for a particular neurotransmitter(etc.) when there is an over-abundance of that particular neurotransmitter or substance.  This is hypothesized to be a major problem with anti-depressants and could explain "poop out".  Because of pre-synaptic blocking less serotonin is made (as a result of less being taken back up).  Further complicating matters, receptors for serotonin on the post-synaptic receptor are pruned away because there is an over-abundance of serotonin in the synapse. It seems that you end up making less serotonin and having less receptors for it.

 

It is like the drug works against itself.  Then, if you stop it, you are left in a state where you make less serotonin and have less receptors for it, theoretically.  I have often wondered if this could be why i am so sensitive to anti-depressants now. I wonder if my brain can't respond to the raised serotonin because I have no receptors anymore.  The question is, do the receptors up-regulate and come back?? Well, it has been 3 years for me and I still am not tolerating another anti-depressant. I don't know.

 

Anyway, so you can see, if you are flooding your benzo receptors with a benzodiazepine that eventually those receptors might start to be pruned and that would leave you with a "deficiency".  So, perhaps, this is why I, and others have tinnitus.  Additionally, the benzodiazepine receptor is on the GABA receptor complex.  When GABA binds to its receptor on this complex a "door" opens and ions modulate so that their is an inhibitory effect.  When a benzo binds to its receptor on this same complex it potentiates GABAs inhibitory effect by making the "door" open and close for a longer period of time. Perhaps your body starts making less GABA because it is using the GABA it has more efficiently because the benzo is on board.  So, knowing that, it makes you wonder if indeed that does happen, will the body start making more of its own GABA again?  How is the whole receptor complex affected in the long term?

 

Additionally, tinnitus has been proposed as a kind of seizure activity.  Perhaps after removing the benzo which potentiates GABA (an inhibitory neurotransmitter) and is a mild anti-convulsant, the brain freaks out and starts "seizing" in whatever way it does that causes tinnitus.  Then, if the brain is not utilizing GABA properly anymore, it can't stop it? Or maybe it is because of some permanent damage? 

 

It is interesting to note that Gabapentin (Neurontin) which is an analogue of GABA, has no effect on reducing tinnitus. So, it seems like the hypothesis about the benzo receptor down-regulation would be a more probable cause.

 

Of course, even if any of this is true, there is no cure. It is nice to know someone is studying tinnitus though.

 

 

Is it just me, or does it seem like a lot of the people who are having a very hard time month out are those who came off of Klonopin?  I know that there are others here who have had a difficult time long term coming off of other benzos, but it seems to me like there is a trend with protracted withdrawal and Klonopin.

 

CC,

 

I was on klonopin (albeit only 4 months). I tapered relatively quickly and have had no lingering post-withdrawal problems.

Eljay that is wonderful news for you and I hope that I can say I am better someday

 

We are all genetically different and I have read that they think it plays a role in why some people can get off benzos without problem and other can't.  Perhaps our genetics could contribute to how long we suffer after coming off too. I must not have the lucky mix of genes others have.  Who knows....  :'(

My GP, who I've had for over 15 years, cheerfully told me that some folks function perfectly well on 4.5mg of xanax. I cheerfully told him right back that I wasn't one of them. (He also was the doc that switched me to valium so I could taper, so I can't really complain.)

 

Unless you've been on benzos for years and years and years I doubt you're one of the ones whose GABA receptors are permanently damaged. Even then, folks have gotten off benzos and stayed off benzos and done really well.

 

I wonder though if eating more protein would help the tinnitus. Proteins helps build receptors so if tinnitus is a by-product of reduced receptors, maybe eating to build them back up would reduce the tinnitus. Just thinking out loud here.....

 

rufus 

 

 

Hi C.C., I have very bad symptoms still. It's easy to feel that it will be forever. I guess how I feel is that maybe my symptoms won't ever go way.... that is better than being on the benzos and creating still more damage. Maybe my symptoms will go away some day..........the more I freak about it the longer an hour seems. 

 

Get my drift? I too know all the science. I know I may be screwed, but then again maybe I'll be just fine!

 

No medicine or Doctor can fix this so I may as well just start living and moving on as best I can. The science is fascinating I think you have a knack!

