Gabapentin (Neurontin)

Hi there,
Even if it is my first message on Tinnitus Talk, I have been reading for quite a while now.
I have tinnitus (+ mild hyperacusis) from an acoustic trauma 10 years ago + worsenings since then.

After a recent spike making my tinnitus really bothering, an ENT specialized in tinnitus and hyperacusis in France prescribed me Gabapentin, saying he had strong results over the last years with a dosage of 300mg per day.

I have also read the below study, not too old, which seems to show good performance of Gabapentin as well (even if very small sample)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5380395/[/COLOR]

The French Doctor said he has never encountered any tinnitus worsening with Gabapentin among hundreds of patients treated.

But, I am now scared to start the Gabapentin after having read the Neil Bauman's website where he says it is known to have caused or worsen tinnitus with hundreds of people (reported to FDA).
Gabapentin is also listed as inducing tinnitus in this list of ototoxic drugs that I am using the most.
https://www.europeanreview.org/wp/wp-content/uploads/956.pdf
But maybe not with that 300mg/day dosage???

Now I do not know what to do anymore… I am frustrated not to start the Gabapentin having in mind it could maybe help even a bit… but I am so scared to possibly make my tinnitus worse...

Is there really a chance that Gabapentin could make my tinnitus worse?
Usually I have no or very little side effect when taking whatever drug so I am not very sensitive to the side effects... normally… but once would be enough...

 

Salut @Darktale.

I assume that you saw Dr Timsit or Dr Fain, right?

As far as I'm concerned, I also took 300 mg of Neurontin for 2 months and it did absolutely nothing to me unfortunately (nothing positive, nothing negative).

 

I have been using Gabapentin (200mg) for one month and the results are quite good for me. It was given to me by my neurologist to treat the pain in my hyperacusic ear (permanent pain /noxacusis).

The pain has decreased a lot and I would say that it also helps with the tinnitus.
I am also using Lenire so it might be a combination of both but even if it is early days I am very happy with Gabapentin so far. Let's see in a few months if it is still the case.

The first 2 weeks with Gabapentin were a bit difficult though as it seemed to increase my pain and sound sensitivity but that changed for the best 2 weeks ago.

Btw I was also supposed to see Dr Fain in March but because of the virus apocalypse my appointment has been postponed to July.

 

Salut Kam75

Indeed, it was Dr Fain.
I am old enough in this Tinnitus "Market" (10 years) not to believe and take for granted all what he was saying but my recent spike makes me quite desperate...

it is now bothering me when watching TV so difficult to enjoy watching TV Shows or movies at night...

Actually, if Neurontin does nothing, it would still be ok for me... What I am afraid of is that it could worsen my tinnitus permanently.
Dr Fain says with 200mg/day dosage there is no risk of side effect but Neil Bauman also says on its website that he got reports from people getting T. after one pill of 100mg...and there also some reports in the previous pages here...

Though I really feel I have to try otherwise I will always have this "doubt" in my head and it will prevent me from habituating to my new T. level, if it worsen my T. then I do not know how I would bear this.

When digging, you can Indeed find some testimonies regarding Tinnitus after Gabapentin but it is mainly people who were not suffering from Tinnitus prior to taking Gabapentin. In the few cases of worsening I have the impression it was mainly people who had tinnitus from another cause than Noise/acoustic trauma or people very sensitive to drugs side effects and for whom any drug spike their T anyhow which is not my case. I read extensively the litterature and various studies regarding tinnitus/gabapentin and no study or trial or article never mention the case of worsening of existing tinnitus (from acoustic trauma) during the trials/studies.

Did you go through the whole drugs protocol trying successively the different molecules? (trobalt...)
You were not afraid of any possible worsening when starting the Neurontin?

