Hyperacusis Cured/Reduced by Clomipramine

@AverageJoe12, @Trafalgar D:

Stick to the thread topic, guys. Racks me off no end looking at threads and seeing conversations completely unrelated to the topic!

 

What the hell did @Trafalgar D do wrong?

 

I have an appointment with my psychiatrist on Monday. I'm thinking of asking to give Clomipramine a go. It's either this or something like Cymbalta, I prefer this as it's not an SSRI/SNRI. I need something and I don't want to increase my Ativan or go onto Klonopin.

 

If you want to try Clomipramine, you may want to mention OCD tendencies. Apparently OCD is the major indication for that drug. I used that line to get my prescription for it.

But I decided to not take it, because I saw a decent improvement in hyperacusis with exposure and "positive thoughts" about sounds. I am at about 80% (100% would be no hyperacusis at all) and I am stuck there with some days being worse than the new baseline. I am contemplating trying the Clomipramine, but I am worried about side effects and perhaps negative effect on the tinnitus. All these drugs are scary like hell. In meantime, I got hearing aids and trying sorta TRT.

But some folks, e.g., @wiektor, say Clomipramine saved their life.

 

Is there anything in particular that helped you get to 80% improvement? How long did it take?

 

I think it wasn't even a week when I went from about 50-60% to 80%. Exposure and mental exercise. Like telling myself "it is only a truck (motorbike/plane/etc)". Trying to find positive associations with sounds - like sound of fish fried on a pan was unbearable to me, but then I was thinking "it is going to be a tasty meal". It sounds stupid, but this is really how it went. I posted about it here in my intro thread:

Hearing Loss and Severe Tinnitus — From Loving Life to Suicidal in 2 Months

After getting better, I am not sure I kept at it, i.e. I wasn't pushing myself further, and sort of started tolerating the unpleasant sounds with lower level of anxiety/animosity if that makes sense. I might have regressed lately, again getting angry at cars/motorbikes. I think I need to try to get back at that, except that I am dealing with a tinnitus spike now (caused by trying hearing aids), which really threw me off.

 

I got a Clomipramine prescription.

Still not entirely sure if trying Clomipramine is the right thing to do for me at the moment.

Maybe there's some substance out there that would be a better fit for me, but I don't like to potentially waste months trying stuff out that no one else with noxacusis has tried out before. At least with Clomipramine some people have reported good results with it.

Hoping the side effects will be tolerable.

 

@Morgoth51 had success with pain hyperacusis and Clomipramine.

My advice is: start really slow and only increase the dose every 5 days. This way you can keep track of the side effects.

My first 4 days on it were very weird. I felt like I had taken MDMA. Luckily the heavy side effects started to wear off with time. My tinnitus seemed louder as well but it was just anxiety. Once the pill tamed my anxiety, I was sure my tinnitus (max and minimum volume) hadn't changed.

In the German forums, people had success with doses as little as 60 mg and as high as 200 mg. For me the turning point was when I went to 100 mg, where hyperacusis was gone 85%. The other 15% were achieved with exposing the ears to sound and not wearing protection anymore.

Good luck and keep us posted!

 

Day 2 on Clomipramine 25 mg.

Tinnitus has been louder than usual these two days.

Woke up early and could not fall back asleep. Feel sickly. Dry mouth.



@Trafalgar D used Clomipramine for more than a year. I am now seriously wondering what the point of taking some antidepressant with possibly all sorts of fucked up side effects is if one is still imprisoned by reactive tinnitus after using it for so long. Especially as my tinnitus & hyperacusis situation seems so much more severe (no disrespect to @Trafalgar D intended of course).

Trying not to give up on my attempts to achieve a not totally gloomy and depressing life. But what a horrendous, nightmarish situation. God...

 

My sleep was fucked for a good three weeks with Clomipramine. But I promise once the side effects start slowly vanishing, the most invigorating feeling is when the depression starts to go away. It's a similar feeling to benzos, but much safer and intended for the long term. That's common with all antidepressants - it gets worse before it gets much, much better.

Dry mouth for me got better but it's still bothersome, yeah. With weed it's even worse, feels like you are in the desert. The excessive sweating is also super cumbersome, luckily winter came where I live and that's solved for now.

I think people risk much worse things to deal with tinnitus like benzos, antipsychotics, Ambien, etc. To me, antidepressants carry much less risk in the long term. And Clomipramine has been in the market for decades and decades...

Keep fighting is my advice!

Got my fingers crossed for you. No one deserves to suffer with tinnitus and constant anxiety/depression.

 

How are you doing a few days out from this post, @StoneInFocus?

