Bupropion Induced Tinnitus, Worsened by Nortriptyline

Hi there,

I developed tinnitus after taking Bupropion in 2022 for approximately 10 days. I discontinued immediately and was left with tinnitus. I started to slowly habituate, still ups and downs and lots of meltdowns - more due to my reaction to the tinnitus rather than the actual loudness. Sleep wasn’t an issue if I slept with my fan, and if I was outdoors I could forget about it. There were even times I had to block my ears to hear it.

However, due to ongoing depression and potentially OCD, I finally gave in and tried another antidepressant - Nortriptyline. I was on this for 9 days total, 5 days 25 mg and 4 days 50 mg. I ceased it after the 9th day due to other side effects. Then I noticed no change, but after a week being off the medication, my tinnitus increased significantly, same tone but it’s now so loud.

It is loud enough to compete with any environment sound. Sleeping with my ear on the pillow even with my fan going (which use to almost drown it out) is now torture. When I’m driving my car it is still audible, but I do have to really focus to listen to it. Shower pretty much drowns it out. Living in the country with cicadas, I can still hear it over that.

My questions are:

1) Has anyone else gotten an increase in their tinnitus from Nortriptyline? Either during or after withdrawal.

2) Does the sound level of my tinnitus appear moderate or severe? I know my reaction is severe, but how does this compare to others’ experience? If the actual sound of the tinnitus were moderate, that would give me hope that I can try to work on my emotional reaction.

3) How on earth do I remain positive? I was barely getting by with the previous level of tinnitus, now it’s so much louder. I don’t know how to live my life like this.

4) I’m currently a medical student wanting to continue my studies to become a surgeon. How on earth am I supposed to just ignore the ringing when doing complex procedures? I am so irritable and my focus is awful. Even writing simple emails is difficult at the moment.

I feel as though my life is over. I feel as if my dreams of becoming a surgeon aren’t feasible anymore. I feel that I won’t have the patience or time to have children.

If you got this far, thank you. I am not in a good place and feel as if the only way out is to leave this earth. But I don’t want to do that to my family and partner.

 

Sorry to hear you’re going through this, it sounds like mega early days from the reaction and I think there’s every reason to believe it’ll fade but may take several weeks or months. Try not to panic which is easier said than done.

 

Are you sure it's from the Nortriptyline?

Could there have been any other factors for the spike, like loud noises etc...?

Whether the tinnitus is moderate or severe, it's just a label. If you feel the label can help determine how well you can get through, then look at it as it is worse than some people but not as bad as others. Maybe that will help you see that it is possible to continue living a life.

My tinnitus sounds similar to yours, and I do work full time in a job which also requires a lot of thinking about complex problems.

I have heard relatively good things about Nortriptyline. I was only prescribed it last month (but haven't yet taken) - but I guess not everything works for everyone.

Give it time. A spike can take time to settle back to baseline again.

 

Thank you for your support. I really appreciate it. Unfortunately, I haven’t had anything to suggest a spike and noise has never affected my tinnitus.

May I ask how long have you had tinnitus? Do you have a family? Are you truly able to be happy, relax and enjoy life?

I sincerely hope that you are well.

Yes, medications affect us all differently, unfortunately it appears as though I took a roll of the dice and came away worse off.

 

Welcome to the forum. Sorry that you are suffering much with your tinnitus. The spike is relatively new but it can settle down to baseline.

In my tinnitus journey I have had many spikes and setbacks. But they always settled back to baseline. I have a jet-engine like rumbling tinnitus on my left deaf ear and an ultra high-pitched dentist drill like tinnitus on my right ear. I also have suffered severe hyperacusis twice. The initial period was always a tough struggle as the nerves were controlled by the limbic system which made me react in a fight or flight mode and which made tinnitus appear much worse. It was a nightmare for me and I never thought I could recover. But given time, my brain got used to the ringing. Today I live a happy life traveling often.

I even wrote my success story and shared some helpful strategies. For brevity I list the link below. Check it out to see if it can help you soldier on with your struggle. Try mask it if it bothers you. Take good care. Give it time. God bless.

From Darkness to Light, How I Recovered from Tinnitus & Hyperacusis

 

I can definitely relate to the issues you are now having with that level of intrusiveness.

There’s no way around the fact that you don’t just have a very mild case - but what you’re experiencing is not out of the ordinary around here, other than maybe your specific medication reactions.

Plenty of us here are quite a bit further along and fully understand the description of the symptoms you’re having and the pain it’s causing you, yet we are still completely baffled about the reactions we get from various medications and how to get a consistent handle on this insane way of living.

Hang in there man and keep learning with the rest of us - you’re not alone in this nightmare, I can tell you that much.

 

Nortriptyline and Amitriptyline have tinnitus as a known side effect. However, as with any medication, it is an individual thing. They are often prescribed for nerve pain. I refused it for nerve pain due to the tinnitus connection.

 

So sorry to hear that you are going through this. While the meds are known to have tinnitus as a side effect, they are not know to be ototoxic, as in damaging your hearing. So hopefully, it will improve.

 

The Nortriptyline was likely an effective treatment for you. It got worse when you came off. There are 2 studies showing Nortriptyline to be effective in some tinnitus patients.