Neil Bauman, Ph.D.
© October, 2017
Drugs are a fickle lot. You take a drug to fix one problem, only to find it causes another—and often worse—problem. For example, some antidepressant drugs alleviate symptoms of depression and anxiety by increasing the level of serotonin in your brain. Unfortunately, at the same time, this increased level of serotonin can affect your tinnitus.
Two such classes of antidepressant drugs are the popular Selective Serotonin Reuptake Inhibitors (SSRIs) and the Selective Serotonin & Norepinephrine Reuptake Inhibitors.
Selective Serotonin Reuptake Inhibitors include such drugs as Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Fluvoxamine (Luvox), Paroxetine (Paxil), Sertraline (Zoloft), Vilazodone (Viibryd) and Zimeldine (Zelmid). (Note: generic drug names are in bold while brand names are in italics.)
Selective Serotonin & Norepinephrine Reuptake Inhibitors include drugs such as Desvenlafaxine (Pristiq), Duloxetine (Cymbalta), Milnacipran (Savella) and Venlafaxine (Effexor).
Every one of the above drugs have tinnitus as an ototoxic side effect.
Unfortunately, people taking SSRIs prescribed to treat their anxiety or depression are often blindsided by the resulting tinnitus. You see, these drugs can cause tinnitus, or make your existing tinnitus worse. The result is that your anxiety and depression actually increases, not decreases.
For example, Zheng-Quan Tang, Ph.D., “noted that a review of existing scientific literature indicated that many patients reported an increase in tinnitus soon after they began taking SSRIs.” (1)
This is nothing new. I’ve received more anecdotal reports of tinnitus resulting from taking the SSRI drug Citalopram (Celexa) than for any other drug.
Numerous people get tinnitus from taking this drug and some are left in worse condition than they were before they started taking the drug. For example, one man told me, “The irony is that the Citalopram I was taking for stress has caused me to have tinnitus which is now triggering more stress than was there before I started the drug.”
Another man explained, “This is so ironic. I started on Citalopram to reduce my depression and now I’m depressed over the side effects of using it.”
Yet another man lamented, “Because of my physical limitations, my depression is terrible. I started taking Citalopram on July 13. I stopped 17 days later because of severe ringing and hissing in both my ears—actually through my whole head. It’s unbearable. My depression is only more-so now.”
And a lady observed, “I took Citalopram 20 mg for 2 days in early November and my tinnitus that was very mild became much worse. Now it is the middle of January and it has still not improved and I am very depressed.”
Medical researchers at the Oregon Health and Science University have recently discovered why these antidepressants make tinnitus worse. Their study focused on serotonin, otherwise known as 5-HT, an important brain neuromodulator (2) and the dorsal cochlear nucleus (DCN), a part of the brain where auditory and multisensory integration and tinnitus occur. They discovered that fusiform neurons in the DCN become hyperactive and hypersensitive to sound when exposed to serotonin. (1) This can result in louder tinnitus.
What is the take-home message? Simply this. Be very careful when considering taking antidepressant drugs if you want to avoid tinnitus in the first place, or if you want to avoid having your existing tinnitus become worse. And a word to the medical professional. “If you’re a doctor treating a person for depression who already has hearing loss or tinnitus, you need to be careful about prescribing a drug that compounds their feelings of anxiety. The SSRI may be enhancing the very thing you’re trying to fix.” (1)
It’s much better to treat depression with natural, non-ototoxic solutions such as proper diet, exercise and if necessary, a herbal such as St. John’s Wort, which a number of studies have shown to be just as effective as prescription antidepressants.
Note: if you take St. John’s Wort, be sure that the packaging explicitly states that the active ingredient—hypericin—is standardized to a given level, typically somewhere between 0.3% and 0.7%. This is very important. Some formulations don’t mention this at all. As a result, you don’t know whether you are even getting any of the active ingredient or not.
________
(1) Oregon Health & Science University. “Serotonin may worsen tinnitus.” ScienceDaily. ScienceDaily, 22 August 2017. www.sciencedaily.com/releases/2017/08/170822123836.htm.
(2) Zheng-Quan Tang, Laurence O. Trussell. Serotonergic Modulation of Sensory Representation in a Central Multisensory Circuit Is Pathway Specific. Cell Reports, 2017 DOI: 10.1016/j.celrep.2017.07.079.
Dave
Hi Dr. Neil,
I had just left a comment asking for your opinion on the home page and then saw your book on Ototoxic drugs that sparked my interest. I mentioned that I had abruptly stopped my SSRI’s on Feb. 1, 2019 but failed to say what they were. I’ve been on these 2 medications since late 2015, Seroquel XR 50mg, 2 @ bed-time & Cymbalta 60mg, 1 @ wake-time. I owe my quality lifestyle to the balance of these 2 drugs taken at the correct times and dosing.
I had no Withdrawals from the abrupt stop or side affects to speak of. I see my psych doc in 2 days and I’m sure she’s not going to be happy but funding became the issue. I was sort of tense the first day, maybe 2 but I knew what to expect but it never showed up.
My Tinnitus started a month before that so I can’t say stopping the SSRIs effected my Tinnitus. I believe it made me more aware of it though. I thought it was a cool white noise at first, one I didn’t have to generate to help me go to sleep, I do use it for now to aid in sleep. It screams so loud now that I’m constantly wondering what’s leaking, or who’s behind me. I want to know what to expect next so I’m not caught off guard by anything. Half the battle to getting thru a symptom and getting thru it comfortably is knowing what to expect. So many get folks get freaked out when something happens that they should have known about or knew about but didn’t believe it. Knowing what to expect alleviates some of the uneasy pinned up stress over excessive worrying.
In my particular case, the SSRIs didn’t play a role in my Tinnitus, I think…
Regards,
Dave
Hi Dave:
It’s not a good idea stop any psychotropic drugs cold turkey. When you do that you never know what untoward side effects might pop up. However, that doesn’t mean that you have to get any serious negative side effects, and hopefully you won’t.
There is no way to know whether your tinnitus will prove to be permanent or will be just temporary. However, the more you worry about your tinnitus, and the more you think about it, the worse it tends to get. Therefore, you are better off focusing on the lips of your life and thereby totally ignoring your tinnitus. When you do this you give your limbic system permission to allow your tinnitus to fade into the background.
If you focus on your tinnitus, in contrast, that tells your limbic system that this is an important sound and so it makes it louder and more intrusive, and it will never fade away.
Cordially,
Neil
Hi Iv been taking venlaflaxin for approx two yrs now and it gave me tinnitus within days but it was bearable and I thought if the benefits out way it I can live with the tinnitus. However this week it’s been getting worse and I feel my hearing is muffled is this normal or is something that can happen after a long period of time or is something else going on?
Hi Sue:
Certainly Venlafaxine causes tinnitus in numbers of people. But it also causes hearing loss in about half as many as for tinnitus.
I don’t have any information to indicate how long it takes for hearing loss to show up when taking Venlafaxine–so it is possible that the Venlafaxine in the culprit, but there could be other things going on. I’d need to know far more about your hearing history, etc. before I could venture an opinion on that.
Cordially,
Neil
Hello Mr Neil
I got tinnitus 3 months ago and started to take escitalopram last 5 weeks. After 4 weeks of use I feel like my T is coming back since I had an improvement on the 3rd week of use of escitalopram. So is the cause of the worsening the antidepressant or not? And how long should take to see if the antidep is worsening or making T more quiet?, Thanks
Hi Zoran:
Escitalopram can certainly cause tinnitus as hundreds of people have reported. For some people the tinnitus seems to be temporary and goes away when they get off the drug. For others, it appears to be permanent.
If you go off the antidepressant for say a couple of weeks or more and your tinnitus calms down or goes away, then you know that the anti-depressant is the culprit. If your tinnitus stays the same, either some other drug is the cause, or it has caused permanent tinnitus.
I certainly wouldn’t take a drug that causes tinnitus in hundreds and hundreds of people to try to calm down my tinnitus. It’s just not logical.
Cordially,
Neil
Hello everyone,
There is information about Taurine and GABA supplements that can help put the BRAKES on Tinnitus.
I don’t know whether it is just garbage but if you can take control of the ringing.. it’s worth a try.
What do you think about that Neil? Here’s a video for people to watch.
https://www.youtube.com/watch?v=izFc3D4XQJY
Hi Nico:
There is truth in this, but it’s not quite as simple as the doctor makes it out to be. Our bodies are very complex and in order to work properly, everything needs to be in balance. If we have too much glutamate or aspartate, which are excitatory neurotransmitters, that speeds up our brains and enhances tinnitus. By the same token, if we have too much gamma-aminobutyric acid (GABA), a primary inhibitory neurotransmitter, it slows our brains and tinnitus down. Incidentally, magnesium also slows things down.
Thus, you want the correct balance between “tromping on the gas” and “slamming on the brakes” to keep your body functioning properly, which includes keeping your tinnitus under control.
Thus, if your tinnitus is acting up, you may want to stay away from glutamate foods and eat more GABA foods to get things more in balance.
Taurine is a type of amino acid that works on both sides of the fence so to speak. Thus it works with glutamate, but also with GABA. In one study, 12% of the participants taking taurine supplements completely eliminated their tinnitus. But note that the other 88% did not. So don’t go overboard on taking taurine. In some cases it may help, but mostly it won’t if this study is indicative of the general population.
Getting your glutamate and GABA in proper balance is not a sure cure for tinnitus, but it will certainly help some people with their tinnitus, especially if their bodies are way out of whack.
An easy-to-understand article on the subject by Barry Keate, the head honcho at Arches Tinnitus Formula, will help you understand what goes on regarding these neurotransmitters. You can read it at https://www.tinnitusformula.com/library/brain-calming-supplements-for-tinnitus/ .
Cordially,
Neil
Hello gain Neil,
Thanks for replying again. Have you tried any supplements yourself? Have you worked for you?
Many say Taurine needs to be taken 3 times a day at 1000mg dosage.. and it can take even 6-8 weeks before you notice your tinnitus getting softer and easier to handle.
Many are talking about it in a Facebook group.
Here’s a very interesting story.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997922/
Dietary taurine supplementation eliminated tinnitus (constant ringing in the ears) in rats. Higher amounts (4 mg/mL vs 1 mg/mL) and frequencies of taurine supplementation yielded better results [123].
The GABA like calming action of taurine in the brain auditory circuits may be responsible for this improvement [123].
Hi Nico:
Just remember, you need to keep your body in balance so you don’t want to take so much taurine that things get out of whack. But taking taurine for some people seems to be a viable treatment.
