Antidepressants (SSRIs, SNRIs, MAOs, TCAs, TeCAs)

[josho771]

Would just like to mention citalopram has never made my T worse

 

[Sonic17]

I had to go on antidepressants to help me cope, they took some getting used to, but have helped me so much. I have been on them for 4 mos now, tinnitus has not improved but at least I am functioning near normal now.

 

[ReyKalinic]

The same for me; after various attempts, brintellix work. Cutted rivotril from 2.5mg down to 1mg. Sometimes 0.5

 

[Sonic17]

brintellix work. Cutted rivotril from 2.5mg down to 1mg. Sometimes 0.5

I have never heard of these meds. but I will look them up. I live in Canada so these meds may not be used here, but I will find out. Thank you for the info.

 

[ReyKalinic]

I have never heard of these meds. but I will look them up. I live in Canada so these meds may not be used here, but I will find out. Thank you for the info.

I don't have ideas if you can benefit from it. Your tinnitus seems recent. Wait before starting a therapy with antidepressants or others, especially because those require at least 2 weeks to show improvement. Follow your doctor's advice and don't give up.

 

[Gordy]

Just joined. I have had mild T for 15 years. Dr. told me to ignore it. I did in a week or 2 and it served me well for those 15 years. In July, I developed pretty severe T for some reason. Skeptical but trying acupuncture. I've been taking generic Paxil and clonazepam for many years for anxiety so adding those for me won't be a game changer. Yesterday Dr. prescribed Flonase, but I don't feel congested, but I'll try it. Thinks maybe I have a dysfunctional Eustachian Tube? Fingers crossed. Great to read from others. Hello!

 

[Jim51042]

Thinks maybe I have a dysfunctional Eustachian Tube?

After 15 years of T and your just getting diagnosed with this now. More likely the Dr. has no F-ing clue and is just experimenting/ giving you something to leave his office. No sweat, if it's noise induced better scientists/Drs. will be coming with something shortly.

 

[Luman]

I'm gong to be visiting my MD on Monday, he does not yet know about my T which I've had for about 2 months. I'm going to ask for an Rx for Clonazepam, for anxiety now, and possibly an SSRI for some point in the not-too-distant future if I need it.

I tried a generic Sertraline last year, before I had T, and the side effects almost killed me, although I had Sertraline in a different generic version some 12 years ago which was pretty good. There's just too many threads and posts here regarding SSRI's to read them all, so I'd like some suggestions of ones that have helped people with Tinnitus, if possible. My insurance only pays for generics (I live in the U.S.), I would pay for the name brand if that's better, depending on the cost. Thank you.

 

[Paulmanlike]

Trial and error In all of them - there is no 'best' one because what works well for one may not work for another.

Paroxetine is the most potent
Venlafaxine is an snri

These two are probably the 'strongest' however the withdrawal is hell on earth if not done properly!

If you have sleeping issues Remeron/Mirtizipine is an older antidepressant that is also very effective.

Good luck!

 

[shasta0863]

Is Mirtazapine or Nortriptyline considered the safest in terms of side affects and low chance of harming tinnitus at all?

Is there any chances these can help slightly lower noise induced tinnitus? Not how my mind views it, but calming it even a little?

I've lost my battle and I have only two options, try to get some reduction or take extreme measures which I don't want to do and can't do to my family. Lost all my progress, tinnitus is now not stable and tone is going up and down and up and down making it not possible to mask without a flood from the faucet.

Not sure what I've done, but it's as if my ear, neurons, something are on constant state of hyperactivity. I have no choice but to try to take something. Even a slight reduction could keep my sane.

 

[IvanRus]

Hello, you helped cipraleks from noise in the ears? What do you think about this drug as a whole? How long did you take it? I drink it for half a year for 10 mg and he helped. Recently I started to reduce to 5 mg, and it got worse. I started again with 10 mg. I hope the former condition will return and there will be no resistance. Do you agree?

 

[IvanRus]

Celexa is Citalopram, and you can google "citalopram tinnitus" for some results. However, do note that SSRIs are very commonly prescribed and only a tiny minority develop tinnitus, and even then the tinnitus is oftentimes temporary which will resolve when you go off the drug. You may find some horror stories on Google, but try to keep it in perspective.

Well, you already have tinnitus, so you are wondering about the possibility of it causing a (permanent) increase. The same still applies.

Back in 2010 (when I got tinnitus), I remember this young man on some other forum who had got tinnitus in the midst of citalopram treatment. It took a few months for the tinnitus to resolve - but I remember that it did. It's possible there are cases where tinnitus has been permanent, but these are few and far between.

Celexa (Citalopram) is included in Neil Bauman's ototoxic drugs list here.
(Which ATA has referenced here.)

