Commercial Lidocaine Patch as a Treatment for Ear-ringing

[erik]

I have tried these patches for several weeks and had no change. I don't think the dosage in the patch was high enough to make any difference

 

[Amv]

Thanks @linearb! But they are not tinnitus approved right? I understand they are for other conditions.

 

[linearb]

I have tried these patches for several weeks and had no change. I don't think the dosage in the patch was high enough to make any difference

Did you place them more or less as they did in the study?

The ones in the study were 5%; the OTC ones are 4%. You'd think that if 5% was actually effective, 4% would do something.

Thanks @linearb! But they are not tinnitus approved right? I understand they are for other conditions.

Yes, as far as I know. The things I've done, modified or ingested on a purely experimental basis are legion, but there could certainly be risks associated with misuse here.

 

[Bndsmheowqhe]

Did you place them more or less as they did in the study?

The ones in the study were 5%; the OTC ones are 4%. You'd think that if 5% was actually effective, 4% would do something.

Yes, as far as I know. The things I've done, modified or ingested on a purely experimental basis are legion, but there could certainly be risks associated with misuse here.

I've been using the OTC 4% patches for about a week and there has been some slight fluctuation in tinnitus levels.

 

[tinmandan]

I just ordered a few boxes of Lidocaine patches and am going to give this a try. I'm curious if anyone knows if the patches need to be worn all day, or just 12 hours?

Also I have tinnitus in my left side only. Caused by blunt force trauma. It sounds like people have been wearing the patches center on back of neck? I'm considering putting the patches more on my left side, but wonder if this won't work because it may not be as close to the larger nerve clusters.

Thanks for any info.

 

[GBB]

It would be interesting to try Lidocaine behind the ear and on the neck separately.

 

[Matchbox]

I really, really, really don't think Lidocaine patches will work. At least unless you start putting a lot of patches on you.

Lidocaine is shown to reliably work, when used as IV/injection.

Dermal transport is so, so bad. It's akin to rubbing pseudoephedrine tablets on your nose in the hopes it dries up your sinuses during a cold. Your skin would likely burn and blister before any meaningful medication levels got into your system (or you'd need patches all over fresh areas).

Diffusion will also get worse with time, not better.

If it's going to work at all, make sure it is "not" the salt version of the drug, that will only react at the epidermis and won't go much further. (HydroBromide/chloride is the salt version, meant for ingestion or to limit dermal travel)

Some medications do work transdermally, but they are typically very lipophilic, electrically smaller, won't react with dermal tissues but will with target ones, and the dose is quite high whereas the needed systemic levels are quite low for the mechanism to work. Nicotine and Scopolamine comes to mind. There are other target tissues for Lidocaine as it traverses, so they'd need to be saturated before it had any meaningful effect (your skin would be extremely numb).

Lidocaine's great for many things because voltage gated sodium channels are everywhere, with obviously lots in your skin, muscles, etc on the way to the bloodstream.

Classic case of it works in vitro but not so much in vivo (the body as a whole makes things stupid complicated). Keep in mind there's an unlucky few where Lidocaine creates tinnitus. It depends upon the mechanism of course of how your tinnitus came to be.

So in my opinion, you'd have better luck sticking it up your butt or via IV.

 

[GBB]

I really, really, really don't think Lidocaine patches will work. At least unless you start putting a lot of patches on you.

Lidocaine is shown to reliably work, when used as IV/injection.

Dermal transport is so, so bad. It's akin to rubbing pseudoephedrine tablets on your nose in the hopes it dries up your sinuses during a cold. Your skin would likely burn and blister before any meaningful medication levels got into your system (or you'd need patches all over fresh areas).

Diffusion will also get worse with time, not better.

