Introduction and Advice

[aurelientt]

Hello everyone,

I wanted to introduce myself. I'm Brandon, 32 and currently live in Alaska. I woke up a little over a week ago with a horrendous screech in my head. What followed were days filled with panic attacks and anxiety. The veil of misery has slowly started to lift and I've been to an ENT and have already discussed and researched some potential treatments.

But, I have a concern which I wanted to see if anyone could help with. My ringing started shortly after I restarted a prescription for Lexapro (20mg). Across several boards I've read of the drug precipitating Tinnitus, so I stopped taking the Lexapro as a precaution, but I used it without worry for over 5 years before the ringing. With respect to generalized anxiety and depression, it definitely works for me. And I suspect that I am quickly habituating to the noise but am hindered and still plagued by the original anxiety and depression which was what led me to renew my prescription. I want to take the Lexapro but am worried that it will worsen the Tinnitus. It is a strange loop of fear and hesitance.

Of course, it is still extremely early but after being reviewed by the ENT and getting a hearing test which found mild hearing loss in the ringing ear I am operating under the assumption that it is probably permanent.

Thank you, and it is a pleasure to be a part of the community.
Brandon

 

[Markku]

Ah, Lexapro is escitalopram. I've taken it (the brand name Cipralex in Finland) and I didn't notice any difference in tinnitus.

http://www.ata.org/sites/ata.org/files/pdf/Oto_toxic_Drug_Packet_Oct12.pdf

According to that a minimum of 1% of patients taking Lexapro gets tinnitus, but it doesn't separate temporary and permanent, chronic tinnitus.

You do have mild hearing loss, just out of interest, do you have a previous audiogram available, i.e. do you know whether you had "perfect hearing" before noticing tinnitus? Comparing an audiogram taken pre-tinnitus and one taken after onset would give an idea whether you had the mild hearing loss before the tinnitus started, or did tinnitus just follow the hearing loss, like it often does.

Do you think the pitch of the tinnitus about matches the frequency at where your mild hearing loss is?

HBO could be something to try. There are several discussions about Hyperbaric Oxygen Therapy here. Do a search for "hyperbaric" and you'll find lots of results.

It should be started ASAP.

Some people have found benefit from prednisone, this also should be started right away. Read mine and the other posts from this thread: https://www.tinnitustalk.com/thread...seconds-when-will-the-noise-go.572/#post-3746

I don't know what to suggest about continuing Lexapro. I myself got tinnitus on very slim odds, like hitting the worst kind of jackpot. I would be hesitant on taking a drug that causes tinnitus for over 1% (even though I myself have in the past! I didn't know better, it now seems). You need to weigh the pros and cons and maybe look into other alternatives that aren't ototoxic.

The rule generally is not to mess with even only slightly ototoxic meds unless absolutely necessary and no other option is found. Better be safe than sorry.

Good luck and as always, with tinnitus as recent as this there's a good chance it will stop or get better soon. Fingers crossed and hang in there!

 

[Karen]

Hello, Brandon; welcome to Tinnitus Talk! We're glad you joined our community.

I don't have any experience with Lexapro myself, although my doctor did give me some free samples. I decided not to take them, because I was afraid of the side effects.

I do, however, have experience with taking a drug that seemed to bring on my tinnitus. I had mild tinnitus for years that didn't bother me. Then, my doctor put me on an ACE inhibitor drug for blood pressure, and within a couple of weeks, my tinnitus became very loud. It was a horrible, high-pitched ringing; and then, I suddenly found myself with pulsatile tinnitus, as well (hearing heartbeat sound in the ear). There was nothing else that could have caused my ringing and pulsating other than this drug. I got myself off all blood pressure drugs, but my tinnitus and pulsating tinnitus are still there, almost 3 years later.

Just a few minutes ago, after reading your post, I looked up Lexapro and found that it does indeed cause tinnitus for some people. On the People's Pharmacy website, several people said they ended up with tinnitus, and one person even had some hearing loss, after taking Lexapro.

Should you begin taking it again? That's a good question. Let's hear what others who have been taking Lexapro have to say about it.

Does anyone out there currently take Lexapro? Do you have any advice for Brandon?

 

[mick]

Welcome, Brandon!

