Oral Gabapentin and Intradermal Injection of Lidocaine: A Role for the Treatment of Tinnitus?

[Nick47]

I have some Gabapentin lying around, shall I try them?

This research is about the combination of Lidocaine and Gabapentin.

 

[slc]

I have some Gabapentin lying around, shall I try them?

If you look back in this thread, you will find the study that included three groups.

During the 6 weeks, subjects groups I and II received gradually titrated dosage of gabapentin (first day 300 mg 3 times per day; second day 600 mg 3 times per day, from third day to the 6th week, 900 mg 3 times per day). Placebo tablets were administered in group III 3 times per day for 6 weeks. Group II underwent local injection, with lidocaine 40 mg in 1 mL of saline, in the external auditory canal, administered at four locations: superior, posterior, inferior and anterior. Injection of saline solution or lidocaine was conducted at 1st, 7th, 21th and 35th days.

The group that showed the greatest benefit 6 months following treatment had both Gabapentin and Lidocaine. There was also improvement for the Gabapentin only group. However, that's a pretty large dose of Gabapentin.

1. 2700 mg of oral Gabapentin
2. 2700 mg of oral Gabapentin plus Lidocaine
3. Placebo group

You should probably meet with a neurologist, ENT, or GP to evaluate this and any other research on Gabapentin alone.

I believe there are also studies of Gabapentin and Klonopin taken together.

 

[elino]

For the Gabapentin & Lidocaine study, I wonder why they didn't include a group that would receive only Lidocaine.

@annV, can you maybe once again come to the rescue and give us the paper for
Lidocaine injections to the otic ganglion for the treatment of tinnitus—A pilot study?

 

[annV]

@annV, can you maybe once again come to the rescue and give us the paper for
Lidocaine injections to the otic ganglion for the treatment of tinnitus—A pilot study?

Here you go.

 

[Pharz]

2700 mg of oral Gabapentin

The pills that I have are left over from my mom's arthritis medicine. The dosage is just 100 mg. And 2700 mg is a lot! I don't think I will try this.

 

[Muggumbo]

Wow, I just read over this thread. Seems too good to be true, but would be amazing if somebody was able to confirm it.

 

[InNeedOfHelp]

There has to be something wrong with the study?

@InNeedOfHelp, what do you make of this now that you can see the full paper?

The results are promising but as with 99% of all research, it will likely not be followed up. I don't see why it would bring lasting effects for that long, looking at the half life of these drugs. I don't see anything on inducing neuroplasticity in the article. I'm personally very hesitant with any form of injection around the ear. Intraoral injections are interesting. Many people claim to get relief after getting numbed at the dentist. My bet it is a subgroup of tinnitus patients which have symptoms more related to the ear compared to the brain.

 

[ErikaS]

Just wanted to give an update!

I spoke with my ENT this evening and he asked me to send over all the links to the studies. He himself has not heard of these studies nor has he used any of the interventions in practice, but he said that does not mean he would not be open to trying. He was very interested in the intradermal in the auditory canal (with the Gabapentin) and said "I would have to read how they did it but I am pretty sure I would feel confident in doing that", which is actually the approach I would want to try first. He said he will read over and give me a call to further discuss. I will let the thread know!

 

[Joeseph Stope]

Here I am on somewhat shaky territory.

No wish to distract from the main discussion but below is the thread of the poor young chap who went to a Korean clinic which were very optimistic on their therapy consisting of similar injections to the outer ear with the drugs Lidocaine -- which by the way has been shown to give temporary tinnitus relief to some -- and Clonazepam (I've no background in pharmacology). Anyway, nuff said.

Here's the link (his username is @Chinmoku):

https://www.tinnitustalk.com/posts/654531/

I hope this gives some perspective.

 

[Nick47]

which is actually the approach I would want to try first. He said he will read over and give me a call to further discuss. I will let the thread know!

It's the approach I certainly would try first. The intratympanic injection is the only one that concerns me.

 

[Muggumbo]

Just wanted to give an update!

I spoke with my ENT this evening and he asked me to send over all the links to the studies. He himself has not heard of these studies nor has he used any of the interventions in practice, but he said that does not mean he would not be open to trying. He was very interested in the intradermal in the auditory canal (with the Gabapentin) and said "I would have to read how they did it but I am pretty sure I would feel confident in doing that", which is actually the approach I would want to try first. He said he will read over and give me a call to further discuss. I will let the thread know!

