Tinnitus Spiked by Vortioxetine (Trintellix / Brintellix)

Hi, this is of course not the first message regarding SSRI and tinnitus... but Vortioxetine is one of the newer antidepressants out there, I wanted to gather some recent experiences on this drug.

I started on Vortioxetine around 2 months ago for depression. The first month I took 5 mg a day, this seemed to cause some changes in my tinnitus, some good, some bad. I started having more "good days", but also the bad days became worse. The equation was kind of even, and even though my tinnitus is bad (really high pitch, I can hear it on a busy street most days), it's been 12 years so most of the time I could tolerate it.

The real problem started a month after increasing the dose to 10 mg. I began to hear a very low-pitched rumble sound (like a big engine running in the background). I started to become worried about it, and some days after I noticed the new sound, it became louder. It happened on a day I went to a birthday party (45-year-old cousin, no loud music, nothing crazy), so it could be that this drug made me extremely sensitive to noise? It's either this, or it's the 10 mg dose that is worsening the tinnitus.

Either way, I will be decreasing the dose, hoping that this is a temporary spike but, if not, then probably stopping the medication after talking to my psychiatrist.

So, any similar experiences out there? I know we are all different, but I'd like to change to another drug. I was a lot better on Vortioxetine and I wouldn't want to be off medications. My tinnitus started while I was taking Citalopram around 2011 (not drug related, I'm a musician and it happened after a loud music exposure), but I don't remember having an improvement on the tinnitus when I stopped Citalopram in 2012. So maybe Citalopram or Escitalopram would be an alternative drug? Any real experiences switching from Trintellix to Citalopram or Escitalopram?

Thanks in advance for your feedback!

 

All SSRI/SNRI medications have the 'potential' to increase tinnitus. In many they will not. Generally TCAs (Nortriptyline, Amitriptyline, Deanxit) are more favourable in tinnitus patients and can reduce the intensity in some. Nortriptyline seems to have some good evidence and less side effects than Amitriptyline.

Some antipsychotics at low doses have antidepressant activity too. Universally increasing serotonin is the culprit, which SSRI/SNRI medications do.

 

Yeah, I am aware of that. On paper, Trintellix didn't have tinnitus listed as a side effect, and being an atypical antidepressant, I thought it could be different.

TCAs have a reputation of more serious side effects, so I'm afraid to try those. Of course, I'm not a doctor, so I don't have enough information or knowledge. But I've seen some articles (here maybe?) mentioning that they are linked to dementia in the long term?