 

 

I was on Klonopin for close to ten years, so I'm pretty certain that I'd fall in the category of "chronic" users. I know that my w/d, however, is based on my underlying symptoms, as the Remeron has alleviated many of my issues. However, the dizziness and other pain issues remain. I popped a Klonopin to see if they'd stop when I took it and guess what?

 

They did.

 

So I'm still in w/d in some manner six months out (almost seven). Do I believe the damage is permanent? There is no evidence to say that it is and lots of people function on benzos for years on end without a dosage increase, so frankly I doubt it. Considering the nervous system is the slowest part of our body to heal, it's going to take a LOT of time - perhaps even years - before I ever feel better. Until then, I need to find a new antidepressant to replace the Remeron and hopefully keep my disorder in place. I'm not keen on being on an AD, but honestly I don't think I can live without them.

 

-Pete

Rufus-

 

I don't eat well.  I usually eat one regular meal a day and I might have a light breakfast. I am so deeply depressed I don't feel like eating or care.  Sometimes I drink a protein shake with breakfast. (carnation instant breakfast)

 

Can your brain even rebuild receptors?  I know for a long time they didn't think the brain could re-generate. I know that is not a concrete belief now, but I don't know much about it.

 

 

Your brain is ALWAYS building new cells and regenerating receptors - that's just natural! However, you do need to eat your full three meals a day, whether you want to or not.

 

The bottom line is that the brain needs food just as much as your body. It wants and craves different types of foods and needs them to operate at a level that is functional. You're going to want to do some reading on it, but believe me - eating well is important.

 

Rich protein rich foods in the morning are great, as are juice and fruits. Natural sugars! Also, a bagel or some kind or carb. My morning meal is almost always eggs, bagels, fruit juice and fruit (banana, orange and apple). Sometimes I have some ham or canadian bacon, too.

 

Lunch should be smaller than breakfast, but consist of a similar regimen. Peanut butter is always great. Fruits and veggies (raw are best).

 

Dinner should be even smaller than lunch, believe it or not. Fish three times a week (salmon and tuna are best), chicken, or turkey is a recommended meat, while rice or potatoes make a perfect complex carb. Also fruits and veggies.

 

-Pete

Pete-

 

   Thanks again for sharing.  

 

   You know, I had a bad emotional breakdown and I guess panic attack last weekend. I called the doctor and of course you know that the way they always handle a situation like that is with a benzo.  So, I let him call me in some 5mg Valium. I went ahead and took one dose.  The next day I felt better than I have in months. (though not by any means well).  That of course scares me.  I don't know if I should be happy about it or sad. I haven't taken anymore of it. I just can't bring myself to do it.  One 5mg dose didn't help the ringing. I still wonder if it might take Klonopin to do that.

 

   I have been of the belief that I can't live without an anti-depressant either.  I certainly have not functioned well in these 3 years of unsuccessfully trying over and over and over and over again to get on another one. Currently I have been on 25mg of Zoloft for 4 days and I feel worse.    The trazadone is helping me tolerate the Zoloft better (helping me not be activated) but I just feel absolutely awful.  I feel apathetic and strange, detached. The ringing seems worse.

 

   I just don't know what to do.  I wish I could find the answer.

Hi C.C., I have very bad symptoms still. It's easy to feel that it will be forever. I guess how I feel is that maybe my symptoms won't ever go way.... that is better than being on the benzos and creating still more damage. Maybe my symptoms will go away some day..........the more I freak about it the longer an hour seems. 

 

Get my drift? I too know all the science. I know I may be screwed, but then again maybe I'll be just fine!

 

No medicine or Doctor can fix this so I may as well just start living and moving on as best I can. The science is fascinating I think you have a knack!

 

 

I just don't know how you think about it so positively.

 

Thanks for the compliment.  I should know it. I obsessively research 6-7 hours a day. I also can't hear the ringing when I am on the computer so that draws me to it in addition to my OCD.

Pete-

 

   Thanks again for sharing.  

