by Neil Bauman, Ph.D.
A lady wrote,
I think the tinnitus and intense ear pain I’ve had for 17 months might be a combination of things—Eustachian tube dysfunction from a lot of airplane flights, and some arthritis in my jaw joint aggravated from dental work? I have been taking 5 mg. Ambien to sleep all this time. As an experiment I stopped the Ambien one week ago and slowly have less pain and tinnitus every day that goes by.
It is true that Eustachian tube dysfunction could result in ear pain and tinnitus. Although, personally, I don’t see why flying should cause Eustachian tube dysfunction. I can see it happening the other way around—Eustachian Tube dysfunction causing problems with your ears during and after flying.
Dental work, especially on the upper molars also can cause tinnitus and ear pain. I’ve had a number of people complain about that.
Thus, it seems perfectly logical to blame the various ear conditions you suffer on your Eustachian tubes or your dental work. At the same time, it never crosses your mind that the drug your doctor prescribed is actually causing your problems.
Did you know that Zolpidem (Ambien) can cause tinnitus, ear pain, and middle ear infection problems—in other words the very problems you list above?
When your ear problems exactly correlate to the time you are taking a given drug, you need to be highly suspicious of that drug. You did a little experiment that proved to me that the Zolpidem you are taking is the real culprit.
When you stopped taking the Zolpidem your tinnitus and ear pain immediately began to diminish. It had stayed constant for 17 months—during which time you were taking Zolpidem. Then within a day or two of stopping it the pain and tinnitus began to go away. That’s not a coincidence. It’s the Zolpidem. To me, this says that your ear pain and tinnitus are more Zolpidem-related than anything else.
Incidentally, you don’t want to be on Zolpidem for very long as it can be dependence-forming, much like the Benzodiazepine class of drugs. If this happens you will have a lot of difficulty getting off it—and may experience horrible tinnitus and other problems in the process.
Don’t let ototoxic drugs inadvertently damage your ears. Learn which drugs are (or can be) ototoxic. The book Ototoxic Drugs Exposed contains information on the ototoxicity of 877 drugs, 35 herbals and 148 chemicals.
Is it possible to develop tinnitus from taking Zolpidem for only a week to ten days? I was taking the controlled release form (12.5 mg) and shortly after I started taking Zolpidem, I noticed that my ears started ringing. Unfortunately, my doctor allowed me to take this drug off and on for almost three months, and to date I still have the tinnitus (going on 10 months after cessation). Would appreciate your comments.
I have been using zolpidem 5 mg 25 times during past 3 months. I have recently come down with tininitus, which is on the mild side. However I cannot fall asleep due to a hissing or swishing sound as I am trying to fall asleep. It’s been 3 days no sleep, no pills and have an appt with sleep specialist tmrw. What can I expect to hear from him
Hi Bapi:
When you have trouble falling asleep because of your tinnitus, a good thing to do is have some background sounds for your ears to listen to. Good sounds for this purpose are fan noise, pink noise, fractal music (sounds much like wind chimes and especially water sounds such as waves on the beach, babbling brook, rainfall or waterfall sounds since water sounds are naturally soothing. You can download such sounds from the Internet and then play them while you are falling asleep, or all night for that matter.
Cordially,
Neil
Hi Craig:
Zolpidem can certainly cause tinnitus. Unfortunately, I don’t have any information on how long you have to take it before tinnitus develops. I am sure this varies considerably, so you may get it after taking the very first dose, or you may have to take it for a number of days, weeks or months to get tinnitus. Thus, it is very difficult to answer that question in anything other than generalities.
Regards
Neil
Can zolpidem as a cause of tinnitus be ruled out if the ringing is only in one ear?
Hi Michael:
No, definitely not. Drugs can affect just one ear for some reason. I know many doctors think that if you have tinnitus or hearing loss in just one ear that it can’t be the drug, because they think a drug will affect both ears. But this is just not so–not sure why–but that is the way it is sometimes.
Cordially,
Neil
I strongly advise you Dr. Neil to conduct a comprehensive survey amongst medical professionals who are knowledgeable in the study of tinnitus before stating Zolpidem may cause tinnitus. An all too obvious syndrome of paranoia now exists in the medical field of prescribing medications that actually work for fear of reprisal by the AMA and FDA. I am in my 70’s and after a demonstrated history of not only tinnitus, but lifelong chronic pain as a result of serving my country, Aspirin is my only option which of course aggravates tinnitus and offers absolutely no pain relief. I would have to buy street drugs which I will never do. I for one am sick and tired of being subjected to numerous exams and tests with no relief offered. If I ask for a pain medication I always get the same reply. “We don’t want to give you a drug that helps because we are afraid for your welfare.” Translation: “We’ll get in trouble if we actually help you.” My thanks to the medical profession.
Hi Stephen:
You’re joking, right? Who are all these medical professionals that are knowledgeable about tinnitus AND knowledgeable about drugs?
And I didn’t just say Zolepidem MAY cause tinnitus. It DOES cause tinnitus in numbers of people. There are hundreds and hundreds and hundreds of reports of Zolepidem causing tinnitus in the FDA’s database. So all that these “knowledgeable” doctors have to do is check the FDAs database to know the truth.
