Antidepressants Make My Tinnitus Louder: Would Doctor Recommended Reboxetine Work Well?

[Paul Walter]

Hello, new to the group and would like some info.

I first got tinnitus 20 years ago for exposure to industrial noise. In the years since I have had severe depression. I find all antidepressants increases the tinnitus level. I have tried every class of AD and believe anything that increases seretonin aggravates tinnitus.

I am at my wits' end and so depressed I need antidepressants but am terrified of even louder tinnitus.

My doc wants me to try Reboxetine as it doesn't work on serotonin but I've have red on the internet that it is mostly ineffective.

My question is if I were to try an SSRI again and put up with the initial spike in tinnitus, will it settle or stay at that constant level or will it just increase out of control getting louder with each dose to the point of a chain saw screaming in my left ear? It is already severe and almost unbearable.

Thank you,

Paul

 

[Bill Bauer]

You are the first to mention this drug on this forum. I also searched for an alternative brand name for this drug, Edronax, and I couldn't find anything. I checked and both names aren't on the ototoxic brochure.

If it isn't listed as being ototoxic, hopefully the risk is as low as it gets. You might want to find more brand names for this drug and see whether you can find any horror stories having to do with hearing loss or tinnitus. If you don't find much, then it looks like it will likely be safe.

 

[Tanni]

Hi Paul,

So sorry to hear of your depression; it's a nasty illness.

As you say, SSRIs are known to sometimes causes issues with Tinnitus -- if you've found this to be the case for you, you might be best to avoid them if possible.

However, there are other non-SSRI ADs that you can try instead. Have you tried Mirtazapine? This one is probably the best known for being very Tinnitus friendly. You will always get the odd negative report because everyone reacts to drugs differently, but it definitely seems to have the safest reputation on here.

If you've tried Mirtazapine, you could give the Tricyclics (Amitriptyline etc) a try? They also have a safe reputation for Tinnitus, and in fact have been known to actually reduce Tinnitus volume in some cases.

 

[Paul Walter]

Hi and thank you for your reply. Unfortunately I've tried nearly all ADs. I read Mirtazapine was tinnitus friendly but I had the same frustrating result same with Amitriptyline. I guess I'll just try Reboxetine as my last resort but I'm not confident. It really is a very poor quality of life. Some research should be done to find a tinnitus friendly AD as so many must suffer.
Thank you again.

 

[Star64]

Sorry to read of your long history of depression Paul, it can be a very debilitating illness and unfortunately for some people depression and anxiety often start after the onset of tinnitus. Medications to treat anxiety and depression come with their own risks, and one of those risks is that these medications could increase your tinnitus temporarily or even permanently.

I do not believe anybody can answer this question for you as to "how" these drugs will impact on you. I worked over ten years in Mental Health and every class of antidepressant drug effected people differently, including at different dosages.

You may get advice about what people call safer antidepressants for tinnitus, however when it comes to psyche drugs they all carry risks!! and not just for people with tinnitus.

@Lane posted this last year

I just did a quick on Mirtazapine, and came up with 33 threads with it in the title. Most of the accounts are that it either caused or exacerbated tinnitus. -- I've noticed that antidepressants are rarely a viable long-term solution for depression or anxiety. You might want to consider non-drug alternatives, which can often be very effective. If you do consider any other drug, you'll want to do an online search of the name of the drug and tinnitus, to see whether it has caused or exacerbated tinnitus. Doctors usually won't tell you these things.

I hope you find something that works for you,
Take care

 

[Tanni]

I've noticed that antidepressants are rarely a viable long-term solution for depression or anxiety. You might want to consider non-drug alternatives, which can often be very effective.

Hi Star,

I assume by quoting Lane's post above, that you are against using ADs in the treatment of Depression? You also mention that all drugs have risks -- certainly true -- but reject the idea that there are any that might be safer for Tinnitus, so again I assume you are against AD use? Is this for all Depression sufferers, or just those with Tinnitus? As you're a mental health professional, it would be particularly valuable to know your stance on this.

