My Tinnitus Started After Taking Ritalin for ADHD for Two Weeks

Knight

Member
Author
Mar 24, 2022
13
Tinnitus Since
2022
Cause of Tinnitus
Ritalin
Hi all,

I am middle aged, recently diagnosed with ADHD. I never had tinnitus before. After I had taken Ritalin for two weeks, I started to get tinnitus and finally I could not take it anymore and stopped taking Ritalin yesterday.

I do not smoke, drink or even have caffeine. As I type this, the ringing in my ears is driving me nuts.

Have you guys come across this, is it temporary? I don't seem to find anything online that is conclusive.

My blood pressure did go up. Max was 140/93 with pulse of 95. But mainly I was hovering around 130/85 and pulse of 78.
 
Hi all,

I am middle aged, recently diagnosed with ADHD. I never had tinnitus before. After I had taken Ritalin for two weeks, I started to get tinnitus and finally I could not take it anymore and stopped taking Ritalin yesterday.

I do not smoke, drink or even have caffeine. As I type this, the ringing in my ears is driving me nuts.

Have you guys come across this, is it temporary? I don't seem to find anything online that is conclusive.

My blood pressure did go up. Max was 140/93 with pulse of 95. But mainly I was hovering around 130/85 and pulse of 78.
Tinnitus and hearing loss are part of the '< 10%' symptoms list of Methylphenidate.

I do not know the specifics of the drug, I do know the basic idea behind the workings but nothing technical or scientific. I'm sure detailed information is available online.

The tinnitus will most likely lessen or even dissipate, as Methylphenidate is a nervous system stimulant and probably takes longer than two days to leave your body.

I know people who have been taking Ritalin and Concerta (slow-release Methylphenidate pill) for almost their entire lives. None of them had related tinnitus or hearing loss.

I have taken this drug long ago and had to stop due to intense derealization and a decrease in mental clarity. I did not have tinnitus or anything hearing-related as a symptom.

Give it a week. If it persists, talk to your GP about tinnitus and other side effects. If the Ritalin was prescribed by a psychologist, make sure to notify them as well about quitting the drug and specifically why you quit. It helps them guide new patients by having a broader picture of the symptoms.

In my opinion, Methylphenidate is not well documented and patients are not made aware enough of the red flags this drug can give before having a major impact in the psychological profile of an individual.

In the meantime, take care of your ears. No headphones, try to keep stress to a low level, sleep enough (8 hours is ideal, even if it is a struggle to fall asleep, sleep is very important to keep your perception of tinnitus down).

Purchase some quality earplugs and carry them with you (the higher the dB number, the better. Substract 5 from the dB protection number to have a realistic reading on how well they protect. Always read the paper as some earplugs do not protect well against high or low frequency sounds, and follow insertions instructions. A video can help with the latter).

Do not overprotect, as this can have negative effects on your hearing, but if confronted with a sound that noticeably discomforts you, plug your ears and create distance between yourself and the source of the sound.

I hope you improve quickly!

Take care and keep us posted.
 
An update from me.

I spoke to my doctor yesterday, he told me that, if I do not notice improvements by Thursday, to contact my GP. He did say that it's a very rare side effect of Ritalin. What he did say is that, if the tinnitus goes away, to restart Ritalin but on super low dose (2 x 5mg) for two weeks, then up it by 5 mg on a weekly basis thereafter. But still, let's see if it goes away. I will report back by Friday.
 
It's blood pressure that's the main culprit? I've been on Ritalin and it sent my heart pounding.
My blood pressure was still not super high. Max was 140/93 with pulse of 95. Mainly I was hovering around 130/85.

Are you still on Ritalin? My doctor said that we can re-introduce it very very very slowly once we get to the bottom of the tinnitus. This is low for me as I am 95 kg, but will start possibly in May depending what the audiologist says or look at alternative ADHD med.

5 mg and 5 mg for two weeks
10 mg and 5 mg for 1 week
10 mg and 10 mg for 2 weeks
15 mg and 10 mg for 1 week

I am seeing an audiologist on Wednesday. Still have tinnitus. It has been over 2 weeks since I stopped Ritalin. My blood pressure is back to normal 120/80.
 
Update: Just saw the audiologist. Hearing is perfect, no underlying issues so most likely it's the Ritalin. Will speak to my doctor regarding ADHD meds. I will ask for Dextroamphetamine first to see if that works, if not then titrate Ritalin back very very slowly.

Tinnitus is still there, I've maybe had 10 to 20 percent improvement or it's just me getting used to it.
 