 

The fact that it increased your hyperacusis during the first two weeks does not reassure me…

 

@Darktale Yes I completed the entire protocol, to no avail... I tried Neurontin, Tegretol, Lamictal, Lyrica, Depakine with no results. Lyrica seemed to work at the beginning. My tinnitus was a bit quieter the first days but the effects didn't last long.

Dr. Fain finally prescribed me Rivotril. It is the only medicine that enables me to find fast sleep. But it is a very strong medicine so I try to take as little as possible (around 5 drops at night once a week or biweekly).

I even tried hearing aids, but I have high frequency tinnitus, so unfortunately it didn't help either.

I've been having noise induced tinnitus from 1 year and 3 months now.

I've completely stopped living: no parties, no clubs, no bars, no alcohol, no cinema, but my tinnitus is getting worse every 2 or 3 months for absolutely no reasons, I don't know why. I have new noises and the spikes are higher and higher, driving me crazy.

I am now at the point that I can't sleep without Laroxyl (amitriptyline), I have everyday headaches, dizziness because of the lack of sleep. I stopped going to sport as I became to weak physically.

All because of a music festival, my life is ruined from my 28 (I'm 29 years old now).

 

It is now much much better. Better than prior to taking it for sure.

 

How are things now? I'm thinking of trying Gabapentin.

 

My hyperacusis is better no doubt about it. There are still times where it comes out of nowhere without any kind of reason (no loud noise exposure) but overall I am definitely feeling better. I take 200 mg per day.

 

Did you have pain hyperacusis or just heightened sensitivity?

 

Well Gabapentin can take a few weeks to take effect for pain issues, so is possible that his pain got worse by coincidence and then drug started taking effect.

 

Both. The pain is not gone but things are improving even though my left can still hurt completely randomly.

 

@alanisnotadj can you describe your pain? I just want to get to tolerable. I'm at suffering.

 

Did your pain hyperacusis go down with gabapentin?

 

I have a quasi permanent dull pain in and around my left ear. It sometimes radiates down my cheek. It is variable in intensity. It is never unbearable but it is bad enough to prevent me from ignoring it. It feels like there is always something wrong with my left ear.

With gabapentin these symptoms have reduced quite significantly but there are still times where the pain is there and I don't know why. Of course my ears hurt when I am exposed to loud noises but normal noises don't hurt me.

Is this hyperacusis, noxacusis or nerve damage?

 

The instant pain hasn't changed at all I believe. The delayed pain has become better but I must note I was taking GABA in combo with Amitriptyline so I'm not sure if the the combo made the delayed effect slightly better or just Gabapentin..

 

My hyperacusis has never been better. I have just had several days of no pain whatsoever, only a slight discomfort in my left ear when I wake up but it goes away very quickly.

I believe it is because I normally sleep on my left ear which is the one with hyperacusis.

 

Hey I just wanted to bump this because I've been taking another swipe at this.

I am still on 2mg/day Clonazepam. I had been at 600-900mg/day Gabapentin (mostly 600, sometimes 900). I held to 600 for a couple weeks, then cut to 450 for about a week and a half, cut to ~350 for a few days and then as of a couple days ago I eliminated the morning dose entirely, so I've only been taking 300.

Sleep is a little weird, some weird physical sensations, and I do think the real high frequency stuff is flaring a bit, but at the moment this seems tolerable. I will probably attempt to just hold @ 300 at night for a while, and then go from there. If I hit a point where I basically feel as stable as I did at 600, I may reduce further. I don't know if I intend to fully withdraw from Gabapentin, I do think there is a particular synergy there with Klonopin as relates to tinnitus, but I am very interested in understanding what the minimal dose of these drugs I can take is. If I could weasel my way down to 100mg of Gabapentin, I might then start cutting back on the Klonopin very slowly. Again, not with a plan of complete withdrawal, just "less drugs == better"

 

Thought I would add: I recently went on gabapentin for ~5 weeks. It didn't help my tinnitus or hyperacusis -- may have even made them worse. I was on 300 mg at night. It did help me sleep though. I am weaning off now.

