by Neil Bauman, Ph.D.
A man wrote,
Is the ototoxicity of Wellbutrin based on anything other than anecdotal reports from readers? My audiologist insists it’s not ototoxic (although rather ironically he said, “I’ve seen thousands of patients on Wellbutrin over the years” as if that’s reassuring!)
As far as I know, there are no definitive studies showing Bupropion (Wellbutrin) is ototoxic. There are a number of reasons for this (and incidentally, these reasons apply to most drugs, not just Bupropion). Let’s look at some of them.
1. It is not ethical to do studies to prove that a drug is harmful to a person. Drug studies are done to prove that a new drug works better than existing drugs in treating a given condition, or if there aren’t any drugs for the condition, that it works better than not treating it at all, or treating it with a placebo. In other words, “Does the drug work or not?”, not, “Is the drug harmful to people or not?” If a study was designed to prove whether Bupropion (or any other drug) causes permanent hearing loss or not, would you participate, knowing that you would be randomly assigned to either the placebo group or the drug group?
And furthermore, knowing that if you were assigned to the drug group, you could end up with permanent hearing loss before the study even ended? I didn’t think so. Neither would I. That’s the ethical dilemma. Since you can’t force people to take part in a study where their health/body may be damaged, you’re not going to find any double-blind studies proving Bupropion is ototoxic.
2. When drug companies conduct trials on new drugs, they focus on the main body organs–heart, lungs, kidneys, liver, brain, etc. They don’t specifically set out to collect data on all the “minor” systems in your body such as hearing and balance. Thus, they systematically collect data on the major systems, but “minor” systems receive attention only if one of the study participants volunteers that information.
For example, if a study participant says to the researcher, “Since I began taking this drug, my ears have started ringing” the researcher will record this information. However, if the study participant doesn’t think to volunteer information not asked for, this side effect will not be included in the list of side effects caused by this drug.
Fortunately for us, sometimes a few people do recognize that a given drug has affected their ears and volunteer this information. Because of the way it is collected, this information is very sketchy and incomplete, but nevertheless, it (hopefully) appears in the main drug “bibles” used in North America—the Physicians’ Desk Reference (PDR) used in the USA and the Compendium of Pharmaceuticals and Specialties (CPS) used in Canada. For example, this is where I found both hearing loss and tinnitus listed as being side effects of taking Bupropion.
3. Many studies are short-term studies—maybe for 30 or 60 days. For a number of side effects, this is too short a period for a given side effect to show up. As a result, side effects like hearing loss or tinnitus may not show up during that time. Thus, everyone assumes that this drug does not affect the ears.
The truth is, some ear problems don’t show up until you have been on the drugs for months or even years. And some ear problems don’t appear until after you have stopped taking the drug.
4. Once the drug trials are completed and approved by the FDA, the drug company sets about making money from this drug. (After all, that is why they are in business.) Thus, they don’t have any real desire to hear about side effects showing up. (Why would they want to “badmouth” their best-selling drug?) So reports of the negative side effects they receive seem to get buried. The result is that health care professionals don’t hear about these side effects. Therefore, when a patient comes to a doctor telling him that the drug he prescribed caused their tinnitus, the doctor says, “No, it couldn’t have” and puts it down to coincidence, not a side effect of that drug. This is why there is little “formal” evidence showing that Bupropion causes hearing loss and other ear conditions.
All that is left are anecdotal reports as patients put two and two together and report these side effects. Some of these reports will be true. Other reports may blame one drug, but actually be a side effect of another drug that they are also taking, or be from a completely different cause, but the person thinks it is the drug in question.
There are three ways anecdotal reports become known.
A) You go to a doctor and report getting a certain side effect from taking a given drug. If your doctor thinks it may be true, and if he writes it up as a case study, this is then accepted.
B) You come to me (or someone else who is not a medical doctor) and tell me the same thing and I write it up (as I often do). My account is considered “anecdotal” and thus not “true”, not because the incident is not true, but because I am not a medical doctor and so what could I possibly know?
C) You, or your doctor, report it to the Food and Drug Administration (FDA) where those anecdotal reports that are deemed “likely” are included in the FDA database.
In any case, these three kinds of reports are anecdotal evidence. Note this: anecdotal evidence IS evidence. If only one person ever reported hearing loss from taking Bupropion, for example, then you and I may put it down as due to a coincidence. However, when numbers of people report the same thing, then the preponderance of evidence lies with it being true and not just being coincidental.
With this in mind, lets examine the anecdotal evidence for Bupropion being ototoxic and causing two specific side effects—hearing loss and tinnitus.
First, as I mentioned above, this information is included in both the PDR and CPS.
Second, in the 3rd edition of my book “Ototoxic Drugs Exposed”, I give not just one, but 4 anecdotal reports all saying much the same thing. Thus, it is stretching it to say this is coincidental. To remove any doubt, in the upcoming 4th edition of Ototoxic Drugs Exposed, that number has now more than tripled to 13 anecdotal reports. This is well beyond the realm of being coincidental.
Third, the FDA database now includes 150 likely cases of hearing loss from taking Bupropion, and 536 likely cases of tinnitus. Again, these figures are well outside of the realm of being coincidental.
Now, lest you think these figures are to low to be significant, consider this. One former FDA commissioner estimated that less than 1% of all the serious side effects are ever reported to the FDA. (Note: in the past, hearing loss and tinnitus have been considered “minor” side effects.) Thus, you can assume that for such “minor” side effects, far fewer than 1% are ever reported—maybe only 1% of the 1%. Assuming for the moment that these figures are in the ballpark, if you multiply the above figures 10,000 times (which would be 1% of the 1%) those figures are now 1.5 million people with hearing loss from taking Bupropion and a whopping 5.36 million now suffering with tinnitus from the same cause.
Maybe these figures are on target. Maybe they are low and the real situation is even worse. Or maybe I’m way off base and they are high. But whatever the truth is, there is no doubt that many, many people have hearing loss and tinnitus as the result of taking Bupropion.
