Hello and My Tinnitus History So Far

[Xynic]

Hi guys,

So a couple of months back, I registered on here, wrote a post, but quickly regretted my decision. The reason was that I didn't and still don't believe that being active on a tinnitus forum is a very good idea for me - I'm a hypochondriac and y'all can imagine how well that plays with reading reports from other patients! I'm well aware of the fact that people who get better rarely still post on tinnitus forums (would you?). However, I'm experiencing a crisis at the moment and really didn't know better. Here I am back - at least for now!

So since none of you remember me, I'll quickly tell about my tinnitus history. I've had my first, "original" tinnitus since I was 16 or so, due to a noise trauma. It didn't bother me at all (well, after a difficult adjustment time in the beginning). I never consciously heard it! I was merrily going out to concerts and raves, playing live music myself, and no problems whatsoever.

Vol. 2 appeared sometime end of May - beginning of June this year. I had just split with my then-girlfriend of one year, I was unhappy with my job and general life situation, I was coming off a major rave/MDMA/ecstasy spree and was generally not a happy camper. I had a bunch of other issues including daily headaches and dizziness, and at some point I'd gotten it into my head that my hearing was diminsihing (complete bullsh*t - my hearing is perfect aside from a slightly diminished hearing in my left ear which I've had for a while and which is stable. Confirmed by multiple hearing tests, as well as subjectively). No wonder one morning I woke up and my left ear was going like an alarm clock.

I'll spare you all the details of what I went through and the long story of my pilgrimage through the doctors (I'm bored of telling it myself!) Suffice it to say, it's ups and downs. Right now it's a down. So here, in bullet points, is what I've tried and/or found remarkable:

- Tinnitus likes to change frequency, intensity and location. This all leads to me "rainmaking" - if I try X and the tinnitus happens to get better, I assume it's because of X, if it doesn't or gets worse, I try something else.
- Multiple cortisone treatments, no notable effect
- Tried magnesium, placebo effect (I think)
- Tried gingko, no notable effect
- Lack of sleep seems to worsen it, surprise
- Tried good food, regular days and lots of sun. Results inconclusive, but seems to improve overall condition, mood and thereby tinnitus.
- Did one more ecstasy session in early June, due to being drunk and totally pissed off at myself sitting at home and being depressed. Went to huge rave, rolled. Woke up with noise trauma, needed a couple of days to recover. BUT remarkable effect - tinnitus vol. 2 disappeared for three days, then came back on slowly. Gave me some more pointers on what might be causing it.
- Doing physical therapy (manual therapy) at the moment for my screwed up neck and back. Second session in, so far no notable effect on tinnitus (interesting effects otherwise, though).

I highly suspect, as probably do you after reading all of this, that my tinnitus is very directly linked to my depression/serotonin levels. As I wrote before I rolled a lot last year, resulting in an even more destabilized psyche and cumulatively with the other events in my life (breakup, general discontent, best friend currently preparing to leave the country, tinnitus) triggered a depression so heavy I haven't had it this hardcore yet. I suspect my serotonin levels are low, though I have no idea how to get that tested. It's also telling that the tinnitus subsides when I'm interested in something, like listening to good music, watching a good movie, having an interesting conversation, and then gets barely bearable once I don't do any of those things or concentrate on it. It's a world of difference, which I guess is testament to the fact it's psychosomatic.

I went to see a psychiatrist, who prescribed Zolpidem (Ambien) and Escitalopram. The Escitalopram is known to cause tinnitus or an increase in tinnitus, so I did not take it (I asked him to give me something that does not have this side effect, but he was having none of it - I want to look for alternatives now. Maybe someone on here knows about antidepressants that aren't ototoxic or cause tinnitus increase, and which would fit my profile?) I really want to feel better because in better moments I do realize that it's all psychosomatic and I don't actually have a big problem - just another sound I can't turn off, and which hardly should affect me - after all, I can still listen to music alright, I can make music, what's even the problem? But in the worse moments it totally gets me down. I don't want to risk an increase in intensity through meds, though.

