Third Time's the Charm → Tinnitus, Hyperacusis and Pain → Clomipramine Was a Game Changer

[Morgoth51]

Hello everyone!

I first got tinnitus and hyperacusis in January 2009, while using a headset. I was recording myself on a computer and, while trying to adjust the volume on Windows XP panel, I forgot about the slider that produces a "ting" to show you how loud (or quiet) the volume is. Sadly, it was at its max and so was the "ting" in my ears.

With time, things got much better until I got this smart idea to attend an airshow, in June 2011. Here we go again! That being said, since I wasn't too focused on my ears at the time, things improved quite fast to the point I joined a metal band during summer 2012.

Again, things got much better. By around 2016, I had almost completely habituated to my tinnitus and hyperacusis had vanished.

Unfortunately, in February 2022, I went to a Dub music party. I had already done that in the past, without any issue. But this time, one of the DJs, suffering himself from hearing loss, put the volume way too loud. Seriously, the volume was insanely loud, probably somewhere around 120-130 decibels.

I had protections and left early but it was already too late: aural fullness, shrieking tinnitus, burning pain descending from my right ear to the jaw and neck... and hyperacusis the next day!

I went to an ENT (ORL as we call them in France) who made me take an audiogram: I had lost 25 dB in my left ear.

I took Prednisolone (70 mg a day) for 10 days and fully recovered from hearing loss. However, it did very little for my tinnitus, hyperacusis and pain.

I went through a lot of medications: Paracetamol, Aspirin, Ibuprofen, Pregabalin, Laroxyl (Amitriptyline), Prozac (Fluoxetine), Quetiapine, Lorazepam (Temesta)... with little success.

Laroxyl, especially, boosted my tinnitus to stratospheric levels!

Finally, my psychiatrist switched my medication to Anafranil (Clomipramine) which turned out to be a game changer (and life saver). My mood improved significantly and rapidly, both my hyperacusis and pain subsided. I started to remove my protections (molded ones, 25 dB reduction) and, step by step, got accustomed to a life without wearing protections 24 hours a day (yes, even during the night).

Right now, I've started reducing the dose, from 150 mg to 50 mg, little by little. My tinnitus is still rather loud (after all, Clomipramine is a tricyclic antidepressant, which tends to boost tinnitus) but it's still much better than what it used to be one year ago.

I now live a rather normal life without wearing my protections, though I always keep them in my pocket, just in case. I've even attended a metal concert and an electronic music festival without significant issues.

I'm fully aware that my ears won't get back to what they were before that damned Dub party. But still, I'm certainly thankful for such progress over a 18-month period.

Also, in my case, sports (cardio, more specifically) helped a ton. I used to swim back in 2012-2015; now I'm cycling. These endorphins are quite the relief, albeit temporary.

Thanks, guys!

Paul

 

[Mister Muso]

Thanks for the informative post! Are you saying you attribute your recovery mainly to your use of Clomipramine? It's not a treatment I recall seeing mentioned a lot here.

I'm desperate to find something that reduces my hyperacusis further, even at the risk of increasing my tinnitus.

 

[wiektor]

Hey! Thanks again for providing your experience!

I had to create an account here just to back this up. I started taking Clomipramine/Anafranil after seeing some German page quoting it. Then I found the report from @Trafalgar D. I thought I had lost everything (fun, joy, etc) so why not give this a try.

Clomipramine killed my depression big time and triggered a remission of my severe hyperacusis. I couldn't shower without earmuffs or open a water tap without at least cotton in the ears. I had been homebound for almost 2 months and I can now leave my apartment again. I couldn't even talk on the phone, the speakers would make my ears spasm like crazy and it sounded piercing as hell.

It is slow progress since I started it six weeks ago. I felt some effects 3 days after 25 mg but the biggest change is coming now that I'm taking 100 mg/day (week 5). My right ear is pretty much feeling normal (no more fluttering to sounds) and the left year, which was always the worst one, is catching up. I am confident I'll be doing normal things again in a month.

I don't wear protection at home anymore. I can listen to music again, have work calls on the speaker and play my games with sound on. It seems I can tolerate louder volumes already but I'm trying it very slow. Increasing the average volume by 1 click every two days just to be safe.

I am also back to my favorite sport: cycling. I wear earmuffs for now because of the wind, but when it's just breezy I can safely take them off.

I almost cried yesterday when I could hang out in my own balcony and have two friends over for a barbecue after all the chaos my life has turned into. It felt great, I talked for 4 hours without a setback. At night my left ear was a bit tired/sensitive but it resets with sleep.

And a massive bonus is that Clomipramine did not change my tinnitus to a worse one. Quite the opposite. It basically put it in the background and I don't give much thought to it anymore. As a matter of fact, I've started to go for a couple hours daily that I completely forget about it. And it can be loud, especially at night (7/10).

