Antidepressants (SSRIs, SNRIs, MAOs, TCAs, TeCAs)

Discussion in 'Treatments' started by Pat, May 10, 2012.

    1. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      Hi mick,

      Just want to add I concur! I know there's a neurological hormone or chemical connection that alternates as part of your body's rhythms. The 24-hour circadian cycle is part of it; but there's more at play. Recently, I was thinking how could our physicians' test this? Perhaps, it's as simple as a blood test; we need only to know what to look for. I do know melatonin helps most tinnitus suffers, myself included. And melatonin acts on your sleep cycle.

      Besides the melatonin connection, I had an incident that reinforced my belief in a chemical cycling. Several months ago, I was lying in bed around 3:30 am listening to my tinnitus--which was being particularly obnoxious. In the course of a few minutes, the tinnitus slowed down. Then it abruptly stopped. No sound. Within 15 or 20 minutes, it resumed, but the volume had diminished significantly. My brain may go through this nightly, for I always wake up with low tinnitus--even if I'm going to spike a few hours later.

      Besides a 24 hour cycle, my tinnitus has its own rhythm that is not predictable. I know if I eat something with MSG, for example, I'll have a bad day or two. But I can do everything right: eat properly, exercise, sleep well, and be very, very happy--and I'll still spike! I've never gone for more than three days without a spike. And the spikes usually last a day or two. Sometimes three. There's no pattern I can discern, yet there must be pattern chemically.

      To anyone still worried about antidepressants: Don't. Antidepressants act on the limbic system, which is key to tinnitus distress, so it's only natural you'll get relief. (Relief of misery, but not necessarily of sound.) As Markku notes, if the antidepressants do increase the noise, it's usually temporary. And if the tinnitus doesn't return to baseline, you can always try a different class of antidepressants. These drugs in general are very safe. You shouldn't combine antidepressants with melatonin unless your physician says it's okay (melatonin is connected with serotonin), but most antidepressants also relieve anxiety and so help you sleep anyway! :)
       
      • Like Like x 1
    2. erik
      Cool

      erik Member Benefactor Hall of Fame

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012 or earlier?
      Cause of Tinnitus:
      Most likely hearing loss
      Trying to figure out patterns of T is impossible. T is like the Borg. We have been assimilated. Resistance is Futile! Sorry for the lame Star Trek reference. Might make a good T-shirt! :)

      Anyway, my point is--it is natural for one to try to figure out the triggers to T etc especially early on, but after a while you do realize that it is a losing battle. T is totally unpredictable except for the fact it will be there the next day and at times a little louder or a little softer. Meds like antidepressants or benzos can really help if you have issues such as depression and/or anxiety which can certainly make T worse. I decided a while back to try not spend my time trying to figure out what triggers my good and bad T, just spend that time with friends, family and doing what I love to do. I also volunteer regularly. Do things for other people can make you feel good!

      The T is there, but I am happier, I spend less and less time thinking about it. Sure, I want it gone for good but for now, I just have to make do. It's tough at first and there can be bumps at any time along the way but it does get better and life goes on....enjoy! Work on the things you can control like quality of life, mindfulness and healthy living and the T will fall into place at the back of the line.
       
      • Like Like x 3
    3. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD

      Well said! :)
       
    4. Job
      Worried

      Job Member

      Location:
      U.S.
      Tinnitus Since:
      7/2009
      So, I was a bit depressed before my two new kinds of tinnitus came into my life, and now, I am even more depressed, especially upon waking. Getting out of bed is hard. Took 2 hours this morning. I know that remeron is prescribed for depression. I don't think it will do anything for my tinnitus, but I am hoping it will help with depression, but especially with anxiety. I have some questions for those who use or have used remeron, especially if your T was noise-induced:

      1.) How long have you used it?
      2.) Has it affected your T at all?
      3.) Have you had any problems with it, or expect to have problems?
      4.) Did it help you sleep the first night of taking it?
      5.) Did it help with anxiety? Depression?
      6.) Do you take it regularly, or on an as-needed basis?

      For anyone knowledgeable enough: Does it affect brain plasticity? I ask, because I have seen stories of people whose T has changed to a shhhh sound after listening to a lot of white noise (people in TRT). I assume this can't happen with a drug that limits plasticity.

      I see that most people are quite fond of the drug on the forums, based on posts I've read that are now 1 to 3 months old. I want to see if anything has changed since then for those people.