Cordially,
Neil
Hi Nico:
I’ve never tried taurine, but then, I don’t let my tinnitus bother me, and because I am so habituated to my tinnitus, it would be hard to know whether it was doing anything or not to my tinnitus.
Cordially,
Neil
Alright Neil,
Thank you for answering!
I’m going to try to take Taurine 1g – 3 times a day so that’s 3g in total and see for 6-8 weeks what happens.
Maybe it will help, maybe not. I just want to try something.. i have it pretty severe so you must understand. Sometimes i notice it being in the background and not bothering me but it does affect my life in a negative way.
Check these out:
https://www.healthline.com/nutrition/what-is-taurine
Taurine helps:
Neurotransmitters. Taurine functions as a neurotransmitter and neuromodulator in your brain. Activating GABA and glycine receptors which affects memory and mood and prevents seizures.[ii]
Neuroprotectant. Taurine protects brain cells by reducing intracellular free calcium (Ca2+) concentrations.[iii] It is a potent antioxidant, protects from mitochondrial dysfunction, modulates energy metabolism within cells, modulates genes to induce longevity, inhibits cellular stress associated with Alzheimer’s, acts as ‘quality control’ in brain cell health, and protects against stroke.[iv]
Neurogenesis. Taurine increases stem cells and progenitor cells (neural precursor cells) in your brain including the aging hippocampus and increases the survival of newborn neurons (neurogenesis).
More INFORMATION:
Taurine Helps Reverse Tinnitus
Taurine plays a vital role in hearing. In fact, studies have found that in some cases, taurine can reverse the biochemical processes behind hearing loss.53,54 Other studies have demonstrated that taurine can almost completely eliminate the ringing in the ears associated with tinnitus.55
Much of the damage to hearing occurs not in the mechanical parts of the ear, but rather in the nerve cells that convert sound waves into the electrical energy that is perceived in our brains. Like other nerve cells, these so-called “hair cells” depend on the flow of calcium ions into and out of the cell. Taurine helps restore and control normal calcium ion flow in auditory cells.53,56
Taurine improves the hearing ability in animals exposed to drugs like the antibiotic gentamicin, which is notoriously toxic to hearing.54 And in a boon for the 17% of us troubled by chronic tinnitus (ringing in the ears), taurine may be helpful in quieting the noise.57 Animal studies using human equivalent doses of 700 mg to 3.2 grams per day of taurine over the course of several weeks demonstrate near-complete resolution of tinnitus with taurine supplementation (the animals had been trained in tasks that are sensitive to distraction by tinnitus).55 And a human pilot study has shown encouraging results, with 12% of people responding to taurine supplementation.
Source: https://www.lifeextension.com/magazine/2013/6/The-Forgotten-Longevity-Benefits-of-Taurine/Page-01
There’s a man who got Tinnitus from Gabapentin and he’s using CBD Oil to make it go away. What’s that all about? It sounds interesting.
There’s also someone who said that Mirtazapine (Remeron) reduced their tinnitus 50-75%. This is really, really weird ?
Sorry for commenting so much, there’s just so much information that’s interesting. Please tell me what you think Neil. I would appreciate it!
Hi Nico:
Let me know how your experiment with Taurine goes. Just remember, it doesn’t help all people with tinnitus, or even the majority of them. In fact, according to your above article, it only has “encouraging results” for 12%. That means it does not work for 88% of the people with tinnitus who tried it.
Gabapentin can indeed cause tinnitus. I’d be cautious of only one man’s opinion about using CBD oil to help his tinnitus. Like taurine, it may work for some people, but certainly not the majority of people with tinnitus.
Mirtazapine is a tetracyclic anti-depressant. Numbers of people have reported getting tinnitus, hearing loss, balance problems, etc. from taking it. But on the other side of the coin, some people may find it helps their tinnitus–basically by calming them down so they don’t worry about their tinnitus. But they probably don’t worry about anything else either when they take it. So it is not a drug I’d take for tinnitus (or anything else for that matter). Remember, the FDA has still not approved ANY drug for treating tinnitus. So that shows you there are not outstanding results from taking any drug to help with your tinnitus.
Cordially,
Neil
Hello Neil,
You are correct. I have just ordered 180 capsules of Taurine 1g. It was around 22 euroa and included shipping.. i think its a fair enough deal to try it out.
Have you seen this.. it’s very interesting:
https://www.hindawi.com/journals/crips/2016/1790692/
I found this aswell, it’s basic information but still good.
Serotonin is a chemical compound that acts as a neurotransmitter in the brain. It is thought to be responsible for maintaining mood balance. Some antidepressants are known as selective serotonin reuptake inhibitors (SSRIs). (SSRI antidepressants include Prozac, Zoloft, Paxil, Celexa, and Luvox.) Recent research from Oregon Health & Science University suggests that some SSRIs may sometimes worsen tinnitus.
Researchers discovered that neurons in the ‘dorsal cochlear nucleus’ part of the brain become hyperactive and hypersensitive to stimuli when exposed to serotonin. (The dorsal cochlear nucleus is where sensory integration and tinnitus occurs.)
QUESTION: So if i have normal hearing according to several tests.. can we call this an ototoxic reaction? There’s no hearing loss for me atleast.. i had one of the normal hearing tests over a year when the Tinnitus had started. The serotonin is basicly making the DCN hyperactive and you can hear it as Tinnitus?
Source: https://www.hearinglikeme.com/5-things-can-make-tinnitus-worse/
Very good information about Taurine here:
https://nootropicsexpert.com/taurine/
Thank you again Neil,
It’s great to share information with you.
I don’t know if Taurine will magically make my Tinnitus disappear, but if it lowers it down im already happy. Only some have had their Tinnitus go away complete with Taurine.. but many others have had their Tinnitus got more softer.. or easier to mask, or just go lower in general.
Hi Nico:
No, I hadn’t seen that article on Sertraline. Boy are they ignorant and masters of understatement. They wrote, “however in rare instances this symptom [tinnitus] may occur as a side effect of this class of medications.” What do they call rare. With Sertraline alone there have been hundreds and hundreds of reports of tinnitus from taking this drug, and if you included all the drugs in this class it is multiplied thousands of people reporting tinnitus. So rare it is NOT. It’s just that doctor are almost totally ignorant of just how often it occurs, so it seems rare to them.
Thanks for the articles. There’s no way I can find/read every article on every subject known about ears so I rely on others to bring some things to my attention while I am busy studying others aspects of ear conditions.
Let me know how the Taurine works for you.
Cordially,
Neil
Neil, my son has been dealing with anxiety since his first panic attack 10 days ago. He had slight tinnitus which has worsened to the point he can’t sleep so he is seeing his primary care physician tomorrow. Should he refuse SSRI meds if his doctor suggests one? He is hesitant to take any antidepressant to begin with.
Hi Judy:
What caused his panic attack–drugs? undue anxiety? etc.?
Personally, I wouldn’t take drugs for this. I’d get to the bottom of why he is feeling panic in the first place, then deal with it. Rather that drugging him to sleep, there are other ways of lessening the effects of tinnitus so you can sleep. One way is to have a fan running in his room so he hears the fan which partially drowns out the tinnitus. Other good ways are to listen to recordings of water sounds–you can get them off the Internet–such as waves lapping on the beach, running water in creeks, rainfall, waterfall sounds, etc. They are soothing and help hide the tinnitus. He’ll still hear the tinnitus, but it won’t be as intrusive.
Cordially,
Neil
Hi Neil, i was prescribed by my doctor Venlafaxine (Effexor) for my anxiety. I’ve had tinnitus before for 6 years, but it wasn’t loud and it wasn’t a concern of mine (probably caused by an infection, i saw an audiologist and she didn’t find anything wrong with my ears at that time). I needed an antidepressant to deal with anxiety in my life. I took the first dose 37.5 mg at night on 3 january 2020, and didn’t notice anything at all, then i took the same dose 37.5 mg at night on the 4 january 2020 and didn’t notice anything. On 5 january, i took a morning dose 37.5 and too didn’t notice anything wrong, but later took another 37.5 in the evening, as my doctor wanted me to start taking it two times a day. I went to sleep and had a bad sleep that day and when i woke up on january 6 i noticed an increase in my tinnitus, it has become very intolerable. It is now 7 january 2020, and i still have it. In total, i took the drug 3 days and the total dosage was 150 mg ( i bought tablets of 75 mg, so i only took 2 tablets, i had to cut them in half). Now i’m really scared for my life, i’m crying and thinking what will i do with my life if it doesn’t resolve. When i woke up besides tinnitus, i also felt a earache on my left ear. The earache is still present on the second day. I’ve had earache on my left ear before, but no tinnitus spike or anything. It is a mild earache, nothing untolerable. Will i recover?
Hi Christian:
I’m not surprised you had increased tinnitus and ear pain. Both of these are side effects of taking this drug. Hundreds upon hundreds of people have reported tinnitus from taking this drug and hundreds more ear pain.
It’s obvious that you are sensitive to this drug, so it is probably a wise decision to stop taking it. As far as I’m concerned, drugs are NOT the way to deal with anxiety. I’d suggest a good anxiety counselor would be a better way to go. Then you won’t have to worry about damaging your ears from taking drugs that ultimately don’t help and often cause more problems–like you are now experiencing.
If you are anxious and worry about your tinnitus, the chances are it won’t go away. However, if you treat your tinnitus as no big deal–and instead of focusing on it, you focus on the loves of your life, you give your tinnitus permission to fade into the background again.
Cordially,
Neil
Hi Neil, i still have Tinnitus 8 days later, and i have earache in my left ear that is more present in the evening, i’d say it’s not even present in the day or morning, and i’m thinking, should i run and buy Steroids and drink them or maybe insert into my left ear? Can antidepressants really be ototoxic? Is there inflammation in the ear? And if antibiotics such as aminoglycosides or chemotherapy agents cause inner ear damage, do antidepressants cause the same type of damage? in general, do people take steroids in such cases?
I’m thinking of taking prednisone/prednisolone.
Hi Christian:
I’m not sure that steroids will help your tinnitus. It’s not something I’d do if I had tinnitus that was bothering me.
Yes, antidepressants are ototoxic–what do you call tinnitus and ear pain–after taking a drug?
I don’t know all the kinds of damage the various drugs do. Some cause physical problems such as killing the hair cells and/or underlying support cells. Others trigger changes in the centers in the brain that deal with tinnitus. This is not damage so much as neural plasticity. And if you change things one way, with the proper treatment, you can change them back again. So if that is the problem, then prednisone won’t help matters at all.
