Can Discontinuing Pristiq Help My Reactive Tinnitus? Should I Wear Hearing Protection 24/7?

[teayom]

Hello!

I developed hyperacusis and mild tinnitus three weeks ago. Since then, I've undergone several tests, including an MRI and a spinal tap, but the results showed nothing abnormal. Two weeks ago, I was prescribed Prednisone 20 mg for seven days. I believe it helped with my hyperacusis, but it may have left me with reactive tinnitus. I am currently taking Pristiq 100 mg, which I have been on for two years.

My reactive tinnitus changes daily, with new tones appearing frequently. I never have more than four tones in each ear at a time. I wear ear protection whenever I leave my room and have covered my vents to minimize exposure to potential triggers. Despite my efforts, each day feels increasingly difficult, and my symptoms seem to worsen daily.

Could discontinuing Pristiq be the solution? Should I be wearing hearing protection 24/7?

Any advice would be greatly appreciated. Please help!

 

[Robster]

Definitely don't wear hearing protection 24/7—that's a surefire way to develop hyperacusis. What I do is always carry earplugs with me for unexpected loud noises and avoid places I know will be noisy, like clubs, cinemas, and concerts.

 

[teayom]

My tinnitus seems to be getting worse every day, with new tones and increased loudness. I'm trying to taper off Pristiq to see if that might be the cause, but the tapering process will take a month. Will it be too late?

Please, I'm so scared. Can someone tell me that I'll be okay?

 

[teayom]

Please help me.

 

[2noist]

Please, I'm so scared. Can someone tell me that I'll be okay?

Please help me.

If someone told you you are going to be fine beyond any doubt, they would be lying. Some of us have worsened over the years to a suicidal state (or even committed suicide). Others get better over time.

Read some of the success stories.

 

[LBE]

Because you don't know what's going to happen yet, your mind is fixating on the worst possible outcome. This feeds the spiral of panic and despair, making the experience of the sound even harder and further fueling the cycle. Give yourself space to breathe, and remain open to the possibility of improvement, because that too is a real possibility.

As much as you can, try not to focus on the unknowns. They don't exist yet and therefore can't be managed or meaningfully prepared for. If there's anything you still enjoy doing that brings you some pleasure or satisfaction, despite the noise, do it.

I was so panicked during the first two months that I nearly stopped eating and lost 25 pounds. I still remember the day a colleague brought me a bowl of homemade curry. I forced myself to eat it, and even two and a half years later, I recall how good it tasted and how comforting her kindness felt.

Would I have enjoyed it more if I hadn't had a half dozen sounds blaring in my ears? Of course. But that small experience helped me get through the day and made it so much better than it otherwise would have been.

As you move forward, try to find those things, no matter how small, that improve each day for you. And leave the future as an open question.

 

[Nettles]

Hi, I have reactive tinnitus with about 10 different tones. I developed several new tones while tapering off prednisolone. During that time, the noise was the loudest I had ever experienced. I also had palinacousis, where my tinnitus mimicked sounds from my environment, like the hum of a vacuum cleaner from another room, and replayed them in my head for about an hour.

Thankfully, the loudness did settle down, and the palinacousis stopped. I haven't experienced any new tones since then. The tones I developed while tapering are still present, but they are much lower in volume and much more manageable compared to how they were during the tapering process.

Tapering is a difficult but necessary process to avoid or minimize lasting effects. Try not to worry; you are doing the right thing. Taper safely, even though doing it over a longer period can feel scary. I completely understand. I wanted to stop prednisolone after just three days but had to continue for 14 days to taper safely. I'm glad I did, because stopping too soon could have made things worse.

What @2noist said is true, but the percentage of people who experience severe, long-term effects is very low compared to those who manage well and lead good lives. While it is a possibility, the most important thing for all of us is to take each day as it comes and try to keep our minds as calm as possible.

You are doing the right thing, and hopefully, within a week or two after your taper, you'll settle back to your baseline volume. I also find that talking to ChatGPT about what I'm experiencing, symptom-wise, is very helpful. It understands the medical side of things and is usually kind and reassuring while also providing factual information.

 

[teayom]

Thank you, @Nettles and @LBE, for your kind replies!

I've been extremely stressed this past month, so it's reassuring to hear that things can get better and hopefully stabilize.

@Nettles, how do you manage your reactive tinnitus? Do you protect yourself from all triggers? One of my triggers seems to be the AC vents in my home, but I can't turn them off because I live with my family. I'm not sure what to do about that. Sorry for all the questions. It's okay if you don't want to answer!

 

[Varda]

I'm trying to taper off Pristiq to see if that might be the cause, but the tapering process will take a month. Will it be too late?