The PDF doesn't tell us the likelihood of tinnitus being developed though. It just lists Celexa as ototoxic. The PDF has 30 pages of ototoxic medications, some of which are more ototoxic than others. SSRIs tend not to be the worst.

The PDF also lists Remeron (Mirtazapine) as ototoxic. I've only heard a handful of times Remeron being the suspected cause of tinnitus, and I don't remember any permanent cases caused by it. Doesn't mean no such unfortunate cases have ever happened, though.

Myself, if I were depressed, I would take SSRIs (incl. Citalopram) or other antidepressants depending on the severity of the depression/anxiety.
I'd want the depression treated and would consider the ototoxicity be the lesser evil between the two - since the ototoxicity isn't nearly as bad with antidepressants as it is with some antibiotics and/or chemotherapy drugs.

Ask your doctor, too. Always tell them that you have tinnitus and you are afraid of the possible ototoxic effects. Ask them to do some research on the subject/drug in question.

Unfortunately, all things considered, there's no 100% guarantee the drug won't affect your tinnitus negatively.
Personally, I wouldn't be scared to take it, but if you do, and are unlucky, and a worsening of tinnitus ensues, you can't blame me or anyone else. Absolute certainty - there is no such thing.

PS./EDIT.
Just now it actually appeared to me that I didn't properly answer your question. You didn't even ask about the ototoxicity. I'm sorry. This happens when you reply to a post the first thing in the morning.
Hopefully someone else can chime in regarding its mood stabilizing properties.
I've taken escitalopram (Cipralex) and it did help with mood - I took it for less than 6 months so no long-time experience.

Hello, Cipralex helped you from noise in the ears? What do you think about this drug as a whole? How long did you take it? I took it for half a year (10 mg) and it helped. Recently I started to reduce it to 5 mg, and it got worse. I started again with 10 mg. I hope the former condition will return and there will be no resistance. Do you agree? Will the tinnitus and condition return to the former, to the same as how it was on the higher dose? I took 5 mg for 5 days.

 

[Anna V.]

Hi all
Regarding Remeron, I'm wondering please does it help with less awareness of t during the day, or is it mostly just good for sleep?

Thanks

 

[Anna V.]

(Sorry if it's a bit off topic at this point in the thread, I'm looking into it and was interested in what people mentioned about it earlier in the thread)

 

[Jiri]

Hi everyone,

Does anybody have any experience with taking Brintellix/Trintellix (Vortioxetine)?

If so for how long have you been taking it and at what dose? Did it lower, or exacerbate your tinnitus?

Thanks a lot.

Cheers,

Jiri

 

[TheDanishGirl]

I have been prescibed mirtazapine but I have read so much negative feedback on weight gain with a handful of people in comparison who didnt gain weight on it, how do you gain weight on it even if you don't over eat?

I take mirtazapine and my appetite has definitly raised from it, so I think I eat a little more then I used to. Luckily I have a very high metabolism, so I havent gained any weight. I think people on it, gain weight because they eat more.

 

[TheDanishGirl]

Hi everyone,

Does anybody have any experience with taking Brintellix/Trintellix (Vortioxetine)?

If so for how long have you been taking it and at what dose? Did it lower, or exacerbate your tinnitus?

Thanks a lot.

Cheers,

Jiri

I started on Brintellix in the late fall, and have taken it for about 3 months now - 10 mg. It has had no bad (or good) effect on my T.

 

[Jiri]

I started on Brintellix in the late fall, and have taken it for about 3 months now - 10 mg. It has had no bad (or good) effect on my T.

Well, I've been on it for 3 months as well. 20 mg dose though. It's SSRI class of antidepressants which are known to be able to cause T. I'm going to taper off from it.

I found this anecdotal comment on this forum regarding this drug and it made me upset:

I only just stumbled across this terrific website, and immediately noticed this older thread. I hope my input is still useful. Although I can only offer circumstantial evidence, my experience does seem to point to new-onset tinnitus associated with my starting a newer, anti-depressant named Brintellix (Vortioxetine).

I started taking it in December of 2014- first 5mg for a week, then 10mg. This was after an extremely difficult few years in my life, and my psychiatrist had prescribed three other SSRI's previously. All were ultimately discontinued for ineffectiveness and typical side effects. I had been clear of other SSRI's for a few months before trying Brintellix, without persistent ill-effect.

After roughly two weeks I noticed an odd, new, sound in my head. By three weeks, it was extremely loud and uncomfortable and certain external sounds (crockery!) were excruciatingly loud. (Hyperacusis, I later learned.) I had never experienced anything similar to this before, nor had had other noticeable hearing problems. There were no other medication changes or any exposure to loud noises during that time.

On my prescriber's advice, I tapered off Brintellix, with my final dose about 1 month after the first. The tinnitus remained. It was bilateral, but slightly "louder" in my left ear- roughly a 60/40 balance and very intrusive. It was (and still is), actually difficult to hear "over" it at times.