Cordially,
Neil
Doc I took cymbalta 9 months 60 mg getting off slowly now tittys started month ago. Should I speed up taper or has anyone ever stopped and gotten rid of Titus or is it guaranteed permanent
Hi Michael:
If you are getting tinnitus while tapering off a drug, that is one indication that you are tapering off it too fast. You want to slow down the taper. Actually, you want to pause the taper and give your body a chance for the side effects to disappear, then continue the tape, but probably at a slower rate so side effects don’t reappear.
There are no guarantees that your tinnitus will completely go away, but that doesn’t mean it will bother you. If you do your slow taper and get off the drug, that’s one step. But the other step is how you deal with your tinnitus. If you don’t worry or focus on your tinnitus, but instead focus on the loves of your life, your tinnitus will begin to fade into the background and will become less and less intrusive and quieter. This is called becoming habituated to your tinnitus. When this happens, your tinnitus won’t bother you, if you even hear it. But be patient–this can take months.
Cordially,
Neil
i have been on overdose 80 miligram of citapolarm and got T a month after that, then stopped takeing but T still with me , but i dont know if that is the cause because when im lying down in bed T dissapears after few minutets + T increases in real yawning and stretching ,so mabey its somatic who knows
i also have misaligned jaw but T doesnt changed by jaw movements
im suspecting that the ssri overdose is the cause of my tinnitus.
but except from the orogon reaserach i dont have a real proof.
do you know if there is any supplement that can help ssri induced tinnitus ?
Hi Lior:
Citalopram can certainly cause tinnitus. In fact, I’ve received more reports of people getting tinnitus from taking Citalopram than for almost any other drug.
At the same time, I wouldn’t be surprised if you have tinnitus from your neck being out. So you may have both drug-induced and somatic tinnitus at the same time.
There are no supplements that are guaranteed to get rid of tinnitus, but Arches Tinnitus Formula does a pretty good job for numbers of people. You probably need to take it for 2 or 3 months before you can be sure whether it will work for you or not. You can get these supplements at https://www.tinnitusformula.com/.
Cordially,
Neil
Dr Bauman,
I have had fluctuating tinnitus for almost 5 yrs.
I have received numerous atlas adjustments, but it doesn’t seem to help. I do have TMJD on my right jaw. The same side as the tinnitus. I have had an MRI and thankfully no acoustic nueroma was found. The T is only in my right ear. Lately it is like Morse Code. It is on and off within seconds and unfortunately it does this the most at night. Do you have any insights as to what may be causing this type of tinnitus? I do have your book, “Taking Control of Your Tinnitus. Thank you for your time.
Hi Donna:
If the Atlas adjustments don’t help, then that isn’t the cause of your tinnitus.
Since you have TMD and tinnitus on the same side, I wonder whether your tinnitus is related to your TMD. If you move your jaw around, clench your teeth or twist your neck from side to side, does that affect the volume of your tinnitus?
Some people do hear what sounds like Morse code tinnitus, but I don’t know why that sound occurs as opposed to one of the many other tinnitus sounds.
Do you hear your Morse code tinnitus at all during the day, or only at night?
And do you only hear it wen laying down and not sitting up, for example?
It sounds like you have somatosensory tinnitus of some sort. See Chapter 9 for what it is, and Chapter 20 for treatments.
Cordially,
Neil
I have severe hearing loss both ears And I wear hearing aids. I’ve been on and off antidepressants for 30 years. I’ve been off antidepressants now since 2013. However, About 3 years ago I took Lexapro, one pill and the ringing in my ear was so loud that I thought strongly about suicide that night!! I knew that was irrational and tried to sleep but kept waking up but I felt like I was in a loop because all I could think about was ending my life to escape the sound. Of course I didn’t. The next morning I called my Dr and they took me in immediately. I am afraid of taking any antidepressants now. I deal with anxiety And depression constantly. During this pandemic I’ve had to take an FMLA because I am 69 years old and with every one wearing masks I panic due to so much stress trying to hear. I’m a teacher. I requested a remote online position at my school but was denied. My principal had me going into several classrooms doing face to face teaching several times a day. I am terrified of this challenge and feel I am forced to take this time off. My question is how do I go about asking for accommodations based on my disabilities of hearing loss and anxiety/depression. Shouldn’t my school have some responsibility to offer an accommodation knowing of my disabilities? I don’t want to cause trouble but I am single and need to work!!
Hi Glenda:
Trying to talk to people wearing masks is very difficult and with a severe or worse hearing loss, its nigh near impossible. Since I am a speechreader, if people won’t lower their masks so I can understand them, I just won’t talk to them–they have to write out everything they say.
It would scare me too if I had to teach with all my students wearing masks. So I know what you are feeling. And having depression on top of this anxiety is ever so much worse.
Since you can’t take antidepressants due to tinnitus, etc., have you considered the herbal, St. John’s Wort. It is as effective as prescription antidepressants and does not have all those bad side effects. That’s one thing I’d suggest. A lot of people do this instead of taking prescription drugs.
But you should get accommodations for your hearing loss combined with everyone wearing masks. The Americans with Disabilities Act provides for accommodations so you can function near normal. I think your school district is supposed to have someone that handles such issues. You need to find out who that is and get the accommodations you need. It’s the law.
Cordially,
Neil
Hi Dr. Bauman,
Firstly, thank you for all of the work you do.
I developed tinnitus after taking one dose (7.5mg) of the medication BuSpar. This was the first and last dose I took. The tinnitus has continued for 4 months now. I had no idea that one dose of a medication could be so harmful.
Have you seen permanent tinnitus as an effect of this medication before, and have you ever seen cases where medication-induced tinnitus goes away?
Thank you!
-Joe
Hi Joe:
Some people get permanent tinnitus from the very first dose of a given drug–so it can and does happen, but this is not the norm.
Up to this point, I don’t have any information on the permanence of tinnitus for this drug.
Tinnitus caused by drug ototoxicity goes away in many cases. It may take a few days, a few weeks, a few months or a few years–so it is variable. But sometimes it just stays around and is permanent.
Cordially,
Neil
Hello Neil. I like many on this site suffer depression and anxiety I need medication but it spikes my tinnitus my question is if I continue to take Lexapro in this case will tinnitus just progressively get louder with each dose or dose your mind come to a point where the tinnitus plateau’s and allows you to continue taking the medication you need ?. I desperately need these meds but tinnitus is severe and debilitating also.
Thank you
Hi Paul:
I think that typically, eventually your tinnitus plateaus and doesn’t get any louder–but that could still be pretty loud. So if your tinnitus has stayed the same for a week or so, you have probably plateaued at that level. I wouldn’t expert it to get louder from then on.
But, by the same token, I wouldn’t expect it to go away either. And I don’t know whether it is possible to habituate to your tinnitus if you keep on taking the drug that is causing the tinnitus in the first place.
Cordially,
Neil
Thank you Neil, I have no choice I will do my best to habituate but most likely will have to mask nearly all of the time. Pray for a treatment one day.
All the best
Paul
Hello doc
Please how can fight this depression resulting from my tinnitus
Its really hindering
Hi June:
What caused your depression–tinnitus? Or did you have tinnitus before your depression appeared?
Are you taking any drugs (perhaps SSRI-) to treat your depression? You should know that all the antidepressants can also cause tinnitus, so that is not an effective way to go.
If I were in your shoes, I think I’d take the herbal St. John’s Wort as it is only very mildly ototoxic and works as well as prescription drugs. The information is given in this article.
Depending on the severity of your depression, I’d see a good counselor that deals with people with depression. Drugs basically aren’t the answer.
Cordially,
Neil
Good day doc,I think my T has reached it highest pick.
Now I know about it,but what I am struggling now to fight is the depression associating this T,its really depriving me of my sleep which in turns make the T worst,I need anything at all,to help with these.
Currently am on nicotinic acid and neurovite…
Have taken betahistamine,prednisolone but still nothing..
Have high frequency HL
I need advice and a better approach.
Hi Ali:
What treatments are you taking/doing to bring your tinnitus under control? Are you using sound therapy, especially at night, to help you ignore your tinnitus so you can sleep better. You can download pink noise, fractal music, or water sounds to listen to all night. The water sounds are naturally soothing and would be my choice.
In addition, you want to get some help from a counselor that knows how to help you successfully deal with your depression. Exercise and diet can make an enormous difference too.
I wouldn’t have expected betahistamine or prednisolone to really help you.
Cordially,
Neil
Hi Dr Bauman,
I suffer with quite severe OCD and have been holding off from taking SSRI meds for many years. I finally gave in at my GPs request as my condition has worsened over the last couple of months. I was prescribed Zoloft which I started taking last Sunday, and started getting high pitched tinnitus on the second day. I then switched to Citalopram for one day on the Thursday with no change. When I saw your forum I’ve stopped taking the medicine completely but I’m scared now the damage has already been done. What other medications can you recommend for OCD? as I’m in a desperate situation, and now this tinnitus has left me in despair.
Hi Harry:
I’m not a medical doctor so can’t tell you which drugs or classes of drugs may work for OCD–I don’t really have a clue.
What I can tell you is that it seems that all of the SSRIs are about the same when it comes to tinnitus. I don’t see one that is dramatically less risk for getting tinnitus than the others in this class. Also, taking a low dose may not cause tinnitus whereas a higher dose can so keeping the dose as low as possible may let you avoid tinnitus.
When you have OCD and tinnitus, you find it very hard to quit focusing on your tinnitus. And this is exactly what you don’t want to do. You want to focus on the loves of your life and totally ignore your tinnitus and thus let your tinnitus fade into the background.
Cordially,
Neil
I’ve been on Effexor for at least 10 years and without any changes in dosage for 2 years and I began developing tinnitus and I’m 38. Have you heard of individuals developing tinnitus from Effexor after such a long time of taking the drug?
Thanks!
Hi Robert:
I haven’t heard of anyone developing tinnitus after 10 years on Venlafaxine (Effexor), but I have heard of it with other drugs. Thus it may be possible with Venlafaxine, but I don’t think it is very likely. I’d look for any other causes that are more likely first, before blaming your tinnitus on this drug.
Cordially,
Neil
Dear Dr Bauman
I’m after 12 days of taking sertaline. After 7 days I started with a dose of 25 mg to 50 mg and after another 3 days my tinnitus increased significantly. I remember that I always had something like this but it was so small that it never bothered me. since I went on 50 mg it got so bad that I stopped the treatment. Unfortunately, it’s been 60 hours now and the tinnitus is still at the same high level. I am asking for some feedback if most of the tinnitus people remain at the same level or is there a chance that it will go away in the coming days? I’m terrified. maybe my tinnitus still persists because I have increased serotonin levels (it’s only been 60h so the drugs still theoretically work, even after 12 days).
