Best Non-Ototoxic Drug / Supplement to Help with Sleep — A Tinnitus Sufferer's Dilemma

Hello, I am calling on you today because I am in very, very great distress.

If you don't want to read the whole thing, skip to the last paragraph.

I'm not going to tell you my whole life story, but to make a long story short, I had a very significant sound trauma at a music festival in February 2019 (while wearing custom hearing protection), at the age of 28.

This has resulted in several extremely high pitched tinnitus sounds including dental drill sounds, electrical noises that travel throughout my head, gutter sounds...

I also have moderate hyperacusis in my left ear.

In September 2020, I made the mistake of taking Naproxen for 6 days because of a foot pain that prevented me from walking properly.

Since then, my tinnitus has skyrocketed, new tones have appeared and the intensity has never come down.

The reason I am contacting you today is mainly because of problems I have with sleep.

I started taking Amitriptyline for sleep (10-15 drops) in September 2019.

I was getting enough sleep to make it through a work day, until the unfortunate Naproxen incident.

Since September 2020 my sleep has been really horrible, again today I practically pulled an all-nighter.

I have the impression that my tinnitus only keeps intensifying, even though I have completely stopped living (I don't go out anymore, I don't drink anymore, I don't go to the movies, I don't do sports, nothing).

My tinnitus is now so intrusive that I can hear it through my tinnitus masker at night and everywhere else (in the train, in the car, on the subway...)

I have tried Melatonin (1.9 mg), CBD oil at 15% (about 10 drops), infusions with verbena, orange leaves, lime and chamomile (I drink 2 cups a day) but nothing helps. In the best case I wake up every 10 minutes, in the worst case it's a sleepless night.

I have also tried therapies such as sophrology or hypnosis, as well as acupuncture, relaxing massages and Chinese medicine, but nothing has helped.

I am afraid that it is the Amitriptyline, which makes my tinnitus worse, but I do not know.

I am in a deep depression because of all this. My ENT and my psychiatrist recommend me to take Amitriptyline in antidepressant dose (so 50 drops per day instead of 15 currently) to treat the depression, but I am afraid because of the ototoxicity of this medication.

The question is: for us tinnitus sufferers, what is the "safest" substance to sleep properly?

From what I have read, most medications are either ototoxic or dangerous in that they shorten life span etc.

Thank you so much for reading and I hope you can help me.

 

I also can hear my tinnitus everywhere I go, for example in my car on the motorway...

For me, a mixture of Quetiapine (Seroquel) and Mirtazapine helps sleeping (25 mg Seroquel and 15 mg Mirtazapine). I also do some meditation before bedtime.

I hope this works for you.

 

Hi @Hamsti!

Thank you for your answer.

Do you take this every night?

From what I understand, Mirtazapine is related to Mianserin. My psychiatrist has prescribed either Amitriptyline or Mianserin as an antidepressant, and from what I have read, both of these antidepressants can cause tinnitus.

 

Natural stuff I use that works (and I’ve tried TONS of stuff but this is the best):

• Gaia Sleep & Relax tea
• Premier-ND Liquid Melatonin (if your issue isn’t falling asleep but staying asleep, then use the sustained release Melatonin - this is the best brand for that: Pure Encapsulations Melatonin-SR Sustained Release)
• AdrenaCalm (one pump rubbed into the inside of the forearms)

The combination of those 3 above will knock you out, literally. But you have to take it with your circadian rhythm (you can’t have insomnia until 2 am and then decide to take Melatonin, it only works if you take it before 11:30 pm), also your body will habituate to anything over time so I also cycle prescription meds.

Ambien: 1/2 of a 5 mg tablet usually is able to get me to sleep for those days I forget to take the above or I know I have an early morning meeting.

If you want to make it even stronger take a .5 mg Klonopin stacked with 1/2 of a 5 mg Ambien.

If you try the above and it doesn’t work for you, I will Venmo you $20. I’m literally that confident because I had really bad insomnia.

 

People on here have different definitions of "ototoxic," but the list of truly ototoxic medications is short. Many medications have the potential to temporarily negatively impact tinnitus, but do not damage the cochlea or auditory nerve. By definition, ototoxic drugs include:

• Salicylates – Aspirin and aspirin containing products
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
• Antibiotics – Aminoglycosides, Erythromycin, Vancomycin
• Loop Diuretics
• Chemotherapy Agents
• Quinine

I know that some on here have claimed to have experienced permanent worsening from non-ototoxic medications, but I can only go by my own experience, and no medication I've taken since my tinnitus started 2 years ago has caused a permanent negative effect.