The Zolpidem I did take for three nights, since in the past few days it's been so bad in the night that it was too loud for me to go to sleep. But it's not a good solution, even short-term - it does send me to sleep, but I wake up after 5-6 hours, just like I would without taking it, plus I wake up horrendously depressed, with suicidal thoughts and tears right behind my eyes. After some research I found that Zolpidem increased depressive symptoms in other patients, too. I would like to use a benzodiazepine as a band aid solution for a night or so, since benzodiazepines usually give me a better mood and help me sleep longer, or so I remember. 5-6 hours doesn't sound so bad when you say it, but over many weeks it really wears you out - I used to sleep 9-10 hours easily on a free day. I live in Germany though, where doctors are very cautious with prescribing any chemistry. I am well aware it can't be a permanent solution, but honestly the place I'm at, I think I just need to get over the mountain first before I can really go about improving my life otherwise.

So this is my introduction here. Any thoughts, comments and questions welcome.

 

[undecided]

Ecstasy did the trick (about your quiet time in June) as I'm sure you must have realized since its an MDMA receptor agonist which is directly linked to serotonin and dopamine levels.
Forget the Escitalopram, there are reports here on TT that it could worsen your tinnitus. If you absolutely feel you need an SSRI drug, you might want to check out 5-HTP, a natural supplement that ends up as serotonin and melatonin in your system instead of trying to fry your brain synapses.
Ambien is a good solution if you absolutely must sleep, however it just induces sleep, it does not maintain it. It lasts for about 2 hours (it has a very short half life).

 

[Xynic]

undecided, thanks for the reply,

All of that is absolutely my experience, too. I already forgot the Escitalopram - I know of the reports and am not risking anything, I'll switch the psychiatrist to someone who hopefully is aware of that, too. The thing is that I'm not totally sure an SSRI is the right way to go in general and that's what I wanted to discuss.

Here's my thoughts on it - I realize that what you described is the reason the MDMA "helped". However, just as it helps short-term, I am suspecting that my regular consumption in the past screwed up my serotonin levels long-term, thus partially causing the tinnitus. I'm afraid any SSRI might have a similar effect - great for a while, worse in the long run. AFAIK there's no SSRI that's not suspected of causing tinnitus.

My psychiatrist told me that with my OCD, tinnitus, anxiety and depression, Escitalopram is the way to go, and yeah I know serotonin helps with all that - MDMA does, too, my OCD got better each time after rolling for a while. Problem is that I think long-term, it makes everything worse. Catch 22?

I've heard of Mirtazapin, which is not an SSRI and is apparently not known to cause any such thing as tinnitus. However, it works on the dopamine levels, so I'm kind of worried that if I manage to get that, I might be working in the wrong direction altogether - taking an antidepressant I don't actually need. I clearly need SOME because trust me, it cannot continue like this - but if an SSRI is all that may help me, I'm sort of screwed. :/

I'll look into 5-HTP and if it's possible to get it in Germany over the counter. If it's a supplement it should be.

 

[undecided]

All I can tell you is that an SSRI will do nothing for your tinnitus.
In the (very) long term, it might make you a bit indifferent to it (and to other things) but even that is not a sure thing.
My personal opinion is that SSRIs are complete crap and useless.

If you feel that treating your depression is a priority, then you might want to consider an antidepressant. The mirtazapin (Remeron) that you mentioned is a good drug (I've tried it myself, no worsening tinnitus, better sleep and mood) but it takes some time to start acting and you need to find the right dose.
You really need to discuss the proper AD with a psychiatrist, if you are worried about the dopamine issue. Maybe you can be prescribed an older but safer AD such as amitriptyline, or a newer one such as valdoxan.

If you feel that the tinnitus is feeding your depression, you might want to lower the volume by trying an anti-seizure drug such as Trobalt / Gabapentin / Tegretol. However these are difficult to get because of their side effects and because they are basically being prescribed off-label for tinnitus.

And as a last resort, there are the infamous benzos (my personal favorites) but getting into them can prove problematic in the long run.

 

[Xynic]

All good advice and really good to hear about the SSRIs, screw them then!

Word on the danger of benzos. I've heard terrible stories about Xanax and its addictiveness. I've used them in the past though, just on an off night to get sleep, and had really good experience. I'll try to get just one pill or so, first priority right now is just to get a couple of nights with GOOD sleep. Thanks for everything man.

 

[Xynic]

Oh yeah, and the seizure drug stuff is crazy, that's actually something I've never heard before. Pretty much 110% guarantee no "regular" German doctor (hehe) will ever prescribe anything like that for tinnitus, but sounds interesting should I be desperate enough to want to self-medicate. Hopefully not.