Hi Michael:
You should have stayed on the 25 mg dose so you could fly under the tinnitus radar. Doubling the dose took you above your magic threshold where tinnitus suddenly shot way up. Now you could be stuck with loud tinnitus. I don’t know what happens to most people that get tinnitus from taking Sertraline. The few people that have reported their stories to me have all had permanent tinnitus as a result of taking this drug at an increased dose.
So all I can tell you at this point is that it may drop back to a low level, or remain permanently. If the latter is the case, you need to learn how to successfully deal with your tinnitus. You don’t have to suffer from it!
Cordially,
Neil
So are you suggesting that going down to 25 mg of sertaline can reduce my tinnitus to lower level? Overall, I made a decision (before I even realized the huge noise problem that arose) that I don’t want to take antidepressants because I don’t think my problem is serious enough to need them. however, if taking 25 mg can reduce noise I can try to do so. I’ll discuss it all with the psychiatrist tomorrow.
It is difficult for me to say if the earlier dose caused tinnitus, when I started taking sertaline I was helping myself with small doses of alprosam (0.5 mg / day before bedtime). I think alprosam may have masked this problem from the very beginning. After 3 days of taking 50 mg of sertaline, the side effects decreased so much that I made a decision that I no longer need alprosam – then in the evening I noticed how much tinnitus had increased and how much it disturbed me from falling asleep. Have there been people whose tinnitus has died down after a long period of time? For example, several weeks?
I really regret that I started taking antidepressants, they were only supposed to help me with my mood a little, and they caused such a huge problem. Psychiatrists write prescriptions for antidepressants that are terribly dangerous left and right without thinking.
Hi Michael:
Alprazolam causes tinnitus in hundreds upon hundreds of people, so the combination of Alprazolam and the Sertraline could have caused your tinnitus to get worse. It’s a possibility. Alprazolam is a benzodiazepine drug and the benzos have a nasty habit of CAUSING tinnitus when you try to get off them.
I agree, doctors hand out drugs like candy. You want to be very sure the actual benefits FAR outweigh all the possible side effects. Unfortunately, side effects are downplayed and the supposed benefits are often grossly inflated. If they knew the true benefit/risk ratio, I doubt many people would fall for all these nasty drugs.
Cordially,
Neil
Hi Michael:
No, I’m saying that raising it above 25 mg increased the risk of tinnitus. Once you have taken the higher dose, and got severe tinnitus, totally stopping or dropping back to a lower probably won’t reduce your tinnitus. That’s why you always want to stay at the lowest dose that does the job.
With some drugs you can lower the dose and the tinnitus will go away or go back to its old level, but unfortunately, not all drugs work that way.
Cordially,
Neil
Thank you for your answer. I have taken alprozam before and it did not cause such side effects, but it is difficult to say if the combination of alprosam + sertaline increased the tinnitus effect. God help it pass. I am grateful for your valuable reply on this topic. Maybe someone else will save his person from the consequences that happened to me.
Best wishes
Michael
Hello Dr Bauman,
I’ve been taking Sertraline 100mg for over 25 years. It’s the only antidepressant I’ve found that works for me. Without it, I would have a very low quality of life. I’ve always had a mild case tinnitus, and fortunately it didn’t get worse when I started taking Sertraline. However, I did develop musical ear syndrome but didn’t realize it at the time because it was so mild. A few years ago it became much more severe to the point where I was hearing distinct words and sometimes conversations in addition to music. It was fascinating. That’s when I found your book about musical ear syndrome. It helped so much. The voices and music diminished a lot when I realized they weren’t real. (I also had a head CT and physical to make sure my symptoms didn’t have a physical cause.) Since then I’ve been able to train my mind to ignore the voices and music most of the time. At any rate, thank you very much for your website and books–they’ve been a great help.
Jane
Hi Jane:
Sertraline has caused tinnitus and auditory hallucinations (this includes MES) in hundreds upon hundreds of people, so you certainly are not alone in your experiences.
I’m glad that I was able to help you in some measure by reading my articles and books on the subject. Once you know what is going on, you can lay it aside and not worry about it.
Cordially,
Neil
Hello Dr. Bauman,
I took Pristiq for 2 weeks 50mg and stopped because I couldn’t sleep and the side effects were terrible. I didn’t have tinnitus after those 2 weeks and had little withdrawal. a few months later I decided to try and take Pristiq 50mg again because I wanted to not be depressed. I wanted to be happy and feel good about my life, and although I was always against Antidepressants and SSRIs made me sick after 1 pill, I took pristiq for 25 days. I discovered a very loud ringing sound in my head after 3 weeks, and stopped immediately, because I could sleep and I hated the way the drug made me feel. After 7 months off desvenlafaxine I have a muffled buzz and high pitched ring constantly in my head, and it is driving me to very dark places and has made me more depressed and given me more anxiety and anger I’ve ever felt before. I never knew prisitq was ototoxic. When I was withdrawing from it I would go on walks and runs and feel very uncoordinated and dizzy, but that went away after 1 month off the drug. I am so scared that I was a victim of ototoxicity that caused permanent damage because I never wanted to take an antidepressant and after 1 month of trying one, I now have tinnitus that never stops, its loud, its intrusive, and makes my mental illness 10x worst than before. My doctor doesn’t think it was ototoxicity, but after 7 months, still suffering from tinnitus, what else could have happened? I have lost hope, and I am in despair. I have never had tinnitus in my life, but this condition is terrible and makes me hate my life much much more than before when I was just very depressed. I am worried it is permanent, but I can not live with a static TV buzzing, and ringing constantly in my head. I need help please.
Hi Jason:
Desvenlafaxine (Pristiq) is not an antidepressant. It is a SSNRI drug, but your doctor may be prescribing it to help your depression.
Like Venlafaxine, Desvenlafaxine (Effexor) is ototoxic. It’s three most common ototoxic side effects are exactly what you experienced–dizziness, ataxia/gait disturbances and tinnitus.
Fortunately, the balance issues have disappeared. Since tinnitus is a psychosomatic condition, it has both a physical and an emotional/psychological component. In order to habituate to your tinnitus so it fades into the background, you need to get your depression and anxiety under control.
Since all antidepressant drugs can cause tinnitus, throwing drugs at your tinnitus likely won’t work, and could make it even worse. That is why I suggest you consider taking the herbal St. John’s Wort. It is as effective as prescription antidepressants and is only very,very mildly ototoxic. I’ve never heard of anyone having ototoxic side effects from taking it.
You need to quit focusing on your tinnitus. That just makes things worse. You need to treat your tinnitus as though it is NOT a threat to your well-being. When you do that, it tends to fade away and not bother you. You do this by focusing on the loves of your life and thereby basically totally ignore your tinnitus.
I’ve had tinnitus for more than 70 years–and my ears are “ringing” away as I write this, but its no big deal. I don’t let it bother me, so I happily live my life in spite of my tinnitus. And when I’m not focused on tinnitus (like I am now in answering your questions) hours can go by where I am not even aware I have tinnitus–but it is always there if I think about it or listen for it. That is why you want to learn not to do either of these things.
Cordially,
Neil
I never wanted to take antidepressants because I knew that they are dangerous and I am very sensitive. It was the biggest mistake of my life taking desvenlafaxine. My doctor didn’t even prescribe me the lowest dose, she just ignored me after I told her I can not handle SSRIs and never warned me of tinnitus. I get panic attacks at night when I can’t breathe out of my nose, Now I get multiple panic attacks every night and when I work in a quiet room. I threw out a pair of very expensive headphone because I could hear static noise in between songs, and it bothered me. Now the static ringing is deep in my brain and I can not stop it. I was strong enough to avoid antidepressants for years, but the 24 days I was weak and tried to change my negative thoughts by taking an antidepressant, now I realize how much of a mistake that was listening to tinnitus and suffering daily. I am not a person who can habituate. I am very weak minded and have issues that are now exasperated due to tinnitus. The anger I feel is as debilitating as the tinnitus, and the depression is out of control, I talk to a therapist, but I feel like there is no hope for me to be happy with this horrible ringing and it being caused by my unfortunate decision to take that drug, and I knew I shouldn’t have. I tried to stop the drug as fast as possible, and I’m trying everything to make the tinnitus fade away. Is there any hope that the tinnitus will go away completely? Is there any stories of ototoxic tinnitus stopping after a long time even years?
Hi Jason:
Yes, tinnitus can go away completely when it is due to ototoxic drugs–aspirin is a good example. However, so much depends on two things–the drug you took, the size of the dose and the length of time you took it, and the second thing is your psychological makeup–how you look at your tinnitus.
If you think of it as a threat to your well-being and thus focus on it, it probably won’t go away, nor will you habituate to it. However, if you think of it as a totally unimportant, useless, background sound that is NOT a threat to your well-being and thus is safe to ignore, over time you will very likely habituate to it and it will no longer be a problem whether you hear it or not. Thus it won’t make any difference to you whether you have it or not.
Cordially,
Neil
Thank you for your response, I greatly appreciate your help. I have been off the drug for 7 months and the tinnitus has calmed down maybe 30%. I have been trying everything to get it to go away. At this point there I am very scared it is permanent. I wake up in the middle of the night and the tinnitus is always very loud and I become very sad and try not to panic. My brain doesn’t feel the same before I took the antidepressants, I know that the tinnitus is stressing my brain and making me much more sad. I’ve been obsessively researching tinnitus and antidepressants. People’s tinnitus usually clears up in about a month, but those who’s tinnitus hasn’t I read that theirs hasn’t stopped after years and decades. I am worried that after 7 months with no real improvement that it is permanent. Its the same cycle everyday, very loud in the middle of the night and morning, is calms down slightly throughout the day, but it never stops. I think tinnitus from aspirin goes away because its not regularly taken. I was regularly taking desvenlafaxine for 24 days (biggest mistake of my life) and really believed it would fad away. I can’t get a straight answer out of my doctor or ENT, they didn’t even listen to me when I told them I was sensitive to drugs. I pray every night that the tinnitus will fade. What should I do? What do you think happened to me? After 7 months do you think it is permanent?
Hi Jason:
Don’t worry about whether your tinnitus will go away or be permanent. That is not important. What is important is dealing with your tinnitus so it no longer is an issue in your life whether you have it or not. I’ve had tinnitus for more than 70 years, but I do not let it bother me. Often I hear it but sometimes hours go by with my not even being aware I have tinnitus. You want to become habituated to your tinnitus–both in volume and in annoyance. When you do that your tinnitus will cease to be an issue.