If it's going to work at all, make sure it is "not" the salt version of the drug, that will only react at the epidermis and won't go much further. (HydroBromide/chloride is the salt version, meant for ingestion or to limit dermal travel)

Some medications do work transdermally, but they are typically very lipophilic, electrically smaller, won't react with dermal tissues but will with target ones, and the dose is quite high whereas the needed systemic levels are quite low for the mechanism to work. Nicotine and Scopolamine comes to mind. There are other target tissues for Lidocaine as it traverses, so they'd need to be saturated before it had any meaningful effect (your skin would be extremely numb).

Lidocaine's great for many things because voltage gated sodium channels are everywhere, with obviously lots in your skin, muscles, etc on the way to the bloodstream.

Classic case of it works in vitro but not so much in vivo (the body as a whole makes things stupid complicated). Keep in mind there's an unlucky few where Lidocaine creates tinnitus. It depends upon the mechanism of course of how your tinnitus came to be.

So in my opinion, you'd have better luck sticking it up your butt or via IV.

What about Lidocaine with DMSO? I wonder.

 

[tinmandan]

Hey thanks guys for your responses. Especially Matchbox. I would really like to give a more in depth thoughtful response, I've had a super long day, and am just getting ready to go to sleep. I'm posting this now because I wanted to express my thanks.

I don't like to be scared of it getting worse. I realize that's possible, but I'm trying to build confidence in a reality that despite me working with pretty extreme decibel level gas powered tools for many hours every day, I've figured out that cozy, good fitting earbuds, playing music or podcast at low to moderate sound, coupled with the best noise protection muffs available will protect my hearing, and prevent tinnitus from worsening, and it's all paranoia, if that it might get louder. I know that might not necessarily be true but this is my chosen path, please don't dissuade me, I understand the potential consequences.

So Matchbox, I'm guessing you're right, you sound like you really truly know what you're talking about. I guess the way I see it, I don't have anything to lose, and I'm not going to be scared of it getting worse. I appreciate your information, and fair warning.

I will report back, so that my experience could hopefully help others, however it goes.

My plan is to wear the patch for 12 hours a day, and I'm leaning on placing it more left sided than simply back of neck. I'll let you guys know once I see the size.of the patches etc...

Stay strong people.

Daniel

 

[Matchbox]

So Matchbox, I'm guessing you're right, you sound like you really truly know what you're talking about. I guess the way I see it, I don't have anything to lose, and I'm not going to be scared of it getting worse. I appreciate your information, and fair warning.

I will report back, so that my experience could hopefully help others, however it goes.

Well obviously I hope it works for you and that I can eat my words. If it helps you, I will gladly put one up my butt to see if it works better.

 

[Poseidon65]

@tinmandan, did you try the patches? If so, how did they work for you?

 

[GBB]

It would be interesting to try Lidocaine behind the ear and on the neck separately.

I tried this with patches though it did not help me.

 

[CGB]

Elvis Costello once said in one of his songs, "I used to be disgusted but now I try to be amused." I noticed that the Dollar Store sells pain patches with menthol and Lidocaine.

I wonder if we could conduct a clinical trial by placing these pain patches in various locations and observing the results.

Instead of a clinical trial, they could have done a cohort study, which would have been less profitable for the university or conducting entity. In a cohort study, we would survey all the people who use pain patches and ask what percentage of them have tinnitus. Then we would compare this to the percentage of the general population with tinnitus. If we find that the people who use pain patches containing Lidocaine have a lower incidence of tinnitus, then we can conclude that Lidocaine helps with tinnitus.

However, I believe these clinical trials are just a way to spend grant money on something they already know the answer to.

 

[Cmspgran]

So, I thought I'd bump this thread as I've been trialling Lidocaine patches on the neck. After a couple of weeks, they were undoubtedly helping quite significantly, especially the reactive element.

Alarmingly, this weekend, my hearing suddenly dropped at 2 kHz and 3 kHz, and I feared SSHL; I went to A&E and was told to come back Monday first thing for ENT.

