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Some will need to increase their dose and some will actually reduce their dose. There is a lot of political correctness out there now about benzos and narcotics and I think the pendulum has swung too far so that patients who would benefit are being denied helpful medications. I do agree that...

This is a great question but one that does not have a simple answer. Some people have a lack of intrinsic 'benzodiazepine' and, like diabetes, require a benzo medication to normalize their neurochemistry and they might well be on the benzo for life. This is, fortunately, only a small proportion...

I think that arguing about actual incidence and whether is is higher, lower or the same in tinnitus sufferers is not a useful exercise as statistical data does not help with an individual case. Any level of suicidal ideation must be taken seriously and approached with urgency. One general and...

White noise (and similar sounds) will be treated by the brain the same way it deals with tinnitus - these are disorganized sounds that repeatedly alert the brain and it cannot habituate. Masking is also not very effective, as you have found out. What I would suggest is that you try some of the...

The best treatment for OCD is medication. Behavioral treatments, if they work, are transient and the OCD will return. For many years it was known that high doses of clomipramine,a tricyclic antidepressant, was effective in many cases of OCD with full remission in some cases. Clomipramine is a...

I am aware of the research and the behavioral tool used - licking suppression. However, many (including me) are not persuaded that this relates directly to tinnitus.

How do you know when the mice have tinnitus?

Mine is more of the classic complex hissing sounds, around 9,ooo Hz. It runs about 30 decibels in volume. This is the more common form associated with age-related hearing loss.

The increase in suicidal ideation may be correct, but that does not necessarily translate into actual suicides. It is currently recognized that not all suicidal thoughts reflect intent and many may be ruminating and being more obsessive than self-destructive. Because we cannot ask them, it is...

A 'yes' or 'no' answer is not appropriate. In about 20% of tinnitus sufferers, there is no measurable hearing loss so the pathology explains the hearing loss but not the tinnitus itself. About 10% of the adult population have tinnitus but 25% have hearing loss, so while there is a link - it is...

Hyperbaric Oxygen Therapy works as well for tinnitus as it does for all the other indications they have pushed it for - a total of NONE. For many years, it was hyped as a treatment for stroke and brain trauma - this was shameless and cruel as it offered false hope with no Phase I or II clinical...

No. What I am saying that such a list is so extensive, that almost everything can be ototoxic (although it is never clear how a medication gets on the list) so the list is impractical and unhelpful for the treating physician and unduly stressful for the patient. However, I don't mind when a...

Thank you for your kind comments. I am a neuropsychiatrist so I hope to manage more than the mental health aspects. In fact, I agree with all those who have posted here expressing their frustration with those who only look at the mental health issues. I also agree that tinnitus is likely a...

No, not until there is reputable published evidence with the pathology, risks and benefits well-described. Stem-cell and PRP (platelet-rich plasma) injections have been recommended for a wide range of conditions, mainly for the pain from osteoarthritis - but with unclear results. I am a bit...

You make some great points. It is the competitive marketplace that should result in effective treatments but absent a clear understanding of what really causes tinnitus, all the current 'treatments' are oversold and overhyped. The 'experts' on Mount Olympus have not been any better so, as a...

There is always a risk of ototoxicity from any medication but a testimonial is not science. I would not doubt that this happened to this woman but treating doctors cannot function with absolute risk or they would end up doing nothing. I do not believe I made a false statement but, yes, I would...

You are very fortunate but if this was a universal treatment then there would be no need for this forum.

With regards to the list of ototoxic medications you cite with your Google search, the fact it is a Google search tells you all you need to know. The issue for any treating physician, such as myself, is not the absolute risk of ototoxicity (which in the majority of drugs listed is extremely...

It is my job to make such statements and I do so based on the best and most up-to-date data I can find. I think your comments about 'the medical establishment' are misplaced as they are incorrect. If it wasn't for the medical establishment, we would not have vaccines, insulin, immunotherapy...

I also have tinnitus which, at times, is severe. I have never said that we need 'psychological help" and I would challenge you to find any post in the 200+ I have written in which I state that.