However, in order to reach this state, you need to quit thinking of your tinnitus as a threat to your well-being. As long as you do that, your limbic system will bring your tinnitus to your conscious level because you/it see your tinnitus as a threat–and you cannot ignore threats.
That is why you need to think of your tinnitus as a totally useless, unimportant, background sound that you can safely ignore–then focus on the loves of your life and let your tinnitus fade away.
Note that obsessively researching tinnitus means that you are focusing on it, instead of ignoring it–and that is just making things worse. And focusing on what is written on various on-line “boards” is notorious for being wrong and biased. You receive an extremely slanted view of tinnitus by the people who do not follow good practices to take control of their tinnitus, but rather wallow in their misery. They are NOT the role models you want if you want to get better. The people who get better seldom frequent such boards so you don’t hear their success stories.
What you need to do is get on a program to properly deal with your tinnitus. Then persevere on a helpful program until you have your tinnitus under control. If you don’t know what to do, I suggest you get and read my book on tinnitus “Take Control of Your Tinnitus” available at https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ and stay away from all the negativity out there.
Cordially,
Neil
Hello Jason, I’ve read all your comments on this page and I want to know how do you feel today as I’ve been prescribed with pristiq too and I suffer from tinnitus since 2021. I don’t want it to get worse.
Hello, Can you please share information on Buspar and tinnitus?
Thank you,
Dee Dee
Hi Dee Dee:
Buspirone (BuSpar) can cause tinnitus, but in the grand scheme of things, the risk is quite low. So you may want to risk it. Just be aware of any developing ototoxic side effects such as tinnitus and stop taking the drug if this happens and hopefully the tinnitus will go away–but as always, there are no guarantees.
Cordially,
Neil
I also was wondering about Hydroxyzine – Atirax or Vistiral and it’s ototoxic level?
Thank you,
Dee Dee
Hi Dee Dee:
Hydroxyzine (Atarax, Vistaril) has about the same risk of developing tinnitus as Buspirone (BuSpar). In other words, as I said in my previous comment to you, in the grand scheme of things, the risk is quite low. So you may want to risk it. Just be aware of any developing ototoxic side effects such as tinnitus and stop taking the drug if this happens and hopefully the tinnitus will go away–but as always, there are no guarantees. On a scale of 1 to 5, I’d put the risk as a 1.5 or so.
Cordially,
Neil
Thank you so much!
Have a good weekend!
Dee Dee
I have another question – what is the effect of CBD oil on Tinnitus?
Thank you,
Dee Dee
Hi Dee Dee:
As far as I know, CBD oil does not cause tinnitus or make it worse. I don’t know whether it has any beneficial effect on existing tinnitus or not.
Cordially,
Neil
I also downloaded your beta blocker pdf – what do you think is the beat beta blocker to replace Metropolol on the list?
Thank you,
Dee Dee
Hi Dee Dee:
Of the most popular Beta Blockers here’s how I rate them. To replace Metoprolol, I’d suggest Labetalol as the least ototoxic for tinnitus based on the number of reports to the FDA’s data base divided into the number of prescriptions issued. Second would be Carvedilol and third would be Nebivolol.
These are in a different order in the report you got because when I wrote the report, it was based only on the number of reports of side effects received, without considering how commonly it was prescribed.
Cordially,
Neil
Excellent source of information. I wonder, since all SSRIs can cause tinnitus, are we safer with tricyclics? The original antidepressants?
Hi Paul:
Tri-cyclic antidepressants are also all ototoxic, but as a rule, they are quite a bit less ototoxic than SSRIs. So, yes, taking them would typically be less of a risk to your ears, and would reduce the risk of getting tinnitus.
But as with all drugs, you still have to keep a weather eye out for any side effects developing.
Cordially,
Neil
Neil, I take mirtazapine each night, I am now tapering by 7.5mg per month, beginning tommorow. I heard that this drug is much less toxic than most antidepressants and is comparable to tricyclics or slightly less toxic. Is that true?
Also, I’d like to know how to describe this tinnitus. Is it a white noise or seashell type tinnitus or that nasty EEEEeeeeeEEEEEEeee type tinnitus that drives so many to the depths of despair?
Hi Benjamin:
I’d say Mirtazapine (a tetracyclic drug) is more or less as ototoxic as the tricyclics, and in general are less ototoxic than the SSRIs.
You can describe your tinnitus any way you want to. Everyone has a different way of describing their tinnitus sounds. There is no standard way of describing tinnitus as there are so many different tinnitus sounds and people perceive the same sound differently.
Cordially,
Neil
Hello Neil,
what is your opinion on the connection between COVID and tinnitus?
What steps/treatment would you recommend?
Hi KS:
Like other viruses, the COVID virus can get into your inner ears and cause tinnitus, hearing loss and other hearing and balance problems.
Treating tinnitus from COVID is basically the same as treating tinnitus from other viruses, ototoxic drugs, etc., etc.
If the tinnitus is not too bad, just ignore it and focus on the loves of your life and let it fade into the background over time. This is called becoming habituated to your tinnitus.
Note that if you think of your tinnitus as a threat to your well-being, then you cannot habituate to your tinnitus. Thus, you need to think of your tinnitus as just another background sound that is totally unimportant and thus is safe to ignore–then ignore it.
If your tinnitus is a serious problem, then seek out treatment from an audiologist at a tinnitus clinic.
You can learn everything you need to know about tinnitus in my comprehensive book “Take Control of Your Tinnitus” available at https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/
Cordially,
Neil
Hello,
I left a comment in September 2021 about getting tinnitus from takin desvenlafaxine 50mg for 24 days. The tinnitus started while taking the SNRI and I stopped immediately, since I wanted to see if it could help my depression after over a decade of struggling.
I have had tinnitus since March 2021. I know that desvelafaxine is the reason my brain is now dysfunctional and causing tinnitus. It seems to be permanent damage in my brainstem, near the Dorsal Cochlear Nucleus.
When I flex my tongue or tighten my jaw the tinnitus gets louder, and puts pressure on the dysfunctional area in my brain. This tells me that it is physical damage to my brain from taking the SNRI. It caused permanent changes and damage, because the tinnitus should have gone away if it wasn’t permanent or physical brain damage.
As i mentioned I never took advil, I don’t drink alcohol, and I never wanted to take the SNRI, so I intentionally didn’t research to take the drug for a month based on the propaganda that it effects everyone differently and can take 1 month to “kick in”, but it made dramatic and permanent changes/damage.
The tinnitus has seem to be less throughout my brain and now it seems to be coming from my brainstem area.
For the entire 1 year and 2 months, i have woke up to tinnitus and become more depressed than before, since I have never had it and know I never would if i didn’t take the Pristiq 50mg for 24 days. The SNRI was overprescribed and I wanted to stop sooner, and I wish I never took it.
I will not habituate, my brain is working to try to drown out the sound since it seems less intense, but I know the damage in my brain is still producing these dysfunctional signals.
I can not sit in a quiet room and read a book. Every night I lay my head down on my pillow to sleep its torture knowing that before Pristiq I could listen to pure silence and relax and drift into sleep, where as now I am angry and aggravated and unable to do that.
I had no goals or loves in my life as I was severely depressed, and now it is worse. I know that if this tinnitus doesn’t stop it will make me commit suicide, the only reason I haven’t is because if the tinnitus does go away I can continue where my life left off before I taken the SNRI.
I’m looking for hope that the tinnitus will stop, but after a year I know its the changes the drug made to my brains chemistry and it more than likely will never go away, since it has been so long and the pain and pressure I have felt in my ears throughout the year of struggling with tinnitus now.
I know its permanent and its damage from the SNRI. Pfizer says that people experience discontinuation syndrome with tinnitus. But I only took the drug for 24 days, there is now way this is discontinuation. This is damage and I am in a crisis because of the amount of anxiety, anger and depression I have now due to the unescapable ringing deep in my brain.
I don’t know why I have to be the 1% of people who developed permanent tinnitus from a SNRI I asked my doctor not to prescribe me and I NEVER took even advil, so why would I take a horrible drug that changes my brains structures and chemicals, I knew it was a recipe for disaster, and I am paying the consequences everyday. I’m giving it 2 more years to go away Completely, but I know its damage and its permanent, so whats the point?
Hi Jason:
Hundreds of people have reported to the FDA that they got tinnitus from taking Desvenlafaxine, so this is a known side effect of this drug.
When you flex your tongue or tighten your jaw, you are not “putting pressure” on the dysfunctional area of your brain. Doing these (and other) things results from activating associated somatosensory nerves that then send signals to your brain where they are “accidentally” sent to the auditory parts of your brain where you hear them as louder tinnitus.
Why will you not habituate to your tinnitus. You say your brain is working to try to drown out the sound since it seems less intense. I’d call that habituating, certainly not making it worse.
You say, “I cannot site in a quiet room and read a book.” Why ever not? I’m sitting here replying to your post yet my ears are ringing away pretty loudly at the moment. You can choose to focus on your tinnitus or you can choose to focus on your book in spite of your tinnitus.
When you say you cannot do something, it becomes a self-fulfilling prophecy. If you want to habituate to your tinnitus you have to quit focusing/worrying about your tinnitus, and focus your attention elsewhere–like on your book.
As long as you think of your tinnitus as a threat to your well-being in any way, your limbic system has to bring it to your conscious attention–that is one of its jobs–so you can take action to neutralize the threat. This means that you cannot habituate to your tinnitus.
However, if you think of and treat your tinnitus as just a useless, totally unimportant, background sound that it is safe to ignore because it is not a threat to your well-being, this gives your limbic system permission to ignore and you gradually habituate to this sound so it no longer bothers you even when you do hear it, but often hours will go by without your consciously being away of your tinnitus.
You want your tinnitus to stop (I wouldn’t mind mine stopping either), but if you habituate to it so it doesn’t bother you, what difference does it really make whether you hear it or not?
It may be unrealistic to expect your tinnitus to totally go away and you never hear it again, but it is completely realistic to habituate to it so it no longer bothers you. I know. I’ve had my tinnitus for more than 70 years now. Even though my tinnitus is screaming away at me, truly, its no big deal. You need to learn to do the same and stop your negative attitudes towards your tinnitus as that is just making things worse.
Furthermore, there are many different things you can try to successfully deal with your tinnitus. You can read all about them in my comprehensive book, “Take Control of Your Tinnitus.” You can get it at https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
You don’t have to suffer from tinnitus. You can successfully deal with it if you choose to and persevere at it.