Fortunately, the hearing came back in less than 24 hours, and I'm convinced that it was the pads and I'd potentially overdosed as I'd been wearing them 24/7 for weeks. Interestingly, the hearing coming back coincided with the half-life of Lidocaine, and looking at some past papers, there is some evidence of this happening when injected into the middle ear.

So, I'm not sure where this leaves me. Now that I'm scared to continue using something that was benefitting me, do any of our more scientific members care to give any ideas or thoughts?

 

[Nick47]

So, I thought I'd bump this thread as I've been trialling Lidocaine patches on the neck. After a couple of weeks, they were undoubtedly helping quite significantly, especially the reactive element.

You found an effective treatment and did not tell us???

Temporary hearing changes happen randomly, day by day. If it is more than 10 decibels, I would have some concerns. If it is 10 decibels or less, I would not flinch.

Can you provide a link to where you purchased the Lidocaine patches from and tell us where exactly you wore them?

 

[BuzzyBee]

So, I thought I'd bump this thread as I've been trialling Lidocaine patches on the neck. After a couple of weeks, they were undoubtedly helping quite significantly, especially the reactive element.

The hearing drop is a little scary, but overall, it's pretty amazing that Lidocaine patches worked for reactive tinnitus.

Can you tell me what brand of Lidocaine patches you were using exactly? Also, after putting on the patch, how many hours did it take until you noticed an initial drop in your tinnitus?

 

[Cmspgran]

You found an effective treatment and did not tell us???

Temporary hearing changes happen randomly, day by day. If it is more than 10 decibels, I would have some concerns. If it is 10 decibels or less, I would not flinch.

Can you provide a link to where you purchased the Lidocaine patches from and tell us where exactly you wore them?

I had planned on writing a full update after a few weeks more. Of course, I'd share it with everyone—that goes without saying—but I wanted to give it a proper run.

It was more than 10 dB, more like 20 dB, focused around 2 kHz and, to some extent, 3 kHz. I'm 99% sure it was the Lidocaine. I'd potentially overdosed by wearing the patches nonstop. I'd searched the literature and had seen a paper where a similar thing happened when they injected Lidocaine into the middle ear, but the frequencies returned within two hours; the fact my hearing took overnight to return concerns me the continuation of using it. I actually wanted your opinion on this @Nick47, along with a few other regulars who get stuck into the science.

However, the benefits were pretty profound, especially for the reactive element. For full disclosure, I'm also taking 300 mg of Gabapentin every night, which helps with sleep. If I recall rightly, there have been studies on the combination.

For those interested, the brand is Aspercreme, and I used medical tape to keep it in place day and night. Per the study, I wore them on my neck and bought them from iHerb.

Any thoughts on the hearing loss element would be appreciated.

 

[Nick47]

I had planned on writing a full update after a few weeks more. Of course, I'd share it with everyone—that goes without saying—but I wanted to give it a proper run.

It was more than 10 dB, more like 20 dB, focused around 2 kHz and, to some extent, 3 kHz. I'm 99% sure it was the Lidocaine. I'd potentially overdosed by wearing the patches nonstop. I'd searched the literature and had seen a paper where a similar thing happened when they injected Lidocaine into the middle ear, but the frequencies returned within two hours; the fact my hearing took overnight to return concerns me the continuation of using it. I actually wanted your opinion on this @Nick47, along with a few other regulars who get stuck into the science.

However, the benefits were pretty profound, especially for the reactive element. For full disclosure, I'm also taking 300 mg of Gabapentin every night, which helps with sleep. If I recall rightly, there have been studies on the combination.

For those interested, the brand is Aspercreme, and I used medical tape to keep it in place day and night. Per the study, I wore them on my neck and bought them from iHerb.

Any thoughts on the hearing loss element would be appreciated.

I'm really impressed you tried to mirror the study. You could cut down the wearing time to 14 hours. So, place the patch 1 hour after waking and remove it 1 hour before sleep. I don't know if it will be enough to give you relief. However, I know the half-life of Lidocaine is very short.