I'm not keen myself and have taken the decision to come off of ADs entirely in favour of therapy and exercise -- I often wonder if I should mention this to anyone who asks about ADs. What stops me is that I imagine for severe depression these kinds of solutions might not be enough.

In the absence of taking drugs, is there something you propose as an alternative? I think it's important to provide alternatives if we are recommending that people don't take ADs. I heard this all the time when I first got Tinnitus and wanted to take an AD, but I didn't know what to do instead.

 

[Paul Walter]

Bill Bauer - thank you. I'm from Australia and I'm assuming you are from the USA. Reboxerine is not available in the US so that might explain why you didn't come up with much on it. It is an NRI antidepressant but now rarely used, it doesn't have a good record in trials but one can only try I guess.

 

[EddieL.]

Since antidepressants are known to exacerbate tinnitus, it really is about choosing the lesser of two evils. In my case, anxiety as a result of tinnitus was making my life unlivable, so I had to take care of my mental health first. I've been on Zoloft for 8 months, and my life has greatly improved. I believe my tinnitus is sometimes louder than before I started taking it, but, honestly, I don't even think about it. It allowed me to stop overprotecting my ears, which was the most important step in my recovery, and, once I removed that fear, things immediately started to get better. I still have good/bad tinnitus days, but, as of right now, the good ones outnumber the bad, and I don't think that would be possible without antidepressants.

Since you've said that you've tried all the antidepressants, how long were you able stay on each one before you discontinued it? Did you stop as soon as your tinnitus got worse, or did you give it some time to start working? For me, it took about 3 months, maybe more.

 

[Star64]

Hi Star,

I assume by quoting Lane's post above, that you are against using ADs in the treatment of Depression? You also mention that all drugs have risks -- certainly true -- but reject the idea that there are any that might be safer for Tinnitus, so again I assume you are against AD use? Is this for all Depression sufferers, or just those with Tinnitus? As you're a mental health professional, it would be particularly valuable to know your stance on this.

I'm not keen myself and have taken the decision to come off of ADs entirely in favour of therapy and exercise -- I often wonder if I should mention this to anyone who asks about ADs. What stops me is that I imagine for severe depression these kinds of solutions might not be enough.

In the absence of taking drugs, is there something you propose as an alternative? I think it's important to provide alternatives if we are recommending that people don't take ADs. I heard this all the time when I first got Tinnitus and wanted to take an AD, but I didn't know what to do instead.

Hi Tanni,

I actually quoted Lanes post because of him noting that Mirtazapine had increased or actually started some people's tinnitus on Tinnitus Talk. I thought this was important to point out, as there are many stories on this forum of all classes of antidepressants causing or increasing tinnitus.

I am not anti-medication, but with psyche drugs I believe where they are prescribed, it should be based on a detailed discussion with the patient to include the potential level of benefit and likelihood of adverse and harmful side effects.

Some psychiatrists I have worked with in the past admit it is a challenge to know if a person will benefit from the use of antidepressants, to what extent they will work, and it is a crap shoot as to what type of antidepressant they should actually try.

Personally, I do agree with @Lane statement though, In more own personal experience with antidepressants they worked in the short term, but the benefit was small and was definitely outweighed by horrible adverse effects.

Exercise has been the most beneficial to me, way more than any psyche drug, of course this will not help everyone. There are many people that have found natural products that work for them, but I do acknowledge that for some people they can also cause unwanted side effects, especially due to interactions with other medications.

Having tinnitus I believe makes it so much more difficult to treat both physical and mental problems for some of us, as you just never can tell what medication will exacerbate it, unfortunately its trial and error most of the time for me.

I do hope you are tapering off your medication and not just ceasing it!!

I really hope the therapy and exercise works for you, it is by far the safest option

 

[Tanni]

[...] there are many stories on this forum of all classes of antidepressants causing or increasing tinnitus.

Thanks for clarifying Star.

As you say, there will be accounts of every single AD on the planet causing or increasing someone's Tinnitus. Advising people not to take them if there are any negative reports would be akin to saying 'don't take any ADs at all'.