My psych gave me a script for 25 mg and I have yet to start it. I am not expecting it to do anything good for my tinnitus or very sound sensitive reactivity component, I am just wanting to take something to help life depression and fixation on the damn condition.

 

"If" it gets better. Looks like antidepressants are only 40% to 60% effective vs. 30% for placebo. I haven't had good luck with them.

I was on a different tricyclic antidepressant (Nortriptyline) for 3 months at 50 mg daily, and the side effects, such as dry mouth, continued, and I never felt I got any relief from the anxiety or depression. No effect on sleep or tinnitus.

I finally weaned off, and everything was the same for anxiety and depression, but no side effects. Maybe I would have seen better results at 100 mg, but I couldn't handle the side effects at 75 mg, 50 mg was a bad enough.

Some people have no luck with one antidepressant and switch to another with better results though, even within the same class, but sometimes trying a different class (SSRI, SNRI, TCA, etc).

 

My quick research (aka Google) shows that the antidepressant dose for Nortriptyline is 75-100 mg, so I don't think you can really say you tried to tackle you depression with that dose.

This is my third time with an antidepressant. They worked all the time:

• 1st Fluxoetine, to treat GAD and depression. It did wonders, I went back to life after 3 months of treatment. I weaned after 1.5 years. Very little withdrawal after slow taper.
  
  
• 2nd Mirtazapine, to treat post-infectious Gastroparesis (it worked like a miracle, and you have to consider that the papers on Mirtazapine for Gastroparesis are scarce and the confidence is even lower - but it worked like magic for me!). I used it for 2 months until my stomach worked 100% again. No withdrawal effects, but I was very drowsy all the time.
  
  
• 3rd Clomipramine, to treat hyperacusis. It worked 100% for me. And the bonus was the depression disappearing

I know someone will always have a reason to be negative since tinnitus is such a complex and sad topic - but I want to bring some light to Tinnitus Talk and tell you that there's a way out. Antidepressants do work (most of the time), and you have to be 100% committed to your treatment & psychotherapy, while trusting your psychiatrist on dose and medication adjustments.

It gave me 100% of my life back, with the exception of concerts (which I rarely attended anyway at this age). I've been living an amazing, normal life for these last two months even with loud tinnitus.

 

Oh no, I certainly tried. I endured the side effects for months and tried to take 75 mg as mentioned. There was just no benefit, and I appear to not be responsive to the placebo effect.

I'm not being negative. Just giving my experience about use of another tricyclic antidepressant and sharing what I had read about a study that showed that antidepressants were not that much more effective than a placebo. But if you're among the 50% of the people that benefit, it can be worth it. The odds improve if you move to different antidepressants if the first ones don't work for you, so maybe reaching 60% to 70%.

 

I must ask, did you only have loudness hyperacusis? Or pain hyperacusis?

 

I had severe loudness hyperacusis.

 

Hey, thank you for asking.

I've quit Clomipramine since then. I was on it only a total of two days. Tinnitus was very very loud. I think it's slowly returning to baseline. I had a hyperacusis setback this weekend it but seems to be resolving.

I am using Flupirtine every day. Good stuff I think.

How are you? Started the Clomipramine yet?

I have made the resolution to increase efforts at combating the disorder. I started restudying the literature, connecting with patients, recording my thoughts and trying to get health care providers from multiple areas involved.

 

I am currently investigating the possibility of using multiple drugs to target specific proteins and receptors related to hyperacusis and using N-acetylcysteine to protect against drug-induced ototoxicity caused by oxidative stress.

Clomipramine increases neurotransmitter concentrations and acts on a bumfuck of other receptors which causes a cascade of all sorts of effects in the body and in the brain, from the micro level to the macro level, across different cells, tissues, organs and regions, that propagate themselves exponentially and in unforeseen ways. It's a pharmacological bomb which to me seems entirely unfit for such a delicate issue as tinnitus and hyperacusis where a fart or an aspirin can already cause a shitshow.

Somewhere along the cochlea/somatosensory system and the brain there is some type of dysfunction. There are multiple treatments which have helped hyperacusis and reactive tinnitus patients before, typically only partly and/or temporary. This means that these treatments acted on at least a part of the disturbed 'cochlea/somatosensory --> auditory pathway --> other parts of the brain back to the peripheral nervous system' pathway. In the case of temporary symptom relief, through some type of homeostatic mechanism, the brain-body system compensated for this drug-induced disturbance in the hyperacusis equilibrium. What we need to do is either transform the hyperacusis equilibrium to the auditory normality equilibrium (curing the disease) or prevent homeopathic mechanisms from countering the symptom-alleviating effects of drugs.

