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

Hi, I'm new here sadly and still reading the entire thread.
I took venlafaxine (EFFEXOR)for 3 years, 225mg/day with a 4 month taper down period at the end.
I never had T until it emerged on about the 5th day that I was cutting them back. I remember is started suddenly overnight and the T still exists today some 3.5 years later. IE 6.5 years after starting the venlafaxine treatment ( 7khz/50db fairly stable, possibly slightly louder when tired ~self diagnosed)

Interestingly I also suffered from Headzaps/brainzaps whilst withdrawing from venlafaxine and these were slightly exacerbated by vestibular loading (or shifting the eyeballs slightly), ( this also happened if I missed a dose of venlafaxine) .I also suffer bruxism ( grinding of teeth) although this came about as soon as I started to take Venlafaxine, I also had restless legs and other excess nervous energy issues but it did not emerge as a result of withdrawing.
-In most cases I've read about Bruxism disappears upon cessation of the venlafaxine, mine still exists today.
-The tinnitus still exists today
-and I also get one or two infrequent head zaps when dozing off to sleep. ( Hot milk, DHEA and melatonin(3mg) tablets make this more prevalent)
So one would think that since all 3 are at least partly related to seratonin levels or fluctuations in those levels that the answer would be close at hand. My depression/anger /anxiety/irritability is sporadic and ( I believe) caused by low or fluctuating seratonin levels. Lately they have been worse and my head zaps and tinitus are more prevalent, my sleep tracker app has also been picking up lots of body 2hertz body movement when sleeping which indicates a sort of restless legs syndrome which is seratonin related but ......
Restless leg syndrome (RLS: akathisia) has been associated with nocturnal bruxism as they both are linked with imbalances in the neurotransmitter dopamine.* Whereas RLS affects the legs often due to low dopamine bruxism affects the jaw often from high dopamine levels.
http://www.drgangemi.com/2013/02/bruxism/
So I have low and high dopamine levels and low seratonin arrrgh !

As a footnote I was only put on these ssri's because I had broken up with my partner, in reality if the doctor had given me a cup of tea and a pep talk rather than a drug with relatively unknown long term side effects I might be able to hear silence and have a normal life. I had to diagnose my own headzaps back to the vestibular system after the local hospital and 2 psych's told me in 2012 it was NOT related to venlafaxine. Anyway, as a result of what I can only call naivety and unprofessionalism on behalf of the medical profession and drug companies I now think people should be very careful with SSRI's unless they are literally considering putting a rope around their neck.

I'm still learning but thinking that modifying the serotonin levels with 5htp might be the answer. I'm not in favour of experimenting with my brain chemistry but since others have for profit ( cough) it might be what's required to put things right again. All feedback appreciated.

 

For those currently on an AD; don't take 5htp while taking an AD. Read the warning from WebMD:

Click on "Interactions."

http://www.webmd.com/vitamins-suppl...veIngredientId=794&activeIngredientName=5-HTP

 

Since I hit the rock bottom with my life affected with T and Hyperacusis I went to pshychiatrist. She gave me escitalopram 10mg. Starting low and going up to 10. I was OK with it since at this point I am very anxius and sad but then I have read side effects and - Tinnitus was listed as on!! And not so rare! And now I'm back to square one - scared to take it cos I don't want to make my T or H worse... What to do???

 

I take it and went off it and back on it. It shouldn't affect your t. I researched it and it is not common at all.

 

Glad to see Mirtazapine is working for some.

I've tried it a couple of times and had to quit after a few days; I had a horrible grogginess/hangover effect the next day and an extreme irritability that I never get (this was before my T started).

 

Hi, this info may help some,

My Tinnitus started 8months ago. I have been on Citalopram (celexa) 20mg for 2 months now and have had my Tinnitus measured before and after the AD'S, there has been no change. Although I am now more relaxed and have learnt to ignore it most of the time. If you want anymore info, please inbox me, I went through panic before going back onto Ad's for fear of making it worse, in which this case it didn't. Good luck.

 

http://www.cell.com/current-biology/abstract/S0960-9822(14)01037-9

Our network-centrality analysis reveals a widespread decrease in connectivity in most cortical and subcortical areas. In the cerebellum and thalamus, however, we find localized increases.