Cordially,
Neil
I never had tinnitus before take Pristiq. What happened? Why do I have to suffer even more. These drugs are supposed to help people with depression, instead I got a permanent condition that now makes my depression worse. How am I suppose to let go of what a unbelievably mindless doctor did to me and what the drug company created to give me permanent tinnitus. I will never forgive my idiot doctor, and I will pursue Pfizer to make sure that they pay for what their fake drugs do to people with serious conditions.
I’m not habituating because the tinnitus is not part of my brain or body. Its from the neurological dysfunction that Pristiq caused me. I only took the drug for 3 weeks and now I haev had tinnitus for 1 year and 3 months. I want to compare this to a Benzo withdrawal but I can not, since I only took the drug for a short time and now it is been such a long time. I have hope that this tinnitus will stop completely, but Everyday it continues and I feel like it will not stop ever and I start to mentally decline, because I had worked for years trying to help my brain feel better, eating well, exercising, sleeping, I don’t do drugs, and now i don’t drink caffeine.
I believe that the drug rushed my brain with these new connections and now my brain is completely dysfunctional, I have had a quivering shaking brain for over a year, I have multiple stress headaches everyday. I don’t know what happened, and no one is helping me find out what happened. I would like to know if it is a discontinuation syndrome, or permanent damage, but I can never find an answer, and everywhere I find a person who had gotten tinnitus from taking antidepressants they all still have it after years of not taking the drug. I’ve wasted my life for over a decade being depressed, now what? Be more depressed with tinnitus, thats not going to work. I don’t think you understand how badly I was depressed in order to even take an antidepressant, and now taking one has completely ruined my mentality even further. I used to wake up knowing I had nothing to live for, and now I wake up to a screaming hiss and nothing to live for. I guess thats just how life is, a series of accumulating how many conditions and illnesses, and dysfunction will it take for me to snap and take my life. Because I tried so hard to not be depressed on my own, and it was working half of the time, but I made the mistake of taking the drug, and never thought I would have a permanent or long lasting condition on top of something it was trying to help.
Do you think it was permanent damage to my brain? I mean it had to be damage which is also changes in the brain according to Pfizer, they need to damage the working parts of my brain to make me less depressed, but it only made me more depressed with tinnitus. how can I not sue them? Oh its a black box telling me that pristqi is extremely dangerous that covers them from a lawsuit, and thats why I never wanted to take this shitty drug in the first place.
Why does benzo withdrawal tinnitus seem to go away after 1 year even if they have been taking them for a long time. Where as mine I took an SNRI for 3 weeks and my tinnitus is still persistent after 1 year and 3 months?
Can i compare to a Benzo withdrawal? Pfizer said that tinnitus is associated with discontinuation syndrome and that could be my case. Although pfizer is not sure since everyone reacts different. I’m sorry for blowing up your page, I just can not handle or cope with my life and tinnitus. And I am desperately trying to find information and hope.
Hi Jason:
I don’t know where you got the idea that benzo withdrawal tinnitus goes away in a year. That simply is not true. For some people it is much longer and possibly permanent.
Numbers of drugs can cause permanent tinnitus–even from just taking the very first (and only) pill. Yet other people can take this same drug with seemingly impunity. It’s not fair, is it? But this is the way life works.
Who knows whether your tinnitus is a side effect of taking the drug in the first place, or stopping the drug too quickly? In any case, there is help out there for you. See my comment on your previous message for the details.
Cordially,
Neil
Hi Jason:
Pristiq is a brand of the generic drug Desvenlafaxine which is similar to the drug it was derived from, namely Venlafaxine (Effexor), a selective serotonin and norepinephrine reuptake inhibitor.
What’s done is done. You can’t change that. But you can do something about it. What I’d recommend is that you go to one of Dr. Amen’s clinics and have a PET scan to see what parts of your brain are not working properly now and then follow their program to help you get better (as much as is humanly possible).
They have clinics scattered across the USA. Go to their website at https://www.amenclinics.com/ and find the clinic nearest you. I think you will have the best chances of getting effective help from them.
I wish you well.
Cordially,
Neil
Thank you Dr. Bauman.
I’m not sure if you are replying to me or David?
I got an MRI and Luckily I don’t have brain cancer.
I know that the tinnitus I am dealing with is 100% a result from taking pristiq. It started on the 2 week of 3 weeks taking it, and I stopped cold turkey which could also have made this tinnitus worse and persistent, but I had no choice. It wasn’t helping and making things worse, but the damage is done, and It seems to continue 24/7 and make everything worse. At this point I’m not sure if it will ever stop and I hope my my brain didn’t learn the new connections and sound and reinforced them, but who know. Everywhere I read and people I talk to has no idea what happened to cause this tinnitus or if it will ever go away, but I know it was from pristiq.
I’m sorry for commenting, I just need some guidance and expertise, and you have help me. Thank you.
Hi Jason:
Sorry, I mixed your name up with David. I’ve corrected it now.
You’d do well to get my latest book on tinnitus and read through it. It contains pretty-much all the information you need to know in order to help yourself successfully deal with your tinnitus including all kinds of tinnitus treatments.
You can get this book at https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/
Briefly, any good tinnitus program consists of two parts–a psychological component and a sound therapy component. For the psychological part, the main things is don’t think of tinnitus as a threat to your well-being, but instead treat it as you would any other totally useless, meaningless, background sound by ignoring it and focusing on the loves of your life. And for the sound therapy part, it does two things, helps to reduce the contrast between your tinnitus and silence and by using constant sound therapy, you habituate to your tinnitus so it no longer bothers you.
Cordially,
Neil
Hello Dr. Bauman,
I’m just letting you know that the tinnitus from taking pristiq for 3 weeks is permanent. If it wasn’t it would have gone away. That antidepressant ruined my life and my ears. Just my luck that I am the lucky 1% of people it gave tinnitus to. OH and its permanent. I hope that antidepressants are abolished, because now I am going to commit suicide, I was wronged and harmed for no good reason other than complete idiots tried to take money out of my insurance pockets and ruin my life.
Hi Jason:
Your tinnitus doesn’t have to bother you even if it is permanent IF you get your depression under control. That is what you need to work on.
Please don’t commit suicide. That is not the real answer. Dial 988 and call the Suicide Prevention hotline and ask them for help.
In addition, in your despair you need to ask the Lord for the strength and courage to persevere in getting your depression under control. He is the one that can really help you get your life in order, and of course, I’ll continue to help you deal with your tinnitus.
Cordially,
Neil
Yes i know suicide is not the answer, Nobody really wants to kill themselves, they just want to escape the pain the constantly face everyday, besides I already am scarred by a parent committing suicide when I was younger.
The tinnitus I have is 100% from taking Pristiq, It fried my neurotransmitters and made my brain dysfunctional and now it cries and screams in pain everyday, and it will never go away completely, no matter how hard I try.
This tinnitus is something I never could have expected in my life and its because of a drug my idiot doctor prescribed me. I can’t sue her for overprescribing and being incompetent, I can’t sue pfizer, and NOBODY cares that a drug gave a severely depressed person another life long condition that is mentally debilitating and its all because I took a drug for three weeks.
My brain hurts everyday from taking Pristiq and the damge it has done to create tinnitus, anxiety and stress headaches that feel like my brain stem is being squeezed to death and the tinnitus is it screaming for help, but I can’t help it.
All i needed to do was start to treat myself with more worth mentally, and my depression would be better, but since I have been raised and taught how I am not shit in life, I was fooled into thinking some incompetents doctors drug would help me.
Logically you would think HM if it is the drug that caused it, they it ( and it is, I know my body and I know I would never have developed tinnitus) should go away, after all I only took it for three weeks. But every night I am reassured it is not going away the same constant tone tortures me. I keep telling myself, well its from the drug so it should eventually go away, but it will never be the same. never complete silence that gave me peace of mind and quite. Every single person I have read about who has tinnitus from antidepressants has it 10 year later, it never goes away completely, and I NEVER NEEDED ANOTHER MENTALLY debilitating condition to suffer through alone and depressed.
I can’t believe drugs like pristiq are legal and given to depressed people, Well I guess I’m just the 1% of people that get permanent tinnitus from it, Another reason why my depression will continue to ruin my life along with tinnitus. I can not believe I have to live my life with being a a victim of an adverse drug reaction that gave me permanent tinnitus, and the worst part is I TOOK IT. So now i look so stupid, and people say well you should have know the risk. THERE IS NO LABEL THAT SAYS PERMANENT DEBILITATING TINNITUS. I hate hate hate this stupid western medicine, it broke my brain, and it caused me much more pain and misery than anything in my life.
Hi Jason:
While it may be true that your tinnitus was caused by taking Desvenlafaxine (Pristiq), there are still things you can do to mitigate its results.
I understand your feelings towards doctors and the drugs they so cavalierly prescribe without regard to the severe side effects they may have on your life.
However, what’s done is done. You can’t undo it. But you can choose to let it go and get on with your life–and take control of this situation.
You need to persevere and never give up working for a solution. You may never be able to totally get rid of your tinnitus, BUT you CAN habituate to it so it is not a problem–even if you do hear it.
In order to do this, you need to quit thinking for yourself as a victim. You need to see that you have a measure of control over your tinnitus. You need to quit thinking of your tinnitus as a threat to your well-being, but as a useless, inconsequential background sound that it is safe for you to ignore. Then ignore it by focusing on the loves of your life.
When you do this, you give your limbic system permission NOT to keep bringing your tinnitus to your conscious attention like it HAS to do with any real or perceived threats to your well-being. After all, that is one of its jobs in order to keep you safe.
As long as you keep thinking of your tinnitus as a threat, you CANNOT habituate to it. My ears are screaming away right now as I write this because I am focusing on tinnitus. But the good news is that I am so habituated to my tinnitus that within 5 minutes for completing this comment and going on to something else, I’ll no longer even be aware I have tinnitus. It’s hard to believe, but it is true for me and it can be true for you too IF you persevere in doing what is necessary to achieve success.
You have a lot to overcome because of your poor upbringing and thus not having a good opinion of yourself. No matter what people have told you, you have intrinsic value because you were made in the image of God. Remember that.
You need to get rid of all the negativity you have towards your doctor and your tinnitus and focus on a future where you habituate to your tinnitus. You CAN do it if you change your mindset so that you view your tinnitus as an unimportant background sound and thus ignore it like you do all other unimportant background sounds.
Since you feel your brain is “fried” and not working properly, I’d suggest you go to one of Dr. Amen’s clinics (https://www.amenclinics.com/) and have a SPECT scan of your brain. The results of the SPECT scan show which parts of your brain are not working properly and the professionals there are skilled in helping you get those parts functioning much better than they are now. These clinics are one of the few places I think can really help you. Why not contact them? You have nothing to lose.