      On the bright side, I find I am able to do some busy work at home. Like math. Unfortunately, the car makes the T in my left ear go way up, and it also makes that ear feel fuller. I guess I'll drive with my etymotics or alpines in ... so far it's been 1 month with that ear ... hoping the reactivity goes away by Thanksgiving (6 months).
       
    5. Job
      Worried

      Job Member

      Location:
      U.S.
      Tinnitus Since:
      7/2009
      Also, I'm asking because I am on my to see my ENT next week (Monday). Should I just tell him: I'm depressed and anxious, how about some Remeron?
       
    6. chad

      chad Member

      Location:
      US
      Tinnitus Since:
      2001
      Taken 40mg Citalopram in the morning but I think I'm coming off it by evening. Have more ringging than normal. This has gone on for a week. Should I stager it? My GP isn't very good with this sort of thing. Going to the Phyc next week to explore poss. another med. The same GP also gave me Xanax .25-.50 three times a day as needed (of course it's needed). I don't you if this affects how the Xanax or Citalopram works?

      Any feed back

      Thankyou for everyone on this foum, it's good to know I'm not alone.
       
    7. hps

      hps Member

      Location:
      canada
      Tinnitus Since:
      14 oct 2012
      Hi @Cher69, how is your T on citalopram and how is anxiety.
       
    8. Gav

      Gav Member Benefactor

      Tinnitus Since:
      06/2004
      The only thing I noticed when I started taking Venlafaxine (SNRI) was that my tinnitus reduced in volume and annoyance. The Venlafaxine may or may not have played a part in this improvement (though I read somewhere that it can), but it certainly didn't appear to make it worse. I've taken Venlafaxine twice after two big tinnitus spikes, six or so years apart, with the same result. I've also taken Citalopram (SSRI) - much better tolerated than the SNRI (head zips aside), with no noticeable negative effects on my tinnitus. My tinnitus levels didn't increase when I stopped either med.
       
    9. Sven
      Fine

      Sven Member Benefactor

      Location:
      Sweden
      Tinnitus Since:
      06/1999
      Cause of Tinnitus:
      Loud music
      @Gav: So you're saying that you've taken medication (SNRI) that has decreased your T. permanently? How did you get your T?
       
    10. Gav

      Gav Member Benefactor

      Tinnitus Since:
      06/2004
      Two noise exposure incidents caused two permanent increases in my tinnitus volume. The second increase was difficult to cope with, so I was prescribed an SNRI within a week or two of the increase and my tinnitus volume subsequently fell to manageable levels very quickly. I moved over to the SSRI for a while as this was easier to tolerate. When I stopped, the tinnitus volume remained where it was at the lower level.

      I had a three week long spike last December and so started another course of SNRI's. Again, the tinnitus dropped back to the base level quickly. The SNRI could have played no part in this improvement - it may have been a natural temporary spike, but it certainly didn't make it any worse and I'd take the same meds again if needed.
       
    11. Sven
      Fine

      Sven Member Benefactor

      Location:
      Sweden
      Tinnitus Since:
      06/1999
      Cause of Tinnitus:
      Loud music
      Interesting. Have you ever heard of others experiencing the same? Right now I'd kill (well, not really. ;) ) to have it back att my "normal" level. 9 days of increase for me now.

      I have never used any anti-depressants, but talked about them with my doctor the other day, since there is a possibility (not that I actually think so), that my current increase is stress-related..
       
    12. Markku
      Inspired

      Markku Founder Staff Podcast Patron Benefactor Hall of Fame Advocate

      Tinnitus Since:
      04/2010
      Cause of Tinnitus:
      Syringing
      It's possible it is stress-related though, right?

      I remember you told somewhere that you have worries about your parents health, weren't you changing jobs and some other family matters that have been on your mind?

      We've discussed the connection of stress and hearing/tinnitus, and it's not something to take lightly.

      Check, for example: https://www.tinnitustalk.com/threads/hyperbaric-oxygen-therapy.211/page-4#post-8111

      How to reduce it, I can imagine it's hard with what you've going on in life.... but it's good to acknowledge the possible connection.

      Markku
       
    13. Sven
      Fine

      Sven Member Benefactor

      Location:
      Sweden
      Tinnitus Since:
      06/1999
      Cause of Tinnitus:
      Loud music
      @Markku

      I answered in another thread, since I don't want to hijack this one.
       