It seems that SSRI has more horrific effect to your brain than previously imagined, and localized increase in network connectivity? Sounds like it has something to do with synchronous firing. I'm more convinced than ever that A/D induce T not simply due to ototoxic effect but widespread alteration of brain function. I'm beginning to see the connections and suspect SSRI caused T and H is somehow related to this localized increase in network connectivity in the cerebellum. According to recent research cerebellum could be a novel T generator.
http://www.ncbi.nlm.nih.gov/pubmed/23418634
thalamus is also involved in the maintenance of T
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904345/
"Limbic and auditory brain areas are thought to interact at the thalamic level."

I remember quite a number of T victims got this sh.t because of A/D

tip-of-an-iceberg report
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357564/

 

@xanaxvictim
http://www.ehealthme.com/ds/celexa/tinnitus
Out of 27,451 surveyed on celexa only about 204 reported ; that is .74 percent not even 1% of people- I hardly think you can argue that is low .

 

@SoulStation
How reliable is this data? Unfortunately, the FDA only receives reports of the most critical and severe cases; these numbers may therefore underrepresent the complication rate of the medication.
I developed tinnitus as a result of taking Remeron. Did I report it to my GP? Yes. Did my GP report it to the local ''FDA (which only represents U.S. statistics)'' in Spain? Nope. In fact, he didn't believe me.

 

I can't imagine why anyone who got severe tinnitus from taking a medication would not want to report it in the survey. It says the data was complied from the FDA and social media. That's all I know. I recently saw a psychopharmacologist who is extremely knowledgeable in side effects some medications and he told me when I asked about tricyclics Such as Remeron that they would be more likely to cause me to get worse ringing then most ssri. however I know of many people who take Remeron and love it

 

I have been on Remeron for almost a year now. It works great for me. I was suffering from terrible insomnia - I wouldn't sleep for days at a time (my worst was four straight days without a wink). Now I have about 3-4 sleepless nights per year. I haven't noticed any effect on my T. See, positive stories exist too.

 

I'm confused. Earlier in the thread you said:

So you had T before you took those drugs?

 

@avocat So do you find the Remeron effective for anxiety/depression as well or it purely for sleep?

 

Well, I'm also on Prozac for depression and Buspar for anxiety, both of which I believe do the "heavy lifting" for my anxiety and depression. I don't know if I could accurately nail down the efficacy of the Remeron for those issues, as I was prescribed it for insomnia. I can't imagine it hurts. I'm in a good place mentally as opposed to where I was before I started taking these medications.

 

If it ain't broke don't it I suppose. As long as the meds are helping that's all that matters. I have Remeron (or more specifically the generic Mirtazapine) for sleep. I'll cut them up into tiny 3mg pieces every now and again for sleep and they do work a treat. I don't take anything regularly though but do often consider trying something to see if it would help.

 

Sounds good, @Marcini. Just know that no anti-depressant is going to work unless you're taking it regularly, and most of them don't kick in for a couple of weeks.

 

I read that SSRI's are safer than tricyclic (TCA's) for T.

 

@SoulStation I feel that your tone is changing in your post, but I want you to know that I'm not trying to argue with you or anyone here.
Of course there are positive stories, and I'm glad you're one of them. But sadly I am one of the people who did develop tinnitus because of Remeron. If you were in my shoes, you would probably also want to share your story.

No need to be confused about my T history: I first developed very mild tinnitus from noise exposure when I was 17, which I could only hear in silence and which continued to improve over the years to a point where I could hardly hear it. About 3/4 years ago, my tinnitus increased a bit due to sound exposure, but luckily it decreased again over time.
The real trouble started last summer, when I was having difficulty sleeping because of stress at work. It wasn't affecting my ears, but it was definitely affecting my concentration. I was weary about taking sleeping medication, so I looked up some information online about different types of meds (including Remeron), and in the end, my GP prescribed Remeron due to its sedative effect.