 

I believe this has been most people's experience (including mine) using gabapentin alone (although, I have seen a couple people say it helped hyperacusis but not tinnitus). Combining it with a benzo, and specifically Clonazepam, seems to have a synergistic effect in some people, but if so it is not understood.

 

I feel like chiming in here. Out of desperation I took 200 mg * 3 Gabapentin on Saturday and Sunday.
It did wonders with my anxiety and tremors (benzo withdrawal) but most importantly it helped my noxacusis I'd say by 70-80%. I suddenly found sound not to be as painful and piercing. Same experience with tinnitus. It did not go, but became less piercing and I found my noise generator actually masked it. It felt miraculous.

I became a member of 4 different Facebook Gapapentin groups to educate myself more (even though Gabapentin is what I have read most about besides benzo) It scared me shitless. People who have been on it practically beg newcomers on their knees to not take the drug as it has ruined their lives in many different ways.
I have not taken any today and everything is back to HELL.

As I understand it, Gabapentin can do wonders with benzo withdrawal, but not the other way around.
They say magnesium will alleviate Gabapentin withdrawal though.

I have to really evaluate this for a while. I'm also up for middle ear surgery next month. Going to cut both the stapedius and the tensor tympani in both ears by an ENT surgeon.
At this point I'm not even sure I will dare going through with that because of the state I'm in.

If only this fucking benzo withdrawal would let up, I will know more clearly where I stand and know what is what.
7 months off. No relief.

I'm sorry it did not help you @Zugzug.

 

Somehow, I'm less surprised that it could help noxacusis than normal hyperacusis. Maybe it's because it helps peripheral neuropathy? Either way, if it helps you, that's wonderful.

Another thing I didn't like about it is that it made me super loopy, and may have made my depression worse. My thoughts felt incoherent and disconnected. Trouble focusing. For whatever reason, I am extremely sensitive to these kinds of drugs. When I took Cymbalta, I was on the lowest possible dose and had all of the side effects. I experienced brain zaps and pretty moderate discontinuation syndrome after just 6 weeks.

For me, these kinds of drugs have to be clearly helping for me to want to be on them. I would love it if there was an anti-depressant that helped my mood, but was neutral or positive for my ear issues.

The middle ear surgery you describe sounds pretty serious. If gabapentin is helping a lot, maybe you should reconsider. Good luck.

 

I want to try combining Gabapentin with Clonazepam (Klonopin). I read a success story on it I think by @just1morething...

Finding a doctor who is in favor of prescribing a benzo is difficult tho.

 

Same here. It seems like all ADs have bad side effects. I tried my old CPAP and that seemed to help my awakening horrible noise.

 

@grate_biff

What is the reason for your middle ear surgery to cut off the middle ear bones? From your profile, it states that your condition was acoustic trauma, which shouldn't relate to middle ear issues.

 

Oh, but it does. In the highest degree possible. It does not involve middle ear bones, just the muscles.

If you are interested you can read this article:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6156190/

In short there are 3 things that can tense or make your MEM to convulse with or without sound stimuli:

Acoustic trauma/shock
Prolonged stress/anxiety
Being very annoyed by ones tinnitus

 

Thank you. That article is quite interesting. Please keep us updated on your progress if you decide to go through the surgery. Also, if and how much hearing loss do you expect with severing the tensor tympani muscle?

 

None. The muscles are there to protect the ear from loud noise exposure. I will lose that so I have to be even more careful to loud noise over time. They won't help with short duration noise like gunshots etc. anyway and that is what is dangerous to our ears.

 

I was just prescribed this by my psych. The ototoxicity does worry me quite a bit, but I'm seeing successes too. I'm really on the fence of whether to take this.

 

So my dog just passed away and it had unused Gabapentin. Who thinks I should take it and see if it helps my hyperacusis pain? Hyperacusis is kicking my ass right now along with facial pain.