I started to take Lexapro after I my tinnitus started and I have not noticed any difference. As you and Markuu indicate, it is a suspected, but probably not proven, ototoxic drug, as is just about every other SSRI. I was never one to take medications until a couple of years ago when I began having other medical problems (I would avoid even taking aspirin and acetaminophen). I have always believed that medicines are bound to cause problems over the long haul, and I suspect that is what may have been what happened to me (either that or just the stress of dealing with my medical issues - more on that later). When I looked over the medications that I have taken over the past 2 years, nearly all of them are either known ototoxins, suspected ototoxins, or there is some anecdotal evidence to make one think they might be ototoxic: aspirin, Zoloft, Xanax, Prilosec, amitriptyline, warfarin, Pradaxa, and doxycycline.

I am beginning to suspect 1 of 2 things: 1) many drugs are ototoxic but it may be a cumulative effect (maybe for you, 5 years of Lexapro was the limit), or 2) stress and anxiety is the common denominator that may cause many individuals T. People who have medical problems are under stress and experience anxiety. Personally I know of nothing that has ever been more anxiety producing for me than unresolved medical problems (and just plain dealing with doctors). People who have medical problems also frequently take medications. Maybe it is really the stress and anxiety that causes the tinnitus, but the medications get the blame.

There is evidence that stress can cause hearing loss. More than one person who has lost a spouse or experienced a sudden emotional upset has gone completely deaf. There is clearly also evidence that stress and anxiety can cause neural re-organization breaking gateways that inhibit tinnitus and establishing new neural links that may trigger auditory neurons to misfire - another possible explaination for tinnitus.

If I were you, and I felt I needed the Lexapro for my depression and anxiety, I would probably take it - serious depression and anxiety are likely to cause more harm than tinnitus (tinnitus is not fun, but it isn't lethal either). You already have tinnitus. I supect the drug won't make your T worse. That's just me though.

I'm curious if you know what frequencies your hearing loss is at. Mine is above the range normally tested in a hearing test. Those tests only go up to 8 kHz. Mine is in the range of 12.5-14 kHz making for a very high pitched squeal. I measure the pitch of my T 13.5 kHz. Most people that I have talked to who have tinnitus from noise exposure have a hearing loss below 8 kHz. Most of the people that I've talked to who have hearing loss above 8kHz acquired their tinnitus without excessive noise exposure. Though it could be that the loss actually occured some years ago but had not revealed itself (I don't think any one with high frequency loss ever notices that their hearing is not as good as it used to be), and later the T was triggered by drugs or stress.

I get a hearing test for work every year. My tests for work always showed I had near perfect hearing, and they still show that because they only test up to 8 kHz. Everytime I've had a test at work for the last several years the doctor would always comment that he/she could not believe my hearing was as good as it was for my age.

I wish I had more certain advice for you, but tinnitus is clearly a tough nut to crack.

 

[Fish]

Hello Brandon,

I am sorry to hear you have a tinnitus problem. SSRI drugs can be ototoxic and thus cause tinnitus, and as this effect accumulates, you may not have any problems until few years after starting your treatment. Have you asked your doctor if maybe a smaller dose would be safer or if there are any safer alternatives? I am not sure if it can be used long-term but many people here (myself included) have been using Xanax to reduce anxiety caused by tinnitus for example.

 

[Markku]

Yeah, we spoke a bit about stress causing tinnitus and the effects of stress on the cochlea, etc. before.

https://www.tinnitustalk.com/thread...for-those-with-cochlea-damage.1033/#post-8111

And mick is right that there are several so-so drugs on the ototoxicity lists.

The problem is that not that many drugs have been tested in random, double-blind trials with the intention of finding out if a drug is ototoxic.

Whenever a drug goes into clinical trial and people report tinnitus as a side effect, that then will be listed in the drug insert. You know, "this adverse effect appears in more than 1/10...", 1/100, etc...)

But those drug inserts don't indicate whether it's temporary or chronic tinnitus (most often it is temporary tinnitus that will go away once the drug is no longer taken), and sometimes it has nothing to do with the drug, the tinnitus just seems to have appeared during the time that the person was in the clinical trial. There doesn't need to be 100% proof that the drug caused the side effect, it will be listed nonetheless.

There are some drugs that definitely are ototoxic (like some chemotherapy drugs and some antibiotics) and which I wouldn't take unless in a very dire situation (if in need of a chemotherapy drug, then a dire situation has indeed happened, and in a situation like that I would take a maximum dosage of N-acetyl-cysteine and other protective supplements).

