Amitriptyline Immediately Changed Character of My Tinnitus

So I have taken Amitriptyline in the past for globus sensation in my throat. I actually do think that it is a major factor that lead to me getting dry eye syndrome.
However, I took it for years and did not develop tinnitus from it. Was not taking it at the time I developed tinnitus either.

So my psychiatrist recommended trying it. I am already on clonazepam currently. Started very low dose 10mg. Within a few hours my tonal tinnitus changed to a hiss. However, IMO not a desirable hiss. Very intense and my left ear which is usually doesn’t have tinnitus began hissing also. So while occasionally it has a tone normally it is quiet. Then I began having intermittent brief periods of complete silence, but then back to the hiss.

Being on clonazepam quiets my tinnitus substantially, but this hiss upped its loudness like 1-2 notches.

Needless to say I’m afraid to continue taking it. I stopped after that night and the second day my tinnitus went back to tonal, but spiked and continued to spike through that night. My left ear is still currently having tinnitus episodes though back to tonal.

This has me scared to try other antidepressants. But I am very depressed and it’s effecting my ability to function in general, especially parenting my three children. 2 of which have special needs.

I guess I’m looking for advice. I’m already avoiding going off the clonazepam for the fear of the noise. I was hoping Amitriptyline May help especially with sleep which is the other benefit of clonazepam (as I wasn’t sleeping more than 2 hours a night before I started it) and I could swap out even though it dries me out. I’m not sure what to do.

 

Amitriptyline will help you sleep as it has a sedative effect.
Some people find 10mg ok, some 20mg. Anything above 50 mg is a therapeutic dose for depression.

love glynis

 

@GoatSheep -- Sorry to hear about your latest setback. -- This will probably sound super odd to most people, but I've been able to effectively treat depression and anxiety for many years using Coffee Enemas (CEs). They have a unique ability to quickly detoxify the body (might help get the amitriptyline out), and also the ability to therapeutically stimulate the vagus nerve, affectively treating depression. They can also be a catalyst for vastly improved gut health. This ability to treat depression was actually first reported in the 1922 New England Journal of Medicine. If you're interested, HERE's A LINK to that NEJM article.

If you have any interest in more links to informative videos or websites let me know. Just to mention, once a person gets used to doing them, they are relatively simple and easy to do. Just have to find a version that fits your schedule. -- BTW, amitriptyline is an anticholinergic drug. Many OTC cold and flu medicines such as Benedryl fall into this category, and all have the potential to cause or exacerbate tinnitus. I read an account of a man who took just a single dose of Benadryl, and it gave him tinnitus.

 

A hiss is an improvement over a tone. The usual scenario when tinnitus fades is for it to first switch from a tone to a hiss, then the hiss gets less intense/lower pitched, then the volume gradually decreases. Just make sure to not hurt your ears again, or you might be back at square one.

 

Yeah but this was intense not like it was fading and it made both ears hiss. So it didn’t seem like a positive change.

 

Many people experience tinnitus spreading to their formerly good ear. If I remember correctly, it has happened to me about 6-9 months after the onset of my tinnitus.

 

I don’t know that I’d call it my good ear. It has hyperacusis. It rings occasionally. Not often anymore. At onset they both blared horribly.

 

There has been research suggesting that serotonergic drugs may worsen tinnitus. Perhaps supplements like tryptophan or 5htp that increase serotonin rather than playing with receptors could have a gentler effect. Unfortunately antidepressants are a mine field with tinnitus.

 

Please do not simply stop trying antidepressants, especially if your psychiatrist thinks they will help you. It is not super common to develop tinnitus from these medications. But it is hard to cope with severe depression. You will have to discuss with your psychiatrist which ones would be the safest to try. And I'm sure there are treatment options available for your tinnitus. Don't give up hope.

 

Thank you everyone for your responses.

 

I’ll look into this. Thanks.

 

As @Chinmoku stated serotonergic drugs may have an effect on preexisting tinnitus. When mine reacted this way to Amitriptyline, which does affect serotonin, I’m not really wanting to risk continuing to take it as it could permanently effect the character of my tinnitus in a bad way. I know normally you have to give anti depressants weeks to work, but my tinnitus is bad enough as is. I can’t chance a worsening.

https://news.ohsu.edu/2017/08/22/study-suggests-serotonin-may-worsen-tinnitus

 

@GoatSheep -- If you're going to looking into tryptophan or 5htp to increase seratonin, you may also want to consider St. John's Wort. It's always cautioned not to take SJW when taking an SSRI antidepressant, as it could lead to excessive levels, potentially causing seratonin syndrome.

 

Of course. And definitely stop taking any that are making it worse. I just meant don't stop looking for something for your depression.

 

Had a very similar experience with trying amitriptyline again a couple months ago. First day felt good, less intense, then second day was worse than baseline (but I also slept very little the night before, which likely had an impact).