Overprotecting my ears did far worse.

I've read about people having success with the antihistamine Hydroxyzine, which is apparently quite sedating, and has actually been used to treat tinnitus in combination with another drug. Depending on which list you look, you might see this drug listed as ototoxic, but, by definition, it is not.

 

Thanks a lot for your advice @lcj!

As I said I already take Melatonin and infusions to sleep, they are not helping me, but why not try the ones you suggested

AdrenaCalm might be a good idea although I already apply essential oils on my wrists, temples and neck before sleep.

Unfortunately all the natural stuff you mentioned are currently unavailable

 

Serotonin is known to affect the cartwheel cells in the dorsal cochlear nucleus implicated in tinnitus. ADs aren’t ototoxic but can induce changes in the brain which can exacerbate tinnitus. That being said, no antidepressant has done that for me personally.

 

What you say about antidepressants reassures me in part, because as I explained in my initial message, I'm considering taking them following the worsening of my tinnitus due to Naproxen.

But when you say that ADs can exacerbate tinnitus, would this be temporary or permanent?

Without indiscretion, what antidepressants did you take? My psychiatrist recommends either Amitriptyline or Mianserin.

 

Like I said, other medications can potentially affect tinnitus, but ARE NOT ototoxic. I see a lot of medication paranoia on the board, and I like to chime in every so often with some facts, since the doom and gloom on here can be counterproductive.

Anxiety over taking/not taking a certain medication can negatively affect tinnitus more than the drug itself.

 

I agree it's not ototoxic, but it's not a risk-free proposition either. I also agree in general people should try things to help deal with this condition, and generally people do not do enough.

 

Although it is in the small minority of people, it can cause both temporary and permanent worsening.

I am using both Mirtazapine and Nortriptyline, and personally it has only helped me sleep, without adverse side effects.

 

You’re welcome! Do you live outside of the US? Is that why the Amazon links don’t work for you?

The AdrenaCalm works through a blend of vitamins and phospholipids. When I first started using it I was using the SE type (one without any essential oils) and it worked just as well.

Like I said I have tried hundreds of different types of teas and Melatonins. I’m super confident these are the most effective ones.

 

I believe you. According to your profile, you've had tinnitus for 20 years, wow... So there is no doubt that you have had time to try everything

I live in France, I opened the links that you mentioned in your message and it reads "Temporarily out of stock. We are working hard to be back in stock as soon as possible.", this is the case for all the stuff you mentioned :/

 

@Kam75, I take Mirtazapine because it doesn't list tinnitus as a side effect. It didn't worsen my tinnitus at all, but it helps me sleep

ADs are always a gamble, but I think staying awake all night listening to your tinnitus is much worse.

 

Hey man, I had the same crippling insomnia AS you (if not worse) and Mirtazapine has been a godsend to me. 30 mg at night and one hour later I'm already drowsy and ready to sleep without a care for the loud ringing inside my head.

It's literally the safest antidepressant, so don't be afraid to take it. Sleep deprivation not only intensifies tinnitus but also affects your overall health negatively.

 

I agree at 100%.

 

I don't want to add to your dilemma but I must share my experience: I first got very manageable tinnitus as part of the Clonezapam withdrawal. I was taking Amitriptyline at the same time and when I stopped it 2 months ago, about 3 weeks after my last dose the tinnitus became brutal. It's now unmaskable.

We are all different and the drugs affect everyone differently. I feel it's impossible to predict what happens.

I'm in a very similar situation - I have barely slept for 6 months now. I tried to stay clean from drugs but at this moment I'm back to square one and probably will have to go back to drugs or I go crazy and hurt myself.

I'd recommend to make any changes in slow doses - super super slow.

Good luck to you, I understand very much how you feel.

 

Indeed, from what I read on the Tinnitus Talk antidepressant thread, Amitriptyline and Mirtazapine seem to be the two safest ADs for tinnitus sufferers.

Oh really? I'm so sorry to read that

I think I will reconsider taking Amitriptyline as antidepressant and take Mirtazapine instead, if it is really the safest.

 

@Kam75, before you try any new meds, go out and make yourself tired from exercise. You wrote you stopped sports. Go and bicycle for an hour, or do some exercises at home. Make yourself physically exhausted. It is 100% safe. It will do wonders.