Posting update here in case someone else comes across the same issue. It's been a month and I still have tinnitus. What is odd, is that up to a few days ago, I almost completely ignored it and felt that it's not there. However, this weekend it feels that it's more promenent.

I spoke to my doctor yesterday and he asked me if I ever had tinnitus, I had to think really hard about it and I think about 3 years ago when I went to bed and it was super quiet I did notice ringing in my ears. So the question is, was the tinnitus always there and I was just ignoring it? Did Ritalin just make me more aware of it?

Anyway, the doctor said that if indeed it was from Ritalin, then it may be a very very very very rare side effect. Other possibilities are either it was always there but I was ignoring it or that maybe it was the blood pressure increse but I did not go over 140/90, maybe because I naturally have low blood pressure and my body was not used to the spike in blood pressure?

Anyway, plan is to reinterduce Ritalin very very slowly (will start today), if that does not work, he will put me on non stimulating Strattera/Atomoxetine.

Week 1:
5 mg morning
Week 2:
5 mg morning
5 mg lunch time

Week 3:
10 mg morning
5 mg lunch time

Week 4:
10 mg morning
10 mg lunch time
 
I still have tinnitus. I can't have anything with caffeine... I was put on Atomoxetine, although it helps with a lot of other ADHD issues, it is useless for me when it comes to motivation, procrastination and task management.

My doctor now put me back on low-dose Elvanse for a couple of days and my tinnitus is so loud as a result.

I am wondering, if I go back on Ritalin, would my tinnitus just keep on getting worse, or is there a limit to how bad it can get?
 
My doctor now put me back on low-dose Elvanse for a couple of days and my tinnitus is so loud as a result.
I'm in a similar situation to you but my tinnitus is from Elvanse 30 mg.

I hope yours goes as it's horrible.

Do your ears also hurt from the ringing? Mine do, they feel almost full but I've had all the checks and everything's fine, including my hearing.

I'll try Concerta next but I'm not overly hopeful - good luck and please let us know if you find any solutions.
 
or is there a limit to how bad it can get?
Hi @Knight -- No, unfortunately there really is no limit. Have you ever considered visiting a Naturopathic Physician? They sometimes can help you pinpoint what's causing your ADHD, and prescribe a variety of non-drug therapies.

Best...
 
I haven't been diagnosed with ADHD but think I probably do have it. I've been using some supplements to help it recently.

I've been using Noopept, 4'-DMA-7,8-DHF and Polygala recently and I'm extremely focused and motivated every day. The difference is insane. No bad side effects for me either and they don't affect my tinnitus. They probably help me forget about my tinnitus by helping me stay focused on other things.

Also, racetams are another great alternative to the pharma ADHD meds.

None of what I mentioned is as strong as the pharma grade meds but they work for lots of people with ADHD.
 
I'm in a similar situation to you but my tinnitus is from Elvanse 30 mg.

I hope yours goes as it's horrible.

Do your ears also hurt from the ringing? Mine do, they feel almost full but I've had all the checks and everything's fine, including my hearing.

I'll try Concerta next but I'm not overly hopeful - good luck and please let us know if you find any solutions.
My ears do not hurt at all, just an eeeeeeee sound.

Elvanse amplified my tinnitus, so I stopped after 2 days.

How are you getting on? What did your doctor recommend?
 
Hello,

My tinnitus is gone for a few minutes when I listen to 4000 Hz on the AudioNotch website. I am not talking about the paid thing. I'm talking about the frequency player that just plays that eeee sounds.

I feel like if I have it at 3900 Hz and let it automatically go up to 4,500 Hz, my tinnitus stop stops for a few minutes.

It's not complete silence. I feel like there is something there but it's not my tinnitus as I know it and it's not as loud.
 
My tinnitus is gone for a few minutes when I listen to 4000 Hz on the AudioNotch website. I am not talking about the paid thing. I'm talking about the frequency player that just plays that eeee sounds.
That's fairly normal. It's called residual inhibition and many experience it. Doesn't mean you can cure your tinnitus unfortunately.
 
Last year I developed tinnitus after taking Methylphenidate (Ritalin) for two weeks. I met with Prof. Dr. Dirk De Ridder last month, I told him I am on Concerta 18 mg and my tinnitus is 6 to 7 out of 10. I have been on 1 mg Intuniv (Guanfacine) for a week. I still can not see any benefits but it may be because it's a low dose.

Dr. Dirk De Ridder's hypothesis: change in sensory gain via NET on Alpha2 receptors in Auditory Cortex and/or change in focus via Dopamine D1 receptors.

