Help Needed: Remeron, Olanzapine, the Tinnitus and Now the Hyperacusis Pain

Hi All,

Thank you for a really good forum. I have read a lot of the post regarding Treatments and Research.

My continued story:
It is about 6 weeks since I got a severe change after having pretty stable Tonal Tinnitus for 18 years.
I have some small TMD issues and can modulate most of the tinnitus with Neck and Jaw Muscles.

After a stressful year + noise trauma at dentist I now have Severe Tonal Tinnitus on left ear and in head + Tones on both left right ear that react to sound and also react to near silence.
I also have Hyperacusis which was really bad up until 2 weeks ago when it got better due to
Remeron (Mirtzapine) 15mg and Zyprexa (Olanzapine) smallest dose. These two meds literally made me into a walking zombie.

Side effects: heavy body, no energy, huge appetite.

They did however chill my Panic, Anxiety, Depression and Hyperacusis.

Due to a weird feeling behind my ear and a small change in tinnitus + a sudden temporary hearing loss and temporary tinnitus change for 20 seconds.
I decided that these pills are probably not too good for my tinnitus so I ditched them after 4 days and felt mentally better for about a week.

BUT

Slowly but surely the tinnitus started to unmask more and show itself in the form it was before I numbed myself.

The hyperacusis is back to the state it was before all this which basically induces pain to sounds that are not perceived loud.

Generally I feel that when a sound hits the tones of my tinnitus and hearing loss (very small 8 kHz and worse at 12-13 kHz) it induces pain. For example: Plastic bags, Raking leaves.

ALSO when I am in a quiet environment at the end of a day of sounds, the pain in my left ear is larger and it almost feels like my cochlea is vibrating in pain with the 3 sounds that get more pronounced when in a relaxed mode.

I have earplugs that are 20dB which I use almost all day today due to feeling pain in my ears due to hyperacusis.

I also have hearing aids that have white noise option, do not really feel that they help too much in this situation since I kinda feel my ears are burning with them either way.

With Melatonin I wake up about 10 times a night and usually in bed about 10 hours.
For sleep I tried some Antihistamines but they just seemed to aggravate the tinnitus.

The tinnitus itself is between 7/10 - 9/10. The hyperacusis + pain, and the lack of proper sleep is what is killing me.

Any tips here for alleviating the hyperacusis and getting better sleep?

After a smaller mail convo with Berthold Langguth he wrote about
1. Carbamazepine starting with 150 mg and increasing the dosage slowly up to 900 mg / day; this could have a particular effect on the tinnitus spikes
2. Clomipramin starting with 25 mg and increasing the dosage up to 100-150 mg / day; this is an antidepressant and we were informed by a musician with tinnitus and hyperacusis, that this treatment helped him a lot to reduce the hyperacusis
3. I also would not be completely against a treatment with clonazepam for several weeks; it could help to reduce tinnitus and then you should try to reduce the dose and stop the clonazepam.

I am in a situation where I am truly looking at trying options that are not standard.
After reading the forum for a bit it seems that people have had some small successes with some meds although clinical trials show they are a mixed bag.

Any thoughts on:
Gabapentin, Pramipexole, Perampanel, BetaSerc, Cinnarizine, Amitriptyline, Keppra or Others?

Stuff in my cabinet:
Benzos: Xanax, Clonazepam
Z: Zolpidem
Antihistamines: Propiomazine, Prometazine,Hydroxizine,
Other: Melatonin, NAC, Magnesium, R-ALA, B-Complex, Thorne Meriva Curcumin, Taurine, PharmaGABA, C-Vitamin


Thanks for reading everyone <3

Would love to get some input from some seasoned veterans as well

 

What happened at the dentist?

If the medications were working, could you get back on them but lower the dosage so they arent as sedating?

 

It was a dental hygienist and they used the ultrasound cleaner. I didn´t feel ear fullness until like a week later and then my T started to come. So it is probably continued sound exposure that did it...
Thing is the meds were working in a way but I felt this damaging feeling behind my ear after eating them. Unsure if it was placebo or not. Also I was basically on the lower end of the Remeron dosage to begin with. Kinda afraid to start taking it again. And will deffo not take the Antipsychotic one since I have a feeling that one was way ototoxic. :/

 

I suggest talking with your doctor about taking just the remeron (if you still need it) without the antipsychotic and see if you can better tolerate. I only say this because you mentioned that it was helping you.

I'm sorry to hear about the ultrasonic cleaner. I wish ENTs would warn people who have tinnitus about dental procedures potentially worsening tinnitus. From what I know from a dentist, he said that ultrasonic cleaners are unnecessary and manual instruments can do just as good a job.

 

Not sure if the Remeron is what I need. That is the problem. Surely I won´t be able to stay of all pills in the future considering my predicament but Remeron might not be the right way to go. Some people also reported H after Remeron but hm.. it is indeed a tough nut to crack. Right now I am basically on sick leave and staying at me moms since if I would be alone I would prolly just lay on couch and not eat lol..

 

Yeah, this is a very complex situation with a lot of moving parts. Hopefully someone else can chime in here who knows more than me. I know @glynis is very resourceful when it comes to these types of posts.

 

@Krolo,
Some Antidepressants can help tinnitus for some people.
Mertazepine
Amitryptaline
Nortriptyline

Make sure antidepressants cover
anxiety
sleep
low mood.

Some Antidepressants don't help sleep like Venlafaxine.

I take Nortriptyline and it stopped my head tinnitus but have severe Bilateral Tinnitus in my ears due to Menieres.

Nortriptyline helps me sleep most nights.
love glynis

 

Hi @glynis . Thank you for your post. I have already tried the Mertazepine. Guess I will have to try the other two. My main problem is sleep. My low mood is basically not that bad. I am in limbo so not sure where my mind is right now.
Will check out on the Nortriptyline. Does that make you crave food aswell?

 

@Krolo,
It doesn't make me crave food.
I was on 50mg and now 25mg and sleep most nights.

love glynis

 

On Remeron. It can easily take more than 2 weeks for your body to adjust. If you are taking 15MG you may want to talk to the therapist at up'ing it to 30Mg. Remron has the inverse effect of other ADs. The more you take , the more stimulative. I felt the same wat at 15Mg and it totally went away at 30Mg.

 

Hmm, Guess my issue is really to be able to sleep and to be able to function during they day. I got severe focus issues with the T and H. How did Remeron help u?

 

I am taking it for the depression.

 

Ahh, Glad the 30mg works for you! I guess I am somewhere around there aswell where I would need to take it for that but. Right now sleep is main darn issue So many things just aggravate the T .

 

Interesting that Zyprexa helped your hyperacusis. I'm starting it tomorrow at 2.5 mg. Hope it helps my severe noxacusis. I'm already on 30 mg Remeron.

 

I was on this for about 3 days in the end since it was a really bad match for me. What worked for me was Zoloft.

 

@Krolo How is your hyperacusis now, and do you think the Zoloft helped?

 

@Krolo How is your hyperacusis now, and do you think the Zoloft helped?