 

   You know, I had a bad emotional breakdown and I guess panic attack last weekend. I called the doctor and of course you know that the way they always handle a situation like that is with a benzo.  So, I let him call me in some 5mg Valium. I went ahead and took one dose.  The next day I felt better than I have in months. (though not by any means well).  That of course scares me.  I don't know if I should be happy about it or sad. I haven't taken anymore of it. I just can't bring myself to do it.  One 5mg dose didn't help the ringing. I still wonder if it might take Klonopin to do that.

 

   I have been of the belief that I can't live without an anti-depressant either.  I certainly have not functioned well in these 3 years of unsuccessfully trying over and over and over and over again to get on another one. Currently I have been on 25mg of Zoloft for 4 days and I feel worse.    The trazadone is helping me tolerate the Zoloft better (helping me not be activated) but I just feel absolutely awful.  I feel apathetic and strange, detached. The ringing seems worse.

 

   I just don't know what to do.  I wish I could find the answer.

 

 

As someone who has been perpetually suffering for months, I can give you only one answer:

 

Give your body and mind some time.

 

Also, it sounds like you've been on an AD for sometime and perhaps you need to have it changed. Why were you on the meds to begin with (I'm flighty and you might have told me already, so I apoligize in advance).

 

Let me say this - I've been suffering for ages, only to realize that a large part of my w/d is my underlying disorder which, as I've said before, I need to medicate. I don't intend to do it forever, but I need to be stable to learn how to do the CBT. I don't feel awful on Klonopin, but I sure as Hell don't feel good, either, so I'm staying off of it and using my AD to help keep me sane. The physical stuff will take time, but it WILL heal. You need to get in the right mind set and that's hard to do when you suffer and I know this first hand. Believe me, this will one day be a distant memory... you just need to regain your composure somehow and keep on keeping on.

 

-Pete

No, I have not been on any anti-depressant or any other psychotropic drug for 3 years now.  I have tried all the SSRIs and lots of other medicines but end up stopping every one of them after anywhere from a few days to at most a few weeks because of side effects (and not just a little headache or something simple). Making it a few weeks is rare. Over the last three years I would often try several drugs in a month.  Lets see, this month I have tried at least four.  I have just been going through this cycle over and over and over again, never getting anywhere.  The whole reason I got on Klonopin in the first place was because I wasn't being able to get on an anti-depressant and I needed something. I had hoped the Klonopin would help me get back on a medicine, it didn't.

 

I am petrified I have ruined myself by either

1.taking an anti-depressant to begin with (as I explained earlier in this post)

2. putting an always changing cocktail of drugs in me every month

3. taking Klonopin

 

Or all three.

Pete-

 

   Thanks again for sharing.  

 

   You know, I had a bad emotional breakdown and I guess panic attack last weekend. I called the doctor and of course you know that the way they always handle a situation like that is with a benzo.  So, I let him call me in some 5mg Valium. I went ahead and took one dose.  The next day I felt better than I have in months. (though not by any means well).  That of course scares me.  I don't know if I should be happy about it or sad. I haven't taken anymore of it. I just can't bring myself to do it.  One 5mg dose didn't help the ringing. I still wonder if it might take Klonopin to do that.

 

   I have been of the belief that I can't live without an anti-depressant either.  I certainly have not functioned well in these 3 years of unsuccessfully trying over and over and over and over again to get on another one. Currently I have been on 25mg of Zoloft for 4 days and I feel worse.    The trazadone is helping me tolerate the Zoloft better (helping me not be activated) but I just feel absolutely awful.  I feel apathetic and strange, detached. The ringing seems worse.

 

   I just don't know what to do.  I wish I could find the answer.

 

Critter -

 

We have a lot more than tinnitus in common.  Although I had success with prozac back in 1991-2, I never found another one that worked as well after it "pooped out".  I did have to take Klonopin with it because I couldn't sleep with the severe RLS.  I hunted for another A/D for close to 10 years (including Zoloft), spiraling downward after every unsuccessful 3-6month trial, and finally the pdoc threw up his hands and said I must have bipolar II.  This started a slew of other drug combinations  but no A/D (he believed it would trigger mania though I could hardly get out of bed those years and would have welcomed a little mania!). Even though I kept feeling worse with the changing treatments, I always thought I needed "something"; it really didn't occur to me that the medicines I was given were the cause of my misery. I have tried trazadone several times over the years for insomnia and it always makes me feel bad the next day.  Mostly a really dull feeling and headache but it turned out not to be worth it to me.