Well-meaning, but ignorant people such as your audiologist, because they have not seen, nor accepted, the above evidence as true, try to pooh pooh the idea that Bupropion is ototoxic with such asinine statements as, “I’ve seen thousands of patients on Bupropion over the years” as if that’s reassuring!)”
When you stop to think about it, rather than being a defense that Bupropion is not ototoxic, it is strong evidence that just the opposite is true, and that Bupropion is indeed quite ototoxic. You see, audiologists basically only see patients that have hearing loss. Thus, if he’d never seen a patient who was taking Bupropion, you could assume that Bupropion did not cause hearing loss.
However, since he’s seen “thousands” of patients that have taken Bupropion (I’m sure there’s a bit of hyperbole here), and since he only basically sees hard of hearing people, the logical conclusion is that many people taking Bupropion lose some of their hearing from taking this drug and have to see an audiologist. Thus, although there are no double-blind studies showing that Bupropion causes hearing loss and tinnitus, the available evidence clearly indicates that Bupropion does indeed cause hearing loss and tinnitus in multitudes of people.
If you want to look up the ototoxic side effects of Bupropion (Wellbutrin), see my book “Ototoxic Drugs Exposed” 3rd edition. This book contains information on the ototoxicity of 877 drugs, 35 herbs and 148 chemicals.
I am looking for help for my son. He has just recently loss of hearing in his left ear. He said he can’t hear and there is a constant ringing in it. A doctor perscribed Wellbutrin for him and he was fine before that. Please can you help him. Ty a very loving and caring mom
Hi Bonnie:
If you haven’t already done so, you might want to stop him taking the Wellbutrin immediately. Run it by his doctor of course. And since he is obviously sensitive to this drug, it would appear wise to not let him take it again. There is a chance that by stopping the Wellbutrin now, his hearing may come back. One boy had his hearing return to normal after 3 months. And his tinnitus may go away too, but there are no guarantees. For numbers of people, the hearing loss and tinnitus prove to be permanent.
Wellbutrin (Bupropion) causes hearing loss and tinnitus in hundreds of people. It is not a drug I would ever take. I can’t see any intelligent doctor prescribing this drug, knowing all its horrible side effects.
Cordially,
Neil
Hi, I’ve been taking generic wellbutrin for 3 weeks and have noticed ringing and plugged up feeling in my left ear. Is there permanent damage now or is there a chance if i stop now that i can still save my ears?
Hi Joel:
Hard to say. Wellbutrin (Bupropion) is one of those drugs that can cause either temporary or permanent side effects. From the reports I’ve received, it seems more or less about half the people reporting have temporary side effects and the other half have permanent side effects. Therefore, it seems prudent to get off the Wellbutrin ASAP and see whether your ears clear up and return to normal. If they do, be very thankful, because that is not always the case.
Cordially,
Neil
It has been around 10 years ago now since I took Wellbutrin and within just 1 month I noticed that I suddenly had tinnitus and read that could be one of the side effects. I immediately stopped taking it with the hope that it would go away but it had not. I reported it to the Dr. that prescribed it but I have no idea if he reported it. I doubt it because he questioned me about the other drugs that I might be taking. At the time the only other drug was the OTC Benadryl which I had neverr had a problems with before. Needless to say the tinnitus has never gone away and I do have more difficulty making out conversations now.
With all due respect, people who have severe depression are left without many options on the medicine that works for them.
I believe you are giving medical advice and may not have the credentials to do so unless your PH.D is in pharmacology.
Those of us who suffer from depression really do not want to be on any medications, but when we are not on something, we really don’t care if we have hearing loss.
There really are few options for us.
Hi Melissa:
I’m sorry to hear of your severe depression. If you feel that Wellbutrin is all that will work for you, by all means take it. I’m not trying to tell you not to take it.
I do NOT give out medical advice. As I clearly said in the above article, I’m not a medical doctor and don’t practice medicine. Rather, I help to educate people as to the dangers of ototoxic drugs and sometimes point them in the direction of alternate solutions. It is up to them whether they choose to try something else–or even believe anything I write.
If you suffer from depression, there are a number of alternatives you can try if you choose to. However, if you are happy with your doctor’s drug protocol, follow it. Just know there are alternatives to ototoxic drugs if you care to search for them.
Cordially,
Neil
Thank you sir for this article and helping people. I developed tinnitus from Wellbutrin after just two weeks and at only 150 mg. I never increased my dosage although I satyed on it for up to a whole two weeks (month total) thinking it might go away as it was not loud. I ceased taking it and it and it’s gotten worse and louder after two months. Do you think it could even get worse and I could lose my hearing? Is there anything that could treat it or minimize the damage?
I have severe depression. I’ve tried taking Wellbutrin but stopped after having tinnitus and hearing loss. You can be damned sure I care about going deaf! I wasn’t warned that this could be a possible side effect.
All things considered I would have to choose the ringing over the depression. The ringing for me is crazy and I use headphones and a noise machine but the depression was worse.
Hi there. I started taking Bupropion last year. My doc told me there were no side effects. Sometime, during the year,I started taking it I noticed that my left ear was ringing and my hearing was getting worse in that ear. I saw comments about the drug possibly causing this problem so I asked the doc if that could be the issue. She said no because 1. this drug does not cause tinnitus or hearing loss, 2. it would not be in only 1 ear. So I just had a hearing test. One ear is perfect, the ear that is ringing has lost 30%. I was told these symptoms sound like an Acoustic Neuroma, which has scared the crap out of me. Today I had an MRI and I am waiting for results. I really feel like it was such a coincidence that these symptoms came after the start of this drug, but now I stay awake at night, like right now, waiting to find out if I have a tumor or something else. Have you heard of anyone else going thru this?
Hi Sunny:
Your doctor sure doesn’t know much about the drugs he prescribes, does he? In just 9 years, there were 7,205 reports of ototoxicity reported to the FDA’s database spread over 25 different kinds of ototoxicity ranging from hearing loss, tinnitus, hyperacusis to balance problems and vertigo, to middle ear conditions, etc., etc. To me that doesn’t sound like “there are no side effects”!
