Can Guanfacine Make Tinnitus Worse?

[dd314]

I need to take something for my Covid-induced dysautonomia and POTS, and Guanfacine looks like the one.

The problem is it can cause cause low blood pressure for some people, so I'm worried about that affecting tinnitus.

Does anyone here take it?

 

[dd314]

Dr. Dirk de Ridder prescribes this medication for some of his patients. I think it would be good for the community to have a larger sample size for this survey. It's a pretty common ADHD drug.

 

[Tomba]

Guanfacine reduces the heart rate and blood pressure. Elevated blood pressure has been known to cause tinnitus flare-ups. So, Guanfacine can only help, IMO.

 

[dd314]

Guanfacine reduces the heart rate and blood pressure. Elevated blood pressure has been known to cause tinnitus flare-ups. So, Guanfacine can only help, IMO.

A lot of these high blood pressure drugs can overcorrect enough to give you hypotension, which can also cause tinnitus; ears are just sensitive to fluctuations in blood flow in general. Guanfacine is also an HCN modulator/closer and HCN channels are suspected to have a role in tinnitus.

 

[dd314]

It's between this and a beta-blocker for me. It would be great if drug surveys on Tinnitus Talk had a larger sample size given the size of this community. I know it's a crap shoot, but some drugs have a much higher probability of causing tinnitus.

 

[Nick47]

It would be great if drug surveys on Tinnitus Talk had a larger sample size given the size of this community. I know it's a crap shoot, but some drugs have a much higher probability of causing tinnitus.

I've often thought about this. For each treatment thread, a pop-up reminder to enter your experience. We don't need a box for not having tried, though; there is nothing to learn from that.

Do they call it crowd-sensing or something?

 

[KellenDryce]

A new random data point: I just started taking the extended-release version of Intuniv (Guanfacine), only 1 mg per day, so a low dose.

My tinnitus resulted from acoustic trauma in my right ear, and I experienced Ménière's-like symptoms for several months afterward, though without vertigo.

Surprisingly, after four days on this medication, I've had no tinnitus exacerbation. Out of the eight blood pressure medications I've tried, this is only the second one I've been able to tolerate. Losartan, Telmisartan, Enalapril, Hydrochlorothiazide, and Indapamide all increased my tinnitus to two to four times its baseline level. Lisinopril caused brain fog and concentration issues.

It's working so well that I'm already having to cut back on Benazepril, and I haven't even titrated up to a standard dose yet.

 

[KellenDryce]

Over three weeks later, and still no tinnitus exacerbation.

 

[dd314]

A new random data point: I just started taking the extended-release version of Intuniv (Guanfacine), only 1 mg per day, so a low dose.

My tinnitus resulted from acoustic trauma in my right ear, and I experienced Ménière's-like symptoms for several months afterward, though without vertigo.

Surprisingly, after four days on this medication, I've had no tinnitus exacerbation. Out of the eight blood pressure medications I've tried, this is only the second one I've been able to tolerate. Losartan, Telmisartan, Enalapril, Hydrochlorothiazide, and Indapamide all increased my tinnitus to two to four times its baseline level. Lisinopril caused brain fog and concentration issues.

It's working so well that I'm already having to cut back on Benazepril, and I haven't even titrated up to a standard dose yet.

That's great! Thanks for contributing your experience.

 

[KellenDryce]

That's great! Thanks for contributing your experience.

Dose has increased to 2 mg, with no exacerbation so far.

It causes a very annoying daytime drowsiness for about a week, but it is well worth considering for people navigating the difficult landscape of blood pressure medications. It also provides some help with impulsivity and anxiety.

 

[dd314]

A new random data point: I just started taking the extended-release version of Intuniv (Guanfacine), only 1 mg per day, so a low dose.

My tinnitus resulted from acoustic trauma in my right ear, and I experienced Ménière's-like symptoms for several months afterward, though without vertigo.

Surprisingly, after four days on this medication, I've had no tinnitus exacerbation. Out of the eight blood pressure medications I've tried, this is only the second one I've been able to tolerate. Losartan, Telmisartan, Enalapril, Hydrochlorothiazide, and Indapamide all increased my tinnitus to two to four times its baseline level. Lisinopril caused brain fog and concentration issues.

It's working so well that I'm already having to cut back on Benazepril, and I haven't even titrated up to a standard dose yet.

I'm researching blood pressure medications that are easiest on the ear, and it seems that Labetalol is the only beta blocker not associated with tinnitus, although there's one story here from someone who said otherwise. It might be a good option to keep in mind if Guanfacine doesn't work out. I'd love to take Guanfacine myself, but the constipation is a dealbreaker for me.

 

[KellenDryce]

I'm researching blood pressure medications that are easiest on the ear, and it seems that Labetalol is the only beta blocker not associated with tinnitus, although there's one story here from someone who said otherwise. It might be a good option to keep in mind if Guanfacine doesn't work out. I'd love to take Guanfacine myself, but the constipation is a dealbreaker for me.

Labetalol is supposed to be one of the safer options, along with Nebivolol.

I had to stop taking Guanfacine because it caused insomnia, which led to some rebound hypertension. I suggested Nebivolol as a substitute, but my numbers were good enough with just Benazepril.

The Neil Bauman blog has a good collection of beta blocker anecdotes.

Which Are the Least Ototoxic Beta-Blockers and other Anti-hypertensive Drugs?

hearinglosshelp.com

Propranolol and Hearing Loss

hearinglosshelp.com

I ran the comments through some AI tools earlier this year, and they suggested that Nebivolol, Labetalol, and Carvedilol are the relatively safer options, though even Carvedilol has many red flags. It might be worth doing something similar with your symptoms.

I am currently testing a beta blocker as a temporary anxiety reducer for a job interview, and the information is very mixed regarding which ones can cause what effects.

Good luck!

 

[dd314]

I am currently testing a beta blocker as a temporary anxiety reducer for a job interview, and the information is very mixed regarding which ones can cause what effects.

Good luck!

Thanks, and good luck with that beta blocker.

Without going over the same ground again, one of the scariest stories I've ever read on this site was about Propranolol, so in my mind, that one's ruled out for good, even though it's considered the best for physical anxiety symptoms. How's the one you're currently testing?

 

[KellenDryce]

Without going over the same ground again, one of the scariest stories I've ever read on this site was about Propranolol, so in my mind, that one's ruled out for good, even though it's considered the best for physical anxiety symptoms. How's the one you're currently testing?

I'm actually planning on testing out propranolol -- just haven't made it to the pharmacy yet. I asked the NP to prescribe the lowest possible dosage, which is 10 mg. The pills are scored, so they can easily be split into 5 mg segments. I might as well split again, if possible, into 2.5 mg based on that one story of propranolol 10X-ing someone's tinnitus.

My research showed that atenolol and metoprolol were more likely to cause tinnitus spikes, and that the closest other beta blocker to propranolol, nadolol, has a very long half-life, is rarely used, and has very limited reports.

Other options might be hydroxyzine (more or less risky than propranolol?) or lavender, mentioned a few times on anti-anxiety psychiatry YouTube.