Be careful not to taper too quickly. There are many reports of tinnitus symptoms being triggered by tapering psychiatric medications too rapidly.

 

[MindOverMatter]

@teayom,

Easier said than done, but let it react. There is no real danger in the annoyance or the increased sensitivity you're experiencing due to things like air conditioning, even though it may feel that way. Trying to cover it up will only make you more sensitive in the long run.

This is just my take, based on my own experience.

Over time, by gradually introducing "positive soundscapes" (sounds that trigger you less), you will eventually be able to shift your focus. However, this process takes a lot of time and effort.

 

[teayom]

Over time, by gradually introducing "positive soundscapes" (sounds that trigger you less), you will eventually be able to shift your focus. However, this process takes a lot of time and effort.

Were you able to see any improvements from doing this? I'm worried that I may never improve and might only get worse.

 

[MindOverMatter]

First of all, @teayom, I believe it won't do you any good to focus on worst-case scenarios. You'll have to let go at some point because you can't control everything. Why not think that you might get better? That's what you want to believe, right? Look for that silver lining.

Once you begin to accept the situation, for now, and let go of the negative thoughts, you can most certainly improve with time. It will take a lot of time and effort, and there will be bumps along the road: spikes, temporary setbacks, frustration, fatigue, and so on.

The key here, eventually, is to create new neural pathways in your brain. With CBT, mindfulness, and some form of auditory input that works for you (with counseling, if that's an option), your brain can adapt. The level of adaptation varies from person to person.

For me, it can go totally unnoticed for many days, or even weeks at a time (especially the reactive part where I used to have negative emotions attached to it). I believe it's a combination of time and practice that has helped me improve a lot, along with neuroplasticity and habituation. If I experience a bad spell now, which can happen because I choose to live my life, I understand it's just part of the journey. There are ups and downs, fluctuations. This is normal, at least for me.

Life happens, and not every day will be good. But if you look closely, you can find something positive in every day. Small things matter.

Avoid stories that drag you down further; they will only make it harder to get back to a sense of normalcy.

 

[KaiT81]

First of all, @teayom, I believe it won't do you any good to focus on worst-case scenarios. You'll have to let go at some point because you can't control everything. Why not think that you might get better? That's what you want to believe, right? Look for that silver lining.

Once you begin to accept the situation, for now, and let go of the negative thoughts, you can most certainly improve with time. It will take a lot of time and effort, and there will be bumps along the road: spikes, temporary setbacks, frustration, fatigue, and so on.

The key here, eventually, is to create new neural pathways in your brain. With CBT, mindfulness, and some form of auditory input that works for you (with counseling, if that's an option), your brain can adapt. The level of adaptation varies from person to person.

For me, it can go totally unnoticed for many days, or even weeks at a time (especially the reactive part where I used to have negative emotions attached to it). I believe it's a combination of time and practice that has helped me improve a lot, along with neuroplasticity and habituation. If I experience a bad spell now, which can happen because I choose to live my life, I understand it's just part of the journey. There are ups and downs, fluctuations. This is normal, at least for me.

Life happens, and not every day will be good. But if you look closely, you can find something positive in every day. Small things matter.

Avoid stories that drag you down further; they will only make it harder to get back to a sense of normalcy.

I also try to follow this good advice for myself.

I'm in my eighth month of dealing with tinnitus, and I'm still struggling a lot. I take light medication to help me sleep, do relaxation exercises, and try to distract myself with various activities. I also use Cognitive Behavioral Therapy with the help of a tinnitus counselor and a health app. During the first few months, I masked the ringing in my ears for most of the day, completely masking it at times.

For about a month now, I've stopped masking it entirely. Instead, I only listen to soft music or nature sounds in the background. Since then, I've had some days, sometimes even several in a row, when the tinnitus bothers me less, and I can even ignore it in situations where I'd normally notice it. On bad days, though, I hear the tinnitus through everything. I hear it while watching TV, listening to music, or doing activities meant to distract me, and during those times, it often drags me into a very dark place mentally and emotionally.

However, your posts give me hope. It reminds me that I'm still in a relatively early stage, and more noticeable progress may come after a year or more. It's really encouraging that you're able to go days or even weeks without thinking about your tinnitus and live your life as normally as possible.

 

[KaiT81]

May I ask another question beyond my previous post, @MindOverMatter? Do you eventually feel safe and comfortable in your body again, even with the ringing in your ears? Does the emotional reaction to tinnitus subside over time, allowing you to focus on other, more important and beautiful things in life? Or is that perhaps the secret to healing and habituation—that you simply move forward and live your life again?

Is it a gradual process, and how do I know when I'm truly on the right path? When you say you don't think about your tinnitus for hours, days, or even weeks, does that mean you genuinely don't notice it for that long, even though it's always present somewhere in the background?