1. This drug DOES cause tinnitus and hearing loss. Numbers of people have reported this to me, plus hundreds upon hundreds more to the FDA. Interestingly enough, tinnitus reports outnumber hearing loss reports by approximately a ratio of 2:1.
2. Drugs DO cause hearing loss and tinnitus in just one ear. It doesn’t have to be in both ears like your doctor thinks.
I don’t think you have an acoustic neuroma. Drugs cause unbalanced hearing, just like acoustic neuromas do. I’ll bet your MRI comes out just fine, so don’t worry. But I would get off the Bupropion before it damages your ears further. The good news is that for some of the people, their hearing comes back and their tinnitus fades away. Unfortunately, for others, the damage is permanent. I hope you are in the former class.
Cordially,
Neil
“I can’t see any intelligent doctor prescribing this drug, knowing all its horrible side effects.”
It’s because it’s the only drug approved for depression that targets both norepinephrine and dopamine. I have treatment resistant depression, and it’s literally the only med that has ever helped me.
Unfortunately, after 6 years it suddenly started causing tinnitus. Reading that other people have experienced the same thing is helpful to know–because it assures me that getting off the med is the right choice–but it’s also meant that the last 10 months have been a totally debilitating series of failed attempts to find new meds.
I appreciate that you’ve done some very useful research. But please remember that you aren’t a medical doctor. Medical doctors have to balance a very low chance of tinnitus against debilitating illnesses for which some patients don’t have another good treatment option.
Hi Nate:
I appreciate you comment. I’m well aware I’m not a medical doctor, but I take umbrage over your statement that “Medical doctors have to balance a very low chance of tinnitus…” What do you call very low? According to the original studies, up to 4% of people taking Bupropion (Wellbutrin) get tinnitus, and this is a very conservative figure. Since 24,903,971 prescriptions were written for Wellbutrin in the USA in 2020, 4% of that number is 996,159. That means that potentially up to 1 million people per year get tinnitus from this one drug. I don’t call that a “very low chance”.
But do what works for you. I just point out the potential dangers of ototoxicity. You can use them however you want. It’s your choice.
Cordially,
Neil
I’m on wellbutrin and have been for around 3 or 4 years and I just started getting tinnitus about 2 months ago. I stopped taking it for a week and it stopped. I started back up because it definitely helps my depression. But the tinnitus returned after a day or 2. So it’s like I deal with the, unbelievably loud at times, ringing in my head, or the depression. I now take the welbutrin every other day and that seems to work best for me.
Im taking Welbutrin for 2 months now. Noticeable tinnitus and unusually difficult hearing TV tonite. So I googled “Welbutrin Hearing Loss”.
Thanks for the info!
I just started Wellbutrin 2 weeks ago, and I now have tinnitus. It didn’t start until the dose was increased from 150 mg to 300 mg.
Hi Amber:
Many times there is a “magic threshold” dividing where you get ototoxic side effects from taking a higher dose and where you don’t seem to get ototoxic side effects by taking a lower dose. I call it a “magic threshold” because no one knows exactly where it is for any given person. The trick is to stay below that threshold so you don’t get the ototoxic side effects while the therapeutic effects of the drug work for you.
In your case, it would appear that your “magic threshold” is somewhere between 150 and 300 mg but only time will tell for sure as some side effects may not show up for months or years after you start the drug.
Cordially,
Neil
I have the same issue. My doctor lowered the dose back to 150, but the tinnitus persists. Has it gone away for you?
Hi, thanks for the post and book. I have permanent tinnitus from taking generic wellbutrin. With hundreds of reported cases of permanent tinnitus, it does seem it should be on the warning label, and yes then most people may decide not to take it.
And I agree, no one should take it. Once you know it’s caused permanent tinnitus it’s too late. For me the tinnitus started immediately. I’ll never know if I would have stopped immediately if it would have gone away. I ended up continuing for several months, and then after stopping it’s never subsided.
One note, I participated in a clinical trial At UT Southwestern for a possible tinnitus treatment (BTW, it didn’t help me), but interestingly, the clinician told me she had also heard from numerous other patients she’s done tinnitus testing on that theirs was caused from taking Wellbutrin.
Thanks again for the post, and the forum.
Hello I am male 30 years old and I took Wellbutrin a long time ago as well as many other antidepressants before and after that and I’ve had Tinnitus for as long as I can remember or there’s periods of months or years why I don’t even notice it or probably don’t have it annoying level.
but now I’ve been on Wellbutrin for about a month and I just realized that’s the major change I’ve made in my life and my tinnitus has gotten significantly worse and I was having balance and hearing problems before I get these occasional deafness in my left or right ear last about 10 seconds I got this before trying Wellbutrin again seems like that’s either and ear hair dying or something else thanks for confirming that this drug probably does worsen tinnitus for people or gives it to them
Hi I had started taking welbrutin 150mg XR for ADD for 14 days from my pysch and then switched to 300mg and about 6-7 days later I is when i noticed ringing in my years…Which I though may have been caused from a going to the gun range a month before and i had issues with my hearing protection, but my ears were never ringing. Then I noticed today 11 days later on 300mg XR online several mentions it causes tinnitus, so I am going to stop taking it … From your experience do you know if the tinnitus goes away when you stop taking welbrutin?
Hi Omair:
Staying under 150 mg of Wellbutrin a day may not cause tinnitus, whereas increasing the dose to 300 mg per day often does. So if you had stayed at the lower dose you might not have gotten the tinnitus. Some do. Some don’t. But at least your risk would have been lower.
After you stop taking the Wellbutrin, for some people, their tinnitus drops in volume by half or more. Unfortunately, for others it stays at the same loud volume. I’m sure there must be people whose tinnitus totally went away, but I haven’t heard from any of them. I’ve just heard from people whose tinnitus persists.
Thus, you’ll have to wait and see what happens with your tinnitus.
Cordially,
Neil
Dear Neil,
you mentioned alternatives for depression that does not cause toxicity. Could you maybe direct me?
Hi Christine:
Sure thing. Here are links to three articles that give excellent advice on how to treat depression with (natural) ways that really work.