    14. jes
      Familiar

      jes Member Benefactor

      Location:
      copenhagen denmark
      Tinnitus Since:
      10/2012
      wel i have alvayes hatet all these drugs,but that t is hard to deal with i have due to an influenza a year ago
      and first now tha last 3 month its really aktiv.Stil i dont know who i am now and whats gonna happen to these dammed ears.for me t is a downvard spiral.ancious and depression.what the hel is going on.right nov i am on some kind
      stand by and wating for what a cure and then al these snake oils, lukyly there is this portal with karen marku sven
      and erik.now i am some kind of servant in the famely.when i am not lying in the bed with the pc i cook fix the gaden
      i drive the children i had just started on pension.i play a little tennis with my son but never really motivated .
       
    15. Sven
      Fine

      Sven Member Benefactor

      Location:
      Sweden
      Tinnitus Since:
      06/1999
      Cause of Tinnitus:
      Loud music
      I think you should go see your doctor if you feel depressed like that. Those antidepressants might help you, that's what they're there for.
       
    16. Piper
      Loved

      Piper Member

      Tinnitus Since:
      Feb 2013
      I d the same with sertraline, so nauseous and panic attacks were worse, they want me to try mirtzaline today but really scared of them now. My sleep was worse on them.
       
    17. Louise

      Louise Member Benefactor

      Location:
      Yorkshire, UK
      Tinnitus Since:
      29/06/2012 worsened Jan 2017 & Dec 2017
      Cause of Tinnitus:
      Noise exposure
      I don't get on with any SSRIs - I've tried a few and have felt poorly on all of them. But, Mirtazapine I've had no problems with at all. No side effects whatsoever.
       
    18. Cher69
      Fine

      Cher69 Member Benefactor

      Location:
      York, UK
      Tinnitus Since:
      20/5/2013

      It's taken 4 weeks but it's helped me greatly I'm focused calmer and I'm sleeping better not without a few hic ups at 4am but I'm getting sleep ! I'm on the road to dealing with my T and citalopram has been my helper with fab support from family. Only side effect was felt a bit sick for a week. Got another 2 months tablets today then another review at docs.

      No change at all to the level of T apart from usual peeks and differences most people experience but nothing noticeable and permanent.
       
    19. Bacus

      Bacus Member Benefactor

      Tinnitus Since:
      02/2013
      Hi,
      Has anyone experienced being on amitriptyline and their tinnitus spiking.
      I have been taking this med. 10 mg (for sleep) for the last 4 days. And noticed a considerable spike.
      I must admit that this med. gives me a restful sleep,which I very seldom had since the onset of the tinnitus.

      I hope that the spike is temporary, and my T.will settle down to normal ( irritating) or much lower.

      Remeron might not be helpful because I am lactose intolerant

      Your help will be appreciated.

      Bacus
       
    20. Golly
      Bookworm

      Golly Member Benefactor

      Location:
      New York City
      Tinnitus Since:
      01/2011
      There are reports of Elavil (Amitriptyline) aggravating tinnitus. You are on a very low dose, but this may be causing your spike. Otherwise, this may be just a periodic spike---independent of the drug---which will calm down on its own. Certainly if the spike persists, you could try going off the Elavil to see if that has an immediate effect. Discuss with your doctor.

      According to Merck, "Lactose is a non-medicinal ingredient in REMERON tablets. Therefore, patients with rare hereditary problems of galactose intolerance or glucose-galactose malabsorption should not take REMERON tablets." ( http://www.merck.ca/assets/en/pdf/products/Remeron-PM_E.pdf )

      Does this condition apply to you?

      -Golly
       
    21. LadyDi
      Busy

      LadyDi Member Benefactor

      Location:
      Florida, USA
      Tinnitus Since:
      06/2013
      Cause of Tinnitus:
      Barotrauma/airplane
      Dear folks: I know this is the antidepressant thread but thought I might ask this question now, as it seems to be active. Please refer me to another thread if need be:

      I am new to T (two months) and quickly developed a panic response that was incredibly debilitating. So am seeing a psychiatrist and CB therapist as well as the ENTs and medical-end folks. The psych started me on generic Xanax: .5 mg for sleep, .25 mg three times during the day as minimums. I have been on them three weeks (always taking the minimum and sometimes less than that) and it has helped. But suddenly, it doesnt seem to be working so well any more and I am having break-thru anxiety (not fullblown panic, though). Also, since Xanax exits quickly, I do not sleep through the whole night. My fear is that my body has built up a tolerance already and now I'll need to move to higher doses -- which I refuse to do.