I'd never even heard the term "ototoxic" before, so I think I misjudged the urgency of my situation. I was ultimately seen and tested by an ENT roughly 6 weeks after stopping Brintellix. Audiometry confirmed some bilateral hearing loss. The ENT prescribed a course of oral Prednisone (80mg, two-week taper). He emphatically told me I needed to start it that day, and to pick up the Rx immediately, which I did.

And this is where it gets mildly interesting. Or at least useful, I hope.

By the end of the Prednisone course, the tinnitus had almost completely resolved- but only in my right ear! Repeat audiometry showed improved hearing in that ear. But the tinnitus in my left ear was still extremely loud, with persistent relative hearing loss of up to 25dB in a range around 4000-7500Hz. It has remained that miserable way ever since. But the fact that the Prednisone apparently "healed" my right ear almost entirely strikes me as a compelling clue that this particular medication may be the source of my new-onset tinnitus. And that I should have sought out an ENT much, much sooner.

Recently, I was examined at a leading hearing institute, where more sophisticated audiometry confirmed the now-asymmetric hearing loss. That made them request an MRI of my head to rule out a neuroma. Contrary to the longstanding beliefs of my wife and family, my head was normal. Unfortunately, they could offer no magic cures, and I try to cope with the usual masking/sleep/distraction approaches that most of us here seem to be stuck with.

So I hope this account is helpful to you Doctor, and to others. And for anyone who arrived at this thread via a search for SSRI or Brintellix and tinnitus or otoxicity:

Get to an ENT. It could make all the difference.

 

[Gl0w0ut]

The current thread in treatments encompasses all possible antidepressants that can be described, which is problematic. SSRIs, TCAs, MAOIs, and so forth are all very different medications in terms of their psychopharamacology and side effects. You cannot accurately compare amitriptyline with Lexapro, for example.

That being said, despite the claims of Josef Rouschecker, I do not believe any serotonergic or dopamanergic drug will correct the so-called "gate keeping" function of the TRN. Antidepressants that are do not elevate serotonin levels can be effective at combating depression, anxiety, and not tinnitus. SSRIs have been shown to potentially worsen tinnitus hyperactivity in the DCN, thus they should be avoided.

I am curios as to whether the so-called "happy neurotransmitters" of serotonin, dopamine, and norepinephrine, which antagonize/inhibited, could improve tinnitus.

 

[Localboy]

SSRIs have been shown to potentially worsen tinnitus hyperactivity in the DCN, thus they should be avoided.

Why do SSRIs help some people then?

 

[Gl0w0ut]

Why do SSRIs help some people then?

Like I said, effective depression treatment, tinnitus, not so much.

 

[TheDanishGirl]

I will keep taking my Brintellix even though it is an SSRI

I really don't have much of a choice....well, I do, but if the choice is between not taking the drug and facing crippling on-going depression or keep taking the drug and being better mentally and only potentially worsening my T, I choose the latter.

 

[Jiri]

I will keep taking my Brintellix even though it is an SSRI

I saw my psychiatrist yesterday and was told that Brintellix/Trintellix (Vortioxetine) is NOT SSRI class of antidepressants.

According to her, it is the "best" that is out there yet and she was not aware of any cases or studies where this particular drug instigated tinnitus in anybody. Though, she admitted she cannot know all the studies. This drug in a combo with Pregabalin(Lyrica) should be safe as well. I was told this by 2 other psychiatrists.

That is one antidepressant in a combination with a antiepileptic type of a drug. I asked then at a pharmacy and they were also not aware of any cases of raised tinnitus levels due to taking this combination of drugs or any other interactions.

Apart from some bad anecdotal stories (10 in total) I was not able to find myself a single study regarding this drug and a tinnitus. One has to bear in mind that those people who report worsening of their tinnitus in association with Brintellix have mostly been either on other type of antidepressants before (usually for years) or have been taking simultaneously other meds. This is all so very difficult to figure out what can cause what. We're all individuals.

I am aware that serotonin reuptake inhibitors influence serotonin levels in DCN which is not good for tinnitus.

I am going to call a uni teaching hospital and ask one psychiatrist there (the same one who put me on those drugs) about his experiences and what he thinks of it AND the withdrawal symptoms (tinnitus exacerbation and brain zaps).

 

[TheDanishGirl]

I saw my psychiatrist yesterday and was told that Brintellix/Trintellix (Vortioxetine) is NOT SSRI class of antidepressants.

According to her, it is the "best" that is out there yet and she was not aware of any cases or studies where this particular drug instigated tinnitus in anybody. Though, she admitted she cannot know all the studies. This drug in a combo with Pregabalin(Lyrica) should be safe as well. I was told this by 2 other psychiatrists.