You would do well to read them and then act accordingly.
https://articles.mercola.com/sites/articles/archive/2011/11/06/vitamin-d-for-depression.aspx
https://articles.mercola.com/sites/articles/archive/2015/01/22/depression-causes.aspx
https://articles.mercola.com/sites/articles/archive/2016/07/14/depression-supplements-vitamins.aspx
Cordially,
Neil
I experienced tinnitus when i crossed the 300mg threshold. I loved Wellbutrin at 150mg (best 3 days of my life). When i increased the dose to 300mg, incredible anxiety, heart palpitations i could hear, insomnia, and tinnitus set in.
I stopped the Wellbutrin immediately (maybe 3 days after starting 300mg – 6 days total on the drug). My tinnitus DID GO AWAY COMPLETELY and hasn’t returned. It slowly went away – getting quieter and quieter every week.
I was actually considering trying the drug again and staying at 150mg, but now i remember how awful the tinnitus was…
Hi Dave:
If the Bupropion worked for you at 150 mg without tinnitus, it may do the same thing again–just don’t raise the dose. I’ve often said there is a magic threshold below which ototoxic side effects don’t show up, but increase the dose above that threshold and wham–there they are. I call it a magic threshold because no one knows exactly where it is for a given person. So you need to find it and then fly below it at all times. You could even reduce the dose to 100 mg and see if that works for you. If it does, so much the better. Find and take the lowest dose that works for you.
Cordially,
Neil
I just went up 75 mg from 300 Wellbutrin for Chronic Fatigue Syndrome, my dr tried to raise it up to 450 for energy? I was on 300 mg already..But I could not tolerate that. But now I’m trying 375 mg for about a week or two an I have a loud fluttering noise in my ear that’s stressing me out. Could it be the increase?
Hi Sheila:
I’ve not heard from anyone describing their resulting tinnitus from taking Wellbutrin as a fluttering sound, but I see no reason why it couldn’t happen. One person described theirs as a clicking sound–and both kinds of sounds can be related to the muscles in the middle ear going into spasms. So, unless there is a good reason to believe otherwise, I’d think your fluttering tinnitus is a result of taking the Wellbutrin.
The solution is typically to reduce the dose to below where you don’t experience such side effects (and hope they don’t become permanent).
Incidentally, if I remember correctly, taking Wellbutrin for Chronic Fatigue Syndrome is an off label use–and, if so, it has not been proven to be effective for this use.
Cordially,
Neil
Mine was fluttering too- I had about four different sounds randomly and inconsistently!
Hello , I wanted to add a comment regarding the fluttering that Sheila T. Reported having. The type of tinnitus she is describing sounds like pulsative tinnitus. I too take generic Wellbutrin (bupropion XL 150mg) and have been taking it for about 5 without any side effects. Recently I began to develop the fluttering that Sheila described and found out that there is another type of tinnitus that does not necessarily come with ringing. Pulsitive tinnitus caused you to feel a flutter type heartbeat in your eardrum. The sound is your own pulse and people can develop this kind of tinnitus because they gave an artery leading to the brain that is building in pressure that can potentially cause an aneurism. It can also be a sign of the coroated artery is clogging. There is also a tumor in the inner ear that can cause this fluttering and pulsing. These are very serious conditions and although the tinnitus piece coincides with taking Wellbutrin or its generic brands , it does not necessarily only come from taking the medication. I certainly don’t want to alarm Sheila but the source of that fluttering pulse needs to be looked at by an ENT ASAP. I wish her the best with resolving her pulsating tinnitus . I’m going to see an ENT right away as well before stopping a medication that has truly changed my life for the better. … Best Regards, Lainey
Hi Lainey:
Fluttering tinnitus may be a type of pulsatile tinnitus, but if it is pulsatile tinnitus it must be pulsing (or fluttering) in unison with each heart beat and Sheila did not mention that this was happening. Pulsatile tinnitus is more often a drumming, beating, pounding, throbbing or pulsating sound, rather than a fluttering sound.
A more likely cause of fluttering tinnitus is from tonic tensor tympani syndrome where the tensor tympani muscle in the middle ear goes into spasm and pulls on the eardrum causing this fluttering feeling/sound.
Since Sheila did not mention anything about her tinnitus being in unisor with her heartbeat and since it began coincidentally with the increase in the drug dose, my money is on it being due to the drug and not to clogged blood vessels near the ear, glomus tumors, etc., etc.
Cordially,
Neil
Hi Neil,
How long do you think it takes to see if the damage is permanent or not, once you stupped the wellbutrin?
Thanks,
Wiebrand
Hi Wiebrand:
My rule of thumb is to give it 30 days and typically that will be what your hearing will be like in the future. But this is not written in stone and your hearing may still improve after the 30 days. But after say 3 months if your hearing doesn’t come back in that time, I’d say the damage was permanent.
Cordially,
Neil
Thanks Neil,
I’ll keep hoping.. Also I’m trying to get in contact with GlaxoSmithKline B.V.. Hope makes life.. It’s dreadful
For me it only took one tablet of Bupropion (generic Wellbutrin) SR 150 mg to cause a feeling of fullness and ringing in my right ear. I never took the medication again and expected my ear would get better but it hasn’t. That was almost a 1 1/2 years ago.
I thought I was aware of the risks associated with this medication before taking it. Obviously I wasn’t, I was not aware that ringing in the ear could be permanent. The Bupropion was to be a short term treatment to help though a difficult time in my life. It only made thing worse. This medication needs to have a warning label wrt the risk of permanent tinnitus.
I agree! I had no idea. I would have never taken it in the first place.
I have had horribly loud ringing in both ears since a week or so before Christmas & it is driving me crazy! I have to have white noise to fall asleep lately & it’s only getting worse. I had a bad fall the other day as well & seem to be having balance issues & ended up falling the other day, cutting my lip, bruising my shoulder & arm, hitting my temple, & landing on my knees…one is being scheduled for replacement…not good!!