This is what he suggested:
  • Trial with Alpha2 modulators (Guanfacine and Clonidine)
  • Trial with D1 blocker (Deanxit or Flupentixol combined with Clonazepam to prevent tardive dyskinesias)
  • If no benefit, sLORETA EEG to see whether tDCS or tRNS is beneficial
I live in the UK and due to the waiting lists I had to go private. I am not sure my doctor in the UK will let me be on any of the other medications. My GP simply said to live with it and to stop ADHD meds (he does not believe adults have ADHD).
 
Last year I developed tinnitus after taking Methylphenidate (Ritalin) for two weeks. I met with Prof. Dr. Dirk De Ridder last month, I told him I am on Concerta 18 mg and my tinnitus is 6 to 7 out of 10. I have been on 1 mg Intuniv (Guanfacine) for a week. I still can not see any benefits but it may be because it's a low dose.

Dr. Dirk De Ridder's hypothesis: change in sensory gain via NET on Alpha2 receptors in Auditory Cortex and/or change in focus via Dopamine D1 receptors.

This is what he suggested:
  • Trial with Alpha2 modulators (Guanfacine and Clonidine)
  • Trial with D1 blocker (Deanxit or Flupentixol combined with Clonazepam to prevent tardive dyskinesias)
  • If no benefit, sLORETA EEG to see whether tDCS or tRNS is beneficial
I live in the UK and due to the waiting lists I had to go private. I am not sure my doctor in the UK will let me be on any of the other medications. My GP simply said to live with it and to stop ADHD meds (he does not believe adults have ADHD).
I don't know what much of that means but I wish you the best! Hang in there!
 
Last year I developed tinnitus after taking Methylphenidate (Ritalin) for two weeks. I met with Prof. Dr. Dirk De Ridder last month, I told him I am on Concerta 18 mg and my tinnitus is 6 to 7 out of 10. I have been on 1 mg Intuniv (Guanfacine) for a week. I still can not see any benefits but it may be because it's a low dose.

Dr. Dirk De Ridder's hypothesis: change in sensory gain via NET on Alpha2 receptors in Auditory Cortex and/or change in focus via Dopamine D1 receptors.

This is what he suggested:
  • Trial with Alpha2 modulators (Guanfacine and Clonidine)
  • Trial with D1 blocker (Deanxit or Flupentixol combined with Clonazepam to prevent tardive dyskinesias)
  • If no benefit, sLORETA EEG to see whether tDCS or tRNS is beneficial
I live in the UK and due to the waiting lists I had to go private. I am not sure my doctor in the UK will let me be on any of the other medications. My GP simply said to live with it and to stop ADHD meds (he does not believe adults have ADHD).
I also had a meeting with Dr. De Ridder. He suggested the same cocktail to me + Aripiprazole 2 mg. He says to do this for 2-3 months, then take as needed. I introduced Latuda as a possible alternative to Aripiprazole and he said in theory it's a good choice. He recommended adding Cyclobenzaprine for somatic tinnitus.

So my GP in the UK looked confused and refused the prescription. I have obtained a 10 day supply from a friend in Belgium to trial though.

I would be very interested in your meeting with a doctor and what they said when you presented the prescription.
 
Last year I developed tinnitus after taking Methylphenidate (Ritalin) for two weeks. I met with Prof. Dr. Dirk De Ridder last month, I told him I am on Concerta 18 mg and my tinnitus is 6 to 7 out of 10. I have been on 1 mg Intuniv (Guanfacine) for a week. I still can not see any benefits but it may be because it's a low dose.

Dr. Dirk De Ridder's hypothesis: change in sensory gain via NET on Alpha2 receptors in Auditory Cortex and/or change in focus via Dopamine D1 receptors.

This is what he suggested:
  • Trial with Alpha2 modulators (Guanfacine and Clonidine)
  • Trial with D1 blocker (Deanxit or Flupentixol combined with Clonazepam to prevent tardive dyskinesias)
  • If no benefit, sLORETA EEG to see whether tDCS or tRNS is beneficial
I live in the UK and due to the waiting lists I had to go private. I am not sure my doctor in the UK will let me be on any of the other medications. My GP simply said to live with it and to stop ADHD meds (he does not believe adults have ADHD).
Has the Guanfacine affected your tinnitus at all so far? I'm thinking about trying it myself.
 
