Hyperacusis Cured/Reduced by Clomipramine

Hey, what's up guys.

I have been visiting Tinnitus Talk for more than 10 years, and I decided to create an account now because it seems like I might have found something that, strangely enough, has not been discussed here yet.

Summary: I found anecdotal evidence that Clomipramine cures or greatly reduces hyperacusis.

I've broken down my post into 3 parts:

1) my story with a 20+ year old tinnitus plus new hyperacusis after COVID-19 vaccine (about 2 pages long)
2) the reports I found by other people on a German tinnitus forum (about 3 pages long)
3) my anecdotal experience with Clomipramine – I have been taking it for 7 weeks with great improvements

I'm not sure where this post belongs – Introduce Yourself or Hyperacusis & Ear Pain Support since I have combined both into one, maybe a mod can help me out.

The Clomipramine I got is: ANAFRANIL 75mg Clomipramine hydrochloride sustained-release tablets, for simplicity I will refer to it as Clomipramine.

Maybe I've written too many details but I figure that the more I explain, the less questions you will have.

Disclaimer: I'm not a doctor so I cannot give any medical advice, I'm simply sharing everything I found out about Clomipramine and hyperacusis, Clomipramine is ototoxic.

1) My story with tinnitus and hyperacusis

My tinnitus started when I was a child in 2001. I was at a summer camp abroad where they would play loud music. I'd occasionally notice a ringing in my ears when going to bed, but it would always disappear the next morning when I'd wake up. Then a few weeks later I caught a cold as I was flying back home. I had minor problems with pressure during the flight - nothing extraordinary. That night I noticed once again a ringing, that was the start of my chronic tinnitus.

Since 2001 I have made the experience that only 1 thing affects my tinnitus – loud noise / loud events (concerts, clubs etc.). Every loud event would make my tinnitus "chronically" worse (hearing protection would help to reduce the damage). Nothing else would ever affect my tinnitus until 2021.

I got 1 Moderna COVID-19 shot in July 2021 which completely annihilated my ears. 2 days after the jab the loudness of my tinnitus doubled. I had new tones – in total at least 4 or 5 which were constantly changing. It was pure chaos. I slept like 1 hour a night while constantly waking up for 1-2 weeks. No amount of sleeping pills would help. It was easily the worst time of my life. I also started taking all kind of supplements, but nothing helped. During the second week I noticed that I was waking up less – as my brain started to adapt slowly to the new sounds, I started to sleep more. I thought I had left the worst behind me.

In August I noticed that the reactivity of my tinnitus started to increase. I listened to 2 songs on my laptop (with the volume set to 24%, keep in mind my laptop has small speakers) as I have done for the past 15 years. I turned off the music, and noticed that my tinnitus was going nuts. I believe that was the start of my hyperacusis which then fully developed by mid-September 2021. Around the same time I noticed that “something” in my ears was "twitching" after certain sounds (tonic tensor tympani syndrome).

My life became living hell. Everything that used to sound “quiet” started to sound “awfully loud”, everything that used to sound “normally loud” started to sound “painfully loud” ( like a stabbing pain).

Some examples: I stopped playing my acoustic guitar, I stopped watching tv regularly, I stopped driving on highways (felt like everything was vibrating including my ears when I was going faster than 50 km/h (around 30 mph) which was around 50 dB – I basically couldn't leave my town (thankfully I can work from home), didn't even wanna try public transportation, I stopped mountain biking, I stopped playing tennis, grocery shopping became pure stress and a huge burden - only possible with hearing protection, I started to avoid people as much as possible as most people were talking “painfully” loud, the lowest volume on my cellphone became “painfully” loud, cooking was only possible with hearing protection, running water/washing hands was “too loud”, taking showers was “painfully” loud at times, strong rain and wind were “painfully” loud.

I was questioning my sanity every time I was outside – how the heck was it possible that birds and passing cars sounded so painfully loud to my ears. It made no sense to me.

When the birds returned after winter, I had to stop jogging in my local park around March 2022. I could not to tolerate the sounds any longer. I felt like a prisoner who couldn't leave his home freely. I also felt extremely anxious about going outside 'cause any sudden loud noise would affect my tinnitus and hyperacusis, such as a dog barking in January in my proximity which made my tinnitus and hyperacusis worse. I decided then to take Prednisolone for 10 days - it did nothing for me (just like the anti-inflammatory diet which I tried from November til February)

I kinda broke down a few times as I had no more power to continue my life. I felt like I did not even have a life. Only anxiety, misery and pain.