I've encountered people here who are at the edge of suicide and terrified of taking any type of AD because of even one negative report, and would be especially dissuaded if sent a message like your original one (or Lane's). After seeing plenty of testimonials in the Success Stories section where people say that taking an AD was crucial for their recovery and even life saving, I worry about dissuading people from taking them when they might desperately need them. Especially when, in my opinion, there are some drugs that are less ototoxic than others - like Mirtazapine, which if you follow Lane's link, appears to me to have a very small number of negative accounts vs positive ones?

It would be great to rely on our GPs for advice on which ADs are risky for Tinnitus, as you rightly suggest, but in my experience they have not ever known this information and have actually had to Google it. Some have even advised me that it is not possible for ADs to affect Tinnitus negatively.

That's why I always try to give my experience as a sufferer on which ones are perhaps safer, as I had to do this very research myself, and was in turn advised by members here.

Thank you for your concern re tapering . I have been off all ADs for a while now. I've taken almost every kind there is, starting even before Tinnitus, but I've decided that I want to try managing without them. It's very tough but, like you, I got fed up of the side effects and worry about the long term efficacy.

Sorry OP for hijacking your thread

 

[Greg Sacramento]

One problem is that mental / health providers don't know what meds may bother a certain individual with tinnitus and often even with not having tinnitus. Some meds are known to cause hearing damage. Often when I'm medically researching a physical problem, I will come across a statement that says, don't take this med or this class of med if you have this physical problem.

My doc wants me to try Reboxetine as it doesn't work on serotonin but I've have red on the internet that it is mostly ineffective.

When @Paul Walter posted, I searched for studies on Reboxetine. Studies that I found also say that it ineffective and may make depression worse or cause other problems? This drug isn't used in the USA. Why??

We are all different and any med may bother a certain individual and that includes Mirtazapine and any antidepressant. I just don't know how, as caring compassionate members, we can safely help someone with a selection of a medication. I think that comments of personal experience should be welcome, but again we are all different. We should mention medications that are known to decrease hearing. I gave all posts on this thread a hug.

My personnel list from experience that has increased my tinnitus, often just temporary except for blood pressure hypertension associations.

noise

ear wax

certain meds

Not a long enough taper - which for me would be 2X the time of taper with tinnitus. Problem is if a med is increasing tinnitus and then a taper needed.

salicylates - green grapes will temporary increase my tinnitus.

posture - body movements --- For me it's lying on my back with head to pillow.

 

[Paul Walter]

I think I'm at the point where I just need to take an AD, I am just so low. I know it will make my tinnitus unbearable but I have no choice. Just how loud can tinnitus get?

Paul

 

[Star64]

One problem is that mental / health providers don't know what meds may bother a certain individual with tinnitus and often even with not having tinnitus. Some meds are known to cause hearing damage. Often when I'm medically researching a physical problem, I will come across a statement that says, don't take this med or this class of med if you have this physical problem.

When @Paul Walter posted, I searched for studies on Reboxetine. Studies that I found also say that it ineffective and may make depression worse or cause other problems? This drug isn't used in the USA. Why??

We are all different and any med may bother a certain individual and that includes Mirtazapine and any antidepressant. I just don't know how, as caring compassionate members, we can safely help someone with a selection of a medication. I think that comments of personal experience should be welcome, but again we are all different. We should mention medications that are known to decrease hearing. I gave all posts on this thread a hug.

My personnel list from experience that has increased my tinnitus, often just temporary except for blood pressure hypertension associations.

noise

ear wax

certain meds

Not a long enough taper - which for me would be 2X the time of taper with tinnitus. Problem is if a med is increasing tinnitus and then a taper needed.

salicylates - green grapes will temporary increase my tinnitus.

posture - body movements --- For me it's lying on my back with head to pillow.

Well said Greg, obviously I tried to point this out in my original post but some people may have misread that to be that I am anti medication.

It is impossible to know how a medication will effect some people and I would never try to dissuade somebody from commencing an antidepressant but I make no apologies in pointing out that nobody can state a medication is going to be "safe for them"

Mirtazapine has been known to cause deafness, tinnitus, otitis media and ear pain. Sure it may be rare, but many Drs do not know or care about these issues, I have had a Dr tell me tinnitus is not a big deal to worry about when listed as a drug side effect.