To be sure, Zolpidem and other drugs do NOT cause tinnitus in everyone that takes them, but a significant number do get tinnitus. Thus I warn people that they need to be careful if they take such drugs. Once they know what they are up against, they can make up their own minds whether they want to accept the risk of tinnitus (or any other side effect) from taking a given drug. They need to weigh the pros and cons, THEN make an INFORMED decision.
It seems to me that your biggest concern is getting pain killers, and your doctors are not willing to put you on narcotic and/or addictive pain killers in the long term. There is a good reason for this as these drugs are not benign like the drug companies have been telling everyone. They are dangerous drugs and are rightfully being restricted now. Previously, they were being prescribed like candy. Now the pendulum has swung the other way after seeing all the damage they have been doing.
If you want to investigate an alternative medication that has been demonized by the powers that be as being a dangerous drug, but is actually a very safe medication and works on many people that have neurological conditions (such as pain among other things) that are not amenable to the standard drugs most doctors prescribe, why not investigate DMSO (dimethyl sulfoxide)? It works so well the drug companies feel threatened because they can’t make any money on it and their sales of largely-ineffective expensive drugs will drop and this will put a large hole in their profits.
If you are interested, I can send you some links so you can do your own research on this little-known, but very effective drug that was used and hailed as a wonder drug back in the 1960’s but has since been replaced by other (read expensive) drugs today.
Cordially,
Neil
I have been taking ambien and trizodone for 3 years. I have had random bouts of tinnitus and dizzyness lasting weeks at a time. I dont know if its caused by ambien because it went away before and i didnt stop taking ambien. I have such severe insomnia that i can not shut off my brain without medication. I also do nit want to permenently wreck my ears. Do u think the ambien is causing it? Mine did nit coincide with med changes. I dont want yo have anymore issues as i have enough to deal with already.
Hi Adam:
Zolpidem (Ambien) could certainly be the culprit. It can and does cause tinnitus in some people. Officially it’s 1%, but dizziness is a whopping 23.5%. So I certainly wouldn’t be surprised if your bouts of dizziness are related to your taking Ambien.
At the same time, I certainly would discount the Trazodone you are taking. It officially causes tinnitus in 1.4% of the people taking it and dizziness in 28%. So it can be even worse than the Ambien.
And on top of all this, no one knows the ototoxic side effects of combining these two drugs and taking them together such as you are.
One of the strange things about the side effects of ototoxic drugs is that they don’t occur all the time like you would think they would. Some side effects can come and go at times, others pretty much are there all the time. I don’t know what factors cause this.
Thus the only way to be sure that drugs are not causing your ototoxic side effects is for you to go off all drugs for a month or two and see whether the side effects clear up or not.
Of course, you need to run this by your doctor before you decide to do this as stopping some drugs suddenly can cause other problems and you don’t want to add to your existing problems.
Regards
Neil
The problem is that if Ambien (zolpidem) is taken for sleep. How can you sleep without the drug?
So your answers are not fully accurate.
I am (was) on Zolpidem 10 mg X2 each night for very, very long time.
When I run out, I did not sleep a minute for the first two nights.
Then it took a very long time to fall asleep. How long did I sleep, I do not know. Yesterday, I filled my script and took 20 mg. I woke up at 5:00 am. Do not know how long I slept.
My tinnitus is more than likely caused by pinched nerve in my neck or back.
I do not yet feel better. I am considering taking 10 mg and see what happens.
I am nausated. by Zolpidem?
Hi Ewa:
You used to sleep just fine without taking drugs. This proves that Zolepidem is not NEEDED for sleep. Your body knows how to sleep already. Your problem is that your body is out of whack, causing you sleeping problems. The solution is not to drug your body into sleep, but to get things into proper alignment and perspective and you’ll be able to sleep again.
Since you have been on Zolepidem for a “long time”, you need to taper off it slowly, not just quit or reduce it by 50%. That’s just asking for trouble. You have to give your body time to slowly adjust to being without this drug again.
If you tinnitus is bothering you and you suspect it is from a pinched nerve, I suggest you investigate treatment from a special kind of chiropractor that specializes in the upper cervical spine (UCS). These people are able to work wonders for certain ailments and they are very gentle–not the bone cracker kind. They focus mostly on your top two vertebra (C1 (Atlas) & C2 (Axis). If this joint is “off” then you could have some of the symptoms you are experiencing.
You can find a chiropractor specializing in UCS by going to the following URL and entering your location. You can also read about the things these special chiropractors can do for you at this same website. Here is the URL.
http://www.upcspine.com/
Choose the “Practitioners” link along the top to find the one closest to you.
Cordially,
Neil
Dr Neil,
I have been taking Zolpidem Tartrate (Ambien) for eleven years at 10 mg per night, and have had Tinnitus for as long as I can remember after starting this drug. However it has not seriously impaired my hearing or increased in intensity, it’s just a mild annoyance.
I would really like to get off this drug as its long-term use certainly disallows the brain to shut-off naturally, but, like other contributors, cannot sleep without it now. I have tried ‘cold turkey’ (which is not advised), but sleeplessness returns after a few days even if I succeed in some night’ sleep after a few nights of no sleep. Any suggestions?
Thank you for your work on this website.