Was your OCD formally diagnosed and what treatment are you getting?

My post is in regards to Neromod's old and new device and anyone else's. With regards to habituation, who best can do this and why is not known.

Please try not to be scared. I am sure nothing terrible is going on but the onset of your symptoms can be quite scary, especially when you are 24. I am sure the mental health team are only trying to help but it seems they are only adding to your anxiety and it sounds like medication side-effects...

I think it's important to bring some scientific facts into this discussion. Antiseizure drugs, such as Keppra, have not been shown in published research to cure or even treat tinnitus. Every so often, a new antiseizure drug or one that is not generally available (like Trobalt) gets a groundswell...

I don't disagree with you that there is both helpful and unhelpful information on this forum but, at the end, the most important interventions will be based on medical science.

Published research, and my own clinical practice, shows that the emotional and mental state is a HUGE element in tinnitus. I just don't understand how you could possibly interpret what I said as "the ‘research’ says we shouldn’t be in the least bit bothered by this." Antidepressants are no more...

You are most welcome. As a fellow sufferer, I understand where you are coming from but I also want to make sure the information you get is accurate and that expectations are reasonable. Unfortunately, tinnitus science is like so-called Climate Science for some in that they will only accept what...

I agree that there is an industry out there that offers false treatments that usually you have to pay them for. Ironically, because we do not understand the pathology of tinnitus (and therefore cannot offer a cure), the only area that we can do something about is the patient's emotional reaction...

I am sorry to learn that you feel that way but the research shows what it shows. Without wanting to trivialize what you feel, thinking about suicide is much more common that committing suicide (thank goodness). Your emotional state may suggest you should discuss this further with your doctor.

Sorry, but this is nonsense as are 100% of the so-called treatments to date. Hopefully, it will not do any harm apart from the cost and the false hope. Those of you on regular medications for other medical conditions should be careful as many herbals will interaction with prescribed medications.

I have been a member of the forum for some years and noticed that by most frequent reason to reply is in response to whatever 'new' breakthrough are so-called treatment is being discussed. Ironically, most medical doctors are criticized on this Forum for not knowing what to do or for saying...

Unfortunately, there are no end of charlatans and con-artists who will try and profit from the victims of chronic incurable disorders, and tinnitus is no exception. This has been true throughout human history. The only 'good' news is that tinnitus won't kill you and, contrary to the widespread...

As for people with tinnitus "topping themselves left right and centre...." this is another often-quoted myth. The only actual study of suicide with tinnitus was a VA study in the US by Martz et al (2018) that looked at more than 750,000 veterans with and without tinnitus. This study showed that...

Actually, until it reaches a dose of 225 mg, venlafaxine is a SSRI. The norepinephrine (the 'N' in SNRI) effect only occurs at higher doses. You can see a similar action with paroxetine, another SSRI. With duloxetine (Cymbalta) the two effects occur at all doses

Technically, as both drugs target the same serotonin system, no withdrawal is necessary and you can switch straight across to Fluoxetine 20mg but, as always, check with your doctor first.

TMS had a big fanfare when it was introduced and as it was typically offered as a private (ie. you paid for it), there was lot of hype and exaggerated claims. After 15 years of so, the results turn out to be much less convincing and often transient.

As you rightly point out, it is a 'theory'. No actual pathology has been reliably demonstrated.

For most tinnitus sufferers (like me), the tone, pitch and volume frequently change - that is quite 'normal' for tinnitus.

Digital (or Q) EEG as well as TMS (trans-cranial magnetic stimulation) have been pushed for a variety of chronic psychiatric and non-psychiatric disorders. While it is not likely that this would be useful for all, it is quite possible that it is useful for none. There is a lot of 'snake oil'...

Tinnitus arising from antidepressants is uncommon and there are only two published cases of tinnitus from venlafaxine even though it has been prescribed to millions since the early 1990's. Sudden withdrawal from any antidepressant can cause transient tinnitus but as depression and anxiety...