I can also smoke weed daily without any spikes and be super chill about it. No bad trips due to tinnitus - quite the opposite - I'm having fun with pot again being around the house and entertaining myself with games and music.

Not being depressed the whole time anymore makes you realize that you have to enjoy life with whatever you have available around you. Find pleasure in the smaller things. I'm being grateful for every new activity I can include again in my life. And I can now can finally digest all the love and support I got from my friends and family. I'm paying that back by being present, asking about their lives, having a laugh over some stupid work gossip.

All my depression wanted to talk about is tinnitus and hyperacusis. Since the depression is under control, I don't even mention tinnitus and hyperacusis to my friends unless they ask how I'm doing. It's not worth investing any more time in tinnitus: it may never go away, it won't stop my life, and yes, it's a 24/7 annoyance but I finally get that it is just a sound.

Not sure if it is a coincidence or rather the natural course of things. But the only reactive tone I had went away with 2 weeks of Clomipramine. It was a whistle that would appear on top of my old, noisy fan.

Side effects for me are dry mouth and constipation. First week was tough with a slight worsening of the depression and a bad insomnia. I was very very weirdly agitated for like 10 days. These side effects are now gone and I'm sleeping fine once more.

I am so thankful that these very few people shared their experiences with Clomipramine. It saved me months of suffering.

So yeah, if you're suffering big time and find yourself obsessing too much over the suffering, I can only recommend you try an antidepressant. It's giving me my life back. And if you have hyperacusis, Clomipramine should definitely be considered. After lurking Tinnitus Talk and seeing all of the bad experiences with antidepressants, I never thought I'd even consider them. I postponed my suffering much much more than I should've!

 

[BrOKeN_1]

I now live a rather normal life without wearing my protections, though I always keep them in my pocket, just in case. I've even attended a metal concert and an electronic music festival without significant issues.

Damn Son. You are a maniac. After experiencing tinnitus and hyperacusis multiple times, you keep returning to the possible culprits of the condition, clubs and concerts. Seriously 'metal concerts'? One begins think you are a glutton for punishment. Glad to hear things are settled down for you though. Most people here wouldn't dare living on the edge of catastrophe. Be safe out there. Keep those earplugs close. Sounds like you are gonna need them. Haha.

 

[Juliane]

Damn Son. You are a maniac. After experiencing tinnitus and hyperacusis multiple times, you keep returning to the possible culprits of the condition, clubs and concerts. Seriously 'metal concerts'? One begins think you are a glutton for punishment. Glad to hear things are settled down for you though. Most people here wouldn't dare living on the edge of catastrophe. Be safe out there. Keep those earplugs close. Sounds like you are gonna need them. Haha.

That is actually one of the things that really scare me about antidepressants... The thought that they might make me so "happy" and relaxed that I would stop being cautious around loud noise - which is something we tinnitus sufferers need to do for the rest of our lives. That risk, and the potential side effects, are what keeps me from ever starting on antidepressants.

Please know that I say this respectfully as I know antidepressants have been live-savers for many people, and I do recognize and respect that. But for me personally, I would not dare take the risk(s).

 

[Morgoth51]

Thanks for the informative post! Are you saying you attribute your recovery mainly to your use of Clomipramine? It's not a treatment I recall seeing mentioned a lot here.

I'm desperate to find something that reduces my hyperacusis further, even at the risk of increasing my tinnitus.

Heya,

This is my view on things, and it's highly subjective; but from February to August, my hyperacusis pretty much stayed the same, with a few improvements, mostly due to time spent in silence, and a lot of setbacks.

That said, once I started taking Clomipramine, the first effect I noticed was on my mood: I started to feel better which, in turns, gave me the confidence to start removing my protections from time to time.

It's a good question: could have I done the same, had I had the confidence (or carelessness) to do so, without Clomipramine?

As I said, back in 2011, I didn't pay too much attention to my ears, before and after the airshow; as for pain, I was thinking, back then, that it came from my wisdom teeth; and I got them removed! Things got much better over a year, without any medication...

To be clear, the improvement I felt with Clomipramine happened before I discovered the discussion thread, so I bet this rules out a placebo effect, at least to some extent.

AFAIK, there's no study concerning Clomipramine and hyperacusis.

What I'm quite sure about, though, is that it certainly helped with depression and neuropathic pain.

In a way, so to speak, it turned my pain hyperacusis into a mostly loudness hyperacusis which, as you surely know, is much more tolerable and easy to get used to.

I would say give it a try, but it might not work for you. It's the biggest flaw with tricyclic antidepressants: they have a lot of possible side effects and depending on the person, they simply overweight their pros. Pretty much what happened to me with Laroxyl (Amitriptyline) and tinnitus.