John Maynard
Hi John:
Zolpidem, although not a Benzodiazepine, acts similar to Benzos, and often forms dependence just like Benzos do. Thus, taking any of the “Z” drugs (which includes Zolpidem) or Benzos for longer than a couple of weeks is not wise if you want to avoid forming a dependence on them.
Once you have formed a dependence on these drugs, it is VERY hard to get off them, but not impossible. As you found, quitting cold turkey doesn’t really work. What you need to do is taper off them VERY slowly–something in the neighborhood of 1% every three days. At this rate, it will take you 300 days to get off the drug–but hopefully, you won’t experience undue side effects. In order to do this, I highly recommend Dr. Heather Ashton’s book on the subject. You can download it free.
Go to my article on Benzodiazepines and how to withdraw from them at http://www.hearinglosshelp.com/articles/benzodiazepines.htm for more information on withdrawal and the link to download this wonderful resource.
If you follow the above directions and stick with it, you can almost certainly free yourself from the nasty effects of this drug. It will just take time.
I wish you well.
Neil
Hi Neil, my doctor gave me ambien 10mg generic for insomnia and i take it off and on 2-3 nights a week every other night when my insonmia is really bad..its been 2 days since my last dose and I’ve had horrible earaches and dizzy spells since i last took it is this normal withdrawal starting to feel like its not worth it when its making me feel like i have a cold or flu oddest part it only seems to effect the left side of my body the most w body aches stuffy nose and earache.
Hi Angel:
Two of the side effects of Zolpidem (Ambien) are earaches and dizziness. It can also cause ear infections so you’d feel all stuffed up and not hearing so well.
Zolpidem can cause dependence–so you have to taper off it very slowly if you’ve been on it for any length of time.
Cordially,
Neil
I have finally been able to lay off the Ambien for over a month but that tinnitus is persist. Is there any hope that the tinnitus will go away or is this permanent damage and what are my options. I have already seen several doctors the Vertigo immediately stopped but that tinnitus is persist. Thank u – Iggy
Hi Iggy:
I suspect that the tinnitus will tend to be permanent, but I have no hard data to support that, so you can always hope.
What I’d do is learn to ignore your tinnitus by focusing on the loves of your life. When you do this and also don’t harbor negative emotions towards your tinnitus, it will tend to fade into the background and not bother you. Oven time, by doing this it will tend to get quieter and you’ll realize that you aren’t even aware of your tinnitus for longer and longer periods of time.
Regards
Neil
Dr. Neil,
I was precribed Ambien for three years, and developed a dependancy. I finally quit on my own, which resulted in many autonomic nervous system mishaps in the first week of withdrawl, and left me with intense tinnitus, going on now for 6 months and counting. Are you aware of any lawsuits surrounding the ongoing prescribing of Ambien to a patient? If I had known it would leave me with irepairable tinitus, I would have never taken it. Your thoughts are appreciated.
Hi Aaron:
Ambien (Zolpidem) can cause tinnitus when you take it. However, if you quit “cold turkey” after you have formed a dependence on this drug, you leave yourself open to severe tinnitus coming on AFTER you stop taking this drug. This is one of the reasons why you NEVER quit “cold turkey” after you have built up a dependence. You need to taper off SLOWLY–taking as long as 300 days to taper to nothing (that’s about 1% reduction every three days). When you taper off this slowly hopefully you will not experience any side effects, or very mild ones if you have any.
Unfortunately, you apparently just quit taking this drug, and the result was severe and permanent tinnitus.
I’m not aware of any successful lawsuits of drugs for damage to the ears. The problem is finding a doctor for an expert witness that is willing to testify that this drug DID cause your tinnitus. Most doctors are so brainwashed that they don’t believe the drugs they prescribe can or will cause such side effects.
I hear the lament, “If I had known it would leave me with …., I never would have taken it” fairly often. That is why I urge people NOT to take drugs EXCEPT as a last resort, NEVER as a first line of attack. There are just too many side effects you will have to deal with whether you like it or not. Furthermore, drugs like Ambien should only be taken in the short term. To me, short term is 2 weeks or less, not 3 years.
Unfortunately, you’ve learned the lesson the hard way. I hope others reading this will do their due diligence BEFORE taking such drugs and thus profit by your experience.
What you need to do now is learn how to deal with your tinnitus, and become habituated to it so it no longer bothers you–although it will still be there.
Regards
Neil
Ive been taking Ambien for insomnia for more than 3 years and have frequent sever dizziness and tinnitus, often with a “full” sensation in my right ear. Only one ear is affected. Should I begin to taper off? And, how do you do that when the pills are small and not scored? Should I ask for my next Rx to be 5 mg rather than 10?
Hi Kelley:
It’s up to you whether you choose to get off this drug or not, but things are not going to get better if the drug is damaging your ears and balance so it seems the prudent thing to do.
If you have built up a tolerance to Ambien (Zolpidem), you have to taper off very slowly or you can cause new and worse side effects. A common problem is tapering off too fast, and like you said, it is hard to cut pills to smaller and smaller sizes. Getting smaller pills is one solution but even so, that will mean you taper by 25% or more with each size of pill reduction. This is MUCH too fast in many cases. I’ve heard from too many people that followed their doctors recommendations and tapered off too fast.