After one week of taking 15mg every night, I started noticing this electric buzz in my head. At first I didn't attribute it to Remeron, but soon after, the electric buzz increased and other strange (and loud) noises were introduced into my head. This time I knew for sure that it was due to the Remeron, as the sounds were very ''electronic'' and nothing like I'd ever experienced. The new sounds literally sounded like a short-circuit was occurring in my brain. I also got restless legs syndrome, started hallucinating during the night and just felt like I was on another planet most of the time. Due to these side effects, my quality of sleep plummeted even further. As I was now sleeping about two hours a night and could no longer get out of bed, my GP thought it would be a good idea to put me on a benzodiazepine. At this stage I was totally desperate and my parents moved in with me to look after me. When I took the benzo, it quickly became clear that my body could not deal with these types of chemical substances. I will spare you the details, but the tinnitus worsened again and I thought my life was over. Getting out of that dark, dark place was incredibly difficult and I still have a long way to go.

So going back to the data on eHealth.Me: the specific figures you are referring to only look at Celexa and they only represent U.S. data. It is also not clear how reliable these numbers are: the vetting of numbers on eHealth.me does not seem very strict. They can say whatever they like about where the data was compiled, but the actual sources are very hard to locate.
Have you seen the number of stars (*) behind their data? At the bottom of the page is mentioned:
* Approximation only. Some reports may have incomplete information.
Also... interestingly enough (not that it matters necessarily), but the company is self-funded. I doubt very much that this self-funded company has truly ''studied'' (studied? surveyed?.. the choice of words can be a tricky one!) 27,451 people who have side effects while taking Celexa. And that's just one of the many medications that they ''studied''.
All I'm saying is that we should be careful with believing this type of data at face value, and especially with using it as ''evidence'' to prove that a drug is likely or unlikely to be harmful.

And in response to your comment: I did report my (very serious) side-effects, but as my GP literally did not believe me (was he afraid of getting in trouble? no idea..) and was therefore not reported to the FDA (or any other official body) and I will therefore never be officially asked about my experience... and I'm pretty sure I'm not alone in this. A quick search on Google reveals that there are plenty of people out there who suspect that their tinnitus was caused by Celexa: http://www.peoplespharmacy.com/2012/02/12/citalopram-celexa-escitalopram-lexapro-tinnitus/and http://healthquestions.medhelp.org/celexa-tinnitus.

What you mention about the psychopharmacologist is interesting, because some professionals will say that ssri's are worse, and some will say tricyclics are worse. I personally believe that we should take into account the fact that nobody has all the answers, not even scientists, doctors, specialists, pharmacologists etc. and that the information that is presented to us is limited.

So for me (but that's a personal choice and I'm not judging anyone!) the only safe option is to try and fight back with practical tools that we do understand and that cannot harm us: change of life(style), partner (if needed!), job (in needed!), physical exercise, excellent nutrition, going back to basics, meditation, distraction, the power of the mind etc. etc.... and I'm not saying it is/was easy, because I truly hit rock bottom, but for me, medication took away my ability to make the changes that would eventually start leading towards (hopefully) long-term recovery. I know that in our industrialised world, saying these types of things are often brushed off (and not economically profitable!).. but going back to nature, back to basics, back to nurturing your body and mind, is the way to go in my eyes.

The way I see it.. even experts aren't really sure how antidepressants work. There's just so much we don't know about how the brain works. Some studies show that antidepressants can be effective in some cases, some show that they are no more effective than a placebo. Maybe it's the chemical substance which is altering our brain in fantastic ways... maybe it's our belief in the pill and in the medical science behind it... maybe it's the fact that our doctor gave us something that our culture has given symbolic healing powers... or maybe it had no effect at all... maybe the patient just healed on his/her own. (..and now I'm talking specifically about antidepressants). I personally believe that it's just impossible to know.