That is one antidepressant in a combination with a antiepileptic type of a drug. I asked then at a pharmacy and they were also not aware of any cases of raised tinnitus levels due to taking this combination of drugs or any other interactions.

Apart from some bad anecdotal stories (10 in total) I was not able to find myself a single study regarding this drug and a tinnitus. One has to bear in mind that those people who report worsening of their tinnitus in association with Brintellix have mostly been either on other type of antidepressants before (usually for years) or have been taking simultaneously other meds. This is all so very difficult to figure out what can cause what. We're all individuals.

I am aware that serotonin reuptake inhibitors influence serotonin levels in DCN which is not good for tinnitus.

I am going to call a uni teaching hospital and ask one psychiatrist there (the same one who put me on those drugs) about his experiences and what he thinks of it AND the withdrawal symptoms (tinnitus exacerbation and brain zaps).

Thank you so much for sharing that new knowledge It definitly makes me more calm to know it is not an SSRI and that their are no cases of T from it (at least that we know of)

 

[fran dana]

I have to say that my problem has gotten worse since it started but the antidepressants are a barrier that i would only go through in the end. my last option
to this day I think it is better to accept the problem instead of masking it. endure it day by day, with the tears and the pain that entails

 

[IvanRus]

I do not even know why in some antidepressants, including modern SSRIs, there is a side effect such as tinnitus.

But it is indicated as a rare side effect. And, it seems to me, even in these rare cases is of a short-term nature.

In general, I believe it is advisable to increase the level of serotonin in tinnitus, especially with its obvious effect on the emotional background and quality of life.

I will give briefly some facts:
- Auditory pathways pass through the centers of mood in the brain, which is why tinnitus is so hard to tolerate emotionally - serotonin is called to stop negative experiences and improve mood;
- In the brain there is a constant struggle "between the forces of brain distillation and the forces of inhibition" - serotonin plays on the side of the centers of inhibition, and, on the whole, has a mild soothing effect.
- Serotonin improves sleep;
- Serotonin increases the threshold of pain sensitivity;

So, in general, the use of modern SSRIs with tinnitus is quite justified. Especially in a situation where we do not have at least some specific remedy for tinnitus in the world.

 

[Gl0w0ut]

I do not even know why in some antidepressants, including modern SSRIs, there is a side effect such as tinnitus.

But it is indicated as a rare side effect. And, it seems to me, even in these rare cases is of a short-term nature.

In general, I believe it is advisable to increase the level of serotonin in tinnitus, especially with its obvious effect on the emotional background and quality of life.

I will give briefly some facts:
- Auditory pathways pass through the centers of mood in the brain, which is why tinnitus is so hard to tolerate emotionally - serotonin is called to stop negative experiences and improve mood;
- In the brain there is a constant struggle "between the forces of brain distillation and the forces of inhibition" - serotonin plays on the side of the centers of inhibition, and, on the whole, has a mild soothing effect.
- Serotonin improves sleep;
- Serotonin increases the threshold of pain sensitivity;

So, in general, the use of modern SSRIs with tinnitus is quite justified. Especially in a situation where we do not have at least some specific remedy for tinnitus in the world.

Except there was an animal model study which showed that increased serotonin agonized the hyperactivity of the DCN, thereby worsening tinnnitus. I would amp up dopamine and completely ignore serotonin. Despite its popularity in pop psychology it's not all it's cracked up to be.

Josef Rauschecker's "gate-keeper" model has been used to claim that commonly prescribed antidepressants could treat tinnitus by restoring the gate keeping function of the SSRI and treat depression too. However, study after study has failed to yield significant reductions in tinnitus symptoms (NOT perception, that's an emotional reaction and has nothing to do with tinnitus itself).

Amitriptyline has been somewhat effective at reducing tinnitus, but commonly prescribed SSRIs should be avoided, snd serotonin should not be increased. If your doctor or psychiatrist prescribes such mood enchanting drugs, you should throw them away in place of something else.

 

[Sven]

I have never before used SSRIs, but 2.5 weeks ago I was prescriped Sertraline to help me battle my spike/worsening T. I can't say for sure that it was the meds, but as far as I can tell, the noise has not faded - at least not by much - but I feel so much better now than three weeks ago.

 

[Pleasure_Paulie]

I will keep taking my Brintellix even though it is an SSRI

So you're benefiting from this med? Any side effects?

 

[TheDanishGirl]

So you're benefiting from this med? Any side effects?

Yes, I do and I have absolutely no side effects. Not that I know of. I also take mirtazapine, so in terms of side effects it is hard to pin point which AD is causing it, but I have no side effects from either, at least they are very mild and not noticable if I have some.

EDIT: Of I forgot, I have a side effect, but I know that is from mirtazapine because it is a wellknown side effect of that drug, and that is a larger appetite, but it is not too bad and I am thin so I could stand to gain some weight.