A much better way, according to Dr. Heather Ashton, is to taper off slowly over a period of 300 days. This means you would reduce your dose by 1/3 of a percent per day. That way you can almost guarantee you will not make things worse as you wean your body off this drug.
“How do you do that,” you ask? One way to precisely reduce the dose is to get yourself a mortar and pestle. Use the mortar and pestle to crush the pill to a fine powder, then dissolve it in exactly 100 mL of water. Now, the first day, pour out 1 mL of the solution and drink the rest. Do this for three days. Now you have reduced your dose by 1%. On the fourth through sixth days pour out 2 mL of the solution and drink the rest. Thus, every three days you pour out one more milliliter of the solution and drink what remains until finally on the 298th day to 300th day you are pouring out 99 mL and drinking 1 mL. After that you are free from the drug!
Regards
Neil
I have been taking Ambium for 5 yrs. I’ve had insomnia since childhood. Staying awake so if my father came home drunk ,I could jump up if he tried to beat up my mother.So my Dr. put me on ambium.I have ringing in my ears and I take blood pressure meds. I am 62 and wonder what I should do.
Thanks
Ringing could be caused by blood pressure meds. Try to take COQ10.
Hi, I took Ambien for 12 years. The ringing in my ears started first and the doctor told me that it was because of my age (58). I am now 62 and one day I woke up and I was completely deaf. It’s been 2 1/2 months and some of the hearing has come back but the ringing is worse, VERY loud. I have been to a specialist and he doesn’t think my hearing will ever be normal again and stated I would need hearing aids. Do you think the Ambien caused this?
I’ve exact case, used Ambien 12 years and now suffering vertigo as well as tinnitus. doctor prescribed hearing aid but vertigo is badly impacting job and daily routines. I stopped gradually taking this medication in 2017 and still have no clue how to get rid of these side effects.
1) Regular alcohol consumption may be a cause of chronic insomnia. I found that once I stopped alcohol intake, I could fall asleep with 400 mg of GABA, 600 mg of L-tryptophan, and 4 mg of melatonin a half hour before bed. Put into one capsule, there’s a preparation called Somniphan that has those proportions. That combination worked great, and I’ve not had an Ambien since. Try it.
Hallo,
I took ambien for a period of 6 month. This was in 2012. Since that time i have problems at the “Palatopharyngeal arch” as if there was a swelling and also the eustachian tube is causing problems.
Pressure in the ears too.
Are these symptoms known to be realted to ambien?
greetings
anthony
Hi,
I was on Effexor for 12 years with having mild tinnitus. After I came off 5 years ago I developed severe tinnitus and Musical Ear Syndrome, also more hearing loss. It took me about 6 weeks to taper off and symptoms started shortly after, the Dr suggested I go back on. I did for about 9 months and my tinnitus seemed to plateau, but got worse after coming off again. My Dr is suggesting I go back on Effexor or Buspirone but fear the consequences. He also suggests Zolpidem for sleep but I see tinnitus and hearing loss as a side effect. Any other safe suggestions for insomnia and anxiety. Julie
Hi Julie:
My choice would be the herbal Valerian. It calms you down and lets you sleep, but doesn’t make you tired the next day. There are other herbals you can take too. Any good health food store should be able to help you find the right herbals that work for you. You can also purchase Valerian on-line.
Cordially,
Neil
I was diagnosed with chronic severe tinnitus with progressive hearing loss and my doctor prescribed me zolpidem to help me sleep. First time I took a 5mg dose I awoke a few hour later with the ringing louder. It made me have one of the worst migraines I have ever had. She asked me on a return visit why I was not taking it and I explained what had happened . She told me that it would go away once my body got used to it. After that I changed doctors. It caused me to have the masker in my hearing aids to be raised. Now my new doctor is concerned that the drug has caused more damage. I only took the drug for a total 20 times over a 2 month period. Now I have bouts of vertigo with nausea plus I have more migraines and cluster headaches. Is this permanent?
Hi June:
Only time will tell whether your tinnitus and balance problems will be permanent or temporary. I don’t have enough information on this drug to know which it will be.
I don’t keep track of other side effects such as migraines, so I can’t speak to that.
So much of whether tinnitus is permanent or not depends on your own attitude towards your tinnitus. If you treat it as a threat to your well being in any way, then it will stay. But if you treat it as “no big deal”, typically it will fade into the background and not bother you. So as much as is possible learn to ignore it by focusing on the loves of your life.
Cordially,
Neil
Hi. Thank you for all the info. My question is. You say in many responses that you believe tinnitus from zolpidem withdrawal ( cold turkey) to be permanent.. can you tell me why you say that? I have at least 1/2 days a week of very little or no tinnitus so I’m hopeful it will stop. I have had it now 3 months after stopping zolpidem ( took for 8 weeks). I have seen doctors and none will confirm that it could be zolpidem. Also do you have any suggestions for supplements like GABA or L theanine?
Thank you
Hi Carina:
If you read my article and all my comments carefully, you’ll see that I say that I don’t know whether the tinnitus will be temporary or permanent. For those people who have been off the Zolpidem for a month or more and still have bad tinnitus, I say I think or suspect it will be permanent. The reason I say that is because some weeks have passed and their tinnitus has shown no signs of reducing or going away.
In your case, since you periodically have times your tinnitus goes away or reduces, you can be hopeful that in time your tinnitus will fade into the background or go away. So that is good news.