Just be careful and do as much research as you can before going through with anything. If you do try it, I hope it turns out good for you.

 

[F-u-T]

It's the approach I certainly would try first. The intratympanic injection is the only one that concerns me.

I had 10 intratympanic injections of Dexamethasome in my left ear over the last year, for sudden hearing loss due to Meniere's.

Each time they also gave me a couple shots of Lidocaine inside the ear canal about halfway in to numb it before the intratympanic injection. Sometimes they would give one Lidocaine shot right behind the ear lobe in the soft spot to numb instead of in the ear canal.

It seems like it would calm my tinnitus some for the rest of the day but not sure if that was also the Dexamethasone.

 

[Nick47]

It seems like it would calm my tinnitus some for the rest of the day but not sure if that was also the Dexamethasone.

It was more likely the Lidocaine. The only thing I would have liked to have seen in this study was a group that got Lidocaine alone. Then we could see if the combination of Gabapentin and Lidocaine is key.

 

[DimLeb]

I had 10 intratympanic injections of Dexamethasome in my left ear over the last year, for sudden hearing loss due to Meniere's.

Each time they also gave me a couple shots of Lidocaine inside the ear canal about halfway in to numb it before the intratympanic injection. Sometimes they would give one Lidocaine shot right behind the ear lobe in the soft spot to numb instead of in the ear canal.

It seems like it would calm my tinnitus some for the rest of the day but not sure if that was also the Dexamethasone.

Did any of those injections have any lasting effects? Did they improve the hearing loss or tinnitus?

 

[Nick47]

Did any of those injections have any lasting effects? Did they improve the hearing loss or tinnitus?

Yes, 3 months after.

 

[F-u-T]

Did any of those injections have any lasting effects? Did they improve the hearing loss or tinnitus?

My tinnitus spiked with each episode of sudden hearing loss in the left ear. The hearing loss recovered and tinnitus calmed back down each time. It happened 3 times in the last year and I got 3 injections 1 week apart each time. I was also put on high dose Prednisone each time. I think the key to effectiveness was starting treatment immediately within 1-2 days of each episode. My ENT would schedule me in on an emergency basis.

 

[Kleiner]

I had 10 intratympanic injections of Dexamethasome in my left ear over the last year, for sudden hearing loss due to Meniere's.

Each time they also gave me a couple shots of Lidocaine inside the ear canal about halfway in to numb it before the intratympanic injection. Sometimes they would give one Lidocaine shot right behind the ear lobe in the soft spot to numb instead of in the ear canal.

It seems like it would calm my tinnitus some for the rest of the day but not sure if that was also the Dexamethasone.

So I imagine you were receiving a shallow injection into the skin of the ear canal? Do you remember how long your ear was anesthetized after the injection?

 

[F-u-T]

So I imagine you were receiving a shallow injection into the skin of the ear canal? Do you remember how long your ear was anesthetized after the injection?

Correct. Maybe a couple of hours. I didn't really pay much attention to when the Lidocaine wore off at the time.

 

[Nick47]

I'm attempting to get in touch with a vaccine injured member on X. She will remain anonymous, however she has said:

I have constant tinnitus in both ears.

Had a battery of tests done with GP and specialists. Full bloodwork panels on two occasions, ECG, chest X-rays. Hearing specialist has injected me with lidocaine around the ears for temporary relief.

None will accept I am vaccine injured.

I'm asking her more about the procedure as it seems it could be what's used in this study.

 

[ErikaS]

My ENT responded last night that he just started looking into the articles I sent him. He's been quite busy. I will update when I hear from him.

 

[ErikaS]

Okay, I talked with my ENT today! We are going to try the ear canal 4-point shots of Lidocaine to each ear. He asked if I wanted to start Gabapentin to follow the study, however I am hesitant on this because not too long ago I was up to 300 mg of Gabapentin a day and it seemed to start to exacerbate my tinnitus and reactivity. So I honestly may just go with Lidocaine only.