As a medication, Lidocaine is an anesthetic and pain killer. The doses in the patches are very low compared to injections.

I thought you were 'quiet,' lol.

How long into the treatment did you notice an effect, and where did you place it on the neck?

 

[Cmspgran]

I was inspired by a comment @linearb made about just taking the medication and getting on with his life. I realized I had been spending too much time worrying about using the medication rather than just 'using it' at the lowest dose possible and getting on with my life.

In answer to your question, I cut a pad in half, as they're quite large, and placed it as close to my neck hairline as possible. I used cheap white medical tape to hold it in place since they don't stay otherwise.

I noticed consistent results within two weeks of regular use. On some days, the improvement was so significant that I was shocked.

I am still using Clonazepam twice a week, Gabapentin before bed, and a low-dose extended-release Melatonin. I've switched from the Lamberts brand Alpha-Lipoic Acid to Lifesystems R-Alpha Lipoic Acid, as I found it crosses the blood-brain barrier more easily. I mention all these things because there might be a harmonious reaction occurring. As with all things tinnitus, it's an ongoing experimentation. Everything I try is based on at least a couple of decent papers on the subject.

 

[Nick47]

am still using Clonazepam twice a week, Gabapentin before bed, and a low-dose extended-release Melatonin. I've switched from the Lamberts brand Alpha-Lipoic Acid to Lifesystems R-Alpha Lipoic Acid, as I found it crosses the blood-brain barrier more easily. I mention all these things because there might be a harmonious reaction occurring. As with all things tinnitus, it's an ongoing experimentation. Everything I try is based on at least a couple of decent papers on the subject.

I think that's all spot on. It's a similar cocktail to mine.

I've ordered some Lidocaine patches from iHerb. Five patches @ 4 %. The same brand as you. I'm also already on Gabapentin and ALA anyway.

After reading up a bit, I would consider wearing it for 12 hours. Let the area rest, then reapply.

I'm not a doctor though.

They are commonly used for pain relief from injury, so even if they don't offer additional benefits for tinnitus, they may still be useful.

You said it took a week to see any benefit?

 

[Cmspgran]

I wish you the best of luck with it. I would've gone for a few boxes and given it at least three weeks of consistent use. It wasn't until about week two of 24/7 use that I began noticing real improvements.

 

[Nick47]

wish you the best of luck with it. I would've gone for a few boxes and given it at least three weeks of consistent use. It wasn't until about week two of 24/7 use that I began noticing real improvements.

Will you continue with the study protocol and reduce the wearing time to 12-14 hours? How long after stopping the treatment did the tinnitus return to its normal baseline?

Those who completed the clinical trial saw a 35% reduction in their TFI, going from moderate to mild. Some people here have tried it without results, while a couple had good results.

Issues:

• Compliance
• Type of patch
• Placement
• Strength of patch
• Duration of use
• Manufacturer

This may be effective only for a subset of tinnitus patients—hopefully, it will be sound-reactive tinnitus, at least.

@Josh59, interested? I have ordered some. They should arrive next week.

 

[Cmspgran]

I probably will, even though the drop in hearing in the right ear scared me a bit. However, from my very rudimentary understanding of the science, I don't think it was due to ototoxicity; it was more likely messing with channels/auditory pathways. With the hearing returning so quickly the next day, it's not like typical SSHL, is it?

I've since dabbled again, and it's super interesting how it begins modulating my tinnitus and making it less reactive in around 5-6 hours; I won't be wearing them overnight anymore. In answer to how quickly it wears off, similar to the Clonazepam effect, sadly, as soon as I stop, I get that horrible rebound the next day.

What's one to do? Wear patches for the next 5-10 years. It doesn't seem too practical. Funny, I finally had my NHS ENT appointment today, and to be fair, she was very thorough. I asked about the Lidocaine causing the sudden deafness, and as expected, she didn't have a clue; she hadn't even heard of the idea of patches.