 

[BrOKeN_1]

Please know that I say this respectfully as I know antidepressants have been live-savers for many people, and I do recognize and respect that. But for me personally, I would not dare take the risk(s).

I totally get the not wanting to medicate. And more power to you if you can manage without. I personally needed Prozac to calm the fuck down. It in no way made me forget I had tinnitus. But I think ultimately I needed the antidepressant to help suppress the constant fight or flight that was literally killing me. But I know everyone is different and side effects vary with each individual.

 

[Mister Muso]

It's the biggest flaw with tricyclic antidepressants: they have a lot of possible side effects and depending on the person, they simply overweight their pros. Pretty much what happened to me with Laroxyl (Amitriptyline) and tinnitus.

Yes, Amitriptyline eased my tinnitus and hyperacusis for the 3-4 months I was on it but the side effects were hard to cope with. I might try this other one you mention instead.

 

[RunningMan]

Yes, Amitriptyline eased my tinnitus and hyperacusis for the 3-4 months I was on it but the side effects were hard to cope with. I might try this other one you mention instead.

Did you end up trying it? If so, how were the side effects vs. Amitriptyline?

I was on another (TCA) ticyclic antidepressant similar to Amitriptyline called Nortriptyline through summer of 2022 at 50 mg/day, and the dry mouth was pretty bothersome and I had urinary retention when trying to go with 75 mg, so I stuck to 50 mg and not sure it ever helped. And there were other side effects like higher heart rate, chest pain, occasional very bad acid reflux like pain. I don't know that it even made any difference in depression, and I didn't have hyperacusis in summer 2022. But it had zero effect on my tinnitus or insomnia. So, on balance, it was just an ineffective medication for me that only caused side effects that kept me from increasing the dose to prescription strength, so I weaned off it.

The tricyclic antidepressants seem safer in regard to tinnitus than the SSRIs/SNRIs, yet you still have some people that report an increase in tinnitus, but one reason I originally took Nortriptyline was because a study showed some people report a decrease in tinnitus, more so than a placebo group.

 

[SarahMLFlemmer]

Yes, Amitriptyline eased my tinnitus and hyperacusis for the 3-4 months I was on it but the side effects were hard to cope with. I might try this other one you mention instead.

What side effects did you experience from Amitriptyline? I'm on it now for sleep.

 

[Mister Muso]

What side effects did you experience from Amitriptyline? I'm on it now for sleep.

It just left me tired the next day although I clearly was sleeping more during the night. Also my anxiety levels seemed to increase whilst on it and I got dry mouth symptoms. Having said that, it was worth it and I feel my tinnitus and hyperacusis were both helped which lasted after I came off the medication too.

 

[StoneInFocus]

Finally, my psychiatrist switched my medication to Anafranil (Clomipramine) which turned out to be a game changer (and life saver). My mood improved significantly and rapidly, both my hyperacusis and pain subsided. I started to remove my protections (molded ones, 25 dB reduction) and, step by step, got accustomed to a life without wearing protections 24 hours a day (yes, even during the night).

Hey Paul, how would you describe your hyperacusis?

Could you tell us after what time period you started to notice effect on your hyperacusis?

 

[Uklawyer]

@Morgoth51, are you French/in France?

Funny, my psychiatrist in France mentioned Clomipramine to me. I thought that Amitriptyline increased my tinnitus a bit (and it knocked me out), and with my history with medication, I passed on it. Some reports on it seem to be brilliant but, as you state, it's a tricyclic - so side effects...

 

[Morgoth51]

Hey Paul, how would you describe your hyperacusis?

Could you tell us after what time period you started to notice effect on your hyperacusis?

Heya, and sorry for the late response, I most likely saw your message but forgot to answer!

For the most part of 2022, my hyperacusis was quite painful: I often had a burning sensation, descending from my ear to jaw, sometimes neck, and more rarely, my eye. I also often had an itch in my ear canals. I would manage to partially and temporarily alleviate the pain by massaging my jaws.

Sometimes, it was more like some sort of tingling.

Loud sounds would result in aural fullness and a long lasting pain.

I still have some painful days but it's way more tolerable than what it was back in 2022.

About your second question, I'd say that I really noticed an effect on my hyperacusis about a month after I had started Clomipramine.

@Morgoth51, are you French/in France?

Funny, my psychiatrist in France mentioned Clomipramine to me. I thought that Amitriptyline increased my tinnitus a bit (and it knocked me out), and with my history with medication, I passed on it. Some reports on it seem to be brilliant but, as you state, it's a tricyclic - so side effects...

Indeed, I'm French and in France!