What do you want the supplements to do?
Cordially,
Neil
Hi I have been on candasarten 16mg and amdolopine 6mg for high blood pressure and now have loss of hearing in one ear, ear pain and tinnitis could any of these medications cause this? Also I was on gabapentin for 3 months for sleep problems but am now off them. I have been told it is related to my high blood pressure and am waiting to see an neurologist.
Hi Eileen:
Candesartan (Atacand) can cause tinnitus and some people, but is not listed as causing hearing loss or ear pain. In contrast, Amlodipine (Norvasc) causes hearing loss, tinnitus and ear pain in numbers of people. Gabapentin (Neurontin) can also cause hearing loss, tinnitus and ear pain among a number of other ototoxic side effects.
My money is on the Amlodipine as the culprit for causing your ototoxic side effects, but the other two drugs could also have contributed.
Cordially,
Neil
Hi sir… Am 25 yrs old.. And I have SNHL in one year and tinnitus in another ear for past 3 years, etiology was stated that noise induced or post viral fever residue(i got this problem one month after dengue fever) and now am using zolfresh at times of insomniac.. Will it worse my ear conditin further???
Hi Neps:
Zolpidem (Zolfresh) is a drug you want to be careful with as you can build up a dependence to it, much the same as with the Benzodiazepine class of drugs. Taking one occasionally is probably ok. Zolpidem is mildly to moderately ototoxic and can cause hearing loss, hyperacusis, tinnitus and a bunch of balance problems.
Cordially,
Neil
Hello Dr Neil,
I am 28 years old. I was diagnosed with Eustachian Tube Dysfunction about 4 months ago. Also, my left eardrum is also retracted. This all started with a severe cold, and then I I went on a plane to Jamaica and back for my honeymoon. I’ve had ear pressure/fullness, occasional pain, ringing in my right ear only (it’s hard to sleep at night), and for some reason I keep over-producing earwax. Cleaning kits at home aren’t helping. I’ve been to 2 ENT doctors. I’ve done allergy meds, nasal sprays, Prednisone (twice), and everything else they suggested. I still have ear pressure, too much wax, tinnitus in one ear, etc. Is it possible that my cold/flying caused this horrible ETD situation? I’m only 28 and I’m scared that this is forever. I had a cold and went on a plane. I can’t even begin to understand why this is happening.
Hi Nikos:
I’ve heard from numerous people in your situation. Their ear are congested and they go on a flight–and then have problems such as you have. That is why it is a good idea to not fly if you are congested, or at the very least, take a decongestant a half hour before you take off and also a half hour before your plane starts to descend to land.
Now, to get to your questions. I don’t see how producing ear wax in your ear canals is associated with your Eustachian tube dysfunction (ETD) problems. Some people just naturally produce more wax than others. You may just have to clean out your ear canals daily. That is what I do. Every day when I shower, I let the shower squirt some water in my ear canals, then after I dry off, I use Q-tips to clean out my ear canals.
There are two cautions when doing this. First, you need to start AFTER you get a health professional to clean your ear canals out. You need to start with clean ear canals or else you will just push the existing ear wax further down and impart it on your eardrum which will affect your hearing.
Second, you need to be careful not to push the Q-tip down against your eardrum. You don’t have to go all the way down your ear canal as the wax producing glands are about half way down. If you do this every day, the wax never builds up. That will take care of your ear canals to your eardrum.
Your Eustachian tubes connect the back of your throat to the inside of your eardrum and the 3 bones in your middle ear. If they get clogged up so air cannot travel up/down them when they momentarily open whenever you swallow or yawn, then bad things happen in your middle ears. You say your eardrums are retracted. That means there is negative air pressure in yur middle ears. Your middle ears have used up the air in there and since more air can’t travel up your Eustachian tubes, that is the result.
Typically, in time–up to 3 months, the gunk in your Eustachian tubes/middle ears drains out after your cold goes away, and things get back to normal. The thicker the gunk, the longer it takes to drain out.
If your Eustachian tubes are truly not working–meaning the muscle at the bottom doesn’t open when your swallow or yawn, or the tube is collapsed, then air can’t get though. If that is your problem, then I’d go to an upper cervical spine chiropractor and have him check my top two vertebrae. When they are not in proper alignment, they can pinch your trigeminal nerve which also controls your Eustachian tubes. The result is they don’t work properly or at all.
Tinnitus is often a result of clogged middle ears because you have a certain degree oef hearing loss since the bones in your middle ear can’t move freely with all the gunk there. You haven’t mentioned hearing loss, but I’ll bet you have some–and thus the tinnitus that so often accompanies hearing loss.
Cordially,
Neil
Dr Neil, I have been on combination of Clonazepam and Zolpidem for more then 2 years. I had occasional tinnitus in my left ear due to hearing loss before I start taking this combination. By now, my both ears are affected badly, it feels like my whole head inside is hissing and burning at the same time from it.
It is very debilitating most of the time. Is it wise to be taking clonazepam and stilnox together as I am prescribed to do so and can be that hissing burning in my head be caused by the combination of clonazepam and stilnox ?