My idea is that the greater the range of positively (theoretically causing symptom reduction) manipulated biochemical phenomena (such as receptors, proteins) related to hyperacusis and tinnitus is, the greater and longer lasting the symptom-alleviating is and the greater the probability of curing the disease is IF the theoretically positive effects are not offset by some negative synergistic hyperacusis-symptom affecting effect of the summed manipulation, such as for instance a potentiation of drug-induced oxidative stress in the cochlea.

 

Heya everyone!

After 15 months on Clomipramine, I'm about to stop it. Right now, I'm on 10 mg a day (mornings only), less than the 30 mg I used to take when I started in August 2022.

My tinnitus has decreased quite a lot, which is both expected, as it was boosted by Clomipramine, like most (all) TCAs, and enjoyable, as it had been a while since I noticed a decrease.

Hyperacusis and pain have stayed the same (so, minimal).

 

Has anyone with dysacusis (distortion) tried Clomipramine? Does it have any effect?

 

I went and got myself Clomipramine to see if it'll help with the hyperacusis and reactive tinnitus, but for the first couple of days it would spike my tinnitus. Then during the 3rd day, things didn't seem to change. Then on my 4th day, my tinnitus spiked to even higher levels and it's been miserable for me. I'm deciding on stopping this drug.

Will the spike go down?

I'm contemplating on trying Mirtazapine.

 

Don't. There is no evidence Mirtazapine helps tinnitus or hyperacusis. While reports of it inducing or worsening tinnitus and hyperacusis are rare, they exist. People mostly take it to manage sleep.

Clomipramine was the only drug I seriously contemplated taking based on the reports here, but since my hyperacusis became mostly manageable, I decided to not tempt the fate.

 

I take Mirtazapine for sleep. As little as possible, and I want to get off of it. It hasn't caused any adverse effects that I know of but, as @gameover said, I don't want to tempt fate. That said, the lack of sleep was killing me and it was the option at the time. It also makes you gain weight, at least it has for me. Not a ton mind you. My advice is avoid it if you can, but consider your situation.

 

Hey there,

I'd say it depends on how intense your hyperacusis is, how much pain you're going through and how efficient Clomipramine would prove in your case; of course, that would require to take Clomipramine long enough to see if it works!

I know how it feels as I went through the same but with Laroxyl (Amitriptyline), which spiked my tinnitus to stratospheric levels.

Clomipramine definitely spiked my tinnitus but it also helped with my depression and neuropathic pain quite fast, in any case, fast enough to motivate me to continue with it.

One thing to add is that if Clomipramine was to work for you and reduced your hyperacusis, you'd likely get more easily used to your tinnitus as you'd become less prone to setbacks.

 

Ever since my Pfizer COVID-19 vaccine in February, my tinnitus, reactive tinnitus and hyperacusis have gotten progressively worse. I've developed a couple of new tones. I did get setbacks the following months, but for the past few months I've been trying my best to stay away from loud noises. My tinnitus reacts to mostly white noise, so I can no longer enjoy the sound of the shower or my room fan without it reacting. My life is miserable.

Antidepressants I took for years were Zoloft and Seroquel. I tapered off Zoloft back in June because I thought it was the reason things went bad, but it turns out that wasn't the case. I think getting off Zoloft is what worsened it further.

I've had severe tinnitus for 15 years and I was used to it thanks to sound enrichment. I was diagnosed with Sensorineural Hearing Loss back in May. I wish it would go back to the way it was.

 

Any reason you stayed on such a low dose? My understanding is that most people do not have any substantial improvement until they hit around 100 mg.

 

Actually, I started at 30 mg but gradually increased the dosage up to 150 mg. I stayed there for a few months, then started to gradually decrease the dosage.

 

When you say it helped with your neuropathic pain, does that mean your pain hyperacusis improved from taking Clomipramine?

Has there been a substantial improvement from taking Clomipramine? Or has it been minor?

 

Yes, sorry if I was unclear.

After my trauma, I did have pain hyperacusis (mostly burning sensation descending from the ear to my jaw and neck, sometimes even behind my eye, plus the usual aural fullness, nose congestion, etc.). And it started to improve once I started taking Clomipramine.

There's definitely been a substantial improvement from taking it. As I said in another post, Clomipramine somehow turned my pain hyperacusis into loudness hyperacusis, the latter being easier to get used to. These days, I'm almost pain-free and even the loudness hyperacusis is very tolerable.

 

Brilliant! Did you experience many side effects on Clomipramine?

How long did you have hyperacusis before starting Clomipramine?