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

[gameover]

I saw a psychiatrist today and she prescribed Zoloft. I've been on Zoloft in the past (before my tinnitus started) and didn't have an issue with it.

I'm very anxious that it will worsen my tinnitus now that I have it, though. But from my understanding, Zoloft is usually one of the more easily tolerated meds when it comes to tinnitus. I know some people have had problems with it, but I need to remind myself that everyone is different, and just because it was an issue for one person doesn't mean it'll be an issue for me. Plus I really need to be medicated. So I guess I'll probably give it a shot. Wish me luck

I am also prescribed Zoloft and I am terrified to try taking it. I never took any antidepressants, as I had no need. Depression wasn't something on my radar at all until this damn curse of tinnitus struck me.

I don't think I am going to take it. Not sure what to do. CBT sucks. I am going to try some other kinds of therapy. I am scheduled for a session with an excommunicated married (!) Catholic priest who wants to put me in trance. I am also going to see a psychologist (PhD) claiming Native American roots who may try hypnosis on me. This curse is making me see some weird people. But now I am crazier than them, probably.

 

[Nick47]

@PennyCat, @gameover, I was told not to take SSRI medications for tinnitus. Instead to look at antidepressants in the tricyclic class (Amitriptyline, Deanxit, Doxepin) as an alternative, together with a LOW dose antipsychotic (Flupentixol or Aripiprazole) and if that doesn't help enough, adding LDN at night and Clonazepam.

All are low doses rather than one high dose SSRI, which sometimes, but not always, makes the tinnitus worse.

Low dose Aripiprazole rebalances the serotonin and has antidepressant effects, as well as tricyclic antidepressants do.

 

[DaveFromChicago]

I am also prescribed Zoloft and I am terrified to try taking it. I never took any antidepressants, as I had no need. Depression wasn't something on my radar at all until this damn curse of tinnitus struck me.

I don't think I am going to take it. Not sure what to do. CBT sucks. I am going to try some other kinds of therapy. I am scheduled for a session with an excommunicated married (!) Catholic priest who wants to put me in trance. I am also going to see a psychologist (PhD) claiming Native American roots who may try hypnosis on me. This curse is making me see some weird people. But now I am crazier than them, probably.

I was briefly on Zoloft, and it gave me paranoid hallucinations (my metabolism could not absorb it, and it backed up in my system). I saw shadow-like figures at the periphery of my vision.

I felt like Catherine Deneuve in Polanski's "Repulsion" when she was going insane all alone in that apartment.

Or, like that figure in Edvard Munch's great painting "The Scream."

It also made me hyperventilate to the point where it was difficult to climb stairs.

I was told, however, that my reaction was quite unusual.

 

[PennyCat]

@PennyCat, @gameover, I was told not to take SSRI medications for tinnitus. Instead to look at antidepressants in the tricyclic class (Amitriptyline, Deanxit, Doxepin) as an alternative, together with a LOW dose antipsychotic (Flupentixol or Aripiprazole) and if that doesn't help enough, adding LDN at night and Clonazepam.

Thanks for the advice. If Zoloft becomes an issue for me, I'll definitely see if my psychiatrist would consider an alternate route. I've never had issues with SSRIs and SNRIs in the past, but those were pre-tinnitus, so I am a little scared due to the horror stories I have filled my brain with.

I think because of my long history of mental health issues, my psychiatrists have always wanted to stick to the "safest" route first, with meds that are generally well tolerated and have less potential severe side effects. I would love to try Clonazepam due to my current issues with insomnia and panic attacks but, unfortunately, I am prone to addiction, so I doubt any doctor would ever give it to me. I get to stick to my lovely Hydroxyzine

 

[Nick47]

Thanks for the advice. If Zoloft becomes an issue for me, I'll definitely see if my psychiatrist would consider an alternate route. I've never had issues with SSRIs and SNRIs in the past, but those were pre-tinnitus, so I am a little scared due to the horror stories I have filled my brain with.