Cordially,
Neil
Lamictal seems ototoxic too. Sadly I’m not having many choices as I am taking it for severe facial twitching caused by nerve damage and it works well for that.
I’m going to ask for an alternative though.
Hi Ruegnueg:
Lamotrigine (Lamictal) is ototoxic, but it works for you so you have to weigh the pros and cons of using it. If you have been using it and have not experienced any ototoxic side effects, then it seems that the pros for taking it outweigh the cons of a risk of ototoxic side effects. You should keep a weather eye out for any developing ototoxic side effects in case some appear.
There is no guarantee that there is another drug that is less ototoxic that will do the job. If you want to, ask your doctor for 2 or 3 alternatives and I can tell you which is the one least likely to give you ototoxic side effects.
Cordially,
Neil
Hello Dr Bauman,
Thank you for providing this forum.
I have unfortunately been on and off SSRI’s, mostly on for 30 years after a TBI. Most recently on Lexapro 5 mg, for about 10 years.
I never had any tinnitus until I got some nasty head virus/cold/infection for 2 days about 4 years ago. It is sometimes quite distressing, and very hard to determine if it is the Lexapro causing the tinnitus triggered by the head cold.
Unfortunately my brain seems to have become dependent on the SSRI (good for pharma profits) and when I try to get off, I get an unbelievable anxiety many times worse than anything I ever felt before taking the SSRI.
So I feel trapped between tinnitus and the terrible anxiety if I stop the Lexapro.
Any ideas of how to maybe escape this trap?
thank you for any thoughts
Chris
Hi Chris:
Escitalopram (Lexapro) can and does cause tinnitus in numbers of people. According to the studies before it was released to the public 0.4% of the people taking it get tinnitus. Since there are 25,960,468 prescriptions for Escitalopram each year in the USA, that works out to 103,841 which is a LOT of people getting tinnitus due to this drug each year in just the USA.
On the other hand, most people do not get tinnitus from this drug–so it is possible that your tinnitus is due to Lexapro or to the virus (or a combination of the two).
If you want to get off a drug after your body has adapted to it, you have to do a very slow taper so your body can adjust as you go along. The “safe” taper rate is considered to be 10% per month on the descending balance. For some people even that can be too fast. For others, they can speed up this taper.
Cordially,
Neil
PS I noticed you seemed to suggest Buspar was less Ototoxic, so maybe some of that would help get off the Lexapro, and then off all.
Hi Chris:
I’m not a medical doctor so don’t know whether switching to Buspirone (BuSpar) would do the job. It is not an SSRI drug. It is true that in my opinion it is less ototoxic so it would seem to be a step in the right direction.
Cordially,
Neil
PPS 🙂 When I had the cold, I had also just switched to the liquid form of Lexapro, I wonder if that could have somehow been more ototoxic?
Hi Chris:
Theoretically it shouldn’t be, unless you took more than prescribed so effectively increased the dose. Ototoxic side effects such as tinnitus can be susceptible to dosage increases, so if you inadvertently took more, that could possibly account for it.
Cordially,
Neil
PPPS ! I also have all kinds of somatic modulation ability of the tinnitus in my neck, jaw and head.
Could that possibly indicate the tinnitus is NOT from the Lexapro/
Sorry for so many messages!
Hi Chris:
That is certainly possible. Or you could have “basic” tinnitus from the Lexapro and the somatosensory tinnitus is parked on top of the basic tinnitus making it seem even worse.
If getting your neck, etc. properly aligned causes all your tinnitus to go away, then you know that was the case. If your tinnitus drops in volume, but doesn’t go away, that could indicate it was double-parked and the “basic” cause of your tinnitus still remains.
Cordially,
Neil
Hello Dr Bauman,
Thank you for all the logical replies. The body is amazing but sometimes quite a puzzle.
Two last questions if you dont mind.
1. Regarding tinnitus from SSRI’s….is it the Ototoxic effect of the SSRI that causes a hearing loss that causes the tinnitus, or is the tinnitus a direct result of the Ototoxicity?
2. Does whichever tinnitus effect from the SSRI above generally reach a stable level, or can it continue to increase over time. For me it seems to be about the same over the past 4 years, but that is quite subjective.
By the way, I do have to moderate high frequency hearing loss above 4000 HZ, who knows if that came from the Lexapro or teenage years with loud music.
thank you again!
Chris
Hi Chris:
1. I wouldn’t be surprised if it is some of both because hearing loss almost always leads to tinnitus, but I also hear from many people who report tinnitus and don’t mention any hearing loss (or maybe it was in the high frequencies where they didn’t notice it).
If you get off the SSRI and your tinnitus goes away, that would indicate that it was directly due to the SSRI and not secondary to hearing loss–unless the hearing loss went away too.
2. I think the tinnitus is stable while you are on it, but it can increase if you increase the dose of the SSRI. If you stop the SSRI, your tinnitus may begin to fade away, or it may remain at a high level. It varies from person to person.
Probably a bit of both–Lexapro and loud music.
Cordially,
Neil
Of course I forgot another question 🙂
What type of medical practitioner do you think might be best equipped to get the neck aligned and might even have some understanding of the somatic effects on the tinnitus? Chiropractor? Osteopath? Physiatrist? Physical therapist?
thank you again for you patience!
Chris
Hi Chris:
Personally, I’d go to a special kind of chiropractor–called an upper cervical chiropractor. These guys know how to precisely align your upper vertebrae and eliminate such ear conditions as Meniere’s disease for example. You can find one by going to http://www.upcspine.com/ and then click on the “Practitioners” button along the top.
To find a good one for your condition, ask them if they have had success dealing with people with Meniere’s disease. If so, they are probably the best suited to helping you.
Cordially,
Neil
Thank you for your time and kindness Dr Bauman 🙂
Hello again Dr Bauman,
I hope you are well.
I am trying to further understand this tinnitus/SSRI puzzle, and hope you might be able to answer a few more questions.
Is it that the ototoxicity of the SSRI causes hearing loss which then causes tinnitus or does the SSRI somehow cause tinnitus directly?
It seems that if it were the first case, it would be unlikely that the tinnitus would stop when the medicine is stopped, which can occur.
If the SSRI ototoxicity does cause hearing loss, would it occur to some limit, or could it continue degrading the hearing over time the longer the SSRI is used.
Personally I have about 50db hearing loss at over 4000 hz. Is that something that could cause tinnitus?
thank you!
Chris
Hi Chris:
To answer your first question, I suspect it is some of both, but I don’t really know whether the drug causes hearing loss that in turn results in tinnitus or whether it causes tinnitus directly.
You would be right if the tinnitus is secondary to hearing loss and the hearing loss is permanent. Then it would follow that the tinnitus would be permanent also.
However, if the tinnitus forms an endless loop, then although you stop the drug, the tinnitus would continue “forever” whether you had hearing loss or not. However, with proper tinnitus treatment, you could largely mitigate the effects of the tinnitus by breaking this tinnitus loop.
If the drug does cause hearing loss, the longer you take the drug the worse your hearing becomes–at least for some drugs. I’ve heard from numbers of people that have found this to be true. I suspect this is generally true for drugs that kill hair cells, but maybe not true for drugs that cause other mechanisms of hearing loss.
A 50 dB loss is well able to result in tinnitus. It doesn’t even have to be that much.
Cordially,
Neil
Thank you Dr Bauman,
I dont really understand what you mean by this:
“if the tinnitus forms an endless loop”.
Also, since at least some of the time the tinnitus can stop when the SSRI is discontinued, this would seem to suggest that there is some other mechanism causing the tinnitus from the SSRI other than causing hearing loss.
Maybe this helps explain it:
https://www.medicalnewstoday.com/articles/319077
A few more questions if you have the patience. 🙂
Also, are you saying that sometimes hearing loss is NOT permanent?
Is there a way to know if hearing loss is caused by an ototoxic medication?
Can hearing aids for hearing loss like mine possibly reduce or eliminate the tinnitus?
thank you!
Chris
Hi Chris:
When tinnitus persists and becomes permanent essentially it forms an endless loop in your brain. That is why when you stop the agent that caused the tinnitus in the first place (i.e. a certain drug) the tinnitus may persist. If your brain hasn’t formed this endless loop, when you stop taking the drug, the tinnitus soon fades away. That’s one way to explain it. I don’t know all the technical details.
Thanks for the article link. It sheds some light on how tinnitus and SSRIs interact.
It also explains why doctors prescribe a given drug for tinnitus and it seems to work for some people, yet at the same time it CAUSES tinnitus in many others. That’s been a mystery.
Hearing loss doesn’t have to be permanent depending on exactly what is causing the hearing loss. An obvious example is if a drug causes excess ear wax that blocks your ear canal. You have a degree of hearing loss until the wax is removed.
The same sort of thing can happen in your inner ears. For example, reduced blood flow to your inner ears can cause reduced hearing and when you take a vasodilator to increase blood flow, hearing returns. This can also occur when heavy metals block the ion gates to the ends of your auditory nerves so no signals can get through. When the heavy metal is chelated and removed, the ion gates function normally again and thus you hear properly.
Another example is when a loud sound destroys the synapses in the support cells underlying the hair cells and thus you lose some hearing. Your body tries to repair these broken synapses over the next few weeks and if successful, hearing returns, but if it can’t, eventually the support cell dies and thus also the hair cell it supports, and then you have a permanent hearing loss.
The only way I know to tell if an ototoxic drug has caused a hearing loss is to have an audiogram taken before you start taking the drug, and then another audiogram after you have completed the drug therapy. If there is a difference, it is likely due to the drug.
Hearing aids often do reduce/eliminate tinnitus while you are wearing them (as your brain now has real sounds to process), but the tinnitus typically comes back when you take them off at night and it is quiet again.
Cordially,
Neil
Thank you Dr Bauman for your time and patience 🙂
Hi Dr. Bauman,
i took Paxil for 6 years. This year in summer I decided to taper off gradually. When finished I experienced horrible withdrawal symptoms. Also my preexisting tinnitus ramped up a little, but not too bad.
The doc I visited because of the panic attacks (withdrawal) said I should go back on Paxil. Unfortunately I did. My tinnitus ramped up even more but I didn’t understand it was the Paxil because it happened slowly. I now have tinnitus so loud I struggle with daily life, work, my kids etc. I can’t stop the Paxil because I’m already 3 months on so I had to endure withdrawal again.
My life is in pieces right now, my ears are so so bad.
What can I do with the Paxil? Taper again? Do I have a chance for the tinnitus to go away after stopping?