Thank you
Hi Ian:
The ototoxic side effects of some drugs appear right away–within minutes to days of taking them. The ototoxic side effects of other drugs may not show up until months or years later. This can make it hard to associate which side effect with which drug, or you may not even think a given drug is the culprit since you have been taking it for so long without noticing any side effects.
Clonazepam (Klonopin) is moderately ototoxic as far as I’m concerned. Hundreds and hundreds of people have reported tinnitus as a side effect, not to mention hearing loss and balance problems, etc.
Zolpidem (Ambien, Stilnox) is about the same as Clonazepam in regards to ototoxicity. So it is hard to tell which drug is worse in your case. And I have no information to tell what taking both drugs at the same time can do to your ears–whether the effects are just additive or synergistic.
Personally, I wouldn’t take either of these drugs. There have to be lesser ototoxic drugs that will do the same job. See if you doctor will take you off one or the other for a starter. Perhaps you no longer need both drugs.
And if you want to consider alternative medicine, there are herbals that may do the job even better than those drugs WITHOUT all the horrible side effects they can cause.
Cordially,
Neil
can you tell me what drugs for sleep do not cause tinnitus
Hi Doug:
I don’t know what drugs doctors prescribe for sleep, so can’t specifically help you there. However, if you ask your doctor for several drugs he would prescribe for helping you sleep, I can tell you their ototoxic properties and which would likely be the least ototoxic.
Personally, I wouldn’t take drugs at all for sleeping aids. I rather use a herbal such as Valerian for that purpose. There are a number of others too. And there are a lot of things you can do to put yourself in a favorable frame of mind so you can drop off to sleep without drugs.
Cordially,
Neil
I quit Ambien cold turkey after 8 years of use and tinnitus set in. I didn’t know it would cause a problem like this, I thought it came about after seeing a band where the sound man decided to turn the volume up to 15. Well now I’ve been taking Ambien for a few weeks again and it has gotten louder , but once again I saw a band for a couple of songs , it wasn’t that loud but I thought that’s what made it worse. Do I need to taper after 3 weeks of use? What an evil drug.
Hi Dave:
Never a good idea to quit a psychotropic drug cold turkey. Always a good idea to taper down to try to avoid nasty side effects that can crop up if you taper off a drug too quickly.
In your case, you can’t tell whether it was the loud music or quitting the drug that caused your tinnitus to go up. Since you were on it for 8 years and only had tinnitus as a side effect (assuming that was the cause of your tinnitus), after only three weeks, maybe you can quit cold turkey again. But you’d be safer if you gave it some sort of taper–even if it is more of a “token” taper, not a long slow taper.
Cordially,
Neil
I took Stilnox 12.5mg between Sep 2018 and Nov 2018 and tinnitus is developed in Nov 2018. I was recommended to taper by decreasing the dose to Zolpidem 5mg. However, there is no improvement in my tinnitus at all. According with your experience, will my tinnitus be consequently be cured if I stop taking Zolpidem?
Hi Daniel:
I have very limited information as to the permanency of tinnitus when you go off Zolpidem. I do know that for some people at least, their tinnitus proves to be permanent. This would be particularly true if you also got hearing loss from this drug since tinnitus almost always accompanies hearing loss.
You can always be hopeful since you do not mention having a hearing loss.
Cordially,
Neil
Cordially,
Neil
I’ve been taking Zolpidem sporadically for a good number of years now. I don’t take it every night…sometimes three or so nights a week, sometimes more, and I may go a week or so and not take it at all. I take it as needed, basically. With this being the case, is there really any “weaning off” to do, or can I just not take it anymore?
Hi Beth:
I’m not an expert on this–but it seems that you have not built up much/any tolerance to Zolpidem since you can go a week without taking it and not feel bad side effects. Therefore, I think you could just stop it without tapering down. To be sure, you could run this by your doctor.
Cordially,
Neil
I’m going into the 2nd month off of Ambien after having cold turkeyed. Tinnitus mild but appeared only recently. Still going through withdrawal symptoms that are diminishing very gradually. Read many of your comments suggesting taper. Do you think it is feasible to go back on tapering at this point to limit any permanent damage or change? I feel like I may need only .10 mg at this point to start taper from. thanks
Hi Bobby:
It all depends on how long you were on the Ambien and how much dependence your body has built up to it. If the withdrawal symptoms are relatively mild and you can stand them–they don’t bother you much, then maybe staying off the Ambien is the better choice. After all, things ARE getting better slowly. Hopefully you are now past the worst of it.
Cordially,
Neil
Thank you for the previous reply Dr. I hung on to my abstinence. Yesterday Oct. 13, after two weeks of ringing, the sound stopped completely for a couple of hours. Went to sleep and woke with it agin. It started somewhat high but subsided to low constant level. I thought it was gone… Your opinion?
Thank you
Hi Bobby:
Any time your tinnitus goes away for a bit or reduces in volume, that’s a good sign that you are probably habituating to your tinnitus. Hopefully, it will disappear for more hours on end and more frequently. All encouraging signs.
Cordially,
Neil
3 weeks, still not resolving. But im habituation. I was able to trace the time before it started, i went out to a club. Now i went out to lots of clubs in my life but never had this issue. But that time i was going through withdrawals from the ambien and my sensitivity was heightened ( in withdrawals) you think the music from that night out may have caused permanent damage?
Anyway, to anyone reading, if you are going through benzo withdrawalstay away from loud places.