I think because of my long history of mental health issues, my psychiatrists have always wanted to stick to the "safest" route first, with meds that are generally well tolerated and have less potential severe side effects. I would love to try Clonazepam due to my current issues with insomnia and panic attacks but, unfortunately, I am prone to addiction, so I doubt any doctor would ever give it to me. I get to stick to my lovely Hydroxyzine

There are a lot of scare stories out there. SSRIs may not change anything, they just sometimes can. It's all trial and error and something Dr. De Ridder said (who I am sceptical of) when I had a consultation with him. To save you the €85 fee, he usually starts off with:

• Deanxit
• Clonazepam 0.5 mg
• Aripiprazole 2 mg
• +/- 5mg LDN

 

[ErikaS]

I'm back on this thread due to stopping the muscle relaxer (Cyclobenzaprine). It affected my hormones, which are already sensitive, and this spiked my tinnitus. Boo

I had a follow-up with my doctor today. He brought up low-dose Abilify (Aripiprazole) and is going to do a deeper search into it before recommending and prescribing it. I will meet with him again next week. I have to say I really appreciate him. He's working with a 33-year-old woman who needs something to help with depression due to multi-tone reactive tinnitus, but this something can't be known to worsen tinnitus, can't mess with hormones too much, oh and can be safe during pregnancy if I continue to use it longer term. I just hope he doesn't hate me lol.

 

[DeanD]

Dr. De Ridder said (who I am sceptical of)

@Nick47, out of curiosity, why are you sceptical of Dr. De Ridder?

 

[Hardwell]

Propranolol has shown to have potential ototoxicity

Well, I'm very glad I stumbled across this. I used to take 80 mg of Propranolol daily for my heart. I never noticed it having any effect on my tinnitus but I can definitely see why it's good for anxiety and panic. It's hard to have a panic attack when your heart rate doesn't go above 53 bpm. I'm still supposed to be on it now but haven't for the last couple of months. I recently thought about digging it back out to counteract the side effects of Prednisone. Glad I didn't, and very glad I caught this post! Thank you.

 

[Nick47]

out of curiosity, why are you sceptical of Dr. De Ridder?

@DeanD, just that his ideas seem a bit "out there." Lots of theories lacking scientific findings.

 

[makeyourownluck]

I've tried quite a few antidepressants recently for nerve pain, so thought I would comment here inc ase my experience is useful for anyone.

So first I tried Nortriptyline - went up to 80 mg - no noticeable difference ear wise or pain wise. I also tried Amitriptyline with similar outcome. Tapering on and off was uneventful. I took this for around 3ish months.

Next was Gabapentin, which worked well for the nerve pain for about 2 weeks at 300 mg daily, but then stopped working for some reason. I increased it to 1200 mg but that wasn't helpful and I started falling asleep about 4x a day. I tapered off that after 2.5 months.

Next was Pregabalin, which seems to work well for my anxiety and has helped take away the feeling that my skin was so tight that, anytime I moved, my skin felt like it was ripping, but has done nothing for the burning sensation and electric jolts. I still take 450 mg daily. No effect on tinnitus or ear fullness.

I'm now also on Duloxetine 60 mg, which has made me feel more mentally stable than I have in years, despite essentially being bedridden. I'm pretty sure I've been depressed for most of my life but just not known it. Lots of scare stories on the internet about side effects for this drug but I only have slight nausea. It has also reduced the pain slightly or maybe I just care about it less so it's a perception thing. I don't know, but this drug seems to work for me. No impact on tinnitus.

Also, just to mention, I am on a muscle relaxer called Methocarbamol, I was only prescribed this recently by a pain specialist as it can be used for longer periods of time than Diazepam in combination with physio. Something worth asking your GP about if your nerve pain is causing muscle spasms.

 

[Tkenupp]

@Nick47, what are your thoughts on Mirtazapine as a safe antidepressant?

 

[Nick47]

what are your thoughts on Mirtazapine as a safe antidepressant?