I live in the UK and due to the waiting lists I had to go private. I am not sure my doctor in the UK will let me be on any of the other medications. My GP simply said to live with it and to stop ADHD meds (he does not believe adults have ADHD).
Did you get any progress with the medication?
 
Hello,

Update: I have tried everything and I am not sure if there has been any improvements or any worsening. My tinnitus would range between 5 to 7.5 out of 10.

This all started when I started taking my ADHD medication, methylphenidate, also known as Ritalin. Over the past six months, I have slowly started taking a long release version form of methylphenidate, which is smoother and with my doctor we have titrated very slowly all the way up to a high dose, which I find somewhat effective. Every time I increase the dose, I feel like the tinnitus would increase to a maximum of 7.5 out of 10 but maybe that was just in my head. Sometimes I have noticed the tinnitus comes in phases, so for a few days I have it, and for a few days I don't. I stopped taking multivitamins and fish oil for the past two months. I am only taking my ADHD medication. I also make sure I get enough sleep and I am well hydrated.

For me the "cure" came from the paragraph below from a doctor who has a video about tinnitus on YouTube. This was via discussion over email. I do not panic about my tinnitus anymore and usually unless I look for it, I do not find it.

"We have a sense that tinnitus is often there for a long time before it is ever perceived, kind of being just below the radar, so your brain never picks up on it or treats it as an actual sound. Often, once it is perceived as a sound due to particular factors that take it above the radar, it continues to be heard even if you undo those factors. The brain is very good at recognising sensations once they are familiar, and tinnitus becomes familiar in that sense very quickly."

Note: The above is in regards to my experience with methylphenidate (brands like Ritalin, Concerta). I understand that other ADHD stimulants such as Elvanse/Vyvanse, dexamphetamine and Adderall have an extra feature, which is to push out more dopamine. Both stop re-uptake, my experience is only in regards to methylphenidate.
 
Hello,

Update: I have tried everything and I am not sure if there has been any improvements or any worsening. My tinnitus would range between 5 to 7.5 out of 10.

This all started when I started taking my ADHD medication, methylphenidate, also known as Ritalin. Over the past six months, I have slowly started taking a long release version form of methylphenidate, which is smoother and with my doctor we have titrated very slowly all the way up to a high dose, which I find somewhat effective. Every time I increase the dose, I feel like the tinnitus would increase to a maximum of 7.5 out of 10 but maybe that was just in my head. Sometimes I have noticed the tinnitus comes in phases, so for a few days I have it, and for a few days I don't. I stopped taking multivitamins and fish oil for the past two months. I am only taking my ADHD medication. I also make sure I get enough sleep and I am well hydrated.

For me the "cure" came from the paragraph below from a doctor who has a video about tinnitus on YouTube. This was via discussion over email. I do not panic about my tinnitus anymore and usually unless I look for it, I do not find it.

"We have a sense that tinnitus is often there for a long time before it is ever perceived, kind of being just below the radar, so your brain never picks up on it or treats it as an actual sound. Often, once it is perceived as a sound due to particular factors that take it above the radar, it continues to be heard even if you undo those factors. The brain is very good at recognising sensations once they are familiar, and tinnitus becomes familiar in that sense very quickly."

Note: The above is in regards to my experience with methylphenidate (brands like Ritalin, Concerta). I understand that other ADHD stimulants such as Elvanse/Vyvanse, dexamphetamine and Adderall have an extra feature, which is to push out more dopamine. Both stop re-uptake, my experience is only in regards to methylphenidate.
Makes perfect sense! The ADHD meds made it possible for you to pay attention to tinnitus!

I am kidding, sorry.

I am curious. You have it some days, but not others? On the quiet days can you hear it if you look for it, or is it actually gone or "below the radar"?

I am glad that you are doing better, so few people on these forums seem to improve. May all you nights be silent!
 
Hey @Knight, I'm sorry to hear you're dealing with this.

I'm in a similar situation. I developed tinnitus after taking what I believe was too high a dose of Ritalin. Early in my treatment, I took 20 mg in the morning and another 20 mg in the afternoon, when it should have been a 10 mg top-up. That afternoon, I experienced a headache, neck muscle tension, and began to hear the tinnitus starting. It's been with me ever since, usually at a 3/10 intensity, though I often don't notice it anymore.

I'm now on 36 mg of Concerta, and while the tinnitus hasn't worsened, it occasionally becomes more noticeable, especially if I wake up during the night or right after getting up in the morning. Since Ritalin raises blood pressure, my tinnitus might have been caused by hypertensive encephalopathy, but thankfully it didn't lead to anything more serious.
 

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