I truly hope that nobody takes this personally, but the medical industry is a multi-billion dollar/euro one... and it scares me. I personally don't believe that giving a cocktail of chemical substances, which nobody truly understands, to vulnerable patients is a good thing. I also believe that this multi-billion industry is very happy to see the tabloids report that we are turning into the ''antidepressant generation'', while in fact, its worrying. Its also interesting to see that this trend is mainly seen in the U.S., and now the UK... and how people's attitudes to the use of prescription medication varies greatly. What is going on here? Surely there are not more people being born with depression in the U.S. than elsewhere? I'm afraid that the way in which different nations, governments, specialists, GPs, deal with clinical depression, but also with milder cases, such as feelings of (temporary/situational) sadness or just ''winter blues'' it is just very different.
Its fantastic that medication seem to be improving quality of life for some, but personally I feel that its just so much easier for doctors to prescribe medication than to take the time needed to address the root cause of a patient's symptom, and finding alternative ways to manage them. I have literally never had (or heard!) of any doctor looking a patient in the eye and asking the question: ''OK. What is really going on in your life at the moment? What got you into this mess and how can we do to get (and keep!) you out of it?''

Again, I am not judging anyone, I just wrote the above as food for thought...

Take care

 

@avocat
Hey I am also on an SSRI and was prescribed buspar for anxiety but didnt get it filled because of fear of worsening my T. Does it help you? Have you noticed any affect on hearing/tinnitus or hyperacusis? How long have you had your T and what was it from? Sorry if some of this info is on your profile as I'm typing from my phone and can't see it!
Thanks.so much for the response....

 

@SoulStation , use @avocat so he/she gets the message.
I think everyone is acting differently on AD's.
But I'm like you also scared for side-effects especially T or H.
But mostly they are like 0,1 till 1 % of the people, very low.

 

Oh sorry I didn't know. Thanks @Markku.

 

@MariaH, I'm just really confused. You stated your T was caused by noise exposure, not Remeron. Remeron caused what people here call a "spike." I'm really not trying to argue, but I don't know if it's correct for you to say that Remeron "caused" your tinnitus when you said that your tinnitus was originally caused by noise exposure. Tracking the cause of T itself and tracking the cause of a spike are two different things.

 

@avocat As mentioned in my post: my original tinnitus was caused by noise exposure, but over the years, it reduced to the point where I could hardly hear it. I'm talking about a severity level of 0,5 on a 10 point scale. It was only when I started taking Remeron that I got severe tinnitus which could not be masked by anything.
As I explained, this T was very different, not like anything I'd ever experienced, and started directly after taking the medication. It was therefore not a spike of my existing tinnitus, it was a very dramatic increase that lasted for over a year and in my case, it was directly related to the medication and completely unrelated to my previous tinnitus.
Also: that's not really what my post is about...
Maria

 

Buslar made my T spike. But everyone is different as you know.

 

mirtazapine ( remeron ) & trazodone ( trittico ) from my knowlegde is very ototoxic.
These medicatications is linked with permanent sudden hearing loss & tinnitus.
Stay away from these.

 

Very confusing. I'm about to take an AD, but this doesn't help at all.

So now I have to live with fear and insomnia...

Doctors over here can't help us. My own ENT said AD's can't increase T/H...

 

ADs are very unlikely to increase T or H so I wouldn't worry too much about that. Any increase is likely to stop upon cessation of the medication. In fact mirtazapine is usually said to be the safest of all ADs from an ototoxic point of view, however its anxiolytic properties are considered to be lesser than some of the alternatives available. I don't know where this information about them being very ototoxic comes from. If you ask Google you will find that everything we eat and drink is supposedly ototoxic according to some crackpot source.

I've taken mirtazapine and trazodone on occasion to catch up on sleep and have never had any problems personally, though have never used any AD regularly so can't add my experience of long term use.

 

1mw I'm sorry your wrong mirtz
or remeron are not ototoxic.there was no one more against meds than me and they really helped Me a lot I took them for at least five months with no issues.Dutch guy I was in exactly the spot you are did not want to take meds but so glad I did to get my sleep back on track.
I understand your concerns but ultimately it has to be up to you.
all the best

 

@Shaun
Did remeron.mirtazapine also help you with anxiety? I read it's useful for depression and sleeping only.
efexor/venlafaxine is good for anxiety and depression both. I have that gut feeling in my stomach.


Also a hard part is how to convince the psychiatrist, and that he/she will not just give some AD the gamble.
Most psychiatrists don't know a sh_t about T and H. I will print the hyperacusis wikipedia page and hand it over to him or her. Going to see a psychiatrist soon. That's why I ask all those questions.