Furthermore, he read up on IV Lidocaine. He said he would have his RN call some injection clinics in the area to see if they provide IV Lidocaine, and if so, he would be willing to write me a script for it to kind of double up on Lidocaine in the system. I need to research this more myself as I believe it can have some adverse side effects, but I would possibly do this a week after the injections or something like that.

I will call tomorrow to schedule the ear canal shots.

I have been very fortunate to find this ENT. He said as long as something is very low risk and he feels confident in doing it, he will try anything with me.

 

[Muggumbo]

Okay, I talked with my ENT today! We are going to try the ear canal 4-point shots of Lidocaine to each ear. He asked if I wanted to start Gabapentin to follow the study, however I am hesitant on this because not too long ago I was up to 300 mg of Gabapentin a day and it seemed to start to exacerbate my tinnitus and reactivity. So I honestly may just go with Lidocaine only.

Furthermore, he read up on IV Lidocaine. He said he would have his RN call some injection clinics in the area to see if they provide IV Lidocaine, and if so, he would be willing to write me a script for it to kind of double up on Lidocaine in the system. I need to research this more myself as I believe it can have some adverse side effects, but I would possibly do this a week after the injections or something like that.

I will call tomorrow to schedule the ear canal shots.

I have been very fortunate to find this ENT. He said as long as something is very low risk and he feels confident in doing it, he will try anything with me.

Good luck! I hope all goes well.

 

[grate_biff]

He said he would have his RN call some injection clinics in the area to see if they provide IV Lidocaine

Bring a bottle of water IV Lidocaine gave me cotton mouth!

 

[Jonno02]

Okay, I talked with my ENT today! We are going to try the ear canal 4-point shots of Lidocaine to each ear. He asked if I wanted to start Gabapentin to follow the study, however I am hesitant on this because not too long ago I was up to 300 mg of Gabapentin a day and it seemed to start to exacerbate my tinnitus and reactivity. So I honestly may just go with Lidocaine only.

Furthermore, he read up on IV Lidocaine. He said he would have his RN call some injection clinics in the area to see if they provide IV Lidocaine, and if so, he would be willing to write me a script for it to kind of double up on Lidocaine in the system. I need to research this more myself as I believe it can have some adverse side effects, but I would possibly do this a week after the injections or something like that.

I will call tomorrow to schedule the ear canal shots.

I have been very fortunate to find this ENT. He said as long as something is very low risk and he feels confident in doing it, he will try anything with me.

Good luck!

I'm sure I've seen before that Lidocaine reduces tinnitus momentarily by itself, but I think this study is presenting the combination as producing a longer lasting effect?

 

[Nick47]

Okay, I talked with my ENT today! We are going to try the ear canal 4-point shots of Lidocaine to each ear. He asked if I wanted to start Gabapentin to follow the study, however I am hesitant on this because not too long ago I was up to 300 mg of Gabapentin a day and it seemed to start to exacerbate my tinnitus and reactivity. So I honestly may just go with Lidocaine only.

Furthermore, he read up on IV Lidocaine. He said he would have his RN call some injection clinics in the area to see if they provide IV Lidocaine, and if so, he would be willing to write me a script for it to kind of double up on Lidocaine in the system. I need to research this more myself as I believe it can have some adverse side effects, but I would possibly do this a week after the injections or something like that.

I will call tomorrow to schedule the ear canal shots.

I have been very fortunate to find this ENT. He said as long as something is very low risk and he feels confident in doing it, he will try anything with me.

You are fortunate to have such an ENT. Personally I would use the Gabapentin to replicate the study, but ultimately it's your choice.

Lidocaine has been studied extensively. It may cause temporary nausea.

 

[Kleiner]

Okay, I talked with my ENT today! We are going to try the ear canal 4-point shots of Lidocaine to each ear. He asked if I wanted to start Gabapentin to follow the study, however I am hesitant on this because not too long ago I was up to 300 mg of Gabapentin a day and it seemed to start to exacerbate my tinnitus and reactivity. So I honestly may just go with Lidocaine only.

Furthermore, he read up on IV Lidocaine. He said he would have his RN call some injection clinics in the area to see if they provide IV Lidocaine, and if so, he would be willing to write me a script for it to kind of double up on Lidocaine in the system. I need to research this more myself as I believe it can have some adverse side effects, but I would possibly do this a week after the injections or something like that.