Thanks!
Daniel
Hi Daniel:
How long was your “gradual” taper. After being on Paxil for 6 years and building up a tolerance to it, I’d consider a slow or gradual taper to take a year or so. A “safe” taper rate is 10% per month on the descending balance. And if withdrawal side effects begin appearing, that means you are tapering too fast so you need to stop the taper at that point and wait until the side effects go away before resuming the taper at an even slower rate.
I suspect your taper was much too fast–faster than your body could handle it.
If you want to get off the Paxil, you need to taper again–but this time with a true slow taper so you don’t experience withdrawal side effects. So you’d be in for the long haul.
Hopefully, your tinnitus will slowly drop back to base level in time, but if it doesn’t, all is not lost. You can learn to habituate to your tinnitus so it no longer bothers you. So much depends on your emotional/psychological state. The trick is to get rid of your anxiety/panic episodes and remain calm. So learning how to keep yourself calm is necessary.
Cordially,
Neil
Hello again Dr Bauman,
I am following up on my earlier comments.
I take 5 mg Lexapro for about 8 years, and other SSRI’s on and off for about 20 years before that due to depression from a head injury 30 years ago.
The tinnitus started 5 years ago, while on Lexapro, but after I had been on it for about 3 years without tinnitus.
It is very difficult if not impossible to know if the tinnitus is caused by the SSRI but if it is from the SSRI, I see 3 mechanisms that could cause it.
1. Directly from the SSRI, There are reports linking SSRI to tinnitus due to excitation of some “fusiform” cells.
2. Jaw clenching from SSRI (common side effect) causing TMD issues causing tinnitus.
3. Ototoxicity from the SSRI causing hearing loss thus causing tinnitus. (I have “mild to moderate” hearing loss in the high range. After 4000 hz my hearing drops by about -40 db then to about -50db at 8000 hz)
My concern is if it is #3, and I have become dependent on the SSRI and cant get off it (have tried several times), does this mean the ototoxic effect would eventually lead me to deafness?
Note, I have “somatic” tinnitus where I can greatly moderate the intensity of the tinnitus with movements in my head/neck and jaw.
thank you
Chris
Hi Chris:
Rather that keeping on taking SSRIs and trying to keep depression at bay, if I were in your shoes, I’d go to one of the Amen Clinics and have a PET scan of your brain. The doctors at these clinics will explain exactly what is going on in your brain–you’ll see the scans–and then they’ll help you to correct the problem so you don’t have to be on drugs for the rest of your life if that is possible. They try to get at the root of the problem–not just put a band aid on it. You can reach them via https://www.amenclinics.com/ .
You have done a great job of enumerating 3 possibilities of taking an ototoxic drug such as Escitalopram (Lexapro). All three could be happening at once or just one or two. This makes it hard to put the finger on the exact cause.
1. If the Escitalopram is an excitatory neurotransmitter, then it revs up your brain and that can cause/increase your tinnitus.
2. This is a distinct possibility–at least contributing to some somatosensory tinnitus. Switching to a different drug might help in this respect. You might also want to go to an upper cervical chiropractor (http://www.upcspine.com/) to be sure your neck and jaw are in proper alignment, and to a massage therapist to loosen tight muscles so they don’t keep on pulling things out of place.
3. I have about the same number of reports of hearing loss as I do for tinnitus from people taking Escitalopram. So that may be the main contributing factor.
If you go to the Amen clinics, you may find they can help you get off this drug. To me it would be worthwhile to at least explore the possibility with them.
I doubt you’d ever go completely deaf–that only very rarely occurs, you typically still have some residual hearing. However, your hearing could possibly drop to a level where you’d be better off getting a cochlear implant if hearing aids don’t help you. I am wearing new powerful hearing aids and they help me a lot.
Cordially,
Neil
Thank you for your time and suggestions Dr Bauman.
Dr. Bauman –
So I developed tinnitus after just 2 doses of 10mg escitaloprám. I took a third thinking it was a temporary side affect and would go away. However I started researching and found that this was way more common and scary than I could of imagined. I had taken Escitaloprám prior within the last year but got off of it and things were going well. Things in life started going sideways and I had some health issues. The doctors told me I had anxiety and I was fine and needed to start taking escitaloprám again. With much hesitation I took it.. so now as I sit here typing this I end up feeling worse than when I started. As my ears hiss almost 2 weeks later the doctors tell me that it couldn’t of been the escitaloprám… I didn’t take enough of it…. I hope this goes away or subsides a bit… the lack of sleep is killing me. I cant think of a different reason I would wake up with this in the middle of the night after 2 doses. The doctor said to take mirtzipan (remulon) for sleep.. but even that concerns me at this point.
Hi Matt:
You can get tinnitus, as did one man, from just take one 10 mg pill. So your doctors are ignorant about the ototoxic side effects of Escitalopram.
When you have anxiety you need to deal with it, not try to drug it out of existence. That just doesn’t work in the long term. Anxiety alone can cause tinnitus. You can find some good information about dealing with anxiety at the AnxietyCentre.com if you are interested.
You are well to be concerned about taking Mirtazapine. Taking another drug is not the answer. You’d just be compounding your problems. Numerous people get tinnitus, or worse tinnitus, from taking Mirtazapam, not to mention hearing loss and other ototoxic side effects.
When you have anxiety, you might want to consider taking the herbal Valerian to help you calm down so you can get a better night’s sleep.
Cordially,
Neil
Thanks for the reply. I will take these things into consideration. Its hard to believe that something that was supposed to help me has made everything exponentially worse. I have a hard time not blaming myself for this. Not only will it affect me, but my family which is the reason I was seeking help from the doctor to begin with. I keep trying to hope it will get better, but as the days go on it seems more like this is going to be a permanent affliction. One I will have to learn to live with one way or another. Again thanks. I hope that this blog brings more attention to an obvious problem with these drugs that seems to be swept under the rug.
Hi Matt:
We labor under the delusion that drugs are there to cure whatever ails us. However, in actual fact, as one medical doctor explained, “The pharmaceutical business model always aims to have proprietary products that partially improve a chronic condition and must be taken indefinitely (as this ensures the largest amount of sales).”
He further explained, “The pharmaceutical business model requires pharmaceuticals that are “effective” enough to somehow justify pushing them on patients but not effective enough to actually fix the issue the drug is prescribed for, thus requiring each patient to take the drug indefinitely. Furthermore, the larger the potential drug market is, the more aggressively the pharmaceutical industry will push to promote it to every available customer.”
Once you realize this, you will look at drugs in a different light and won’t be so willing to take them without proof that they will not only effectively help you, but at the same time won’t harm you.
Cordially,
Neil
Hi Neil, I was wondering what you think about this? I have had tinnitus for a couple years and it’s very loud. However, about a few months ago I did finally habituate but I have a problem, I have very severe major depression and need an antidepressant but every single one triggers the tinnitus from one ear to coming from my brain and I hear it in both ears. My question is if I continue to use my sound therapy hearing aids and turn the volume up to just below the noise, since it’s a new sound do you think I will habituate to this antidepressant sound in time? Perhaps in 3 months like it took me to habituate to my original sound? I know I toxic medications like Zoloft is a bad idea for perhaps making my tinnitus worse or hearing damage but without this relief for my depression it’s scary how bad I get. It’s really severe dark depression. I do see a counsoler and take mood stabilizers but it’s not enough I need seratonin affect. I haven’t tried at John’s wort yet like I know you advise. So, my main question is if you think I will habituate and volume eventually go down for this loud tinntus hissing I get from this Zoloft and other antidepressants? Thanks so much Neil for you time.
Hi Michael:
You are asking a tough question. Normally you think of habituating to tinnitus AFTER you have removed the trigger that caused the tinnitus in the first place. In your case, you want to habituate to a sounds that the drug is constantly causing. I don’t know whether that will work or not. My gut feeling is that it won’t work, but it certainly doesn’t hurt to try it and see. I’d love to know the answer to that too.
Why haven’t you tried St. John’s Wort before going on the prescription drugs? That would have been the track I’d have tried first.
Cordially,
Neil
Hi Neil,
I was wondering if once your emotions stop responding to the sound and the volume becomes less bothersome, does the volume continue to go down over time or is it a one time thing? I have noticed some volume desiccation but it still seems very loud especially in the morning and doesn’t seem so much in the background but more very much in my head.
Thanks for your time,
-Mike
Hi Mike:
The volume can continue to go down, or remain at the new lower level, or it may seem to disappear and only reappears when you think or talk or read about tinnitus. Thus, hours may go by without your being aware you even have tinnitus. Everyone is different.
Are you still taking the drug that caused your tinnitus, or did you quit it and now want the tinnitus to fade away as much as possible?
How long has your tinnitus seemed to be more in your head than in the background?
Cordially,
Neil
Hi Neil,
I am still taking the Zoloft but had to back it down recently cause it was getting so loud. However, I do have a lot going on as I quit taking lithium about a month ago after taking it for several years and my brain seems to be all over the place ever since. The reason I stopped the lithium is my blood tests are showing some lower scores that could be indicating I have kidney issues looming. Once I get this all figured out I am hoping the volume goes down further and I can get some consistency. So far it doesn’t appear the brain wants to habituate to the Zoloft loudness. It’s almost like it’s an echo in my head or some sort of sound perception due to the medication. The other big factor that makes things more difficult is my sound goes on 3 days and off 1 to 2 days so my brain deals with that on and off issue as well. I like the days off but then I pay when it kicks back on.
Hi Mike:
Changing drug doses can probably change your degree of habituation as the resulting “side effects” as your body adjusts to the lower dose cause you to focus more on your ears and thus subvert the habituation process temporarily.
I’ve heard of others that have a cyclical tinnitus problem somewhat like you are experiencing. One reason for this is that “According to Dr. Hazell, the reason this can happen is that everyone has cyclical activity (feeling up or down) in their limbic and autonomic nervous systems. This is more obvious in some people than in others. When you are in a down cycle, you will perceive your tinnitus as more of a threat to your well-being. Consequently, you will perceive it as louder and thus more noticeable during those times”. This quote is from my tinnitus book.
Do you think this applies to your situation?
Cordially,
Neil
Oh and my sound has been more loud and in my head and not the background for about 3 weeks. When people lose their habituation and have to get back habituated can this take longer than a month? I am using my hearing aids/sound therapy to try and get it to happen asap.
Hi Mike:
You can’t “command” habituation as such. It comes naturally as you focus away from your ear problems and focus on the loves of your life. When you try to habituate fast, you are focusing on your ears and thus subverting your attempts at habituation.
Cordially,
Neil