Advice Please on Asking Doctor About Venlafaxine or Clonazepam...

[Gav]

Hi everyone,

After habituating rather nicely to my tinnitus after first acquiring it in 2004, I had a recent volume spike in mid-December last year. Unlike previous week long spikes, this one has not abated and I think is likely here to stay. I'm not sure what caused it, but I guess that is irrelevant now.

So, I've been looking again at all the latest research sites and tinnitus forums and hit upon this one, which seems to be the most active and positive of the ones I've found. I'm hoping to get some advice from you all before seeing my doctor on Tuesday this week.

When my tinnitus had its first significant spike after attending a wedding in 2005, it was loud. So loud that I wasn't sure I could cope. I was put on (I think) Venlafaxine before later moving over to Citalopram. A week or two after starting the Venlafaxine, the tinnitus reduced to perhaps 50% or less of the original volume and was enough for me to then completely habituate. Perhaps it took my mind off the T or genuinely reduced the original onset, preventing it from fully taking hold elsewhere in my brain a few months later.

I'm seeing my doctor on Tuesday and I'm wondering whether to ask for Venlafaxine again to try and reduce this new spike. The question is – did the Venlafaxine reduce the tinnitus or was it just a regular spike that was always going to reduce slightly in volume? It could even be that the Venlafaxine prevented the tinnitus from dropping back in volume as much as it could have done!

Perhaps a short course of Clonazepam may be another option? I've noticed a few of you talking positively about this.

I just don't know, but would love to do anything I can do now to stop this new tinnitus volume taking hold while I can. Any advice you can offer would be greatly received!

 

[Louise]

Hi Gav,

I see your dilemna. But it may be safest to stick with what worked, or seemed to work, the first time around?

 

[Paul D]

So are you saying that specific drugs actually worked on your tinnitus condition? The only thing I've seen recommended out there are sleep medication or antidepressants, nothing, and no report of, any meds that actually reduce symptoms. Certainly no emperical study to support such. The message I'm finding has been loud and clear: "There is no cure for tinnitus, and no proven treatment that works for even a minority of cases." Why do you suppose that is?
Thanks for your insight,
Paul D

 

[Fish]

Paul D - there is no universal treatment that works for EVERYONE, because the etiology of tinnitus is not well known. Some people, however, have experienced an improvement in their tinnitus with many kinds of drugs!

Betahistine is one, for example. More recent, experimental drug called AM-101 is another. Take a look at the "research" section and look for Erik's posts. He often finds really interesting information about researched drugs that have helped some patients!

 

[Paul D]

Fish - I appreciate the feedback. When one has no insurance and very little money, there is no room to experiment with treatment options by health professionals who can make only an educated guess as to what might possibly help. So many people are throwing thousands of dollars into the wind out of desparation, with pseudo-experts lining up to catch them as they fall. Sorry about the pessimistic attitude; I just don't believe there's anything out there and during bad days it really sucks.

 

[Gav]

Hi Paul D. Yes, I hear what you're saying. I've tried all sorts of eating and vitamin regimes over the years and absolutely nothing appears to have made any noticeable difference to my tinnitus. Conversely, I've eaten and drank all the sorts of things you're not supposed to for tinnitus, with no negative effect. In addition, finding substances that may improve tinnitus isn't helped by the fact that tinnitus naturally ebbs and wanes for many people.

The only thing I've noticed have a negative effect over the years have been anti-inflammatory's such as Diclofenac (I have psoriatic arthritis). Even large daily doses of Ibuprofen and Methotrexate have been fine for me and both are supposed to aggravate tinnitus. I find the fact that some substances, like Diclofenac, have a negative effect on tinnitus quite encouraging. It means the tinnitus is pliable, i.e. what can go up can come down.

My high pitched tinnitus remains pretty constant in volume and I get volume spikes if I'm exposed to louder sound than I should, but this has never lasted longer than a week and the volume always attenuates, like clockwork, back to the baseline. It's been pretty predictable for many years.

