lanky said:
I have only experience with patients on clonazepam from a psych standpoint. generally mechanism of action is sedation by stimulating inhibitory GABA receptors.
Yeah, even the Physicians Drug Handbook, 11e, states that the mechanism of anti-convulsant activity is unknown... and they don't even mention how it works for neuralgia (or how certain TCA's like amitriptyline HCl work outside of their norepi action). All the pharmacodymanics I read focus pretty much solely on clonazepam's anti-seizure action.
I also wonder if, knowing that clonazepam works in some way or another with GABA, how does taking moderate doses of gabapentin (Neurontin) effect things, if at all? Funny thing is that gabapentin is pretty much a synthetic GABA analogue, but does not react with GABA receptors, isn't converted to GABA or a GABA agonist, and doesn't inhibit GABA uptake or degredation. No affinity for other comon receptor sites, either, so it just does _something_, then is eliminated completely unchanged. I swear it has an effect on my RBC count, though. Unfortunetly, the two blood tests I took were looking for something else (of which I wasn't familiar with), so I can neither confirm nor deny it's lowering of RBC or having an effect with blood clotting.
As for the exact mechanism it works on neuropathic pain i am still unclear of myself as well.
Don't worry, ENT surgeons from WI, IN, and the MN Mayo clinic don't even know.
You mentioned you have damage to cranial nerve VIII , and it causing hearing impairment and pain.
The primary problem was an extreme reaction to sound at certain ranges that I can audiably pick up... e.g., enclosed room with someone using the chalkboard, cars with loud/missing mufflers, and other strange things. There was also an issue with "popping", but not in the sense of normal popping for pressure equilibrium... it was sometimes caused by noise (any noise, talking, classroom, et cetera), and other times, came from nowhere, seemingly going in rythem with my heartbeat, and othertimes being more of a machine-gun type popping.
The hearing impairment is a direct result of the tumor eating away my eardrum and all of my hearing bones. Apparently, my eustachian tube is messed up as well, but they couldn't do anything for it except remove the small amount of tumor they found during the second surgery.
if you dont mind i like to ask you the following personal health questions,it is up to you if you would like to answer or not, you can either answer by posting or send me a PM depending on how you feel about sharing personal info on the net. is the pain a burning pain or shooting? where exactly is the pain located, what other symptoms do you mainifest. What was the cause of your nerve damage? Describe hearing impairment in detail? What are some exacerbating factors in your pain How is your mood compared to before you were prescribed Klonopin.
Not at all, I'm open on here, and have nothing to hide (nor do I have any affiliation with illicit drugs).
The "pain", to me, isn't really a physical, 'owch-that-hurt' kinda pain. More of a overwhelming audio sensation in situations addressed above. I told the surgons that it didn't "hurt", but they said it was still classified as "neurological pain".
The docs think the malfunctioning/malformed eustachian tube has something to do with the "popping", but they have no idea with the audio sensations and distortian (like playing music through an 8" woofer with a 4" tear).
The cause of the nerve damage is from the tumor. After it returned the third time, my new surgeon decided it was time for a walls-down modified radical typamomastiodectomy. It turned out that this time around, the tumor had grown substantially, and besides eating what was left of my half eardrum and 1.5 hearing bones, it was spreading to places that made it a potentially life-threatening issue ("potentially", it wasn't really that serious, but medically, they said it could be, as it could easily spread to my brain). This third surgery, the doc also found the tumor had eaten into the mastoid or whatever area housed the crainial nerves... he informed me prior to surgery that I may have facial paralysis, as he thought it was the (I think) C7 or whichever nerve affected that.
Hearing impairment in detail: I will post the different lab results tomorrow, or try scanning and posting them if you'd like to see the hearing test results. Basically, low frequencies are near deaf, mids are right at the borderline of deaf and not deaf, and around 9k Hz I believe it drops off the chart.
"How is your mood compared to before you were prescribed Klonopin". Ummmm... lol. Funny you ask that. Clonazepam actually makes me pretty... umm... I suppose you could say that it shortens my fuse -- and I've always had a very long fuse. It can make me somewhat irritable, and sometimes damned annoyed due to it's effects on my memory. We've been trying different drugs and drug combinations to try and find something that works as well as Klonopin, but without the narcotic-like effects. I've never had anxiety or depression before, so all these drugs are kinda making me out of it. I have trouble telling what works and what does't anymore... all I know is that clonazepam is the ONLY drug that has a REAL, noticable undeniable effect on the ear (and I think hearing as well, but that doesn't make sense to me?). The SSRI Cymbalta seemed to help a bit after a couple weeks, but it was more like it allowed me to ignore the effects rather than eliminating them like the Klonopin.
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Sorry it's kinda long, but with three major surgeries and a host of other EENT problems from this plus my digging into my med records and doing my own research, I have trouble getting my problems across in a concise manner.
I'm thinking of switching to a different benzo (not Xanax...) to see if it's the benzo class of drugs that help, or something exclusive to clonazepam.
I'm also wondering if barbituates, if they're even still prescribed, would have any positive effect. I just want off the Klonopin because of the memory issue, but it's the only thing that works so far.
Thanks,
-Tim
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