It would be great if restoring hearing resulted in tinnitus going away but I am not sure it is clear what you mean be 'restoring hearing'. We can use modern computerized hearing aids that try to fill in the lost frequencies but tinnitus does not go away. Patients with a cochlear implant for...

I may not have made myself clear - while we have some idea of the context of tinnitus, for example with hearing loss, we have no idea about the brain mechanisms that underlie the perception of noise that we call 'tinnitus'. Hearing loss is not the core pathology - it is a condition in which...

Look at Alzheimer's research. This started in 1990 and was well-funded by government and big pharma. Earlier this year, it was announced that all this research was stopping as nothing tangible or helpful had come of it in almost 30 years. Without a known pathology, 'treatment' research is...

The problem here is that we have no accepted pathology or mechanism for tinnitus. One study talked about excessive activity in the temporal lobe and used repetitive transcranial magnetic stimulation (TMS) to reduce tinnitus loudness and prevent its return over time. But another published study...

Tinnitus is a symptom. It is the result of various pathologies. It is not a discrete disease. So until we understand what the different causes are and until we can distinguish between all of these causes, we just do not know on what to focus our research efforts. As I have written before, with...

I was asked what kind of physician I was - a good one, I hope. I am a psychiatrist.

Sure, but "...we need to focus on treatment more?" is fine but we really have no idea how to go about that. It is not like we doctors have a treatment that we just don't want to give. We really know so little about tinnitus and the 'treatments' to date have been all over the place so they do...

Sure it would better to focus on a cure and prevention of tinnitus but our level of knowledge about tinnitus is just not adequate enough for that. I would like a cure for Alzheimer's but after 40 years of research, it was realized by the scientific community that its understanding of the...

Of course it would be better and preferable to look for a cure but that seems well beyond our current knowledge. We do not even understand the actual pathology of tinnitus. There are many theories but no demonstrable pathology.

The vast majority of tinnitus suffers have disorganized noise and hissing rather than a single steady tone. A single tone could be effectively managed by listening to the same frequency but 180 degrees out of phase - a sound cancelling effect. Very (lucky) few have a single steady tone as their...

Many manufacturers of Ginkgo Biloba (GB) will make all sorts of outlandish claims about its safety. While the substance is generally well-tolerated, it can be a significant problem when taken with other common medications - ASA (aspirin), NSAIDS (eg. ibuprofen, naproxen) and thiazides (for high...

This is drivel. Given that about 10% of the population suffer from tinnitus, any meaningful sample size would have to be huge. On the the face of it, trying to link any medical disorder with any personality type is nonsense. However, this has been done many times throughout recent medical...

Actually, serotonin and dopamine and norepinephrine (aka: noradrenaline) are not the three major neurotransmitters but they are the ones whose metabolites can be measure in urine. That is why in the 1960s, there was such focus on these. Seeing mood disturbances and their treatment in terms of...

Actually, science knows very little about the cause and determinants of tinnitus. Anything that happens from the middle ear on into the auditory cortex affects tinnitus. There is no real equivalent of tinnitus in any other sensory system so there is no other measurable abnormality to compare it...

Robin Williams learned he had a progressive dementia....much more serious that tinnitus.

What I am going to say, I have said many times before so bear with me. I have had my tinnitus since September 2013 and while it is somewhat worse than it was, it generally bothers me less. Educating yourself is the most important 'therapy. There is no cure. There are no effective treatments...

Angela: There is no medication that directly treats tinnitus however, the secondary consequences (anxiety, depression, insomnia) can be treated with medications. There is no specific 'best' medication for treating each of these problems - it is a combination of what works and what you...

Nortriptyline is a tricyclic antidepressant which is relatively specific to the norpinephrine neurotransmitter. It can also help with insomnia. It does not 'calm nerves' and tinnitus is not due to 'inflamed nerves'. Anxiety and/or depression will amplify the perception of tinnitus and so...

Dave: First of all, I can only speak in general as I cannot interfere with or undermine your care from another specialist who know you far better than I can. I would strongly suggest that you allow your psychiatrist to manage your psychotropic medications, especially the diazepam (Valium)...