2) German Clomipramine posts

I have been randomly googling, trying to find some kind of help since 2021. Once again I was visiting Tinnitus-Liga Forums. It is a German tinnitus forum, you need to be a member to be able to view the posts which is quite annoying. I created an account there a few years ago when I was searching for more information on the Lenire device.

I found posts saying that Clomipramine cures/reduces hyperacusis in May 2022.

I have summarized and translated all the important posts that I could find. Sorry if some translations seem a bit awkward, it was getting late last night.

It all started with this user "Frida". She posted in 2009:

"I developed hyperacusis for the first time in 2003 after a fall down the stairs. Playing children, laughing neighbor, dogs - everything was too loud.

After further research I found out I should see a neurologist. Then I met a super nice doctor, I told her all about my suffering. She understood my problem right away and explained to me that this was an overreaction of the vegetative nervous system and it could be treated. She prescribed me Clomipramine which I had to increase until the symptoms disappeared. After the symptoms were completely gone, I had to take the medication for another year in this dosage and 1 more year while tapering it off.” (so 3 years in total)

All the initial side effects of the drug were not nearly as bad as the disease! I would have taken anything to to get rid of it.

My doctor also told me right away that I had to be patient.

So I started in March with 25mg daily and then gradually increased until I reached 200mg in March of the following year and that is when the hyperacusis stopped. I took that dosis for a complete year, then slowly tapered off. Side effects were dizziness, dry mouth, sweating, constipation, fatigue, and sexual feelings changed."​

Another member “Pfifferlinga” wrote in 2010:

"I tried Clomipramine thanks to Frida. I was taking 60mg. This drug has side effects, but also thank God an effect - namely the elimination of my hyperacusis."​

She doesn't mention her exact side effects.

Another member "Kane" tried Clomipramine in 2015:

"I had my hyperacusis because ob brute loudness - noise (acoustic) trauma. I took Clomipramine for 2 years because of a break in between. My hyperacusis dropped down to 5% within a few days.

Now I have suffered a 2nd noise trauma at a festival, because the organizers fired a cannon. So my hyperacusis increased to around 30%-40 % compared to back then - so kind of tolerable."​

He also shared his experience on another German tinnitus forum (you don't need an account to to view this so you can take a look for yourself).

Back on the “hidden” German forum another member "Lila" wrote in 2016:

"Based on Kane's report, I have been taking the recommended Clomipramine since early December 2015. My hyperacusis has decreased significantly and I continue to feel ongoing improvement.

So guys, I would like to encourage you to try this medication, the side effects are minor and easy to endure. I have taken Clomipramine for 1/2 year (slowly increased to 100 mg) and it helped me. 80% improvement."​

Another member "Elisa" wrote in 2017:

"For me, my hyperacusis has also improved by taking the psychotropic drug which I started taking for my depression because of my tinnitus."​

I assume the psychotropic drug she is referring to is Clomipramine.

Another member "jermaiine82" (who was active from 2016-2019) wrote:

"I have been suffering from severe hyperacusis for 3 years.

I have been taking the Clomipramine (or Anafranil as it is now called) for almost a week now, 37.5mg every night and after 2 days I started to perceive an attenuation of noise.

I have been taking it for almost 2 months now, the first 2 weeks 37.5mg, since then 75mg. I already feel an improvement."​

"Jermaiine82" took a break, then started taking Clomipramine again:

"Now I would like to give everyone some feedback on the drug - it is amazing.

I have been taking it for 2.5 months now. After the first 1-2 weeks were a catastrophe (depression), I am now better than I have been in a long time. I have been wearing hearing protection permanently for about 2 years and now I feel confident enough to take out at the protection on the right side (hyperacusis is stronger on the left).

I can only recommend this drug. I'll be taking it for at least 1-2 more years.

Side effects: first week depressed, then ravenous appetite for candy, lust for sex decreased, hard to reach climax.

I have almost no side effects now, I just often crave for sweets."​

3 more members wrote a few years ago that they are currently taking Clomipramine - they didn't report back, and have not been online for years. I asked if the drug has helped them as well - I have received no answer. I assume they were able to solve their problems and moved on.

I also found this German site with general advice on hyperacusis.

There it is written that "Clomipramine is said to have led to cure or significant improvement of hyperacusis after at least 6 months of taking it, according to some forum posts on the Internet.”

It also mentions the experience of a woman: she took Clomipramine for 3 months, she noticed significant improvements, she abruptly stopped taking the drug because of constipation. Her hyperacusis returned then.

I could not find the source of this experience.

I also found a member on Tinnitus Talk "MatthijsDJ" who reported taking Clomipramine:

"Update: The combo Mirtazapine and Clomipramine is fixing my reaction to tinnitus. My issue is that I'm far too obsessed with it.