 

I was at my lowest ebb and scheduled for electroshock therapy when I came here last January.  I was told I had to be off the benzo to get the ECT and was terrified about stopping it.  Instead of ECT, I decided to see if the depression and apathy would lift if I just got off the benzo and started my taper.  (I had been started on Wellbutrin the week before which probably wasn't a great idea but being suicidal I thought I'd better try it.)  Anyway, while I am not where I hope to be, I am way better than I was a year ago at this time.  I'm still on the Wellbutrin and shaving a little off of my dose every few weeks. Had a setback when Jake died so am holding for now.  I may always need some mood support but I want to see how little I can get by with.  Healthier and cheaper!  

 

I just saw that you posted you've been on a lot of different drugs, too, over the last three years and at least four different drugs this month!  Girl, this could be the source of your misery.  I did the same thing for aobut 3x as long as you did and I'm healing, so there's no reason to think you've done any permanent damage.  I do think there's a good chance that the changing drug cocktails are making you sicker, just like they did me.

 

 

 

Hi Crittercuddle:

I can relate. I am on a taper and while I don't suffer tinnitus, I do have a lot of other symptoms, in the beginning of my taper sx were more physical, towards the end more emotional. I too wonder if I can live off benzos, been on them at various doses for 10 years. Increased from .25 for sleep PRN in the last 5 years after I started taking wellbutrin. The wellbutrin really helped with depression, but the dose was probably too high and I needed more xanax to help with the anxiety and insomnia the wellbutrin induced. I had anxiety and insomnia anyway. So I am doing a rapid taper. I don't think any of us have permanent damage from benzo use. It's a belief or fear or a thought, not scientifically supported as Beeper pointed out.  I do think there is tendency to attribute any symptom to having been on benzos and coming off them. I think you hit the nail on the head when you said you "believe" you have to be on some med and maybe benzos. The key word is believe. The stories we tell ourselves are our belief systems and we make our experiences work with our belief systems. I am examining my belief system and your post has helped me clarify some things, thank you. I share that fear that my genes or biology has destined me to a life on meds and I don't like it. So I am trying to be off meds for now, because I also believe that biology and genes can be modified by other means that taking medications. For some meds are essential, while others have alternative options. It's hard to figure out what applies to you. I do however as of late experience a lot of emotional distress that prevents from functioning at a "normal" level, but I keep asking myself, "was I functioning at a normal level before I started my taper?" and the answer is, no. I was in tolerance withdrawal, I needed more xanax to stabilize and that wasn't even working. So I knew tapering was the only answer. I'll find my baseline once I am off, but right now it's hard to tell if my symptoms are wd sx or sx from some underlying condition, like anxiety, insomnia, depression, etc. Until then I try to believe that I will be normal again. I do believe I will be normal again. I do believe that this is a process and it's going to take longer than I want, but I got myself into this mess, so I have to find my way out with the help and support others like you and people on this site. I have hours and days where I feel like I am going to give up, and that's usually about the time I make my next cut. Playing around with a bunch of meds can't be helpful, but I understand the frustration of needing and wanting to feel okay. While none may be as quick as a benzo, some have been mentioned, like diet. I support exercise, it always helps me get things back into perspective and regulate my physical self. I go even when I don't feel like I can and I always end up feeling better. Reading a book, yoga, breathing exercises really help, but whatever works to help you regulate and feel more stabilized, do it. The other thing I try to do is realize my thoughts can feed my fear, thoughts are just thoughts and you have the power to have all kinds of thoughts, including thoughts about feeling good. I have to consciously tell myself, I am better now than I was in the beginning of my taper and when I think back to the wd in Nov, and compare it to my wd right now, I am better even though I am still experiencing wd sx. Thanks for sharing and hang in there, you will find your path, you are doing it now. Thanks, Trueblue

CC-- You said up above that when you're on the computer you can't hear the ringing. That's great! No wonder you're on it 24/7. Does the focus make you not hear the ringing or does the computer actually ask the sound of the tinnitus?