It's what I take. 30 mg. No noticeable impact on tinnitus. It helps sleep. I would rather be on no medication but not if my life is even worse. I still take 2 mg Diazepam most days and Clonazepam once a week.

 

[Ben Winders]

Relevant update: I just sent an email to Dr. De Ridder this afternoon to ask him what he thinks about me getting back on Deanxit/Clonazepam combo.

Reason: I don't want to spend my life struggling only because I'm scared of taking medications that have already proven to make me react less to the tinnitus and be a lot less anxious.

When I was taking Deanxit, I always described it as "my tinnitus, anxiety and stress is like a big wheel that is spinning and everytime I grab onto the wheel and I am taken for a ride of guilt/anxiety/stress/high blood pressure/..., the Deanxit coated that wheel with some sort of soap that made it harder for me to latch on; the wheel was still spinning but it wasn't taking me for a 'ride' that easily anymore."

I asked Dr. De Ridder for the lowest possible maintenance dose as he mentioned on my consult with him (2 years ago) that some of his patients are on a VERY LOW maintenance dose and see benefits.

I will report back when the team at Brai3n responds.

I would like to get back only on Deanxit, but I guess they add the Clonazepam to prevent Deanxit from causing any facial spasms (that's at least how they explained it to me).

 

[Nick47]

just started Cyclobenzaprine yesterday. 10 mg a night. After a few days, I am going to increase it. My psych said I need to cut back 25 mg of Amitriptyline per 10 mg dose of Cyclobenzaprine. I will post back if I have any improvement.

@T Toledo OH, what was your experience with Cyclobenzaprine?

was thinking to ask my psychiatrist for Cyclobenzaprine or Deanxit. Has anybody got experience with Sertraline plus one of those two drugs? Is it even possible to combine them? Does anybody have any idea what substitute for Risperidone I could take that doesn't have weight gain as side effect?

@Wuul, did you try Deanxit or Cyclobenzaprine?

 

[T Toledo OH]

@T Toledo OH, what was your experience with Cyclobenzaprine?

It did not have any effect. I was up to 30 mg a day. I discontinued.

 

[RunningMan]

Nortriptyline - I also was prescribed this tricyclic antidepressant over a year ago for anxiety & depression as well as potential lowering of tinnitus volume (didn't happen) and possible improvement in sleep (didn't happen) but could not work myself up to the 100 mg daily prescribed dose. I hit 75 mg for a few days, but due to dry mouth and especially urinary retention, I backed off to 50 mg.

I tried cutting cold turkey a couple times through last year but started back up when felt depression suddenly hit back.

Finally last September I started reducing my dosage slowly every several weeks.

And at this point, I'm down to 12 mg daily. I still feel anxiety and depression, sometimes more than others, and I don't really know if Nortriptyline is even helping with that at this small dose since I was prescribed 100 mg, but someone else on this forum said they were receiving a benefit of reduced depression at just 10 mg. So, who knows.

I want to get off of it because of the side effects mentioned, plus I've had a few isolated cases of pain/discomfort that feels like bad acid reflux except it's worse than I've ever had and lasts longer with seemingly no benefit from popping TUMS. It has only ever happened after my bedtime daily dose when I had eaten something late. Very strange. It happened a few times while on 50 mg and once when I was on 25 mg and never experienced anything like it when I didn't take the drug. Also, it increased my overnight heart rate about 10 bpm over time while on 50 mg, but that's back to normal at my 12 mg dose.

It never helped me sleep - which remains poor over more than a year. It never helped or hurt my tinnitus the best I can tell. And I can't be certain the dosage I was on at 50 mg even helped with depression or anxiety since that varies, but I felt that it did, which is why I went back up to taking it after a couple unsuccessful cold turkey attempts. Hopefully I can continue reducing my dosage and get off of it.