I will call tomorrow to schedule the ear canal shots.

I have been very fortunate to find this ENT. He said as long as something is very low risk and he feels confident in doing it, he will try anything with me.

Of course it's your choice, but Lidocaine alone does not have much benefit beyond what we know.

Personally, I have never had any problems with Gabapentin, even at high doses.

Maybe consider low starting doses?

It's a real chance to have such an understanding and competent ENT.

 

[Jonno02]

You are fortunate to have such an ENT.

Absolutely. My most recent ENT at a private hospital in the UK told me 'there's no glory for us ENTs in tinnitus as there's no cure.'

But I also feel like @ErikaS is 1000x more proactive than me so she's found a decent ENT through hard work.

 

[ccm302]

Okay, I talked with my ENT today! We are going to try the ear canal 4-point shots of Lidocaine to each ear. He asked if I wanted to start Gabapentin to follow the study, however I am hesitant on this because not too long ago I was up to 300 mg of Gabapentin a day and it seemed to start to exacerbate my tinnitus and reactivity. So I honestly may just go with Lidocaine only.

Furthermore, he read up on IV Lidocaine. He said he would have his RN call some injection clinics in the area to see if they provide IV Lidocaine, and if so, he would be willing to write me a script for it to kind of double up on Lidocaine in the system. I need to research this more myself as I believe it can have some adverse side effects, but I would possibly do this a week after the injections or something like that.

I will call tomorrow to schedule the ear canal shots.

I have been very fortunate to find this ENT. He said as long as something is very low risk and he feels confident in doing it, he will try anything with me.

Godspeed.

 

[ErikaS]

Just wanted to "update". I went to my ENT this past Thursday and the Lidocaine that was ordered came in the wrong amount, so I couldn't get my first injections! They said the correct one should be in in about a week or so. We will do just my right ear for now (ground zero for inner ear never damage and inflammation that caused my tinnitus) and we will follow the schedule that they did in the study. Like I said before, if I can find an infusion clinic near me that will do Lidocaine infusion, my ENT will write a script for that too.

I am very aware it would be best to follow the study completely and incorporate Gabapentin. I tried Gabapentin for a few weeks a few months ago and got up to 300 mg, and it seemed to eventually worsen some things for me. I am still on a low dose daily Ativan which does help some to this day, and I have had some of my best days and finally stabilizing over the past 3-4 weeks. I have attended social functions in friend's homes, three bars, and just out and about a lot more than I ever was in several months. The tinnitus is still there as well as its sound sensitivity, but my endurance seems to be lasting longer and I am not worsening. Therefore, I do not want to introduce a medication when I am finally reaching some stability and when Gabapentin seemed to exacerbate me. What I do need is for something to get in my system and numb/calm/help reset inflamed nerve endings in the right inner ear.

Will let you all know once I get the first shots done!

 

[AverageJoe12]

Just wanted to "update". I went to my ENT this past Thursday and the Lidocaine that was ordered came in the wrong amount, so I couldn't get my first injections! They said the correct one should be in in about a week or so. We will do just my right ear for now (ground zero for inner ear never damage and inflammation that caused my tinnitus) and we will follow the schedule that they did in the study. Like I said before, if I can find an infusion clinic near me that will do Lidocaine infusion, my ENT will write a script for that too.

I am very aware it would be best to follow the study completely and incorporate Gabapentin. I tried Gabapentin for a few weeks a few months ago and got up to 300 mg, and it seemed to eventually worsen some things for me. I am still on a low dose daily Ativan which does help some to this day, and I have had some of my best days and finally stabilizing over the past 3-4 weeks. I have attended social functions in friend's homes, three bars, and just out and about a lot more than I ever was in several months. The tinnitus is still there as well as its sound sensitivity, but my endurance seems to be lasting longer and I am not worsening. Therefore, I do not want to introduce a medication when I am finally reaching some stability and when Gabapentin seemed to exacerbate me. What I do need is for something to get in my system and numb/calm/help reset inflamed nerve endings in the right inner ear.

Will let you all know once I get the first shots done!

So you're just taking Ativan and getting relief? Nothing else?