It wasn’t till a few minutes ago when I started thinking about recent medical/medicine changes & guess what? The only one I’ve had is changing from Nortryptilyne to Wellbutrine. This angers me to think that pharma hasn’t acknowledged this particular issue!! You better believe I’m going to be reporting this to the FDA & my doctor. Thank you for sharing your information!!
Hi Rebecca:
Bupropion can indeed cause all the sysmpoms you describe from loud tinnitus (hundreds and hundreds of people have reported this side effect to the FDA already), balance issues such as ataxia (staggering gait), vertigo and dizziness, etc.
This is NOT a good drug to take if you want to protect your hearing and balance.
Cordially,
Neil
Is there anything we can do? I can’t live like this. There has got to be a cure.
Hi Debbie:
Why does the HAVE to be a cure? When you damage your body, sometimes it is beyond your body’s ability to fix. This is what can happen with certain drugs. They permanently change your brain. Sometimes you can ameliorate the effects of the drug so the residual damage is minimal. This is what I think you’d need to do in this case. Probably the best place to start is to taper slowly off this drug, and if needed, replace it with a natural herbal.
Cordially,
Neil
I have been on Wellbutrin for 3 years now and only lately noticed the tinnitus. So thanks for the warning. I will ask to have my drugs changed.
I am very upset. I have been taking Welbutrin for approximately 3 years. I didn’t put two and two together until recently. My ears have been ringing since I started taking it. I also get a horrible pulsating feeling in my ears, usually at night while I’m in bed. I was recently diagnosed with Tinnitus. I also spoke with a Psychiatrist about this and she said most people have these symptoms when they are coming off Wellbutrin, not while taking it. She said I may have a sensitivity to the drug. I am very upset about this. I cannot live my life like this. I recently tried to quit taking it but the withdrawals are horrible. I need to slowly get off of this drug. I think we need a class action lawsuit!
Hi Debbie:
To get off these psychotropic drugs, you need to do it very slowly. Slowly to me means something like reducing the dose by 1/3 of 1% per day. Thus it would take you 300 days (or even more if you have to go even slower) to get off it.
To have a class action lawsuit, you need to get some qualified doctors on board who are willing to testify–and that is nigh impossible. And to win, you need to have lawyers and witness doctors that are better than what the drug companies can produce with their deep pockets.
Cordially,
Neil
I also started taking Bupropion and now have permanent tinnitus. I told my doctor after 30 days that I had the side effect but he did not say it was an issue and I kept taking it for another 6 months. My ears ring all the time. I also think there should be a class action suit. My tinnitus has not subsided at all since stopping taking the drug. I now take Vortioxetine (Trintellix) and feel great.
I took Wellbutrin for a very short time and have tinnitus that seems to be irreversible; this is not fair or as I made sure to ask my doctor about the side effects before going on it and he assured me it was not an issue
Hi David:
I know it is not fair–and your doctor most definitely lied to you (perhaps in ignorance). Just so you know, of all the ototoxic drugs of which I know (around 900), tinnitus from taking Wellbutrin is very common. In fact Bupropion (Wellbutrin) is the 7th most commonly-reported (to me) drug regarding having ototoxic side effects. Most of these reports are from people like you who got tinnitus from taking this drug.
Doctors SHOULD know this before they prescribe this drug.
Cordially,
Neil
Hi. Thank you for your work and this forum in particular. I have been taking 450mg of Wellbutrin XL for 5yrs now and not knowing any correlation I began experiencing some mild hearing loss over the past couple of years and just thought it was a matter of growing old (50). I noticed a need to increase my tv volume to be able fully hear all dialogue but more recently over the past couple of months I began to experience tinnitus. Initially it was only noticeable if there were no other distracting sounds but more recently it has become louder and more chronic and sharply increases in volume if my jaw is clenched biting down. I was never concerned about the max dosing because I’m above-average in size at 6’1″ 250lbs and because it helped bring me out of a dangerous depression. Because of the tinnitus my doctor wants to change me over to Prozac but I was hesitant because of the benefit I’ve experienced and don’t know much about Prozac. BUT since having read your comprehensive work just now I will immediately be contacting her to make that transition. I don’t really have any questions but wanted to thank you and add my own experience to your research, while alerting others who might read this. I am very much interested in any type of class-action lawsuit if you or anyone reading this has knowledge of one but in the meanwhile just thanks for this forum.
I started zyban around 10 days ago, 300mg for the last week.
Ringing in my ears just started today but it’s pretty loud actually causing some discomfort because it’s been going all day.
I won’t be taking any more of this after reading this board! Really hope this wares off!
I have been in denial about being depressed for a long time… I didn’t have an erection for around 3 solid months before taking zyban, the last week i have been waking up and walking around with spontaneous erections which has been awesome!
Any idea what else I could try?
Pretty much all other antidepressants cause sexual
Impairment and this had 100% helped!
Hi Tony:
The way to treat depression is to first determine the cause, then deal specifically with that cause and your depression should lift. For example, depression can be caused by poor gut flora, lack of exercise, lack of sleep, etc. etc. Taking probiotics, getting proper exercise and sleep can do wonders for your depression. So can counseling by a counselor skilled in dealing with depression.
As you have found out, anti-depressant drugs have unwanted side effects that are often worse than the depression itself.
However, if you want to try a natural anti-depressant that is not ototoxic, you might want to check out St. Johns’ Wort. It works well for many, many people. Just be sure to get a bottle that has on it the words “standardized” and Hypericin ( the active ingredient) and 0.3% to 0.7% so you know exactly what strength you are getting.
Cordially,
Neil
Hello, I don’t see a work cited… Where are the research articles? I would like to read them myself.
Hi Corey:
Read the first sentence in my reply in this article. I state clearly that I’m not aware of any research studies done specifically on Wellbutrin to prove that it’s ototoxic. However the growing pile of anecdotal evidence shows that it is quite ototoxic.