 

Now if you could find something else to research besides benzo withdrawal and GABA damage...

 

rufus

“I obsessively research 6-7 hours a day.” I think this may be a big part of your problem. How about doing something else! Reading about how you may or may not have permanently changed your brain is not going to make you feel any better.  I agree with Rufus that you need to find a new research topic – howabout looking at how meditation (that's meditation not medication!) effects GABA production – that’s an interesting one.  Also exercise affects it I think. If you want to get a bit biological you can look into how supplements like vitamin b6 affect it.  You should be able to find decent published papers on this stuff.

 

Maybe if you research these areas you’ll come to the conclusion that even if you have somehow permanently decreased your GABA receptors (unlikely), it doesn’t really matter cos there is plenty you do to boost your GABA levels!

 

 

Rufus-

 

I don't eat well.  I usually eat one regular meal a day and I might have a light breakfast. I am so deeply depressed I don't feel like eating or care.  Sometimes I drink a protein shake with breakfast. (carnation instant breakfast)

 

Can your brain even rebuild receptors?  I know for a long time they didn't think the brain could re-generate. I know that is not a concrete belief now, but I don't know much about it.

 

 

 

CC,

I know from experience that not getting enough calories can create or perpetuate depression. Your brain needs food to feel good.

Also, I"m not 100% sure about this, but I think Carnation instant breakfast is mostly sugar and not much protein. Sugar can cause anxiety and depression in some people (me!). It would be better to go to a health food store and get a higher quality protein powder. It doesn't have to be super high protein, but you should get at least 50mg of quality protein a day.

 

Petey gave some really great nutritional advice!

Hi,

I have been on Diazepam (Valium) 5 mgs. for 11 years taking average doses of 15-20 mgs. daily. I was first prescribed Diazepam to help me sleep, as I was also prescribed by my psyquiatrist to try and take Ritalin (Rubifen) for my attention deficit hyperactivity disorder, and I could not sleep properly because of Its stimulating effects.

 

I never suspected that benzos were so addictive, that I would suffer such a long withdrawal and that is why I continued taking them for such a long time.

 

I totally quit Diazepam (Valium) in September 2011 after a 9-month taper.

As of today I still suffer of hypersensitivity to stimuli since I started quitting benzos, specially light and sound, and this hypersensitivity has not diminished one bit. As well my brain does not process information or thinks as fast as it used to do before starting quitting benzos.

 

My hypersensitivity to light is a big concern for me now. I can't be long time without sunglasses indoors, in places where there are fluorescents or any type of artificial light (computers and any digital screens included), as the brightness of the lights seem unbearable to me.

 

Long term benzo withdrawal use seems to leave a permanent super sensitive nervous systems on many people.

 

I have taken natural herbal supplements, as I read in other forums, such as muira puama and bacopa, to help regulate the gaba receptors system. Also I have taken piracetam, l-theanine and Omega-3 capsules for this very purpose, but It has not helped at all with my hypersensitive nervous system and hypersensitivity to artificial light.

 

 

I wish this hypersensitivity to light and stimuli would diminish, but It hasn't after 3 years and two months of not taking any benzos. So my very sad conclusion: If it has not diminished in three years and two months, probably some conditions after benzo withdrawal are permanent, as there may be permanent "functional" damage in the gaba receptors system (meaning by functional, the way the gaba receptors system functions), or permanent "functional" change in the gaba receptors system.

I still can't shake what my previous doctor told me about some people "never healing" and needing benzos forever. God I am so scared I have ruined myself. :'( I am scared I will have to take Klonopin again if I ever am to function at even a minimal level.  Then, of course, I will need more and more of it as the years go on... and I will become more and more of a moron as a result. :'( 

 

Is it just me, or does it seem like a lot of the people who are having a very hard time month out are those who came off of Klonopin?  I know that there are others here who have had a difficult time long term coming off of other benzos, but it seems to me like there is a trend with protracted withdrawal and Klonopin.

 

im scared too. ive had no help from any dr. doing this ALONE.

im glad i have benzo buddies.

im going on two yr off.