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

Duloxetine - complete game changer.

 

He added 2.5 mg of Aripiprazole to my script. This seems like something he started doing 18-24 months ago. He recommended adding a bit of Cyclobenzaprine if you have somatic tinnitus and if that's not enough, LDN. His premise is that these on their own won't help much but by combining them they might.

 

So there are these studies that talk about antidepressants "rewiring the brain", suggesting permanent changes:

Antidepressants can rewire the human brain, study reveals

This kinda further supports the idea that antidepressants are Russian roulette in general, but particularly so with tinnitus. No surprise why often tinnitus (or a spike) does not go away after stopping these drugs. Permanent changes were made, done deal.

 

I feel like you are the 2nd or 3rd person on Tinnitus Talk that have stated Duloxetine (Cymbalta) was a game changer. I brought this med up with my psychiatrist two weeks ago and he was "hesitant" about SNRIs.

 

Thank you for your response. It’s helpful to get input from another tinnitus sufferer. I think I’ll postpone the antidepressant route for now. It feels kind of scary to be on a medication long term. Also, it appears the understanding of how antidepressants work is lacking.

I’ll continue trying to manage the tinnitus by cold plunges, exercising, and spending time in nature. Let’s hope Dr. Shore’s device is a success so we can get some relief in a couple of years.

Right now I’m kind of in the hamster wheel of work, workout, eat, sleep repeat. But I’ll at least take two weeks’ holiday this summer.

 

Obviously there are risks. If I wasn’t completely desperate, I probably wouldn’t have taken it, but it really has helped me. I’ve gone from being in pain, lying in bed basically all day, to baking cakes with my little girl and managing my physio every day.

A few months ago I was really far gone, completely numb to everything, like on a different planet. Couldn’t even muster the energy to reply to people on here.

Fair enough, tinnitus makes meds a bit of a minefield unfortunately. I actually just started doing ice baths, it’s brutal when you’re in the water, but helps a lot with pain. I don’t think it’s had any impact on tinnitus though.

I hope you get a bit of time for yourself over the summer to recharge the batteries.

 

I tried it for a few weeks, I stopped when I started getting essential tremors. Like I couldn’t use a spoon any more and writing was challenging. It took a couple weeks for my hands to stop shaking when I stopped. Long term all side effects went away. Kind of scared me though.

 

I am reinforced in my belief that antidepressants are the devil's pills. Here are a few short, worthwhile videos to watch. These people are not quacks.

Dr. Peter Breggin: ¿tiene usted un...

Psychiatric drugs are incredibly destructive...

There’s No Such Thing as an...

 

I think I might give Cymbalta a shot. I will report back if I do.

 

What on earth are you going on about?

 

Because you found 3 videos? As much as antidepressants do cause issues with people, they also pull people back from the edge, allowing them to maintain some kind of normality in their life. It's unfortunately 50/50 with antidepressants; you either risk using them for benefit, or you don't. Each to their own.

 

I'm all for people's experiences, good or bad, but ranting and screaming things like 'poison' or 'the devil' offers nothing. These same people will then be happy for XEN1011 or any other medication to treat their tinnitus. Some of these people down alcohol and eat processed foods.

 

I hope it helps. As I said, it’s been brilliant for me. At this point it’s looking like a sustained improvement - contemplating upping my dose also. I will update you all on the outcome if I do.

 

I appreciate you sharing your experience. What dose are you on now?

 

Did you watch those videos I linked above? Antidepressants can at times help. The help can be short lived, and may lead to more problems. For people with tinnitus, it's a Russian roulette. I think people going on antidepressants should be aware of the risks. Ultimately it's one's own decision. Doctors are happy to prescribe this stuff because they will not bear the consequences.

Sure. 50/50 are pretty poor odds in my book, YMMV.

 

No worries, I’m on 60 mg.

I took 20 mg for 2 weeks (ish), 30 mg for a week, now I’ve been on 60 mg for 4 weeks. I started to see a difference on week 4, so 1 week after taking 60 mg.

I will talk about potential increase with my doctor next Friday and report back.

 

@makeyourownluck, how has the Cymbalta helped you?