      So: Am going to the psych tomorrow and asking about some changes.
      My question:
      Are antidepressants a better way to go than the benzos, even though I am on a low Xanax dose?
      I also am looking at a better solution for sleep, maybe trazadone or Rozerum.

      Thanks for any help and any advice you might have. It has been depressing to take a couple steps back as I was moving forward. I am working my therapy hard but know changing your thought patterns doesnt happen overnight.

      LadyDi
       
    22. Bacus

      Bacus Member Benefactor

      Tinnitus Since:
      02/2013
      Thank you Golly,


      Hopefully, this is a temporary situation, I will continue taking elavil which also contain a small amt of lactose with no side effects
      Hoping it is a temporary spike.
      My pharmacist is not sure if both the lactose ie anhydrous and monohydrae that is contained in remeron will cause a problem.

      I have been lactose intolerant for as long as I can remember. And I am not sure how to answer your question.

      Bacu

      Lady Di,


      I am the least qualified to answer your question,
      from my experience it is best to go with an antidepressant , because benzos are a short term solution,


      Your psych. will determine the best medication that will work for you. Hopefully he or she will get it right the first time.

      Most of us are reluctant to go on medications including myself. But look at what the alernative is,

      As for therapy, it takes a long time to re- train the brain, but I have been told it is possible and to hang in there ( frustrating even for me

      I trust that your sleeping concerns will be resolved .

      Bacus
       
    23. Golly
      Bookworm

      Golly Member Benefactor

      Location:
      New York City
      Tinnitus Since:
      01/2011
      Hi All:

      For the past four months I have been taking 15mg of Remeron nightly. I sleep like a baby! However, I don't seem to feel any benefits beyond that. Given that I would probably get just as good a sleep on 7.5mg or even 3.75mg, I am thinking of reducing my nightly dose.

      Does anyone have experience with tapering this drug? Is a gradual reduction even necessary? I'll discuss with my doctor tomorrow (and report back his advice), but I would value any insights some of you might have.

      -Golly
       
    24. Angelique

      Angelique Member

      Tinnitus Since:
      01/06/2013
      Hi Everyone,

      I saw the doctor again today and she decided to give Zoloft a try. I googled it and got conflicting reports about it's use for T. Some say there was some improvements with the severity of T while other reports say that it triggered T. I also googled the otoxocity of it and it wasn't good. Has anyone used this AD and if so, did it help or cause more problems (e.g. got louder)?

      Angelique
       
    25. Mekhail Blanco

      Mekhail Blanco Member

      Location:
      spain
      Tinnitus Since:
      3/2008
      anti depressant worsen my tinnitus to be specific i take sertraline, so i stop it then something good is happen my T decrease its sound.
       
    26. Golly
      Bookworm

      Golly Member Benefactor

      Location:
      New York City
      Tinnitus Since:
      01/2011
      While drugs like Zoloft might aggravate tinnitus, my understanding is that they are unlikely to be truly ototoxic (in the sense that certain antibiotics are). If indeed Zoloft makes things worse, your tinnitus will very likely return to baseline levels upon ceasing the drug. Be sure, however, to listen carefully to your doctor when it comes to proper dosing and tapering.

      -Golly
       
      • Informative Informative x 1
    27. Bacus

      Bacus Member Benefactor

      Tinnitus Since:
      02/2013
      Hi,

      I have been taking 10 mg of elavil for 6 days now, and I have definitely noticed a spike, for a longer period,

      Mekhail, how long did u take anti depressant and did u stop cold turkey

      Thank you
      Bacus
       
    28. Bacus

      Bacus Member Benefactor

      Tinnitus Since:
      02/2013
      Sorry,

      I meant to ask if I can stop taking this medication now without any side effects or do I have to taper off.


      Bacus
       
    29. Golly
      Bookworm

      Golly Member Benefactor

      Location:
      New York City
      Tinnitus Since:
      01/2011
      Discuss with your doctor to be sure, but I am confident that with such a small dose of a non-addictive drug like Elavil, you will be fine stopping cold turkey after just six days.

      -Golly
       
    30. Markku
      Inspired

      Markku Founder Staff Podcast Patron Benefactor Hall of Fame Advocate

      Tinnitus Since:
      04/2010
      Cause of Tinnitus:
      Syringing
      I agree with Golly. I can see no problems arising from stopping cold turkey in this instance.

      (Of course the usual "Information published on this site is not intended as a substitute for medical advice. For medical care, consult a medical professional." applies.)

      Let us know of any developments!
       
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