Cordially,
Neil
Hi, this is the only place I’ve found on the web regarding the association of ear pain associated with Wellbutrin use, so I thought I’d post and ask questions on what to do next! Quick history: I am currently a 40 year old healthy woman. I had had a divorce and loss of a parent in sequence and tried therapy alone for over two years to deal with the grief and depression. Finally after 2 years of weekly therapy and support groups my therapist recommended I consider antidepressants. I had taken Wellbutrin in the past when I was in my late 20’s and it worked great, I never had a problem. So when I went to my psychiatrist I let him know my history and he put me on Wellbutrin since I was satisfied with the results prior.
The first day of my first dose of 150mg in the morning I immediately had ear buzzing…I brushed it aside as a side effect and thought it would subside. I then increased my does to 300mg on day 4 as MD directed and I had the most unbearable pain in both of my ears. I popped every pain pill I had and again brushed it aside as a side effect that would go away. When I went back to the psychiatrist for the next appointment after about a month, I told him what was happening and he immediately took me off Wellbutrin, but didn’t say much about the ear pain side effects. Today it has been 28 days since my last dose and I just left my local urgent care due to the persistent and worsening of my consistent ear pain, ear ringing and tiniuts. He basically told me nothing was wrong with me and he couldn’t help me. I asked if I should see and ENT specialist and he said he would refer me but didn’t think he could help 🙁 the urgent care doc told me to take a decongestant and sent me on my way. My ear pain, ear clogging feeling and tinitus has not improved in a month since my last dose. What can I do? Will an informed ENT doc know how to help me?
Hi Krista:
I feel bad for you because it seems you are stuck with the negative side effects of Bupropion (Wellbutrin). I hear from many people who now have permanent side effects such as hearing loss, tinnitus and ear fullness from taking this drug.
Some people find their tinnitus decreases over time. Others aren’t so lucky.
The first thing you need to determine is whether your ear pain, ear clogging feeling is based on real ear congestion or not. If it is due to ear congestion, then decongestants may help. But I suspect that it is NOT due to actual ear congestion, but more a psychological pain. If that is the case, then decongestants won’t help.
Unfortunately, most doctors fight such symptoms by prescribing other drugs which just cause other problems.
You can learn how to take control of your tinnitus so it will not bother you, even though it may never go away. So that is the second thing I’d do. You would do well to read the latest edition of my book “Take Control of Your Tinnitus” to learn how to do this. I’d particularly recommend chapter 16. You can get this book at http://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/.
Cordially,
Neil
Neil,
It seems like many or most of the prescription anti-depressants have the same problem as Wellbutrin…not officially deemed ototoxic (for the reasons described in your article), but then no shortage of patients taking to the web with horror stories about hearing loss and tinnitus as a result of using them.
But of course, as others have commented, the need for anti-depressants is sometimes very real and very necessary too.
Therefore, I’m wondering if there are any prescribed anti-depressants you know of that do not return a string of hearing loss claims when one googles them to check their safety?
I notice one other commenter saying they plan to switch to Prozac as an alternative. Is the incidence of ototoxic effects any lower with that drug? And/or which if any of the major anti-depressants appear to be the safest choice for those who are particularly concerned with hearing related impacts?
Much thanks for any better options you can name.
Hi Al:
You are right that all antidepressant drugs are ototoxic. Yes, some are more ototoxic than others. For example, Paroxetine (Paxil) and Sertraline (Zoloft) cause hearing loss in numbers of people. Behind them come Citalopram (Celexa) and Escitalopram (Lexapro). Distantly trailing them are Fluoxetine (Prozac) and Fluvoxamine (Luvox). The least ototoxic are Zimeldine (Zelmid) and Vilazodine (Viibryd).
So that gives you a clue what to expect. Thus Prozac is definitely better than Paxil, Zoloft, Celexa and Lexapro in that respect. But Zelmid and Viibryd are probably even less ototoxic.
And if you want to take something that is not ototoxic at all, try the herbal St. John’s Wort. Numerous studies have shown it just as effective as the above drugs so it seems to be a great alternative.
If you take St. John’s Wort, just be sure that the bottle says certain things. First–it has the word “standardized” on it. Second, it tells you that the active ingredient, Hypericin, is standardized to a given level–namely somewhere in the range of 0.3% to 0.7%.
I know numbers of people that have switched to St. John’s Wort to control their depression, without negative side effects–including my wife.
Cordially,
Neil
Huge thank you for all the added info. I tried SJW long ago without a ton of success. But good chance that I was not armed with the details about being standardized and at certain levels. So I’ll give that another shot. Thanks again for all of the critical information.
Hi Al:
Also, give it time. Natural herbals don’t act as fast as do prescription drugs.
Cordially,
Neil
I think it’s important to warn people that you have to be careful with natural supplements too. SJW can cause photosensitivity and have bad interactions with other drugs so taking the amount required to have a therapeutic effect for depression should happen while being monitored by a professional. Also, people who are depressed have a hard time sticking to routines and I know you have to take SJW multiple times a day for it to have the right effect and even tho it sounds “silly” staying on top of taking more than one pill a day on a schedule can even be too much for people who are struggling. Not discounting the effects of SJW but think it’s important to note these things.
Hi Dominic:
Yes, St. John’s Wort can cause photosensitivity in some people. And you are correct that some drugs interact with St. John’s Wort–so you have to be careful if you are taking any othe psychotropic drugs. If not, its not really a problem.
I don’t know where you get that you have to take SJW multiple times a day. I’ve only seen people take it once a day. What does were they taking. Was the SJW labeled as being “standardized” and to 0.3 to 0.7% hypericin? If it wasn’t standardized then they could be getting any amount of hypericin or none at all.
Cordially,
Neil
P.S. Just curious where you would fit Wellbutrin into the above hierarchy of Ototoxicity? Is it as bad as Paxil & Zoloft? Or more in line with Prozac, etc.?
Hi Al:
I’d put them in this order from least ototoxic to most ototoxic–Prozac is definitely the least ototoxic, then way down the list would be Paxil and Zoloft, and bring up the rear much further down is Wellbutrin.
