Approaching Recovery (Supposedly) — Would Like Advice

[Srebint]

I've made repeated threads here about aspects of my struggle with hyperacusis/tinnitus. Suffice to say, I feel like I for the most part am approaching recovery. I experienced a threshold increase later last year per a sort of parameter of how bad my hyperacusis is per someone that made it the worst it's ever been, and the tinnitus pervasively noticeable to a degree it's never been in my life. Much of earlier this year revolved around struggling with it, and it wasn't until I stopped wearing protection at all per suggestion of a specialist around the end of April that I saw improvement, which turned out to be pretty rapid. My tolerance ended up the best it'd ever been since I developed this, and the only thing that really seemed to persist was the increased tinnitus. I've had tinnitus since I was very young, but it's never been noticeable. Even after this improvement, it remained much the same as it had been since the fall.

Things continued to improve, until I took an amitriptyline for insomnia a month ago. That honestly seemed to cause it to regress. Even though my broad tolerance was the same, some major aspects went back to how they were beforehand. I think it was largely coincidental, and thought the amitriptyline had little to do with it. It wasn't until I took another several days ago I saw exacerbation again. That too has largely subsided, but this medication clearly effected it.

At this point, all I can see doing is avoiding taking medications like amitriptyline and avoiding caffeine. There doesn't seem to be much else I can do other than just wait. But I don't know if that's really enough for me at this point. I expected this sometime ago to last a full two years, but it's getting to the point where I'm having serious difficulty handling it anymore. The first third of this year largely revolved around this, and seeing this partial regression has really gotten me down. It's absolutely fucking maddening how this refuses to go away. It's like it taunted me with the rapid improvement I saw earlier this summer. It wants to drag this out as much as possible. And it could be even longer than 2 years. I can't believe I still have to go through more of this.

I also want to make absolutely sure nothing like this ever happens again. I know what triggered it, and I'm going to cautiously test the audio equipment that triggered it. I'll either physically disable the features that led to this or sell it. And I'd like to know if I'm at all at increased risk for this. The last audio test I had showed no hearing loss, despite all this, and I'm wondering if there's something else I should be on the look out for.

I'm probably rambling with posting this thread, but I'm just at wit's end. I guess I'd like to know if what I'm describing is typical for people who are approaching recovery- apparent, borderline recovery, then a regression beforehand. And what I should keep a look out for from here on out.

 

[Lane]

Things continued to improve, until I took an amitriptyline for insomnia a month ago .. and what I should keep a look out for from here on out.

Hi @Srebint,

Sorry to hear about your setback. Are you by any chance aware that amitriptyline is an anticholinergic drug? Meaning: it blocks acetycholine receptors in virtually all parts of body, including the brain, nervous system, and of all places--the inner ears. Anticholinergic drugs are all ototoxic, something that doesn't appear to be well known on this forum.

I cringe every time I hear amitriptyline brought up as something fairly benign that might be worth trying. Any drugs that are taken by people with any kind of ear problems should be studied extensively before being taken. A single dose of an "anti-nausea" medication given to me in the ER has given me extreme tinnitus, significantly worsened my hyperacusis, and negatively impacted my body in many other ways.

When it comes to drugs, we can't be too careful about researching them thoroughly before putting them in our bodies. And if we do decide to "give something a try", I think it best to start in the very smallest increments. -- I hope you can reclaim the gains you made, and your amitriptyline experiment will turn out to be only be a temporary (albeit frustrating) setback for you. -- BTW, amitriptyline is considered a "high activity" anticholinergic drug.

All the Best!​

 

[Srebint]

Wow, had no idea it was that bad. I googled around and saw scattered indications of it exacerbating such things, it happened but it didn't seem that common, and some would report it made things better. My doctor after I brought this up likewise wasn't familiar with it exacerbating hearing issues. I recall that when I originally went to him about this, I didn't bother taking any sleep meds for sometime because I was concerned over it effecting this.

Do you think my setback last month was really mostly due to the amitriptyline, that it wasn't just largely a coincidence? The last dose I took seems to have effected it far less than the first. I forgot to mention they were both 25 mg.

I forgot to mention this, but despite the setback, there is one thing I've noticed recently that seems strongly indicative of approaching recovery is that what I could describe as my resting tinnitus- when I'm not being really exposed to stimuli, mainly when I'm bed- is the best it's been since my threshold increase (I don't remember what it was like before exactly though), and altogether seems like just a louder version of my pre-hyperacusis tinnitus. It generally lacks the elaborate, layered and abnormal quality of how it used to be, and while there is still ringing at times, the tinnitus was the one thing that never changed much after my improvement earlier this summer, and this is hopefully a sign of things to come.

It's not exactly like the setback was that big after my first amitriptyline dose, as I was able to handle working at an Amazon plant (for about a week, quitting due to another medical issue) with minimal issues sound-wise. But it was a setback nonetheless that in ways hasn't completely gone back. I'd really like to know if this was largely coincidental or not.

I'm still interested in taking sleep meds, though it would just be changing the dose of a tizandine I'm taking for a muscle issue. They can cause drowsiness if taken in succession, and I've had this happen by accident before, but it never caused any hearing issues. I'm going to consult with the doctor who prescribed them for me to begin with, but are you familiar with tizanidine causing exacerbation? It would be just 2 at night, as opposed to each 12 hours apart.

 

[Coffeebean]

Hi @Srebint

I'm glad to hear that you are approaching recovery and I can understand that it is frustrating if you progress stalls. I am quite close to recovery as well but still dealing with some remaining sensitivities, and I also get frustrated when improvement is not going fast enough. But if anything, hyperacusis is a test of patience and perseverance, often taking months or years to fully go away. Try to be happy for the progress you have already made and focus on improving more without trying to rush it. It's easier said than done, but time really is a great healer. I wish you all the best!