But yep, mick gave good advice above and I have no further.

Good night,
Markku

EDIT: Oh Fish got his reply in before mine even though I started writing earlier. Xanax is good for anxiety but it's extremely addictive. I would suggest trying Clonazepam (Klonopin, Rivatril) first. It builds tolerance too and might get you in trouble if used daily for a while, but it's usually a better starting point than Xanax. YMMV.
Fish got a good point about a maybe reduced dosage of the Lexapro or looking for alternatives.

And yep, while Xanax is very addictive, it is successfully used, the famous "Jack Vernon protocol": http://faculty.ksu.edu.sa/drhagr/Research/BPPV and Anxity/Xanax For Tinnitus.pdf

Ask your doctor for the best approach. Consult maybe - if possible - different doctors and try to find one that is interested in treating tinnitus.

And I wholeheartedly suggest reading previous discussions here on Tinnitus Talk, you will find lots of helpful insight!

 

[aurelientt]

Thanks to you all for the wonderful advice as it is also a source of comfort. I looked into HBO as a potentially useful therapy for recent cases of Tinnitus. We have two practitioners, one in Anchorage and another in Wasilla (which is about 45 minutes away). Concerning the Lexapro, I will probably just take the minimum dosage it for a couple of days and see what effect is produced on the ringing.

 

[Emma]

Hi, I am sorry to hear about your tinnitus. May I suggest, I have found exercise to be the best remedy for anxiety and depression. And it has no hearing -related side effects as long as it is not done somewhere with loud music. I know you might be limited on time, but an hour of exercise a day can do wonders for your mood. It also has the added benefit of controlling your blood pressure and blood sugar over time. Exercise is a pharmaceutical-free solution if you are wary of the Lexapro. It also reduces stress and you will sleep better at night. Do you have a regular exericse routine? I am glad you are looking into HBO and also vitamin b12 deficiency can cause ringing, so b12 injections from a doctor can help. I have heard that taking too much vitamin e can cause ringing- do you think either of these apply to you?

 

[calin]

aurelientt, Hi and welcome!

Nice picture... oh, and you are a handsome one too!

Anxiety and depression... and then with panic attacks! I can relate! So sorry.

Have you tried natural supplements for the conditions?

http://www.rxlist.com/lexapro-side-effects-drug-center.htm Side effects of lexapro

You don't know me as you are new, but I used to have the title here of Afficianado of Alternate Therapies I am a big proponent of natural ways to fix ourselves. With every new illness or condition afflicting my 60+ body, I am off to find alternative ways of dealing with the issues. Of course, just ask me anything and I am off googling again. haha

Sooooo... I will offer a new technique that may serve your needs.... Just give it a try. Maybe a few days or so. Or, you can ignore it.... just offering.

When you get in a down mood or have anxiety pop up, ask "Who does this belong to?"
If you feel lighter when you think "not me", then mentally send the emotion or feeling back to the originator. If it belongs to you or you are picking up something from the earth or the people on it, then say, "I destroy and uncreate it all."

Next thing is to say... "How does it get any better than this (or that)?" Say this for anything good or bad. When I say that phrase concerning my business, I actually get more business!!

You don't have to get into the whole Access Consciousness program, just try the tools I suggested. It can't hurt! Oh, and do it constantly for about a week. A shift will come... watch and wait for it!! :

Here is a vid on it.....

 

[hps]

Hi Markku and Mick
How long you took lexapro ? are you still taking? I am planing to start but very afraid ,it may not increase my T as few reported cases on differant forums where T remained persistantly high even after stopping Lexapro .I am very depressed of late[ after 8 months of T].I tried mirtazipine but could not bear sedation.Is lexapro ototoxic? I donot think it should be ,it may cause tinnitus due to neurotransmitter changes rather than by ototoxicity.Please advice.

 

[hps]

Hi Markku and Mick
waiting for your reply

 

[Markku]

Hi Markku and Mick
How long you took lexapro ?

I took it for about half a year I think, a little less.

 

[hps]

Hi Markku
Did lexapro helped you to come out of crisis of anxiety etc? why did you stop it?I am in deep crisis presently

 

[Markku]

Hi Markku
Did lexapro helped you to come out of crisis of anxiety etc? why did you stop it?I am in deep crisis presently

It maybe improved my general mood a bit. In retrospect, I wouldn't start on them again. My anxiety and low mood wasn't that bad to begin with. Doctors in Finland just prescribe SSRIs without giving it a second thought... they're like aspirin nowadays.

