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

[RunningMan]

So I've been on Cymbalta for almost two weeks now, and while it has helped with the depression, it has changed the nature of the tinnitus in my right ear. It is now musical tinnitus or musical ear syndrome. The left ear still hears regular tinnitus.

Well, that sounds mostly successful if you're not having other side effects. Did you make the jump to 60 mg?

 

[ECP]

Well, that sounds mostly successful if you're not having other side effects. Did you make the jump to 60 mg?

Yes, I went to 60 mg. My head still tingles at random times, so there's been no change where that's concerned.

An odd thing happened just now. I went to the supermarket, and while I was in the produce section, the song in my head changed to the theme from the "Family Feud" game show from the 1980s!

Twenty minutes later, it changed back to the original song, but now it sounds like it's being played with flutes or clarinets.

There is no rhyme or reason to any of this.

 

[Tryn2BHopeful]

My head still tingles at random times, so there's been no change where that's concerned.

I would get that when I was on Lexapro the first time.

 

[ECP]

I would get that when I was on Lexapro the first time.

Did your doctor have an explanation for why the Lexapro made your head tingle? Or why it stopped?

My head has been tingling since late February or early March, and I don't know why. It seems to be a fairly uncommon symptom around here. Many more people on this board say that they have facial tingling or numbness, due to some problem with the trigeminal nerve.

 

[Tryn2BHopeful]

Did your doctor have an explanation for why the Lexapro made your head tingle? Or why it stopped?

My head has been tingling since late February or early March, and I don't know why. It seems to be a fairly uncommon symptom around here. Many more people on this board say that they have facial tingling or numbness, due to some problem with the trigeminal nerve.

No and to be honest I don't think most doctors prescribing the medications know any more about it than you or I could learn from the pamphlet.

Overall SSRIs are going to mess with the balance of the chemistry of your brain to get the desired effect. In this case it's blocking the reuptake of serotonin so more is available overall to make you happier. I honestly don't know what it takes to break those neuro connections but it's messing with something.

The tingling did stop for me over time but it didn't last more than a month. So my experience may not be what your experiencing. Brain zaps are also common of Lexapro, but I only got that during withdrawal. The feel like a tingling shock to the head for a second.

 

[blamingeverything]

So I've been on Cymbalta for almost two weeks now, and while it has helped with the depression, it has changed the nature of the tinnitus in my right ear. It is now musical tinnitus or musical ear syndrome. The left ear still hears regular tinnitus.

Most of the time, the song sounds like it's being played by the horn section of a high school marching band. Other times, it sounds like bagpipes. It's annoying, but it's preferable to ordinary tinnitus because the melody is repetitive and unchanging. I can see myself habituating to this over time, whereas I could never make peace with the constantly changing volumes and tones of regular tinnitus. I also like the fact that the melody in right ear is loud enough to drown out the regular tinnitus in my left ear for the most part.

I'm going to wait another day to see what happens, and then I'll report this to my doctor and see what she says. I'm kind of torn because I really don't mind the musical tinnitus and I'd hate to make it go away if that means having regular tinnitus return to my right ear.

That's interesting. And I'm still interested in Cymbalta vs. Lexapro. Anecdotally, my tinnitus was much more susceptible to being changed by medications/drugs in the first year (or less) than it is now. Trazodone, alcohol, marijuana, even different foods would change it. Now, I'm either overlooking that variability or I've settled into a steady state.

 

[ECP]

No and to be honest I don't think most doctors prescribing the medications know any more about it than you or I could learn from the pamphlet.

Overall SSRIs are going to mess with the balance of the chemistry of your brain to get the desired effect. In this case it's blocking the reuptake of serotonin so more is available overall to make you happier. I honestly don't know what it takes to break those neuro connections but it's messing with something.

The tingling did stop for me over time but it didn't last more than a month. So my experience may not be what your experiencing. Brain zaps are also common of Lexapro, but I only got that during withdrawal. The feel like a tingling shock to the head for a second.

Thank you for your reply. Gosh, between your tinnitus, your head tingling and your brain zaps, it sounds like Lexapro was not a great experience for you. I'm so sorry.

The Cymbalta I'm taking is an SNRI, so it's supposed to have an effect on norepinephrine as well as serotonin. I'm still hearing music in my head as of today. I thought I could habituate to that, but now I'm not so sure.

I miss having complete control of my own thoughts, not to mention total silence inside my head. I feel thoroughly broken, even though I look like a healthy person based on all outward appearances. I'd give anything to have my old brain and my old life back.