 

[Loui]

Lately, I have been more affected by my tinnitus than normally. I just feel depressed because I have to live with this damn thing. I get jealous of my friends living their carefree lives, while I'm struggling daily. I was just 29 when I got tinnitus and feel like I've been robbed of so much in life.

I've been on Sertraline periodically since my tinnitus onset 5 years ago. It does something because I'm able to handle life better but I get kind of numb. I've been without antidepressants for almost a year now but I'm unsure if I can go like this.

Would you continue with Sertraline or would you recommend a different antidepressant?

 

[Nick47]

Would you continue with Sertraline or would you recommend a different antidepressant?

Depending on where you are, some people get good results with Deanxit. It's also worth reading through @Mentos's posts, he had good results with Doxepin and Flupentixol (mimicked Deanxit) and @Mike2022 here posted good results with Latuda and Lexapro about 6 months ago on this very thread. It seems results are very individual.

 

[Strawberryblonde]

Would you continue with Sertraline or would you recommend a different antidepressant?

Would you consider tapering up to a higher dose to see if that helps? Have you ever tried any other antidepressants before and after tinnitus? Maybe try something non-medicated such as CBT perhaps Having tinnitus makes managing things 10x worse

 

[Nick47]

Would you consider tapering up to a higher dose to see if that helps? Have you ever tried any other antidepressants before and after tinnitus? Maybe try something non-medicated such as CBT perhaps Having tinnitus makes managing things 10x worse

I'm worried about people going on SSRIs as there is some evidence that it can make tinnitus worse. I say can, not usually, as I don't want people not considering them if they get a benefit.

Recently, Tang et al (2017) have provided some further insight into the role of serotonin on tinnitus and some additional support to not using SSRIs for tinnitus management. Using mice, Tang and colleagues examined changes induced by serotonin in the dorsal cochlear nucleus (DCN), the portion of the cochlear nucleus with inhibitory characteristics. Aberrant serotonin signaling has previously been implicated with hyperactivity in the DCN related to tinnitus. Tang identified that serotonin does not simply or globally increase activity in the DCN, but rather the neurotransmitter appears to suppress signaling through the auditory pathway while enhancing transmission through a multisensory pathway. This activation may have positive biological implications, such as integration of multisensory input for response to salient environmental events or negative implications, such as tinnitus and help explain modulation of tinnitus with head movement and changes in jaw position.

(Source: Audiology.org / Tang, 2017)

If you check the Tinnitus Talk Podcast episode with Prof. Dirk De Ridder, he says the same thing when talking about medications. He also said this about Mirtazapine I am taking when I had a consultation with him. I disagreed because it's not an SSRI.

For example, SSRIs (Selective Serotonin Reuptake Inhibitors), which are very often prescribed for tinnitus actually can worsen the tinnitus; they can improve the suffering, but they can worsen the tinnitus, so then the question is what are you really doing? So a lot of antidepressant medications, actually as a side effect, can generate or worsen the tinnitus which is present and so then you create a vicious circle where you have to keep on adding medication, which worsens the tinnitus, which can then—so that's not a good option.

(Source: Tinnitus Talk Podcast: Tinnitus, Ingrained in the Brain?)

Then again, out of all the SSRIs, Sertraline has benefited some patients with tinnitus and depression:

The effects of sertraline on severe tinnitus suffering--a randomized, double-blind, placebo-controlled study

I know it's difficult with this beast!

 

[gameover]

Would you consider tapering up to a higher dose to see if that helps? Have you ever tried any other antidepressants before and after tinnitus? Maybe try something non-medicated such as CBT perhaps Having tinnitus makes managing things 10x worse

I find it funny that CBT and CTB are anagrams. I believe the former is wholly ineffective at helping dealing with tinnitus, while the latter should eliminate it completely with 100% efficacy.

 

[Nick47]

I will report back when the team at Brai3n responds.

@Ben Winders, did you hear back on the maintenance dose?

 

[Strawberryblonde]

I'm worried about people going on SSRIs as there is some evidence that it can make tinnitus worse. I say can, not usually, as I don't want people not considering them if they get a benefit.

