In today's world, it seems more people than ever are experiencing anxiety. When you take the time to stop and look around, it's easy to understand why more and more people are becoming anxious. The incessant noise of traffic, longer working hours, social isolation experienced during the pandemic, and worry about the future are all perfectly legitimate reasons.
Fortunately, more and more people are now seeking help for their anxiety. Mental health is much more normalized than before and is becoming less of a taboo subject, which makes it easier to seek consultation.
There are various treatments that can be offered to anxious individuals. Benzodiazepines are one of these options. While this medication can help relieve anxiety, it can also cause various undesirable side effects, such as tinnitus.
Here's a comprehensive overview of what you need to know about benzodiazepines, their link to tinnitus, and existing solutions.
What are benzodiazepines?
Benzodiazepines are a class of drugs that act as sedatives in the body. Also known as "benzos," they are widely prescribed medications that can relieve severe anxiety and other health problems. Despite their therapeutic interest, their effects can be addictive and potentially dangerous.
Here's a more detailed look at exactly what benzos are and how they affect the body.
How Benzodiazepines Affect the Body
The human body contains hundreds of different chemical messengers constantly circulating. These chemical messengers play a very precise and essential role in ensuring the body functions as it should. Even though the body is an extraordinary conductor for all these messengers, it sometimes needs the help of medication.
Benzodiazepines are medications that act on the chemical messenger GABA in the brain. GABA is a brain neurotransmitter that works by slowing down nerve activity. It plays an essential role in your ability to calm down.
For people suffering from anxiety or sleep disorders, the brain can have a very hard time calming down. This is where benzodiazepines come in.
Benzos work by amplifying the effect of GABA on the nerves. In essence, they make GABA more effective, thus allowing anxious individuals or those who struggle to fall asleep to achieve a more serene state of mind.
Types of Benzos
"Benzodiazepine" is a term that refers to an entire class of drugs; well-known examples include Klonopin, Xanax, Halcion, Ativan, and Valium. All these drugs work by enhancing GABA's action, but they differ in their speed of action.
Benzodiazepines fall into two categories: fast-acting and slow-acting. Each has its own specific indications and also presents a set of potential side effects unique to it.
Fast-acting benzodiazepines tend to increase the risk of experiencing withdrawal symptoms after use and are more likely to promote dependence. Slow-acting benzodiazepines, on the other hand, work for a longer duration and can reduce the risk of withdrawal or addiction.
What are Benzodiazepines Used For?
According to the FDA, benzodiazepines are approved to treat anxiety disorders, insomnia, social anxiety, panic disorder, and certain seizure disorders. In addition to these specific indications, they are also authorized before medical procedures to aid sedation.
Precautions
Like any medication, benzodiazepines can be misused. They have a powerful effect on the brain. The body can therefore develop a tolerance to the product, which makes dependence easy to establish.
Precisely because the body can develop tolerance, benzodiazepines are generally prescribed only for relatively short periods, or under strict medical supervision. This ensures that the medication is not misused and that high tolerance does not set in.
Another essential precaution: benzodiazepines are not a treatment to be stopped on your own initiative. If you need to discontinue treatment for any reason, talk to your doctor first so they can gradually wean you off and help you avoid very unpleasant withdrawal symptoms.
What is the link between tinnitus and benzodiazepines?
Tinnitus and sedative medications may seem completely unrelated, yet they are linked in a very specific way. As mentioned above, taking benzodiazepines can lead the body to develop tolerance. This tolerance is essentially how the body adapts to a medication.
Take caffeine as an example. Caffeine works by preventing a neurotransmitter called adenosine from binding. Adenosine binding contributes to the feeling of fatigue: by blocking it, you feel more awake.
In response to this lack of binding, the brain produces more adenosine receptors. Adenosine can then bind even in the presence of caffeine. When you suddenly remove caffeine from the equation, the brain is left with all these free receptors without enough adenosine to occupy them. The result: a good headache and caffeine withdrawal.
The same principle applies to benzodiazepines, but with a much more serious set of withdrawal symptoms. These symptoms can include insomnia, nausea, seizures, irritability, depression, anxiety, and even tinnitus.
Withdrawal-related Tinnitus
The fact that a medication like benzodiazepines can cause tinnitus is not exceptional: many medications can promote its appearance. What is peculiar about benzodiazepines is that tinnitus usually appears when treatment is stopped.
Another peculiarity of benzodiazepine withdrawal-related tinnitus is that it can be long-lasting. Most tinnitus caused by a medication dissipates as soon as it is stopped. However, some case studies seem to show that tinnitus can persist after benzodiazepine withdrawal.
What is tinnitus?
Tinnitus is a condition that causes you to hear a sound that is absent from your immediate environment. Perceiving a non-existent sound may seem harmless, but it can seriously harm your general well-being.
Imagine having to go about your day and work with a high-pitched whistle constantly ringing in your ears. While the exact tone and volume of tinnitus vary from person to person, its ability to negatively impact well-being is common to all.
The Underlying Cause of Tinnitus
According to the American Tinnitus Association, nearly 50 million Americans suffer from some form of tinnitus. Despite these millions of affected individuals, the underlying cause of tinnitus remains partly unknown.
Tinnitus falls into two broad categories. The first is objective tinnitus, which results from internal noises becoming perceptible. One of the most common forms of objective tinnitus, pulsatile tinnitus, is caused by turbulent blood flow near the ear structures.
These turbulences emit a faint sound which, due to their proximity to the inner ear, becomes perceptible and causes a form of tinnitus that beats with the pulse. This type of tinnitus can come and go and vary depending on the level of activity, intracranial pressure, and blood pressure.
The second and most widespread form is subjective tinnitus. It has no external sound source. This is typically the tinnitus associated with hearing loss, medication, and exposure to loud noises.
Treatments
In the vast majority of cases, tinnitus cannot be directly cured. This is discouraging, but there are different management approaches that help you manage your tinnitus and live better with it every day.
A helpful solution for people suffering from both tinnitus and hearing loss: hearing aids. Hearing aids are ideal for compensating for hearing loss symptoms, but they can also relieve tinnitus by masking it with other sounds, making it less perceptible.
Another option, which provides lasting relief, is therapy. Tinnitus therapies focus on how you react to your tinnitus and your thoughts and perceptions about it. By accepting it and undergoing habituation therapy, you can go about your day without tinnitus having such a negative impact.
Medications and Tinnitus
In summary, benzodiazepines are commonly prescribed medications for anxiety and sleep disorders. They are effective, but tinnitus can appear when treatment is stopped. Although this risk remains relatively low, it is an important side effect to be aware of before starting.
Sources
Benzodiazepine Drug Information | FDA
Understanding the Facts | American Tinnitus Association
Tinnitus associated with benzodiazepine withdrawal syndrome: A case report and literature review | NCBI
