Update on my post above. I would love to hear any feedback from anyone having similar experience with anticholinergics, in particular Diphenhydramine and Amitriptyline.
I had neglected to mention that I was using Diphenhydramine, too, along with the new addition of Amitriptyline. Elated with the performance of Amitriptyline, I dropped my Diphenhydramine. The tinnitus came back. So, now I'm back on both. This seems good. Time will tell.
To be clear: I have been using Diphenhydramine, 10 to 12 mg, at bedtime. (I use the syrup marketed as a sleep aid. A "dose" is 50 mg. I drink about 1/5 or 1/4th of a dose.) It has helped a lot, but not reliably. I've been using it most nights for about six months. It usually gives me a good day the next day, sometimes not, and sometimes an excellent day.
My ENT suggested Amitriptyline two weeks ago. Adding that to the Diphenhydramine gave me three excellent days in a row (tinnitus near zero) so I got a bit excited. Dropped the Diphenhydramine. Had a bad day of tinnitus, not the worst, but bad.
So, I'm trying a bedtime cocktail of both drugs at bedtime now. Both of these are at low doses, with the Amitriptyline at 10 mg. I can tell I am being sedated by the Amitriptyline. In the event this is a successful cocktail (after a couple months of test), I'd like to lower the Amitriptyline to 7.5 mg, probably by breaking the tiny pills up. Would like to lower the Diphenhydramine dosage. Goal would be very low dose of both and tinnitus near zero.
These are anticholinergics. They are said to be associated with dementia. My ENT doesn't place a lot of weight on that for people who aren't tending toward dementia, anyway. Who knows. If I knew that I'd get dementia in my old age from these drugs, it wouldn't faze me. I would still take them if they keep working. It would be worth it. Anyway, at low dose, I'm thinking they won't do too much damage. My ENT said the goal would be to go off them after the brain gets used to not having tinnitus.
It's possible that it was simply the increased level of anticholinergics in my blood that caused the excellent three days in a row, and that doubling my Diphenhydramine would have done the same thing. But I feel the sedative effect of the Amitriptyline is different from the "sleepy" effect of the Diphenhydramine and so there is a cocktail effect. A simple experiment would tell the tale: Go off Amitriptyline and double my dose of Diphenhydramine for a while.
My background: no other health issues. No depression. In great physical shape. Great blood work. 56 years old. Tinnitus in left ear from bad sinus infection on the left side ten years ago. Meditation has helped a lot but it is difficult to keep to that schedule, a constant fight of 20 minutes meditation, three times a day, fighting tinnitus. When you get ahead of the tinnitus, you slack off and back off the meditation, and the tinnitus gets bad again. It's grueling. So, I'm reaching for meds. Had MRI (clean), CTA scan for pulsatile tinnitus (negative), nasal endoscopy. Only thing I haven't had is a CT scan of sinuses which ENT has offered. Haven't tried CBT.
I'd say that my tinnitus ranges from zero to 6 on a scale of zero to 10, where 6 means "life is still worth living but not by a large margin." I totally understand what it must be like to have tinnitus at 7 to 10. If you have tinnitus at 7 to 10, my heart goes out to you. I get it.
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