 

[Tryn2BHopeful]

Thank you for your reply. Gosh, between your tinnitus, your head tingling and your brain zaps, it sounds like Lexapro was not a great experience for you. I'm so sorry.

The Cymbalta I'm taking is an SNRI, so it's supposed to have an effect on norepinephrine as well as serotonin. I'm still hearing music in my head as of today. I thought I could habituate to that, but now I'm not so sure.

I miss having complete control of my own thoughts, not to mention total silence inside my head. I feel thoroughly broken, even though I look like a healthy person based on all outward appearances. I'd give anything to have my old brain and my old life back.

Well the tinnitus is all that remains. The other side effects went away when I was on Lexapro the first time. The tinnitus makes up for the other 2! I totally agree, I would like to go back to before I took those 3 pills. Unfortunately it's not going to happen so have to keep moving forward.

 

[ECP]

That's interesting. And I'm still interested in Cymbalta vs. Lexapro. Anecdotally, my tinnitus was much more susceptible to being changed by medications/drugs in the first year (or less) than it is now. Trazodone, alcohol, marijuana, even different foods would change it. Now, I'm either overlooking that variability or I've settled into a steady state.

It must be nice to settle into a steady state. My tinnitus doesn't react to food or drink, but it reacts to ambient household noises like fans, air conditioners, and refrigerators.

They say Cymbalta is for neuropathic pain combined with depression. If it hadn't been for my ear pain, headaches, and head tingling, my doctor probably would've chosen a different medication.

Are you reasonably satisfied with Lexapro?

 

[blamingeverything]

It must be nice to settle into a steady state. My tinnitus doesn't react to food or drink, but it reacts to ambient household noises like fans, air conditioners, and refrigerators.

They say Cymbalta is for neuropathic pain combined with depression. If it hadn't been for my ear pain, headaches, and head tingling, my doctor probably would've chosen a different medication.

Are you reasonably satisfied with Lexapro?

Yeah, I'm more than pleasantly surprised. I wasn't expecting much but it's totally changed my outlook on life, I didn't know I could feel this good. Inclusive of a previous life without tinnitus.

 

[DeanD]

I want to try Cyclobenzaprine on its own first. Ativan is not an issue with it. The study I think was 30 mg, however some have had success with lower doses.

@Nick47, did you ever try Cyclobenzaprine in the end?

 

[Nick47]

@Nick47, did you ever try Cyclobenzaprine in the end?

@DeanD, I've not. It's not available in the UK.

 

[DeanD]

@DeanD, I've not. It's not available in the UK.

Ahh ok, I knew in parts of Europe it wasn't but wasn't sure about the UK.

Would a UK equivalent be something like Baclofen?

 

[Nick47]

Would a UK equivalent be something like Baclofen?

Not in terms of tinnitus. Baclofen is a GABA B agonist whereas Cyclobenzaprine is an antagonist at 5-HT2A/C. So completely different mechanisms of action.

 

[DeanD]

Not in terms of tinnitus. Baclofen is a GABA B agonist whereas Cyclobenzaprine is an antagonist at 5-HT2A/C. So completely different mechanisms of action.

OK, thanks Nick. I am struggling with chronic spasms of the mouth, throat, eye lids, and chest which have been triggered off by the microsuction than turned my mild tinnitus severe. I am pending scan and blood tests results before medication is spoke of, and I came across Cyclobenzaprine for this condition - and then cross referenced it on here to see some were finding some reduction of symptoms with it.

I don't know what will be recommended to me in terms of medication for the spasms (obviously not Cyclobenzaprine), but was trying to go armed with as much info as I could to the appointment at the Neurological hospital in London before decisions were made.

 

[Nick47]

spasms of the mouth, throat, eye lids, and chest which have been triggered off by the microsuction than turned my mild tinnitus severe

I would think it is highly unlikely that microsuction has caused these symptoms apart from the tinnitus.

 

[DeanD]

I would think it is highly unlikely that microsuction has caused these symptoms apart from the tinnitus.

I guess we will never know but this is the conclusion from one of the head neurologists at the London Neurological Hospital.

His view is the microsuction has caused some damage to the cochlear region of the 8th cranial nerve, and due to the close proximity of the 9th cranial nerve (millimeters away) it is interfering with this signal too, where the 9th cranial nerve provides sensory input to the mouth and throat.

Unless the audiologist who performed my microsuction did something drastically wrong (I did feel a bit of a sharp sting at one point) I find it a struggle to see how the damage seems to have caused this in me, yet not to anyone else who has become a victim of increased tinnitus as a result of microsuction (and I have searched extensively) - but the neurologist has a lot more experience of nerve damage and impact than I do I guess.