In my case, even though there definitely were some side effects (increased tinnitus, dry mouth, severe sweating, a hard time to climax, plus the anticholinergic issues), Clomipramine was such a help with both depression, hyperacusis and pain that it was worth those side effects.

Do you suffer from hyperacusis?

It's been a month now since I took my last tab of Clomipramine. The side effects were one thing: stopping it for good was another one! Brain zaps, headaches, fatigue, a mix of sadness and apathy, with a tad of irritability... and yes, I did taper!

Still, I'm in a much better place than 2 years ago. I'd say give Clomipramine a go, and stop it if the side effects are too much for you.

 

[Uklawyer]

Heya, and sorry for the late response, I most likely saw your message but forgot to answer!

For the most part of 2022, my hyperacusis was quite painful: I often had a burning sensation, descending from my ear to jaw, sometimes neck, and more rarely, my eye. I also often had an itch in my ear canals. I would manage to partially and temporarily alleviate the pain by massaging my jaws.

Sometimes, it was more like some sort of tingling.

Loud sounds would result in aural fullness and a long lasting pain.

I still have some painful days but it's way more tolerable than what it was back in 2022.

About your second question, I'd say that I really noticed an effect on my hyperacusis about a month after I had started Clomipramine.

Indeed, I'm French and in France!

In my case, even though there definitely were some side effects (increased tinnitus, dry mouth, severe sweating, a hard time to climax, plus the anticholinergic issues), Clomipramine was such a help with both depression, hyperacusis and pain that it was worth those side effects.

Do you suffer from hyperacusis?

It's been a month now since I took my last tab of Clomipramine. The side effects were one thing: stopping it for good was another one! Brain zaps, headaches, fatigue, a mix of sadness and apathy, with a tad of irritability... and yes, I did taper!

Still, I'm in a much better place than 2 years ago. I'd say give Clomipramine a go, and stop it if the side effects are too much for you.

Mais ton Anglais est superbe!

Happy to hear that you are doing much better. 2.5 years ago, I was in a clinique psychiatrique in Nîmes. I am doing much better as well.

I did have some hyperacusis soon after it first got worse - and some dysacusis with high-frequency sounds like hair dryers, air conditioning, and the shower but all that has, fortunately, gone now.

 

[ellees]

Mais ton Anglais est superbe!

Happy to hear that you are doing much better. 2.5 years ago, I was in a clinique psychiatrique in Nîmes. I am doing much better as well.

I did have some hyperacusis soon after it first got worse - and some dysacusis with high-frequency sounds like hair dryers, air conditioning, and the shower but all that has, fortunately, gone now.

Have you ever tried Gabapentin?

 

[Uklawyer]

Have you ever tried Gabapentin?

I have not tried Gabapentin. I took Pregabalin for a bit after the initial low-level tinnitus. It made me groggy and I could not work whilst taking it so I stopped.

 

[ellees]

I have not tried Gabapentin. I took Pregabalin for a bit after the initial low-level tinnitus. It made me groggy and I could not work whilst taking it so I stopped.

Thanks. How long did you take it, and at what dose? Did you notice any changes in your tinnitus, either while taking it or after stopping?

 

[ellees]

I went through a lot of medications: Paracetamol, Aspirin, Ibuprofen, Pregabalin,

What was your experience with Pregabalin like? Did it affect your tinnitus at all?

 

[Uklawyer]

Thanks. How long did you take it, and at what dose? Did you notice any changes in your tinnitus, either while taking it or after stopping?

I think it was about two doses, but I'll need to check the packet to be sure. I didn't notice any changes in the tinnitus while taking it or after stopping. It does seem to be a strong medication with significant side effects.

Are you considering trying it for tinnitus?

 

[ellees]

Are you considering trying it for tinnitus?

No, I'm not looking for something for tinnitus, but rather for chronic pain. I developed tinnitus from an SSRI, so I would prefer to avoid taking antidepressants for my chronic pain. Given my aversion to antidepressants, I assume that when I am able to get a prescription for my pain, it will likely be Gabapentin or something similar.

 

[Uklawyer]

Pregabalin is used as an antidepressant. Have you considered Amitriptyline or Nortriptyline? It's hard to predict how these medications will affect you, so whatever you choose, take it slowly and monitor your response carefully. There are also pain clinics, apps, and psychologists that focus on reducing chronic pain through mind-body approaches. Are you familiar with these? What kind of pain are you experiencing?

 

[Nick47]

I'm not looking for something for tinnitus, but rather for chronic pain. I developed tinnitus from an SSRI, so I would prefer to avoid taking antidepressants for my chronic pain. Given my aversion to antidepressants, I assume that when I am able to get a prescription for my pain, it will likely be Gabapentin or something similar

I would look into Nortriptyline. It is not classified as an SSRI.