I don't have enough personal experience, but I want to offer some information.
Tinnitus psychopharmacology: A comprehensive review of its pathomechanisms and management
Antidepressants
Baldo and colleagues performed a meta-analysis in 2006 on tricyclic antidepressants (TCAs) and SSRIs, which questioned substantially their efficacy in the treatment of tinnitus, although most evidence may have been invalidated by methodological bias or the reliance on single case reports.
47 In 2007, an analysis of four RCTs by Robinson found that higher doses of SSRIs and TCAs appear to work for tinnitus patients who also exhibit depression and anxiety48 or insomnia,49 both of which are frequent comorbidities among chronic otolaryngic patients.50 What appears to be irreversible disability of otologic origin may, in part, be a reversible disability of psychiatric origin when treated51,52 with drugs proven to be effective antidepressants such as nortriptyline.53
Some TCAs have proven not to be effective for tinnitus,
54,
55 or were even less effective than placebo
56 (or possibly being associated with tinnitus onset with high doses of clomipramine).
57
A possible dose effect may exist as lower doses have sometimes been related to tinnitus onset,58,59 even when the same agents were reported as being effective60 (as in non-TCA heterocyclic antidepressants such as trazodone61 and mianserin).62
Sertraline was found to be more effective than placebo for severe refractory tinnitus cases63 although its discontinuation was associated with tinnitus onset.64 Other SSRIs (eg, paroxetine) provided no significant improvement for nondepressed patients
65 or even exacerbated tinnitus (eg, fluoxetine).66
While newer antidepressants have not been investigated as thoroughly as SSRIs and TCAs, little data on their role in the treatment of tinnitus has been reported and which has sometimes led to inhomogeneous evidence.
Serotonin norepinephrine reuptake inhibitors (SNRIs) withdrawal has seldom been associated with tinnitus (both for venlafaxine67,68 and duloxetine69), while the norepinephrine dopamine reuptake inhibitor (NDRI) bupropion may mimic a transient ischemic attack that may induce tinnitus,70,71 that is most likely due to DA-ergic enhancment.
Antidepressants for patients with tinnitus
Main results: Six trials involving 610 patients were included. Trial quality was generally low. Four of the trials looked at the effect of tricyclic antidepressants on tinnitus, investigating 405 patients. One trial investigated the effect of a selective serotonin reuptake inhibitor (SSRI) in a group of 120 patients. One study investigated trazodone, an atypical antidepressant, versus placebo.
Only the trial using the SSRI drug reached the highest quality standard. None of the other included trials met the highest quality standard, due to use of inadequate outcome measures, large drop‐out rates or failure to separate the effects on tinnitus from the effects on symptoms of anxiety and depression. All the trials assessing tricyclic antidepressants suggested that there was a slight improvement in tinnitus but these effects may have been attributable to methodological bias.
The trial that investigated the SSRI drug found no overall improvement in any of the validated outcome measures that were used in the study although there was possible benefit for a subgroup that received higher doses of the drug. This observation merits further investigation. In the trial investigating trazodone, the results showed an improvement in tinnitus intensity and in quality of life after treatment, but in neither case reached statistical significance. Reports of side effects including sedation, sexual dysfunction and dry mouth were common.
Authors' conclusions: There is as yet
insufficient evidence to say that antidepressant drug therapy improves tinnitus.
Louise might chip in with her ototoxic drugs book with information about how ototoxic Celexa or Cymbalta are classified as.
But, I wouldn't expect miracles taking ADs. They might help you if you are depressed/anxious, thus they might indirectly ease the perception of tinnitus, too.
Worth remembering that some antidepressants have caused tinnitus or made it worse, so proceed with caution.
Remeron is a good one and praised here for its sleep-inducing properties. Its chances of causing hearing loss/tinnitus is somewhere between 0,1% - 1%.
You could also try natural alternatives, such as melatonin (for sleep). It's also a good antioxidant and might protect your hearing.
Now, let's hear from others!
Markku
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