Before the microsuction I was fit, happy, healthy, content with zero stress, depression or anxiety. Something has triggered this whether damage from the microsuction, the cocktail of medication I was prescribed to handle the symptoms, or the stress of it all - although to be honest I was managing the stress quite well (a qEEG in December confirmed normal levels of anxiety and only slightly high stress levels) until the onset of these chronic muscle spasms and twitches.

 

[Leon K Fox]

I can only speak for my own experiences, but 100 mg of Sertraline (Zoloft if you're in the US) basically saved my life from the catastrophic anxiety my tinnitus worsening caused me, which in turn eventually helped me to combat the insomnia as well and go back to living my normal life.

I am and was aware of the risk of worsening before starting it but thankfully this didn't happen to me.

 

[juliob]

Has anyone here tried Rexulti (Brexpiprazole) as an add-on to their treatment?

If so, I would like to read about your experiences and thoughts.

About my Luvox experience:

I decided to updose Luvox (from 100 mg to 125 mg) again but am now taking the extra dose in the morning. By the 3rd day I experienced muffled hearing in the left ear, and a few days later the ringing seemed to move to the left ear where I didn't have tinnitus before.

I have been on the new dose for more than 2 weeks and I feel it's helping me with treating both anxiety and OCD, but I wonder if I am playing with fire. Can these side effects subside after I have been on the drug for a longer time?

I am over the fence regarding treating OCD versus avoiding tinnitus. That's why I am wondering about going back to 100 mg of Luvox and trying Rexulti.

 

[juliob]

How often does Clomipramine (Anafranil) cause tinnitus or hearing loss? Has anyone with pre-existing antidepressant-induced tinnitus tried it?

Clomipramine is considered one of the best treatments for OCD. I am almost giving up SSRIs given the events mentioned on my previous post.

I read a lot about Clomipramine and tricyclic antidepressants in general being very ototoxic but it's kinda rare to find reports of it causing tinnitus on the internet compared to other antidepressants. Makes me wonder where does this "most ototoxic" fame came from.

 

[Ksharky13]

Re-starting an SSRI:

A couple of years ago I transitioned from an SSRI (Sertraline) that I had been on for a couple of decades to a new one (Duloxetine). I didn't feel that one was working, so I was on my 5the day of transitioning to Lexapro when I thought I had a spike in my mild tinnitus, which I had recently acquired about 6 months prior. So, after researching and reading that SSRIs can exacerbate tinnitus, I stopped taking any SSRI. I did not have any significant discontinuation symptoms that I can remember.

Fast forward to today, I have been in therapy for a significant anxiety disorder (yes, probably because I'm not taking an SSRI anymore), and have been very reluctant to re-start Sertraline out of fear of making my tinnitus even worse (it's worse now than it was 2 years ago).

My question is: Since I never had an issue vis-à-vis tinnitus with Sertraline for over 2 decades, should I be OK to re-start it again? Does anybody have any experiences they can share with a similar situation?

Thank you.

 

[BB23]

My question is: Since I never had an issue vis-à-vis tinnitus with Sertraline for over 2 decades, should I be OK to re-start it again? Does anybody have any experiences they can share with a similar situation?

You only have one chance with these drugs, should you ever go on them.

Once you are off, any subsequent attempt might induce a sensation called kindling.

Do a search.

 

[RunningMan]

Re-starting an SSRI:
My question is: Since I never had an issue vis-à-vis tinnitus with Sertraline for over 2 decades, should I be OK to re-start it again? Does anybody have any experiences they can share with a similar situation?

There's no way to be certain. I know I have read comments from people who have said they never had a problem with a medication in the past and then got tinnitus or some other issue when they restarted it at a later time.

I actually felt Sertraline had a negative effect on my tinnitus (newer chirping tone) within days, so I switched to Lexapro for 7 weeks before weaning off entirely. That new tone seemed to become less frequent after that.

 

[Tryn2BHopeful]

Re-starting an SSRI:

A couple of years ago I transitioned from an SSRI (Sertraline) that I had been on for a couple of decades to a new one (Duloxetine). I didn't feel that one was working, so I was on my 5the day of transitioning to Lexapro when I thought I had a spike in my mild tinnitus, which I had recently acquired about 6 months prior. So, after researching and reading that SSRIs can exacerbate tinnitus, I stopped taking any SSRI. I did not have any significant discontinuation symptoms that I can remember.

Fast forward to today, I have been in therapy for a significant anxiety disorder (yes, probably because I'm not taking an SSRI anymore), and have been very reluctant to re-start Sertraline out of fear of making my tinnitus even worse (it's worse now than it was 2 years ago).

