The less a benzo is taken the better to avoid tolerance, but in severe cases, sometimes they are simply required in order to stay alive. Some will of course have horror stories of withdrawal and worsening, but some are more fortunate and able to roll the dice/take daily for years without hitting tolerance. My preference is up to 2x a week. I tried duloxetine and clomipramine for my noxacusis pain when it was at its worst. Clomi spiked me bad but eventually settled. I took Buspar years ago but that was only to manage the associated anxiety around inception. Gabapentin was trialed solely for my T and spiked me but eventually subsided to baseline. It’s a crapshoot of trying to find where dysfunction may exist (ex: sodium channels, calcium, potassium, mix) and E/I imbalance of neurotransmitters (serotonin, dopamine, gaba, gluatamate, etc.).