Same here, the worry is 100% justified. If I knew what I know now, then I'd have thrown my Amitriptyline in the bin and never touched it but I risked it during a mental health crisis. It's a minefield, what works for one, completely ruins someone else. And when someone suffers from anxiety, myself included, CBT is usually offered in place of pills but it's not a quick fix.

 

[Ben Winders]

@Ben Winders, did you hear back on the maintenance dose?

Nothing yet. I will shoot out a reminder email in the meantime.

I saw mention of "numbness" above. Deanxit has that effect too, for sure. When I took it regularly, I said it "sucked the soul/spirit out of me". But isn't that a very common effect for many antidepressants?

In my experience, regarding Deanxit's effect on tinnitus: it made me care (a lot) less about it, and made my life easier. It did not bring the volume down.

 

[Nick47]

sucked the soul/spirit out of me". But isn't that a very common effect for many antidepressants?

Were you not referring to Clonazepam?

 

[Ben Winders]

Were you not referring to Clonazepam?

It's been a little while but pretty sure I dropped the Clonazepam early on and only took Deanxit, but I'm not certain anymore.

 

[Nick47]

It's been a little while but pretty sure I dropped the Clonazepam early on and only took Deanxit, but I'm not certain anymore.

No worries, I've read all your posts regarding your experiences

It was Clonazepam.

 

[Ben Winders]

No worries, I've read all your posts regarding your experiences

It was Clonazepam.

Haha - unsure if Dr. De Ridder will prescribe Deanxit by itself (as he was the one that came up with the Deanxit/Clonazepam combo). I always thought Clonazepam was only included in the combo (which is really a triplet because Deanxit in itself is already a combo drug) to prevent facial 'twitches'.

I almost immediately got an email back this morning from Brai3n stating Dr. De Ridder had been on a holiday and is catching up on his emails, that's why it might take a little longer.

EDIT:

I got a reply back from Dr. De Ridder just now.

To re-iterate: I already took Deanxit/Clonazepam (Rivotril) a couple of years ago, it helped me to care less about my tinnitus.

I asked Dr. De Ridder what the minimum maintenance dose is to make my life a bit easier... I don't feel like we need to suffer needlessly if there are meds (in low doses) that can help us. Even if it shaves off 5 years in the end, I would not mind at this point. I also asked if there is something new / else that have come on the market recently to help the same as Deanxit did, but I guess not - Deanxit/Clonazepam is still his go-to combo.

Start up Deanxit for 3 weeks (1 pill in the morning). Afterwards scale down to 1 Deanxit every 2 days for 1 week and then finally 1 Deanxit every 3 days. Always take Deanxit together with Rivotril (before bed). Minimum Rivotril dose: 0.25 mg."

 

[makeyourownluck]

Would you continue with Sertraline or would you recommend a different antidepressant?

I would try a different one. I get a bit of a buzz off my antidepressant. Like I feel a lot more upbeat, chatty, etc, but still me. It definitely makes me less bothered about stuff but not like I don't care, and it's kinda giving me the drive to sort my life out.

I had to trial 5 or 6 meds before I found the right combination (which I'm now going to tweak). This is just my personal experience. Obviously everyone's reaction to drugs is different.

Not sure about you, but I need plans for the future, things to look forward to. When I'm depressed, these things disappear and I just go on autopilot getting nowhere.

 

[blamingeverything]

I would try a different one. I get a bit of a buzz off my antidepressant. Like I feel a lot more upbeat, chatty, etc, but still me. It definitely makes me less bothered about stuff but not like I don't care, and it's kinda giving me the drive to sort my life out.

I had to trial 5 or 6 meds before I found the right combination (which I'm now going to tweak). This is just my personal experience. Obviously everyone's reaction to drugs is different.

Not sure about you, but I need plans for the future, things to look forward to. When I'm depressed, these things disappear and I just go on autopilot getting nowhere.

Which med do you take?