My question is: Since I never had an issue vis-à-vis tinnitus with Sertraline for over 2 decades, should I be OK to re-start it again? Does anybody have any experiences they can share with a similar situation?

Thank you.

I was on Lexapro for 10+ years. I stopped about 2 years ago. When I started taking it again, I immediately got tinnitus. I would express caution in starting any antidepressant. I would certainly discuss your concerns with your doctor.

 

[BB23]

I would certainly discuss your concerns with your doctor.

Doctors do not accept the side effects of the drugs they push, or other sensations like withdrawal and kindling. Most likely they'll say it is OK to go back on the drug.

 

[Tryn2BHopeful]

Doctors do not accept the side effects of the drugs they push, or other sensations like withdrawal and kindling. Most likely they'll say it is OK to go back on the drug.

Sadly I have to agree with your sentiment. My doctor denies to this day what happened after I took Lexapro, stating it's "impossible." These drugs do help a certain number of people, and some have had success with them. We were not among those people and got the "shit end of the stick." There is no doubt that antidepressants are powerful drugs and should be approached with extreme caution. Advice I wish I would have gotten ten months ago.

 

[Ksharky13]

Sadly I have to agree with your sentiment. My doctor denies to this day what happened after I took Lexapro, stating it's "impossible." These drugs do help a certain number of people, and some have had success with them. We were not among those people and got the "shit end of the stick." There is no doubt that antidepressants are powerful drugs and should be approached with extreme caution. Advice I wish I would have gotten ten months ago.

Thank you for your comments. I am in such a distraught state right now. I never should have stopped my SSRI 2 years ago after being on it for over 2 decades. It's a long story as to why/how that happened, but it's a major regret of mine now. Since then, I have developed severe anxiety, now bordering depression, and I am nowhere near the person I used to be. I have also developed a more constant tinnitus as well as sound sensitivity & TTTS. There's no underlying reason or cause for the sensitivity & TTTS, other than this severe anxiety.

On the one hand, I know I need to be on medication for the anxiety, as other things (therapy, CBT, mindfulness, supplements, etc.) are essentially useless and ineffective. On the other hand, as soon as I start thinking of medication (i.e., SSRI), I go into panic mode with thoughts of getting permanent debilitating tinnitus. The dilemma is that I can't live the rest of my life either with anxiety and the related ear issues or with debilitating tinnitus. As soon as I get up in the morning, I start thinking about when I can go to bed again. The bottom line is I'm going to lose my family if I can't get better, and soon.

 

[Ngo13]

Thank you for your comments. I am in such a distraught state right now. I never should have stopped my SSRI 2 years ago after being on it for over 2 decades. It's a long story as to why/how that happened, but it's a major regret of mine now. Since then, I have developed severe anxiety, now bordering depression, and I am nowhere near the person I used to be. I have also developed a more constant tinnitus as well as sound sensitivity & TTTS. There's no underlying reason or cause for the sensitivity & TTTS, other than this severe anxiety.

On the one hand, I know I need to be on medication for the anxiety, as other things (therapy, CBT, mindfulness, supplements, etc.) are essentially useless and ineffective. On the other hand, as soon as I start thinking of medication (i.e., SSRI), I go into panic mode with thoughts of getting permanent debilitating tinnitus. The dilemma is that I can't live the rest of my life either with anxiety and the related ear issues or with debilitating tinnitus. As soon as I get up in the morning, I start thinking about when I can go to bed again. The bottom line is I'm going to lose my family if I can't get better, and soon.

Have you looked into Clomipramine? It's an old TCA mainly used for OCD, but there have been some anecdotal reports popping up recently that it has helped cure/greatly reduce hyperacusis and noxacusis in some people. From what I've read, you have to get up to a dose of 125-150 mg, but then it works, and people are able to titrate off okay, too.

 

[Ksharky13]

Have you looked into Clomipramine? It's an old TCA mainly used for OCD, but there have been some anecdotal reports popping up recently that it has helped cure/greatly reduce hyperacusis and noxacusis in some people. From what I've read, you have to get up to a dose of 125-150 mg, but then it works, and people are able to titrate off okay, too.

Thanks for the comment. Unfortunately, Clomipramine has tinnitus listed as a "common" (1-10%) side effect on Drugs.com. I can't afford to risk having my tinnitus get any worse than it is. Part of my catch-22 is that almost all of my treatment options for either my mental health or tinnitus/TTTS situation have tinnitus as a side effect. What a twisted nightmare this is.

 

[Travis Henry]

Many meds, even OTC ones, can make tinnitus worse or cause it.