Cal18

Was on Paxil for 8 years, quit in 2010 - had all kinds of withdrawal including tinnitus. It went away for the most part except for a tiny lingering which was on and off, pretty low and not bothersome. Then, I started Celexa in 2013 I quit Celexa after being on it for 3 years (I did notice that being on the Celexa made my tinnitus slightly worse especially after I used the hair dryer) but overall, it was still very manageable. I quit Celexa in February of this year. The first 8 months of withdrawal were totally fine. I did notice a sensitivity to sound but I thought it was just me being irritable (the sounds felt more annoying than they did painful). A couple times, but not frequently, I would also notice my hearing would shut off slightly in on of my ears for a day or so then go back to normal (however, this hasn't happened in a while). Then after a stressful event which went on for 2 months, my tinnitus was getting a bit louder at times, especially at night while watching TV (at this time I was doing some clenching and grinding of my front teeth - this was something new for me because I was stressed). The tinnitus also felt more solid and was a totally different sound. My normal sound was a broken high pitched ringing sound mainly in my right ear. This new occasional sound was in both ears and was more of a solid hissing. At that time, it wasn't super loud but I did notice it. That happened on and off a couple nights without too much frequency but I didn't think about it too much as my tinnitus has always fluctuated in the past and I was somewhat okay with it.

After the stressful 2 months, I decided I wanted to go back on the Celexa. Upon restarting, I had a severe reaction. My body had built a tolerance to it and rejected it on the 3rd dose. I got Akathisia which is an oversensitization of the CNS (it's a really bad thing) caused by medications like SSRIs or Anti-Nausea. At that point, I didn't notice any changes with the tinnitus and I'm not sure if I even got the fluctuation at night which I was previously having.

During the Akathisia fits (adrenaline filled, glutamate, dopamine and norepinephrine related fits which could be anywhere from a couple hours to the entire night) I noticed I would clench my jaw very tightly. This went on for about 2 months. It was severe torture. However, I still didn't notice any fluctuations with my tinnitus. What I did notice, is that I have occasional pains in my ears and my hyperacusis was extremely apparent (Akathisia also causes a sensitivity to sound so I connected it to that). Then I started doing better for a couple weeks, when it relapsed again really hard. This time, after the first few days of the relapse, I developed severe hyperacusis and very loud tinnitus - I haven't measured it but it is literally unbearable and much too loud be muffled by other sounds. It was the shrill hissing tinnitus in both ears. I could barely hear my old tinnitus, it was covered but the other sound.

The intense tinnitus has stayed its course over 2 days solid, along with severe hyperacusis, then on the 3rd day, everything seemed to let up a bit. The tinnitus lowered by about 80%. I spent most of the day like this and was totally relieved. By the evening, I noticed it started getting a little louder. I woke at 4am and it was full blown again. Later in the day it seemed to increase in volume EVEN MORE which I didn't even think was possible, however the hypercusis seemed to be a little less but was replaced by ear pain/fullness in both ears. My hearing does not seem to be effected. I do notice increased pain when driving and going up and down hills but I don't feel any "popping".

Today, to my surprise, it seems to have lessened again by around 50%.

I saw an ENT yesterday and she said I had three things that could be causing this.
1. She saw some irritation in my nasal passages and said my equestrian tubes could be irritated (she gave me 2 types of sprays), I did notice I was recently getting some bad sinus headaches over the past month. 2. She said it could be from the clenching. 3. From the drug reaction

Question 1:
Since this seems to be in the phase where it's going up and down and in the hypercusis/ear pain phase, the precursor to tinnitus, is there anything I can do this phase for prevention on permanent onset? (i.e. take NAC, gabapentin, steroids, etc.) Currently, I'm on 2.5 mg of Propranolol (it's a baby dose, starting dose is 10mg, I know this is an Ototoxic drug but I need to be on it for the Akathisia - Note: the loud tinnitus started before I started taking this). I can not take an SSRI as I have become sensitive to them. I have prescription for Lamictal which I'm scared to take because it can cause tinnitus. I'm also a little scared of Mirtazapine because it has weird side effects but could potentially help me if my condition is serotonin related.

Question 2:
Best guess as to what's going on. Not sure if this is ototoxic because I was sort of already getting it slightly during late onset withdrawal, now it just seems to be amped up. Can this just be an exasperated withdrawal/reaction? Is there a chance it might go back to normal? I saw that usually most SSRI withdrawal cases get mostly better with time.

Thanks again, your input is appreciated.