 

[Nick47]

What's one to do? Wear patches for the next 5-10 years. It doesn't seem too practical. Funny, I finally had my NHS ENT appointment today, and to be fair, she was very thorough. I asked about the Lidocaine causing the sudden deafness, and as expected, she didn't have a clue; she hadn't even heard of the idea of patches.

My Lidocaine patches have arrived. I will start today or tomorrow, applying it in the morning after a shower. The patches are best applied to clean skin. Are you wearing half a patch directly under the hairline in the middle of your neck? If so, I have ten days' worth to go at this initially.

It's all trial and error. I may wear it for 24 hours for 2-3 days to build up levels, then reduce it to 16 hours.

I'm not surprised at the useless ENT/Audiologists.

Did you get any side effects from this treatment?

 

[Nick47]

Are there any updates on how you are going about this, @Cmspgran?

Regards,
Nick

 

[Cmspgran]

I've stopped for now because the hearing loss in my right ear really freaked me out. Honestly, I'm in a tough spot. I had to stop taking Gabapentin because it was causing stomach issues and didn't help much, aside from aiding sleep. Now, I basically just look forward to taking Clonazepam twice a week, but then I have to deal with the crash and subsequent depression the day after. It's like riding a rollercoaster every week, and it's not a sustainable way to live. I'm not sure what to do next.

I'm planning to focus on mindfulness meditation for three solid months and give red light therapy a try to see if it helps with my mood and depression.

How are you getting on with the patches? They were definitely working for me, and if it hadn't been for that hearing loss incident, I'd still be using them every day.

 

[Nick47]

@Cmspgran, I wore one patch as a test for 16 hours to check for any side effects like irritation. I have had none. I'm planning a run on them soon.

DEFINITELY no placebo? Were there any side effects other than fluctuating hearing conductance?

 

[Cmspgran]

@Cmspgran, I wore one patch as a test for 16 hours to check for any side effects like irritation. I have had none. I'm planning a run on them soon.

DEFINITELY no placebo? Were there any side effects other than fluctuating hearing conductance?

This is definitely not a placebo, mate. I've suffered long enough and tried every supplement under the sun to know the difference.

Only two things have ever improved my tinnitus: Clonazepam (which was almost a miracle for me) and now, Lidocaine patches.

I believe the drop in hearing is proof that it was affecting certain channels. Some scientific speculations suggest that it works by modulating a range of channels. My suggestion is to wear the patches consistently for a couple of weeks. I was wearing them day and night, so don't forget to ensure they're taped securely to your neck.

You're basically taking the same stuff I did, so you should notice a difference within a fortnight.

 

[Nick47]

This is definitely not a placebo, mate. I've suffered long enough and tried every supplement under the sun to know the difference.

Only two things have ever improved my tinnitus: Clonazepam (which was almost a miracle for me) and now, Lidocaine patches.

I believe the drop in hearing is proof that it was affecting certain channels. Some scientific speculations suggest that it works by modulating a range of channels. My suggestion is to wear the patches consistently for a couple of weeks. I was wearing them day and night, so don't forget to ensure they're taped securely to your neck.

You're basically taking the same stuff I did, so you should notice a difference within a fortnight.

Were the Lidocaine patches more effective than Clonazepam?

I think the hearing fluctuations are due to conductance. This is similar to Carbamazepine.

Did you get any other side effects?

 

[Cmspgran]

Were the Lidocaine patches more effective than Clonazepam?

I think the hearing fluctuations are due to conductance. This is similar to Carbamazepine.

Did you get any other side effects?

At peak concentration, it is probably just as good, yes, but bear in mind this was the rigmarole of applying patches with tape for weeks compared to popping a pill and then two hours later getting relief.

I've felt nauseous on and off recently. It could be related, but it might not be. Who knows.

Can you give me a little more of the science around the conduction theory? Am I risking permanent hearing loss continuing?