So, my current spike lasted for four weeks and was not receding in volume. It was also, unusually, ebbing and flowing throughout the day – from piercing to painfully piercing. My doctor told me I was indeed prescribed Venlafaxine many years ago and I am now taking that again. I've been taking a very low dose for four days, which I started four weeks after my recent big tinnitus spike. The Venlafaxine hasn't affected my mood yet, but whatever the reason, my tinnitus feels like its reducing in volume. It still comes and goes throughout the day, but the peaks and troughs are definitely getting lower in volume and are less noticeable. This is the same pattern that my big tinnitus spike followed all those years ago. Perhaps it's just a coincidence and perhaps it's was just a long lasting spike, but I'm really glad I gave the Venlafaxine a go again.

 

[Paul D]

Gav - Having just started the process again searching online for new ideas and alternatives, I'm simply amazed at how people throw medical terminology, particularly exact chemical names, around as if it's part of every day conversation. Goes to show that there's a whole community out there desparately searching for some relief. The ones lucky enough to have insurance or a nice nest egg to throw money, like spagetti at a wall hoping something sticks, in their doctor's or specialist's pockets at least have some sense of action toward a possible remedy. I think those of us forced by circumstance to count our pennies (eat...or doctor? Is it really THAT bad?) are a lot more cautious in trying new alternatives, spending time instead exposing all the charlatans out there. Don't get me wrong... I AM listening. I was just reading today that Xanax may be a viable option, but that your doctor can only prescribe it for depression; they won't prescribe it for tinnitus since it's not approved. But who knows how true that is?!

Anyway, it's good to have some conversation about all this. Makes things somewhat more bearable on bad days.

 

[Louise]

Gav - Having just started the process again searching online for new ideas and alternatives, I'm simply amazed at how people throw medical terminology, particularly exact chemical names, around as if it's part of every day conversation. Goes to show that there's a whole community out there desparately searching for some relief. The ones lucky enough to have insurance or a nice nest egg to throw money, like spagetti at a wall hoping something sticks, in their doctor's or specialist's pockets at least have some sense of action toward a possible remedy. I think those of us forced by circumstance to count our pennies (eat...or doctor? Is it really THAT bad?) are a lot more cautious in trying new alternatives, spending time instead exposing all the charlatans out there. Don't get me wrong... I AM listening. I was just reading today that Xanax may be a viable option, but that your doctor can only prescribe it for depression; they won't prescribe it for tinnitus since it's not approved. But who knows how true that is?!

Anyway, it's good to have some conversation about all this. Makes things somewhat more bearable on bad days.

I had some thoughts like this the other, the knowledge I now have about the auditory system is mad. There are some potential neuroscientists on here too! (Karl, I'm thinking you here ).

All stuff I wasnt interested in knowing. I so want my ears just to be ears and never think about them again, like I never thought about them prior to 29/06/12.

 

[Louise]

I think this community may become a force to be reckoned with, sort of a force for lobbying for things etc

Of course the numbers will decline as people's tinnitus resolves and that's a good thing.

 

[Paul D]

I think this community may become a force to be reckoned with, sort of a force for lobbying for things etc

Of course the numbers will decline as people's tinnitus resolves and that's a good thing.

Louise - At least you're staying optimistic about progress toward standardized evaluation and treatment methods yielding empirical results. My search over the last couple of years has turned me into a pessimist; I'm looking only for realistic coping mechanizms for the bad days.

 

[Louise]

Louise - At least you're staying optimistic about progress toward standardized evaluation and treatment methods yielding empirical results. My search over the last couple of years has turned me into a pessimist; I'm looking only for realistic coping mechanizms for the bad days.