I stopped because I decided I don't like to be on ADs unless absolutely necessary. I'd rather not have drugs tinkering with my neurotransmitter levels. I'm not against ADs per se, they can be a necessity for some people in some situations, and depression is a real and difficult problem.

I'm not a good role model for you in this case though, because you are in a deep crisis.

What I would do in your situation is consult a therapist (usually therapy + ADs give a better response than ADs alone) and figure out how to proceed.

I would probably start on ADs if I were in the same kind of crisis as you, but I can't directly advise you to do that because I wouldn't want to be held liable if your tinnitus did get worse due to them.

It's up to your doctor, and in the end, yourself, what to do.

You are in my thoughts, I hope you'll start to feel better,

Markku

 

[hps]

thanks

 

[mick]

Hi Markku and Mick
waiting for your reply

Hi hps,

I'm still taking Lexapro. It's been about 7 months. It most certainly helped control anxiety and depression early on for me. My anxiety and depression is not entirely due to T, however. I have other medical problems that cause me more trouble in that department than tinnitus.

I will reverse something I said in an earlier post in this forum. That is, I do now think that escitalopram effects my tinnitus a little in a negative way, but I don't think it has harmed me in a permenant way. I stopped taking the drug for a few weeks, and during that time my ringing seemed to be less shrill and I had fewer occurrences of transient lower pitched ringing sounds on top of my steady high pitched ringing. It was not a tremoundous difference. My T volume varies so much from day to day though that it is hard to tell what causes what.

I agree with Markku's advice - if you are in a crisis and feeling like anxiety or depression are getting out of control, then I think it is a good idea to see someone qualified to address such issues for advice. If you talk to someone about SSRIs you might want to do some homework ahead of time. My experience is that few doctors pay attention to the side effects listed, so you might want investigate for yourself which SSRIs list tinnitus as a side effect and which do not, and bring documentation with you.

Take care, and I sincerely hope you feel better soon. Being sick is bad enough, but it is especially worse when others don't understand what you are going through, and that is something many of us can empathize with.

mick

 

[oldnwizr1]

I developed tinnitus around age of 50 in both ears and like everyone else went to ENT doctors. Two ENT docs and 4 hearing test later I was referred to a neurologist who after several blood tests said I had an autoimmune disease which was destroying my hearing. He put me on large dosages of steroids and Zanax. later dropped Zanax and continued the steroids for over 2 years. Hearing tests remained the same. So I sought a second opinion and saw a second neurologist. San Diego has some good doctors. She said she had never heard of the previous guys diagnosis and wrote a script for Lexapro which she said would reduce the ringing and left. She had numerous certificates and accolades on her wall so I said on will try it. I don't know if it was psyosymatic or what but the ringing decreased. But now had a bad addiction to steroids and had to have another doctor wean me off. I had no depression but took the Lexapro for 5-10 years. Do not run out! Cold turkey off Lexapro causes severe panic attacks. Well, a month ago I began to wonder why I was really taking it and weaned myself off over a three week period. I feel physically better, ears still ring, maybe a bit higher. So I googled Lexapro to see how it decreased the noise and the internet is full of people complaining Lexapro caused their ringing in the ears! I just thought putting a different perspective on the drug might help, as I had tinnitus before taking the Lexapro.
As we all know it is caused by the brain substituting white noise for the frequencies it can't hear. But now I have prostate cancer and leukemia and a little ringing is only a minor worry. The steroids are dangerous, I
had bad cataracts in both eyes and had to have surgery. Be careful of them.
James. San Diego, Ca

 

[BobDigi]

Thanks to you all for the wonderful advice as it is also a source of comfort. I looked into HBO as a potentially useful therapy for recent cases of Tinnitus. We have two practitioners, one in Anchorage and another in Wasilla (which is about 45 minutes away). Concerning the Lexapro, I will probably just take the minimum dosage it for a couple of days and see what effect is produced on the ringing.

I too suffer with anxiety issues. I also have OCD. Both of which, at the age of 36, am currently in a cognitive behaviour therapy programme. Have you thought about trying something like this? Perhaps it could help to the degree you don't need any drugs?