Sometimes people may decide that taking a certain drug has benefits that outweigh the risks, and I am all for people making this choice, but as you would know from working in the medical field people are often not informed properly to make this decision.

Maybe it is because I have seen so many people walked over when it comes to health care, especially in mental health where many people get poly drugged and families are told it is for the best...

Like you pointed out Greg, as compassionate members of this forum medication discussions can be very personal, we all have different input. I just hope everybody finds something that can help them without causing anymore harm

 

[Star64]

Thanks for clarifying Star.

As you say, there will be accounts of every single AD on the planet causing or increasing someone's Tinnitus. Advising people not to take them if there are any negative reports would be akin to saying 'don't take any ADs at all'.
It would be great to rely on our GPs for advice on which ADs are risky for Tinnitus, as you rightly suggest, but in my experience they have not ever known this information and have actually had to Google it. Some have even advised me that it is not possible for ADs to affect Tinnitus negatively.

Tanni, you are right GPs know very little about tinnitus but my reference was actually to them discussing with their patients the benefits of the medication as well as the risks which includes increased suicidal ideation which has been known to happen. Sadly I believe members of the Tinnitus Talk community know way more than most GPs and ENTs when it comes to tinnitus.

 

[Greg Sacramento]

@Paul Walter

In the years since I have had severe depression. I find all antidepressants increases the tinnitus level. I have tried every class of AD and believe anything that increases seretonin aggravates tinnitus.

My question is if I were to try an SSRI again and put up with the initial spike in tinnitus, will it settle or stay at that constant level or will it just increase out of control getting louder with each dose to the point of a chain saw screaming in my left ear? It is already severe and almost unbearable.

I think that it's very important for all of us to consider what you stated above, before giving medication input.

I do know that some ER doctors will give N-acetyl cysteine (NAC) and sometimes added magnesium and vitamin C, one hour before a non emergency medication to someone with tinnitus. This is mentioned in some studies. Maybe research this to your satisfaction and talk to your doctor or pharmacist about this.

 

[all to gain]

Antidepressants are a nightmare. I fully recommend keeping away from them.

After 20+ years of use, and them being one cause of my tinnitus, hearing and eye problems, I am now tapering off of them off over... wait for it... 5 years! I am doing this so slowly as the last time I tapered off over six months all hell broke loose.

Never trust a doctor when it comes to drugs. They know little about side effects and even less about how to taper off of ADs. They are completely underqualified in the matter and don't really care. If you want to learn how to taper off of them look online at sites where people describe how they have taken the matter into their own hands and how they do it.

Like for @Star64, exercise is also key for me. And keeping busy and having a good diet help too.

 

[Paul Walter]

Just an update, as stated my doc prescribed Reboxetine and for anyone outside the US with tinnitus, do not take this drug. 4 doses and the tinnitus much much louder. There simply isn't an AD that does not make my tinnitus scream. There is a desperate need for research to find such an AD for tinnitus sufferers.

I totally agree about doctors knowledge on AD and tinnitus; I had one assure me Amitriptyline would in no way harm my tinnitus and another tell me the same about Mirtazapine and each led to severe increases in tinnitus volume. They know nothing.

 

[Paul Walter]

Hello again to the group.

I am again posing a question on ototoxic antidepressants. I am severely depressed and in desperate need of help with mental illness but also have tinnitus so debilitating I need masking 24 hours a day. My tinnitus started out so slight and over the years medication has increased it to a roar.

My psychiatrist has bluntly told me take medication and put up with any increase in tinnitus as you are so unwell you have no choice.

My question is are there any of you in the same situation as myself and has anyone taken a medication that spiked their tinnitus but continued to take it because they had to on medical advice?

After a time has anyone found their system has become accustomed to the medication to a point where it doesn't make tinnitus louder any longer?

Thank you. I'm in desperate need of help.

Paul

 

[DreiT]

Did your increases from the antidepressants return to baseline? I'm scared to take anything because of this stupid tinnitus. It's like walking on eggsshells