Cordially,
Neil
I am an audiologist and have been since 1986. In 2007 a 14 year old was sent to me by an ENT for hearing aids with a flat sensorineural hearing loss in both ears. I was taking my pharmacology course for my doctorate and when I saw he was taking Wellbutrin, looked in up (In one of our textbooks, your book!) When I saw it COULD be ototoxic I called the prescribing physician who agreed he had never heard of that but “let’s try!”. Switched his medication. 3 months later his hearing was normal. 3 months later still normal. I would have put hearing aids on him and he would have been in a hearing impaired classroom for high school!
Since then I have maybe seen 100s of people on Wellbutrin with no effect on hearing, but maybe 20 that it did affect.
Audiologists need to be suspicious of ototoxicity if there is a flat sensorineural hearing loss with no obvious cause.
My view is who cares PDR states a medication affects one in a million if you are that one! Always consider you may be that one!
I am so glad I found this site. I have been plagued with a pulsatile tinnitus and just today it has gotten worse and is screeching in both ears. I was on 300 mg Wellbutrin but went down to 150 mg when I first complained to my doctor, but now I think regardless of what anyone says I will take myself OFF this drug completely!
Hi Sarah:
I agree with you. Hundreds upon hundreds of people have reported tinnitus from taking this drug. Hundreds and hundreds more have complained about auditory hallucinations, and hearing loss and thousands more about balance issues. It’s not a drug I’d ever want to take.
Cordially,
Neil
Hi. Depression over hearing aids. No question for this bi-polar sufferer. All other anti-depressants were ineffective or too debilitating in other unpleasant ways. I’ve taken 450 mg of Wellbutrin for 21 years and very rarely suffer from a day or two of depression. It could be the Wellbutrin but on other meds, given that bi-polar disorder often includes multiple other issues. So hearing aids over the possible horrible outcome of so many inadequtly treated suffers of this disorder, I’m going with hearing loss. One mans opinion…..
I was only on Bupropion for 8 months and Tinnitus came on, I got off it, it has been 4 months and the Tinnitus has not let up, I am becoming worried as I am not able to sleep it is so loud. If there was a class action I would be onboard in a heartbeat.
Hi Richard:
It sounds like your tinnitus will be permanent. You are in good company. Hundreds or thousands of others are in the same boat. You need to learn how to effectively deal with your tinnitus so it no longer bothers you. If you need some direction, let me know.
Cordially,
Neil
I have been taking Wellbutrin for many years. I have 40% hearing loss. I had no idea until today that they might be connected. Is there any point in stopping the medication now? Could continuing to take it cause continued loss of my hearing?
Hi Debbie:
Hundreds upon hundreds of people have reported getting hearing loss from taking Bupropion (Wellbutrin). And double the number have reported getting tinnitus from this drug. On top of this, thousands upon thousands of people have reported all sorts of balance issues. And there there are the other ototoxic side effects they report. So it can damage our ears in many different ways.
It seems the higher the dose the more damage it does. You don’t mention your dose, but if it is less than 100 mg, you may avoid many of the side effects but above 150 mg they side effects can become more common and be much worse.
And some good news. If you stop the Bupropion, you may get some or most of your lost hearing back. Your tinnitus may reduce in volume, but typically not completely go away. So stopping this drug may be very beneficial to your ears. You’d need to slowly taper off it of course.
One lady found that dumping the Bupropion and taking Vortioxetine (Trintellix) instead did the same job as the Bupropion but without the side effects. So you might want to ask your doctor about switching and see how it affects you.
Cordially,
Neil
Hi, I have been taking 150 mg of Wellbutrin and recently suffered 100percent hearing loss and severe tinnitus. I was told a virus did this but my increased dizziness and off balance has led me to suspect otherwise. I am stopping the drug immediately and will discuss this with my doctor. Thanks for the information.
Hi Debbie:
Bupropion (Wellbutrin) can cause 25 different ototoxic side effects including the 4 you’ve experienced, namely hearing loss, tinnitus, balance disorders and dizziness. Viruses can cause these same 4 disorders.
If you had a recent (last 2 weeks before the hearing loss episode) virus active in your body–cold, flu, herpes, etc., etc. then there is the possibility that a virus caused it, but if you didn’t have any active virus in your body, then it would be unlikely. In that case, the obvious culprit is the Bupropion.
Other people have reported being on Bupropion for some months or years and then suddenly wake up one morning and be totally deaf in one ear (more commonly) or both ears (less commonly). So you are not alone in your experience.
Cordially,
Neil
I’m super glad to have found this site, thank you Neil, this website is the only one that clearly states the risk. I started at 150mg 3 weeks ago, which were ok, the upped to 300, and boom, huge tinnitus, searched the web, found your site, and immediately downed to 150mg. I’m not just having tinnitus tho, my mouth and tongue is badly covered by canker sores, and terrible sore throat like an angina. I found a forum listing many cases having the same: https://www.drugs.com/answers/wellbutrin-you-experienced-sever-canker-sores-649281.html
So, bupropion is not just ototoxic, but also affects the tissues in the mouth, tongue and throat in many cases.
How do you call the toxicity for the mouth and trhoat ??
I’m still on 150mg, and still don’t see an improvement. I wnt to persevere though, as it is supposedly a good complement to sertraline.
Is there another NDRI safer than this poisonous bupropion?
I am actually stunned by the fact that we still use drugs from 1960’s that have such harmful effect. How come in 60 years of research, a 4th, even 5th generation has not been researched?? This is such an important problem in society. I believe that pharma companies actually DO have much better drugs to treat depression and anxiety, but meds like bupropion and sertraline bring so much benefit, that they just don’t release them unless these become too exposed and constroversial. The problem is that these severe advers effects are affecting ‘only’ about 10% of users. But that represents millions. It’s just amazing, and ugly to consider this fact.
do you kave any suggestion as safer NDRI?
Also, do you happen to know the real fact about the interactions between sertraline, bupropion, and lamotrigine taken together every day? That’s the regimen I started a month ago, and still not out of side-effects, also I fell much more stable and start to be motivated again.
Hi Lexa:
You are not alone in getting tinnitus as soon as you upped the dose to 300 mg from 150 mg. Even 150 mg gives some people roaring tinnitus. I’m wondering if a safer dose would be 100 mg. That seems to work for some.