You and me both and I've ony been searching for 6 months. I've done something I never thought I'd do - resorted to prescription drugs to cope. I cant handle it any other way and I have always been 'against' medication (side-effects etc etc).
In the future people wont have to suffer as we do. They will go to the GP, get diagnosed with tinnitus and then there will be a proper treatment path with the promise of real relief/cure. Unlike us now who are thrown out onto the street to deal with it. I welcome the day that comes so that others dont go through what we have.

 

[Paul D]

Hi Louise,
Have you monitored intake of different foodstuffs and how it affects the severity of your condition? I've been trying to isolate aggrevating factors of mine for a long time. I was poking around the net and found this, somewhat confirming what I'd been experiencing:
http://www.food-info.net/uk/qa/qa-fi27.htm
I believe salisylic acid is the base ingredient of aspirin, which is supposedly a possible trigger for tinnitus. I've tried to eliminate aspirin, naproxin, omiprisole, and others from my diet and have had no success. However, I'd noticed extreme volume shifts after dining on Mexican food, so I thought I'd experiment the other day after a day and a half of relatively low volumes (the good days). I'd read that tomatoes, cooked or raw, and peppers, can aggrevate the condition. However, eating a half-bean half-salsa dinner did not change my brief respite from the condition. I also had several meals over two days with sliced tomatoes, pepperocinis, habenero sauce, and the like. No change. Then, cooked up a taco meal, and within a few hours, away we go! Also went out for Mexican food the other day. Got off of that for a few days, the condition got somewhat better, but then had nachos with the leftover taco meat for dinner. Within two hours my tinnitus got as bad as it ever gets. Still going strong over a day later. Yesterday was horrible. So thinking my suspicions are confirmed, I believe I've developed an intolerance for cumin, and possibly paprika. There may be another spice in there that when combined with cumen and/or paprika tends to set off the freight train in my head. Looking back, cumin's always in the mix when things get bad.

I'm going to try avoiding any source of cumin and paprika for a month, then go to other spices that are normally combined with them and see if I can get this condition more livable. Of course, Mexican food is my favorite! I think stress is the most dominant factor in setting my tinnitus off, and I'm in a particularly stressful time now. But I believe the condition of high stress and uncertainty combined with a particlar food combination may be the catalyst in setting off the worst of the worst episodes.

Let me know what you think.
Paul D (can't figure out how to get my name on my icon)

 

[Louise]

Hi Paul D,

Because my T came from one particular night when I exposed myself to noise I tend not to look to diet etc for reasons because I know mine is from that night and the hearing loss I suffered.

However, I have definitely noticed that alcohol (red wine) makes it worse.

In the experiments they do for drugs etc that can help they often induce T in rats with salicylate. Hope there's not too much of it in those veggies in your link?

I think you've been a good detective with your T, what worsens it etc. Its a shame its in your favourite food!

Good luck with excluding cumin & paprika and with finding an alternative dinner to Mexican

 

[Paul D]

Louise,
One of my theories is that ear and neck injuries when I was sixteen to nineteen (gunshots, firecrackers, swim ear, etc. plus a series of concussions via football, hotdog skiing, and getting bucked off on my head a few times, combined with a couple extreme flu/sinus cases a few years back, created "perfect storm" conditions for accute tinnitus to set in. I'd had bouts of ringing in the ears over the years, but it always cleared up in a matter of days or weeks. Never thought much about it, figuring that a lot of people probably experienced the same thing.

So what I'm saying is that perhaps it's possible that your "one particular night" might just be that final straw to set things in motion from occurrances both past and present. I believe that horrible sinus flu, or sinus + flu, I had a few years back is what set this thing on its present course. But then, what do I know?!
Paul D

 

[Louise]

Yes, it could have been the final straw Paul. I think that night I got just too much damage in one hit and my brain noticed it. Whereas I've been noisy places before and will have sustained damage that was not enough to be noticed. The audiologist did say he doesnt think all my hearing loss couldve happened in one night so there was some cumulative damage before that night. But that night was LOUD and I was next to a speaker with my left ear and my left ear does have more haring loss (10db at least) than the right.