Tinnitus Got Worse from Jaw Clenching Caused by Antidepressant — Can I Sue? All Suggestions Welcome!

[East_LDN]

Where: London, England.

Who: Unemployed 36-year old guy. Possible ADHD (undiagnosed due to public waiting lists and private costs). Definitely an anxious and depressed mess even before this fuckup. Have savings but worried about being ripped off and ending up worse off.

When: Tinnitus since young (parents: don't let your kids stand in front of the sound system at parties, no matter how fun the rumbly bass is!). Very mild.

Then: In November 2019 felt depressed due to yet another failure in full-time education. Was in Counselling but decided I needed medication. Went private due to previous incompetence of local NHS GP and Community Mental Health Team. Was prescribed 20 mg Citalopram once-daily. All good at follow-up appointment one month later.

Private GP then repeatedly lost all records of treatment plan from 3rd appointment onwards. Video appointments during COVID-19 mostly spent convincing Doctor I was a patient undergoing treatment. Asked for and got dose increase around July 2020 to 30 mg Citalopram due to anxiety caused by COVID-19 and, secretly, GP repeatedly losing records. No follow-up appointment to check dose increase.

Jaw started clenching, bad enough to lock up. Tinnitus goes wild. But too anxious/apathetic to ask private GP due to fear of ending treatment (Had previous sudden end of treatment with NHS). Last appointment January 2021. Fell off meds April 2021.

Now: Jaw still clenching. Tinnitus now loud in left ear and screaming in right. The inside of my ears feel hot and slightly painful with an odd pressure. Slowly going insane. Am thinking about suing private GP. Turns out SSRIs make ADHD symptoms much worse, including extreme apathy (Hence why I didn't stop taking the meds).

Why: I need treatment but am scared of NHS incompetence and waiting times. Might have to go private, which costs. Plus after the fiasco worried about losing yet more savings to charlatans and incompetents. Would also like a little payback if possible.

How: I've found a whole bunch of Solicitor firms (lawyers in non-British speech) who do No-Win! No-Fee! clinical/medical negligence claims. There's a hard three year limitation on claims though. All of the No-Win! No-Fee! Solicitors (lawyers in non-Brit speech) offer a free initial consultation. So there's no harm in me asking them if this is possible.

What: While I had tinnitus before the 30 mg Citalopram daily the subsequent jaw clenching made everything so much worse. The last thing I hear before I fall asleep and the first thing I hear when I wake up is the tinnitus screaming in my right ear. Does anyone have advice? I have no idea who to go to or what to say or even how to describe what I'm hearing. I'm hopeful that if the jaw-clenching is sorted out the tinnitus might lessen, but not very hopeful. There is a British Tinnitus Association support group that used to meet near me, but they're now virtual and don't have a meeting til the end of the month anyway.

I've searched Tinnitus Talk for suggestions, but there are thousands of posts across hundreds of threads all covering a span of years. I read about multiple potential treatments: Sulodexide+Melatonin; CBD Oil; Neuromodulators; Mouthguards; Muscle-relaxants. But for each one that works for one person doesn't work, or even makes worse, for another.

The Knowledge Base also hasn't been of much use as it was last updated in 2017 with one update. Previous updates include: 2016 - One update; 2015 - Two updates; 2014 - Four updates; 2013 - 105 updates. What happened?

Heart of Matter: In all honesty this is me flailing around looking for something to save me from my problems. Not just the tinnitus, but the depression and anxiety that made me seek medication in the first place. About the only thing I can do that isn't collapsing into a blubbering mess is waiting to collapse into a blubbering mess.

My sleep is wrecked. My diet is a joke. My health is nonexistent. Can somebody please save me?

 

[Robster]

I don't think anyone here can give you a definite answer. Ring the no win no fee solicitors you have listed and see what they have to say.

 

[East_LDN]

I know nobody can give a definite answer. I was mostly flailing around, although I do wish more people would chime in. Probably my fault for writing such a wall of text. I guess I should wait awhile and try asking about how try and sort out my jaw clenching. Maybe in a week or so.

 

[Kriszti]

I am not sure you have a case here. You probably won't be able to prove causation between your elevated tinnitus and the SSRI. Also if your medicine had a patient leaflet which listed your apathy as side effect, I think they are covered. Your GP was negligent losing your records, but you still have to prove that this affected the care you received.

But go to the solicitors, no harm in having free consultation.

If you don't mind, could you update with what they have said?

 

[Leila]

How are your overall chances when it comes to suing for maltreatment in the UK?

Here in Germany it doesn't really make sense because you'd have to find another doctor to confirm your version of the story and that is usually where things get difficult and come to an end. But even if you are lucky and get your day in court the kind of compensation you get is a joke compared to the time, energy and oftentimes humiliation you have to invest in order to get there.

If that is different in the UK, go for it. If not, make a list and check if the costs are worth the (potential) gain.

Best of luck with whichever way you go!

 

[East_LDN]

After thinking about it for awhile, I've decided there's zero chance of suing them (I'll still be emailing the No-Win! No-Fee! Solicitors/Lawyers because they do a free consultation and it never hurts to be sure).

Instead I'm planning to make a formal complaint to them and, most likely, the Independent Healthcare Sector Complaints Adjudicator Service (ISCAS).

Does anyone think it'd be useful for the Tinnitus Talk community if I do a post (either here or a new thread) naming the private GP and what happened?

 

[T_Almost_Gone]

My advice.

Set aside the legal stuff & see what can be done for yourself healthwise.

Need to isolate if the SSRI has worsened your tinnitus or the jaw clenching or a combo of both.