Hi Bobby:
Some drugs make your ears more sensitive to sound, so that could have been your situation. Also, your ears can only take so much loud noise before they begin “failing” and maybe you reached that point. In the future, you always need to wear ear protectors to protect your ears when going into loud clubs, etc.
Cordially,
Neil
Thank you Dr. Neil for all your support and info. Come to think of it, being in a constant stress state from benzo withdrawals for 6 weeks is enough to give someone tinnitus. dont think 1 hour of loud music was the culprit but it sure didnt help. but how do you relax when you have tinnitus? thats the catch 22
Hi Bobby:
Just tapering off benzos too fast could give you tinnitus. And of course the stress could do it too. And as you say, the loud music didn’t help. So you may have two or more factors that caused your tinnitus.
You learn how to relax, then do it and slowly you’ll be able to relax in spite of your tinnitus. There are lots of sites on the internet that talk about how to relax and give you relaxing “exercises” and relaxing sounds to listen to, etc. The secret is to just get started and then persevere.
Cordially,
Neil
Dr. Bauman. Took 0.5 of clonazepam for the first time since onset of T one moth ago. Tinnitus went away completely.. returned the next day at same level. There is something here (it is clearly brain tinnitus). What is your take and what specialist do you suggest I see?
Thank you
Hi Bobby:
Sometimes taking Benzodiazepine drugs can cause your tinnitus to go away for a bit, but ultimately, these drugs just make things worse and worse.
And just so you know, tinnitus is a brain phenomenon, it doesn’t have to have anything to do with your ears at all, although sometimes it can have.
Is your tinnitus bothering you? If not much, just ignore it–it will not hurt you at all. If you need help in dealing with it, the person to see is an audiologist that runs a tinnitus and hyperacusis clinic.
Cordially,
Neil
Thank you Dr. Bauman. I’m getting used to it. At the beginning it gave me anxiety but now it’s become an annoyance. Seeing a specialist soon.
T take 1/2 ambient every night for one year. Last night I skipped taking it and my Tinnitus was quiet all day. List time that has happening in weeks. Should I stay off the ambien permanently?
Hi Mark:
If Ambien is causing your tinnitus, then obviously, if you want your tinnitus to go away, you need to get off this drug. You might want to do a bit of testing to see if stopping it always causes your tinnitus to go away. If so, you’d probably want to get off it as quickly as possible. If your body has not developed any dependence to this drug, then you could just stop “cold turkey” and not have any withdrawal side effects, but if you have any dependence built up, you want to taper off it.
How fast the taper depends on your body and how much dependence you have built up.
Cordially,
Neil
Yes been on ambien for over 10 years have ringing in hearing want to get off this unfortunately dr prescribed this for every month I am 68 years old now living alone what do I need to know to get off this safely
Hi Kathy:
Zolepidem (Ambien) although not a benzodiazepine drug has similar characteristics and can build up a dependence, just as the benzos can. Thus, once you have been on it for a long time and have built up a dependence on it, you have to tape off it very slowly.
A safe taper is considered to be a 10% taper on the reducing balance. The taper steps may be for a month each, or for longer or shorter periods depending on how your body reacts.
Read my article on tapering off Citalopram (a benzo) and read all the comments and my replies below this article–there are many–this should give you an excellent idea of how to safely proceed. You can read this article/comments at https://hearinglosshelp.com/blog/tapering-off-citalopram-safely-without-side-effects/.
Cordially,
Neil
I just took 10mg zolpidem for 2 nights and got this ringing in my right ear the next day … if I stop taking it, will the ringing fade or goes away ?
Hi Larry:
There’s a good chance your tinnitus will go away as you only took it for 2 nights–but unfortunately, there are no guarantees. Since I’m a bit behind in answering you, you probably know by now whether it went away or not.
Cordially,
Neil
I took Zolpidem for a total of 11 weeks once a day before bedtime at a 10 MG dose. After the first week of taking this chemical my right ear started to ring. At first I didn’t make the connection it was the Zolpidem. After coming across this site and reading the posts, I took myself off the Zolpidem and this will be my 4th day without taking it. I didn’t sleep last night and I feel this is the reason for the increased tinnitus today. My question is am I considered dependent on the drug after only 11 weeks every night or can I quit cold turkey as my physician suggested?
Hi Dominic:
That’s a tough question to answer because so much depends on your body. If you have built up a dependence, then you have to taper. If you hadn’t, then you don’t have to.
Also, the withdrawal side effects are a factor. If you can stand them till they go away, you can quit cold turkey. If not, then you’ll need to taper off the drug more slowly.
I side with your doctor because the half life of Zolpidem is only a few hours, so by only taking it once a day, you are going into withdrawal by the time you take it the next day. Therefore, you probably can quit cold turkey in your case.
But that decision is up to you.
Cordially,
Neil
About 10 years ago I got tinnitus in my left ear only from taking a benzodiazepine. That’s when I learned about ototoxcity. Fast forward to a back injury in 2023. I took 300mg. Of gabapentin for 2 months. I looked to see if it was ototoxic and didn’t see anything online. I am left with more tinnitus and damage to my vestibular system, resulting in imbalance and disequilibrium. My question is why in the world are there not warnings on ototoxic drugs?? Why are we all just suffering the consequences unknowingly? Is there anything we can do??