(Write-up here: https://www.tinnitustalk.com/threads/retigabine-trobalt-potiga-—-general-discussion.5074/page-267#post-459960)

My T actually started while on amitriptyline too, so there isn't any doubt in my mind it has the potential to make things worse. The fact that it can also make it better, at least temporarily, prompted me to try it again.

I wonder if taking it alongside some other med that quiets tinnitus for some people -- e.g. along with intravenous lidocaine, or with benzos, or gabapentin -- could help make the change in character permanent.

The way it was once explained to me was that "amitriptyline opened up a window of plasticity" in my brain, during which the tinnitus was triggered. Why not try to open up a window of plasticity with amitriptyline again, I wonder, and use other meds to silence it during that time? Could be an interesting experiment if someone finds a doctor willing to try.

 

I am taking clonazepam. My psych prescribed the Amitriptyline in addition because he thought it would help with both the depression and tinnitus. It made it louder even through the clonazepam. So at least for me that approach didn’t work.

 

I'm starting to struggle with my Amitryptilene usage.

I'm only on 10mg. The benefits are:

• easier to fall asleep again when waking during the night
• improved mood
• reduced hyperacusis

But the side effects are:

• I feel hungrier
• I feel thirstier
• I need to pee more
• It worsens my ETD and breathing difficulties
• my heart rate is elevated - feeling more jumpy
• my dreams are really weird and busy

I've been telling myself it's worth it for the benefits, but I'm starting to dread falling asleep with it because of the crazy dreams, and feeling exhausted the next day.

And I'm only on 10mg! Thinking about looking for a pill-cutter and reducing it to 5mg to see if that's enough for me.

 

I took it before tinnitus for globus sensation in my throat. It was a major contributing factor to me developing dry eye syndrome and I’m 37 years old. I have to have my tear ducts plugged and use preservative free tear drops throughout the day or wear $2000 scleral contacts to keep my eyes moisturized enough throughout the day. My dosage was 10mg also.

 

Granted I took it for years before this happened.

 

I was not taking it when I developed tinnitus though.

 

So after a break of about a week, I resumed my amitriptyline on a reduced dosage to half a 10mg tablet per night, as the side effects were proving too much. It still helps me sleep most nights, but I feel the benefits to my hyperacusis are reduced since I reduced my dose. If no further improvements on the next month, I'm seriously considering asking for sick leave from work so I can hammer myself with the drug and see what happens. My wife tells me some people take up to 150mg of the stuff which I can't imagine, they must be elephants or something! I'm thinking 50mg tops. Has anyone increased their success by increasing the dose like this?

 

I stopped taking amitriptyline because it didn't seem to be working. A nurse practitioner asked me to increase my dose and then I reduced it again until I stopped taking it altogether. It's possible I didn't take it long enough though?

I am wondering if SJW might be worth taking instead? It might not help for sleeping but is there any chance of it being helpful regarding tinnitus? I have it, at least. I didn't feel tired or drowsy at all while I took amitriptyline although I did get dry mouth.

 

https://proceedings.med.ucla.edu/wp...ng-and-Stimulating-Effects-of-Mirtazapine.pdf

While it’s not Amitriptyline it may be they have similar mechanism with increasing dosage. Maybe someone knows or you can find some research.

I’m almost positive @glynis mentioned this for mirtazapine also.

Originally when requesting Amitriptyline for my globus sensation I went to my PCP instead of an ENT. I explained why I wanted it and that I found evidence for its use online. She however gave me 100mg dose which was way too high for globus. I took it once. It did nothing for my globus and gave me horrible restless legs. I then went to the ENT and he gave me 10mg which helped with globus and didn’t cause restless legs.

 

Hi Selah,

Yes, amitriptyline can cause tinnitus in some people. I am one of those. I have been on 25mg amitriptyline for many years for pain and developed a mild tinnitus. I did not even connect the tinnitus with amitriptyline because it did not bother me to function properly (Work, sleep, docial life). A bit of white noise at night did the trick..

Recently I went through a bad patch and my dose was increased to 50mg. At the same time I was given valium and zopiclone. At first my tinnitus did not go worse because the valium/zopiclone were enhancing the action of GABA transmitters connected to my hearing system thus calming my ears.

However, when I stopped valium and zopiclone (but remained at 50mg of amitriptyline) my tinnitus went through the roof!

My first reaction was to think that valium/zopiclone were the culprits but they were not, it is amitriptyline which is the source of my tinnitus. Valium/zopiclone were just masking the louder tinnitus caused by amitriptyline via the serotonin channels...

Now I hope my tinnitus will subside as I reduce/discontinue amitriptyline so I can wean off zopiclone/valium.

Well that's my understanding. I am not a doctor so take everything I write with a pinch of salt...

 

I would take everything doctors say with a pinch of salt...