My tinnitus is still there, sometimes loud sometimes I can't even hear it (most parts of the day). But the thing that is making me happy and hopeful for the future is the fact that my hyperacusis is gone!"​

I also found 3 reports on Sanego, which is a German site where you can leave reviews for drugs. The first 2 reviews are by the aforementioned "Frida" and "Kane", the third review is by a new person "Simba10":

"I can confirm Kane's experience 100%. I too suffered from hyperacusis and was desperate. Then I found this entry here on the Internet. After initial skepticism about the side effects of the drug, I contacted Kane68 (a thousand thanks to him!) and also took the drug under medical supervision. I was perplexed by the positive effect! The side effects were not a problem for me at all. I had the usual ones (dry mouth, a little more sweating, more appetite and therefore a slight weight gain, fatigue), the side effects stop as soon as you stop taking the drug. My dosage: slowly increase to 125mg, then keep this dosage for three months, and back to zero. it was 1 year in total."​

I tried reaching out to Kane and Simba10 - I heard back from Simba, he has no hyperacusis anymore.

3) My experience with Clomipramine

After reading all these experiences I had a very strange feeling. I had hope for the first time since July 2021. Considering my 20+ years of pure disappointment and misery with tinnitus, I was wondering where the hell was this hope coming from? My second thought was that I'll probably be the first one to report that this drug has done nothing for me.

So I made an appointment with my neurologist, told him that my tinnitus and hyperacusis are just pure torture, and that this is the worst year of my life. I told him I found random experiences saying that Clomipramine has helped.

He told me to start with 37.5mg (half of a tablet) – for 1st week. 2nd and 3rd week – 75mg (1 tablet), then I think I was supposed to start taking 150mg (one in the morning, one in the evening) after the 4th week but I think made a small mistake, and started taking this dose after the 3rd week.

He also told me that 200mg (like “Frida” was taking) was way too much in his opinion, and that I should not expect any wonders.

I started taking Clomipramine on the 16th of May 2022 (I would like to emphasize that I had not noticed any kind of improvement with my hyperacusis until then).

By the end of the 1st week: I had a feeling that running water in the sink/shower was starting to sound “more normal, more tolerable” and “less aggressive”. My following thoughts were: this can't be real - you must be imagining that, the solution to this terror cannot be that easy, you were probably swayed by the one dude who reported improvements after his 2nd day.

By the end of the 2nd / 3rd week: I was feeling like minor improvements were taking place, nothing specific, I felt like my ears were feeling a little less pain throughout the day on average. I had enough courage to go jogging in the park (for the first time since march). The experience was still pretty loud but tolerable to a certain degree. However, my big discovery was that cars were starting to sound “more normal” and “less painful”, my urge to cover my ears and turn away was gone when small/electric cars passed.

Also by the end of the 3rd week: I met a friend who'd always speak “painfully” loud, we spent almost 90 minutes talking, and I was fine more or less, I did not have the urge to tell him to speak more quietly which I had since September. That had never happened before, but of course, the skeptic that I am, I instantly argued – maybe he finally learned to speak “quietly”.

3rd/4th week: I noticed that the tv volume that used to be “painfully loud” stopped causing pain to my ears. I thought to myself, the tv is like 25 years old - maybe it's finally breaking apart and not working properly. When watching random YouTube clips I noticed that I could enjoy shows with live audiences, that their laughing did not cause me any pain or discomfort, and that I could watch these shows without turning the volume constantly up and down.

I started to accept that I'm actually improving, and Clomipramine is actually working.

Around the 4th/5th week I noticed could drive at higher speed without feeling pain. I started to drive 15 minute on a daily basis. I also started walking/jogging for 1 hour in the evening. I feel like this helps me as well.

I'm finishing now my 7th week. I feel like it was the greatest week so gar.

On the 27th of June I noticed the lowest volume of my phone didn't hurt my ears anymore.

I have been grocery shopping for the first time since 2021 on the 1st of July without hearing protection. The fridges and freezers were definitely a loud challenge, but I think I'll get there as well.

My next big goals for July are driving on the highway and cooking without hearing protection.

Side effects:

• Dry mouth when working out.
• Clomipramine has solved my problems with insomnia, it usually took me more than 1 hour and lots of Melatonin to fall asleep because of tinnitus – now it happens in around 10 to 20 minutes without Melatonin. It just “knocks” me out around midnight. I haven't slept that great in 10 years.
• Lower sex drive.

That's about it. I feel quite energetic throughout the day.