Hi KT:
Gabapentin is quite ototoxic. Thousands of people have reported it to the FDAs database as causing them hearing loss and/or tinnitus and tens of thousands have reported balance issues so it’s hard to see how it could not be ototoxic. The upcoming 4th edition of my book, “Ototoxic Drugs Exposed” lists more than 1,800 ototoxic substances.
To answer your question–if they warned about ototoxic drugs, they would have to put the warning on almost every drug out there and it is not in the drug companies best interest to “bad mouth” their drugs. That affects sales you know.
In order to protect yourself you have to do your due diligence and that means not trusting just what the various media tell you, but do what I have done and really research about the side effects of drugs, or you could ask me as I have been researching ototoxic drugs for the past 30 years or so.
What can you do about it. First, don’t take drugs unless it is the only solution. Instead, try all sorts of alternate treatments. Drugs should be your last line of defense, not your first line of attack.
Second, follow my three rules of thumb.
1. Take the least ototoxic drug that will do the job.
2. Take the smallest dose that will do the job.
3. Take the drug for the shortest time possible.
When you do this, you can often fly under the ototoxic drugs radar and not experience any (or just mild) side effects.
Cordially,
Neil
Thank you for your response. Yes, of course drug companies don’t want us not buying their drugs. I forgot it’s not actually about helping people, it’s about the bottom line. So basically I will be treating my ototoxicity as I would a food allergy. That brings me to my current situation. It appears that I will be having thyroid surgery soon. I have never had surgery. I am terrified of ototoxicity of all the drugs involved. Do you have advice for me? Is general anesthesia ototoxic? All the other drugs involved? I’m terrified to do any more damage to my vestibular system. I would love any information or surgery ototoxicity protocol. Thank you!
Hi KT:
If you need surgery, I’ve found that just let the doctors give you the anesthetic mix of drugs that they use–as many as 7 different drugs–but since they are only used once, they seldom (in my opinion) cause ototoxic side effects. That’s the good news.
However, after you wake up is when you have to be careful and from then on. Doctors want to give you all sorts of painkillers, anti-inflammation drugs, antibiotics, etc. Typically, some of these drugs are “just in case” drugs (especially antibiotics). I refuse all “just in case drugs” and have not had any infections because of it.
I also almost never take any painkillers, even though I’m offered high-powered narcotic drugs for the pain. For example, when I had lower back surgery, they gave me a pain-killer just after I woke up. After that, I didn’t take any painkillers–not even an aspirin. I just laid down and iced the area and rested as needed. That looked after the little pain I had. Unless you have severe pain, it is just best to “tough it out” in my experience.
Furthermore, I do not take anti-inflammatory drugs. Instead, I eat an anti-inflammatory diet.
Doing the above, I’ve not had to worry about ototoxic (and other) side effects for the 5 surgeries I’ve had in the past 6 years. And I might add, the surgeries were all wonderfully successful. Maybe you want to do the same.
However, if you NEED a certain drug then take it–but make your doctor justify exactly why you need it and what will happen if you don’t take it. And even then, find out if there is a lesser ototoxic drug that will do the job. I can help you with that if the time comes.
So calm down and relax.
Cordially,
Neil
Thank you! I appreciate your help. Thank you for answering my questions. It’s very nice of you to take the time. I spoke with my surgeon, she said the only antibiotic she uses is one dose of cephalosporin at the time of the surgery. What is the ototoxicity of that drug? Other than that it should be standard anesthesia, with the recovery up to me. I usually eat an anti inflammatory diet anyway. I don’t often take even ibuprofen or anything. That being said, having never had surgery, I don’t know what to expect pain-wise. I guess I’ll cross that bridge when I come to it. Thank you again!
Hi KT:
The cephalosporins are a large family of drugs. The good news is that although they are ototoxic, just taking a single dose is unlikely to cause you problems, so I’d go for it. I’ve taken Cephalexin–one of the cephalosporins–and never had any ototoxic side effects.
As far as pain goes, it depends where the surgery is. Some parts of your body have a lot of pain sensors and other parts hardly any. So the pain levels can vary a lot. I’d go on the assumption that the pain will be bearable so you won’t need any high-powered pain killers. And if you do need pain-killers, you can always use them–just use them only when really necessary. That reduces your chances of side effects.
Cordially,
Neil
I have a few more questions regarding a couple of different drugs etc. Is this the proper platform to ask you those questions , or would you prefer to be contacted some other way?
Hi KT:
It’s up to you. If you want the answers to be public, ask away here. But if you want things private between us, then send me an email and I’ll answer you privately. My email is at the bottom of every page on this website.
Cordially,
Neil
I have been on ambien 5 milograms for 4?months. The pain and ear itching started within a month. I slowly tapered off but seems like the pain and itching has gotten worse with the tapering. Is this withdrawal?
Hi Dreana:
Ear pain and itching ears are two of the many ototoxic side effects of taking Zolpidem (Ambien) while you are taking the drug. You don’t say how fast you tapered off the Ambien, but it is possible that tapering to fast could have exacerbated these side effects so you now perceive them as worse than before. Incidentally, a slow taper to get off Zolpidem safely could take close to a year.
Cordially,
Neil