If you're still on the SSRI & it's safe to do so, taper off or stop - this could definitely be the cause.

Search the forum for TMJ and a good practitioner near you. Worth paying private for this. Hopefully it can get your tinnitus back to the baseline.

 

[East_LDN]

Ugh. I had a long draft that I hadn't posted yet and it seems to be gone. Probably because I hadn't touched it in ages. Anyone got any idea how to get it back?

As for me, I've decided that there is zero hope for suing, or even making a complaint. I was planning to post what had happened on here in hopes that what happened to me doesn't happen to someone else, but as said the draft seems to have disappeared. Ugh.

After reading about SSRI-induced Bruxism I'm pretty certain that the increase from 20 mg Citalopram once-daily to 30 mg is what caused it. I've also read that it might be treatable by taking Buspirone (trade name Buspar), an anti-anxiety drug. I'm currently waiting for an appointment with my counsellor, who knows some Psychiatrists, to ask him about this. Fingers crossed.

 

[East_LDN]

I doubt anyone will read this, but here's an update anyway (In hindsight it was a stupid title): I've talked to my Counsellor and all the Psychiatrists he knows are fully booked until September/October 2022. I know of a couple other private psychiatrists who are in opposite directions. The one in the City has no fees listed and is around the corner from the private GP who I was thinking about sueing (But don't worry, they're part of a different private GP group. He says sarcastically). The other is on the eastern end of the Central Line and charges £700 for an initial assesment.

I had a phone consultation with my GP (I say my, but it was just whichever GP got the job of calling me). They won't prescribe Buspirone as I want it for something off label. End of. Obviously it was phrased alot nicer than that, but that's the gist of it. Am I anxious? Yes. Am I depressed? Yes. Am I going to tell them that? Fuck no. I've been through "treatment" before, fuck doing that a third time. Who knows what they'll prescribe and how it'll affect me before they start listening to what I actually want.

The only suggestion the GP had was to go to my Dentist and talk to them about my jaw. Sure I could have a Nightguard fitted, but that won't cure what ails me. It'll treat it sure, but it won't cure it. I could ask the Dentist about prescribing Buspirone, but me thinks that any Dentist who prescribes psychoactive anxiolytics that they have zero experience with are best avoided. Hell, I don't even know if I'm on my Dentist's books anymore, it's been so long since I was last there.

Anyway that's me, I hope you all reading this (whoever you are) are having a better time than I am.

 

[East_LDN]

Update time! It turns out that even though my last dentist appointment was about 14 years ago (!) I'm still on their books. Told them about the jaw-clenching and how long it's been going on. They took a mold of my lower jaw and I should get the nightguard in about two weeks. Interestingly the cost to do it private was less than the cost to do it on the NHS. Obviously the nightguard won't cure my tinnitus, or even the jaw-clenching, but it'll help.

Just wish I could find someone to prescribe me the Buspirone.

 

[makeyourownluck]

Hi @East_LDN, I hope you're doing ok. My partner is struggling with undiagnosed ADHD. He is full time education and finds the workload unbearable at times. The waiting time for ADHD assessment is ridiculous, but so are the cost of going private.

Anyway, I wanted to let you know that my partner didn't get on well with SSRIs, but is having some luck with Effexor, it's an SNRI. Of course, tinnitus is listed as one of the side effects, but many people take it without worsening.

 

[East_LDN]

A slightly more hopeful update for a change today. I'm just back from a trip to the Dentist to have a nightguard fitted. I don't know if this'll ease my tinnitus or not, but hopefully it'll mean I no longer have to click my jaw back into place every morning. For some strange reason it would've cost me more to have a nightguard made on the NHS than it did privately. Odd.

Apart from trips to the Dentist I've also been doing some reading on TMJ and possible treatments for it. I've already mentioned the use of Buspar/Buspirone to treat SSRI-induced Bruxism/Jaw-clenching, but I don't know any Psychiatrists who'd be willing to prescribe an experimental treatment like that (My GP's already said no).

Two other interesting treatments I've read about are the use of a TENS (Transcutaneous Electrical Nerve Stimulation) device to massage the jaw muscles so they aren't so tense and an ear insert called Cerezen. They're basically stiff hollow earplugs that are custom fitted to have the same shape as your ear canal when your jaw is open.

Unfortunately, Cerezen production was discontinued due to lack of provable efficacy and the last references I can find to it are from 2017-2018. But as it's basically a rather stiff, hollow, and custom-fitted earplug it should be possible to get some made somewhere.

There are, of course, other possible treatments. But those are less interesting to me because they mostly involve some kind of surgery, whether minor or major. Considering how my luck's been for the past few years if I go under the knife I'll probably end up with facial paralysis or worse.

Does anyone know of any other ways of treating TMJ disorders? I've read about the facial/muscle massages and the advice to stick to soft foods. I've also found a few private practices claiming to treat TMJ problems, but after my bad experience with the private GP I haven't got much trust in the power of private enterprise to solve my problems. Unfortunately, the only trace I've found of an NHS specialist group for TMJ is a single PDF from 2012 and nothing since, so I doubt it's still going.

Now please excuse me while I go get ready for my afternoon session with my drug-addicted Psychotherapist (yes you read that right, it seems if it's not one thing it's another with my life).

 

[East_LDN]

An update to mark one week since getting the nightguard:

The good news is that I no longer have to click my jaw back into place every morning.

The bad news is that's the only positive I've noticed so far. Tinnitus is still there and isn't any quieter. The slow-motion jaw-clenching is still there. And I'm not getting much sleep, not sure if that's due to the nightguard or not.

Oh well, only another two months and three weeks til my next Dentist appointment!