Final thoughts:

• Why are there no studies on Clomipramine and hyperacusis?
• Tinnitus didn't change.
• I plan to take Clomipramine for at least 1 year.
• I am very very happy right now. mainly because until 2 months ago I thought my life was over, I really could not imagine a life with this kind of hyperacusis and tinnitus.
• Yesterday a dog was barking in my proximity – although I was quite anxious out of habit, I was fine, no changes with tinnitus or hyperacusis.
• Regarding TTTS – I'm not sure yet, maybe it marginally improved.

 

Hi Trafalgar D,

Thanks for sharing your story. Has Clomipramine been the first and only antidepressant that you have tried? I have tried a few and all of them increase my tinnitus. Did it have any affect on your tinnitus at all?

Diego

 

Hey Diego LR,

I took escitalopram 7 years ago for around 2 years, it did not affect my tinnitus. So far Clomipramine has had no effect on my tinnitus. There is also no mention of a “tinnitus worsening” on the German tinnitus forum, but then again not everyone explicitly stated to have tinnitus.

Did your tinnitus return to baseline after you stopped taking the antidepressants?

 

Interesting find, thanks for sharing.

I'm told Clomipramine comes from the same class of antidepressants as Amitriptyline and Nortriptyline, the former of which helped me with my hyperacusis and sleeping problems. I could only tolerate the Amitriptyline for a few weeks at a time due to side effects which also included dry mouth. Hopefully Clomipramine may give people another option to try.

 

Hey, thanks for the post, we all really appreciate it. I always like seeing new testimonials and it’s interesting it’s on German websites. Because I would have definitely never found that. I’m going to get the team and look into it and do more research. Let me know how your trial with the drug keeps going! I’m interested to hear. Never even heard of that drug before.

 

If this doesn't have any horrendous permanent side effects I'll definitely consider giving it a shot. Nice find.

 

Congratulations @Trafalgar D and thank you so much for sharing your story, I am happy the side effects are not too bad for you.

The Wikipedia page on clomipramine reads that "like other TCAs, clomipramine weakly blocks voltage-dependent sodium channels... sodium channel blockade is also thought to contribute to the analgesic effects of TCAs, for instance in the treatment of neuropathic pain."

Maybe there are other drugs available which also block sodium channels but do not affect neurotransmitters?

 

I’m on Amitriptyline. Its effect is subtle. It feels like it calmed down my nervous system/limbic system. As in hyperacusis had me constantly on edge, so much so I could feel the anxiety, my jaw would shake, visual things were startling me. Amitriptyline turned down the nervous system and helped the ears very slowly improve. Is Clomipramine similar to this?

I also have jaw/neck problems which is part of my hyperacusis puzzle.

 

I also took Escitalopram. Yes, It did return to the baseline after I discontinued it.

 

Hey Mister Muso,

Yes, they seem to work in a similar way. It has done wonders for my sleep as well.

Were you able to fully recover from your hyperacusis? If so, how much time did it take?

 

Hey Brian Newman,

I´ll definitely keep all of you updated. I hope you find something in your research because I don’t think it was a coincidence that my hyperacusis started to improve after I started taking this drug. I was also quite surprised that I could not find anything in English since sites like Tinnitus Talk are usually miles ahead when it comes to this kind of information.

 

I'm three years in with my hyperacusis and I'd say it has improved about 20% per year. At the start I couldn't tolerate my own voice or anyone else's without earplugs. Now I still need them when washing up pots and pans but most every day sounds are fine. I didn't feel like the Amitriptyline was giving me any more benefit when I stopped it, but I may try it or something similar again at some point.

 

Do/did you have also pain with hyperacusis? If you want to try some other drugs, give Duloxetine a try, it's newer than Amitriptyline and has fewer side effects, although many compared to other drugs. The dry eyes/mouth of Amitriptyline killed me, also, I had red-eyes non-stop.

 

What was your Amitriptyline dosage?

 

Trafalgar d, has your reactive tinnitus gotten any better?

 

What's confusing is that there are lots of folks here for whom Amitriptyline worsened their tinnitus. Clomipramine is also thought to cause tinnitus as well. It's a pity that every single thing that might help hyperacusis seems like playing Russian roulette...

 

My tinnitus is still the same. The drug has not affected my tinnitus, and I have been careful not to aggravate my tinnitus with “loud” noise. I also don't expect my tinnitus to get better as it has been only getting progressively worse since it started 21 years ago. I just hope that a “reduced“ hyperacusis will lead to a decreased reactivity.

 

Thanks for the tip.

Yes the dry mouth was awful, not to mention the wild and crazy dreams every night, and feeling drugged all the time. And I was only on 10 mg a night.

 

OP, are there any accounts of this drug *not* working in the German forum? Would like to get as objective as possible here. Maybe some folks say it didn’t help them at all?