This drug is not just ototoxic, but affects many parts of your body. I’ll bet it has 300 or more reported side effects, apart from ears and canker sores. Since I just report on ototoxic side effects that’s all I show, but don’t let that fool you. There are many other side effects.
There is no guarantee that going off Bupropion will get rid of your tinnitus. For some people, their tinnitus drops significantly in volume when they go off this drug. For others, it stays the same and is permanent.
Diclofensine has FAR fewer reported ototoxic side effects–so that may be one to try. Varenicline has about half the reports of Bupropion, so that may be less risky. But one lady dumped the Bupropion and switched drugs.
She wrote, “I started taking Bupropion and now have permanent tinnitus. I told my doctor after 30 days that I had the side effect but he did not say it was an issue and I kept taking it for another 6 months. Now my ears ring all the time. My tinnitus has not subsided at all since I stopped taking the drug. I now take Vortioxetine (Trintellix) and feel great.” Since Vortioxetine doesn’t have many ototoxic reports, you might want to run this by your doctor and see what he says.
You have to do your due diligence before taking any drug. No one is going to tell you all the possible side effects–just a few of the main ones–and typically that does not include ototoxic side effects.
I don’t have a clue about the interactions between various drugs. Some combinations are synergistic. That is why taking multiple drugs can greatly increase your risk of side effects. So taking as few as possible is a good idea.
Cordially,
Neil
Thank you sir! Will ask my doctor about Diclofensine, Varenicline, and Vortioxetine. Will definitely switch if I don’t feel an improvement after two weeks. All best, and thank you for doing such a great job at preventing people about these risks.
Hi Neil, I’m so appreciative of your site and all the research and knowledge on here.
Just wanted to ask you whether it makes a difference between Wellbutrin XL vs Wellbutrin IR. Do you find that there are less reports of tinnitus regarding the instant release version? Because I keep reading about the 150mg XL and 300mg XL causing tinnitus, especially the jump from the 150mg to the 300mg.
I’m just struggling because I’ve now tried many antidepressants including Trintellix and have found nothing like the NDRI effect of Wellbutrin. It just helped me a lot so I am considering 100mg but wondering if the IR might be better.
Just looking to you for an opinion.
Thanks so much.
Hi Mariam:
I have no information on whether instant release is more or less ototoxic than extended release versions. It’s hard enough just gathering data on the basic drug itself.
I can tell you that the dose does make a difference. The higher the dose, the greater the risk of ototoxic side effects. So keeping the dose as low as possible means you could fly under the ototoxic radar and not have any obvious ototoxic side effects.
Cordially,
Neil
Oh man. I started taking Wellbutrin earlier this year, and was on it for almost six months. It was just 100mg of the slow release formula. I stopped cold turkey and had a few little brain zaps on day two, a numb wrist for four hours on day three, and now on day four I’m having ringing in my ears. Yawning pops them, but it comes instantly back. I’m really hoping this is a short term symptom like the others were.
I’m a 36 year old, overweight female with high blood pressure that I manage with another low dose prescription, but that’s the only other medication I take, and I’m working on a diet and exercise programs to get off that as well. I gotta be honest, I was not expecting any withdrawal symptoms from Wellbutrin since I was on the lowest dose for less than six months. I think it helped me get over a super rough patch in my life, but now I’m regretting taking it.
I am super bummed by the withdrawal symptoms, but I was happy to find this forum, as it helped me understand what’s happening. I figured if the ear ringing lasts longer than 3 days I’ll make an appointment with my provider. But for now, thank you for the information.
-Megan
Hi Megan:
When you are taking psychotropic drugs, you never want to quit cold turkey as that leaves you open to withdrawal side effects.
Some people find that after stopping this drug, their tinnitus volume drops way down, but doesn’t go away. Unfortunately, other people find their tinnitus persists at the high level. There’s no way to tell in advance. That is why I try to avoid all such drugs and use other means to control anxiety and depression, etc.
Six months is more than enough to change your brain and thus leave you open to getting tinnitus while you are on the drug, or when you stop taking the drug.
What are you expecting your provider to do if your tinnitus persists–give you another drug (and likely just compound your problem)? There is no drug approved by the FDA for treating tinnitus, so don’t expect your provider to do much.
Cordially,
Neil
Neil – do you think I should take Predisone my ENT described to help with the onset of Wellbutrin induced Tinnitus? I can find much on it and not sure if you’ve heard of this helping or not.
Hi Pam:
Some doctors seem to think that Prednisone is the treatment for most ear condition, but I don’t know where they get their facts from.
You can try it and see whether it helps you or not, but I wouldn’t hold my breath. I haven’t seen any specific information that it helps, but then, I haven’t specifically looked for any either.
Cordially,
Neil
Hi. I was on Bupropion 150 mg for about 1,5 months.
While I was on it one morning I woke up and my left ear was clogged and the skin on that ear and the left side of my jaw and neck was clompletely numb. The symptoms went away in an hour or so.
But the next morning my left ear was clogged again, and this time it didn’t go away. It didn’t even cross my mind at that point that it might have something to do with Bupropion.
The clogged ear lasted for three days straight. On the fourth day the ear opened suddenly and my hearing was otherwise back to normal except that there was a low humming and momentarily roaring type of tinnitus. It was then that I googled ‘bupropion hearing problems’ and realised that the medication had probably caused it all.
Needless to say, I stopped taking it immediately.
I haven’t had that clogging anymore (it’s been now over a year without Bupropion). The humming, roaring tinnitus persisted for a couple of months on and off daily after stopping the medication, but has now mostly gone away. It does still happen occasionally (maybe couple of times a month) and it seems to be triggered by car engine sounds sometimes that I hear from the street into my otherwise quiet appartement.
Based on my own experience I would advice to stop Bupropion immediately if you experience any type of hearing problem. Then the likelihood perhaps is higher that they are reversible.
Wishing good health to you all.
Hi Johanna:
Your experience with Bupropion mirrors what numbers of other people have found. I hope people reading this will take your advice and save themselves needless ear problems.
Cordially,
Neil