The human body is not made to sit around in a house in stress and anxiety.

How can you get serious acoustic trauma with custom hearing protection? I'm really curious.

 

@Kam75, sorry to hear about your sleeping problems. I too had a lot of problems with sleeping. I did not take ADs but I tried everything else like calming tea, trying to relax before going to sleep, staying active during the day, and going for long walks. The long walks really helped me to be tired and more relaxed when going to bed.

 

Hi @Robin21, I used to go to the gym every other day before my tinnitus worsened (so before September 2020), I really enjoyed it, but with the lack of sleep now I'm so weak I don't have the strength. I have strong dizziness and headaches constantly because of the fatigue.

The music at this festival was extremely loud, I felt vibrations in my body, but I thought I was protected with my custom hearing protection.

I'm really unlucky...

 

Sorry to hear that... I guess we all are in other ways. Deep bass in low frequencies goes through pretty much anything. Ear protection is useless because of the bone conduction and it resonates the whole body. I guess you have low frequency tinnitus then...?

I know how you feel, I used to train 2-3 times a week, but the last time I was at my Dojo was in November before the 2nd COVID-19 wave lock down. Now with my elevated tinnitus and hyperacusis I can't even imagine how I'll manage to go back. There is always loud music, the round signal alarm is crazy loud and high pitched. It's a sound hell. Also, I'm not vaccinated, but it's another story itself.

You have to make a conscious effort to get yourself moving, even if it's at home. Get a 30 minute intensive body work out on YouTube and I really believe it will help you sleep better.

One step at a time!

 

Does sensitivity to low frequency noise cause or make tinnitus worse?

 

I think sensitivity is in itself not, but prolonged exposure to high levels (anything above 85 dB) can probably cause it or make it worse.

 

That is how I got this horror show. The serotonin in Amitriptyline.

 

What about Azithromycin? That's when mine started.

 

@Kam75, how are you these days? And did you ever try the Mianserin? I am in France and my psych has recommended it.

 

I've been in hell due to lack of sleep, too. But some of my problem has been my reaction to various supplements that basically backfire then I can't relax and feel jittery. Tonight I think I'm going back to a combo that worked relatively decent for me (like 6 hours of sleep + sometimes another one or two after eating breakfast) before I decided to try a bunch of other supplement combos to get more sleep.

What has worked for me:

Exercise hard 6 days a week *regardless* of how little I slept the night before.

Absolutely no caffeine. I haven't had any in 6+ months.

One hour before bed:

--300 mg of Magnesium L-Threonate (Life Extension brand).

--Two pills L-Theanine, purchased on thorne.com (this is the ingredient in Green Tea that helps you stop overthinking).

Immediately before bed:

--33-67 mg of CBD isolate (zero THC). I have been using CBDistillery.

(Note: you have to build up your tolerance or CBD will have the opposite effect and make sleep impossible. Also note: brands with.3% THC will help you sleep better but, at least for me and many others, will temporarily make tinnitus louder. For a while, getting the sleep was worth the louder sound during the day, for me, but then I couldn't stand it anymore.)

That usually puts me to sleep for 4-6 hours.

After waking up:

Immediately take .5 mg Melatonin (Pure Encapsulations). If you can't sleep, get up and eat a bunch of carbs like cereal + yogurt (I eat bobs muesli + blueberries + half banana and tend to eat healthy overall.) Often the carbs plus Melatonin will make me tired enough to sleep again.

(For both CBD and Melatonin, you can take too much and or for too long and have the opposite effect. You have to take let's say one week break every time they stop working.)

Important. Get sunlight in your eyes every day before 9 am, and just before dark, for a few minutes. (Don't squint -- look into the horizon without hurting your eyes. The point is outdoor light.)

My therapist today suggested I wake up my husband and have sex. I guess that might be worth a try although I hate to wake him even for something I'm sure we would both enjoy. But worth considering.

Be careful about supplements that can be stimulating. I think that's been my problem lately.

 

Mirtazapine made my tinnitus worse like every other serotonin drugs I've tried, and I've tried a lot of them.

Seroquel helped me sleep, and actually had a positive effect on my tinnitus, but I had to quit because I started developing tardive dyskinesia, which at the time was essentially untreatable.

Now I get by the Melatonin.

 

Maybe try Cyclobenzaprine, or another drug that's a serotonin antagonist.