Thanks for the post, I seem to have had a small setback after massive improvements so kinda bummed. Nice to see there may be a new treatment option for us...

 

Hey @chinup,

I just checked again, and I noticed I did skip a guy who gave an update after a few weeks.

“l3anback” wrote on 3. November 2019:

“I have been taking the medication since mid-September, it makes me quite tired, and have other side effects. But the tinnitus has changed a bit and has somehow become more bearable. My hyperacusis is still there but I will take the medication until mid-September 2020.”
8. November 2019
"I take 75mg in the morning and 75mg in the evening.
As I said, I will continue to take the medication until September 2020,
let´s wait until then"​

He did not report back later. Other than that I´ve reported everything I found. So far, all people (who have taken the drug for at least six months) have reported improvements.

 

I saw my neuropsychiatrist for the first time yesterday and wanted to jump into this as soon as I saw this thread. Unfortunately he's really wary of tricyclics just because of how extreme the side effects are... which is understandable.

It sucks that you have to be on it so long, or even forever, for it to be effective. But getting your life back from hyperacusis seems worth any sacrifice. It's just too bad we have to gamble with annoying side effects.

 

Hello,

It's a good thing for you that your hyperacusis is calming down.

An ENT doctor also suggested Amitriptyline. The box of medicine is at home but I don't dare to try it for fear of worsening the tinnitus and hyperacusis symptoms.

Like NewLionel, I also have jaw problems and somatosensory modulated tinnitus which has worsened over time. One wonders if the hyperacusis is not also aggravated because of this.

(For me the main cause is the various sound traumas due to headphone music).

 

@chinup, since you have seen so much improvement, I wouldn't let it get you too down. I was reading a book on recovery and it described setbacks as being speedbumps on the way to recovery which are trying anything to stop the pain from disappearing. They will slow you down, but should not stop you. It sounds like you have found what works for you and should just stick at it. Apparently, mental state has a lot to do with one's recovery. In the simplest form, people who believe they can get better have a higher chance of recovery. People who do not believe they can get better have a lower chance of recovery. I'm trying my best to stay in the best mental state possible as it appears that it could be an important part of recovering from hyperacusis (and anything).

 

Ambroxol. It's a cough medicine, but has sodium channel blocking properties. Literally the only thing that has helped me manage my symptoms.

 

Thank you for your reply, appreciate it. May I ask you at what dosage you take it? I've read online that Ambroxol can only be taken in 3 consecutive days, have you any experience with taking it longer than that?

Do you feel Ambroxol just lowers your hyperacusis symptoms day by day, or do you also think it makes your hyperacusis better in the long term? Which part of your hyperacusis is helped by taking it, the general burning or the stabbing pain?

Don't know how bad your tinnitus is but do you notice any effect on that?

 

Well Clomi is well known for it's anti obsessive potential that already can do a lot for us T suffers.

 

@Josh59, I have been taking Amitriptyline for a couple of months now and have certainly not had it worsen my symptoms. Like you, my hyperacusis comes from headphone usage. I have not noticed an improvement from taking 10 mg and then 20 mg over the first 2 months. Going on to 30 mg and will try that for a few weeks. These are fairly low doses for Amitriptyline so actual improvement may require a higher dose.

 

Since we are discussing other drugs, I´d like to add the following:

When the user "Jermaiine82" asked for Clomipramine for the first time, the doctor decided to give him something else “that works just like Clomipramine”. The "just like Clomipramine” drug (he doesn’t mention the name) had no effect. Later he tried Clomipramine which greatly helped.

 

I usually take 60 mg twice a day or 30 mg three times a day, but it has an extremely good safety profile even at higher doses. The only reason why I don't take more is because it can upset my stomach a bit, which seems to be the case for about 50% of people who take it, but many have no issues. It's an OTC drug, so as I said, its safety profile is extremely favourable.

Regarding only being able to take that for three days, I haven't really heard of that before. There are fibromyalgia and gaucher's sufferers who take it at much higher doses on a daily basis. I've personally been taking it on and off for the best part of the year with largely no issues.

The biggest thing the Ambroxol seems to help with is the face pain/neuralgia. However, I've noticed that if I take it long enough it does also seem to help with my sensitivity/loudness. I can only speculate as to why this is but here's an educated guess:

1) Improvement in pain symptoms provides relief/improves mood, so in turn changes sympathetic/parasympathetic response.
2) Ambroxol can work as a middle ear surfactant in the eustachian tube and middle ear mucosa

No effect on tinnitus, personally speaking.

 

Where do you get it? I haven't found any good place to buy it personally. Thanks!