 

1. Reduced pain significantly
2. Evened out my mood so I can cope with pain flares
3. Given me a general sense of well-being, sometimes borders in euphoria
4. Sex drive is back
5. More energy throughout the day
6. Given me an over all sense of ‘ok, you got this’ instead of ‘omg, my life is over’

Probably more benefits that I can’t think of Yeah, it’s been night and day really. Nightmares are the only issue - very intense and realistic dreams.

 

That's really great. I tend to be a very sensitive person (imagine that, being here), and range from debilitatingly anxious to depressed to being rather normal. My sleep suffers greatly. I really need something to even me out so I don't resort to taking more Clonazepam over time.

 

Yeah, I’m the exact same in terms of how varied my moods can be. Since starting Duloxetine, I’ve noticed a huge difference and so have the people around me. I’m just generally a bit happier I suppose. Up and about etc.

I had a few realisations too which I’m now sorting out - decided to take some time completely off work. Focus on getting better.

 

Tinnitus/hyperacusis doesn't seem to be your main issue?

 

No, my main issue is chronic nerve pain. My tinnitus has been fine though. If anything I’m finding it easier to deal with.

 

OK guys, last night I upped my Duloxetine dose to 90 mg. My doctor originally suggested going from 60 mg to 120 mg but I’m being a bit more cautious. I will do 90 mg for 2 weeks and then go up to 120 mg. I will keep you all posted on how my ears are fairing.

 

You seem to understand a lot about how antidepressants work. Mind helping me with some doubts?

I am on Luvox, which has an affinity of 5,786 on 5-HT2C.

I am considering taking Palmitoylethanolamide (PEA) to help with benzo and Pregabalin tapering.

Searching on Google I found that PEA "increases serotonergic neurotransmission through the serotonin receptor 5HT1 and downregulates 5HT2A/C receptors" (reference).

If it downregulates a certain receptor, does it mean the same as being an antagonist to that receptor? Given that, would it be risky in my case, tinnitus-wise, or risky in other ways, to take PEA, given the Luvox profile?

I would appreciate any help on this!

 

I'm no expert.

Little effect.

I'm not sure here. You should ask an MD in my opinion.

 

I asked for Cymbalta and was told they (psych practice) don't see it as a first line treatment. So I started Lexapro a week ago, 5 mg for 5 days, now 10 mg. I feel it, and I feel better, it's giving me a boost! This is contrary to expectations which were fed by all the negative-to-horror stories surrounding SSRIs. Nothing negative yet, early days after all.

My biggest concerns remain eventually coming off of it and sexual sides.

 

As I know I can´t continue like this, I´m thinking about trying antidepressants soon. I never liked the idea of taking them, but at this point I don´t have a lot to lose.

Excuse for my question, but is the plan to use antidepressants forever? Do they need to be taken in higher doses over time, or does that only apply to anti-anxiety meds?

I really need something to lift me up, but I don´t want to become addicted to anything, if possible.

 

I am not a doctor. It seems it varies. Some people take them for a while, then wean off. Some take them for years, if not "forever". Highly individual.

 

I have been up at 120 mg for a about a week now, no new ear issues. Yeah, feeling good. Sleep issues and nightmares have finally levelled off - even had a few full night's of sleep recently.

I also managed a cheeky few beers without killing my stomach. Just needed to have a proper meal first - make the most of that sunshine guys! Get all those good mental health benefits

@blamingeverything, happy to hear about your progress! Really happy for you. How are you doing now? The way I feel about it, is I’d rather worry about coming off later and just get on with feeling better now!

 

The general opinion of GPs in the UK is they are happy for people to stay on SSRI/SNRI medications for life but not other types of medications (benzodiazepines, antiepileptics, antipsychotics, opiods) unless necessary.

Of course the ones that help tinnitus and hyperacusis patients don't tend to fall into the SSRI/SNRI groups, although a small minority get a benefit.

I think there was a meta-analysis conducted that showed Sertraline benefited tinnitus patients with depression. It also showed Amitriptyline most effective "overall."

Yet, go to a doctor in Italy with intrusive tinnitus and you will often get Clonazepam/Alprazolam/Cyclobenzaprine in some format.