Low-Dose Nortriptyline for Tinnitus?

I saw an ear doctor this week for tinnitus and she said my hearing was fine for my age.

She prescribed Nortriptyline. 10 mg a day for the first week, then 20 mg a day for the second week. This seems like a very low dose... is this common to be recommended?

I have never taken anti-anxiety or antidepressant meds before so I am unsure about taking it, but I could really use something to help me relax and sleep.

Has anyone else taken this low of a dose of Nortriptyline for tinnitus?

 

I thought the lowest dose of Nortriptyline was 25 mg but I could be wrong. It may help but dry mouth was a problem for me. So drink a lot of water if you take it. I now see it does come in 10 mg.

 

I take Nortriptyline 50 mg.

It stopped my head tinnitus and I sleep really well on it.
No side effects. Only a little bit of tiredness when I started it.

It's been the best thing for me.

Love glynis

 

Anyone heard about Nortriptyline helping pain hyperacusis? Considering going on Nortriptyline.

 

My doc just prescribed me 10 mg of Nortriptyline. He said he has used it with good results for people with tinnitus and hyperacusis. This is my GP and not an ENT. He also believes that a lot of my symptoms mimic those of a migraine and thinks it can be treated using Nortriptyline. I am a little skeptical but I also trust his medical knowledge and overall he is a great doctor with good bedside manners.

Has anyone recently had success with low dose Nortriptyline?

 

You will certainly sleep better. The dose, if low, doesn't pose a huge threat. Depression-induced tinnitus is a real thing. You can always taper off if nothing is happening in a week or so.

At least you have someone researching and giving you a best shot.

 

Did you see this trial going on at UC Irvine? They are testing Nortriptyline & Topiramate together for the treatment of tinnitus. You must have a really good GP.

https://clinicaltrials.icts.uci.edu/trial/NCT04404439

 

No I didn’t see it. I hope you are right but yeah he’s pretty on the ball.

 

I currently live in Irvine. Maybe I'll schedule an appoint at UCI medical center and see what this is all about. My doc was already telling me to go there since they are much more academic than an ordinary doctor's office.

 

Lucky Man. UCI has some top notch docs and researchers. Dr. Djalilian and Dr. Lin are pretty big deals in the vestibular world. I don't know how it works with insurance but just be prepared to pay the really big bucks.

 

Seriously? How did I not know this? Insurance will be fine.

 

I took 10 mg Nortriptyline while I was also taking Xanax which I'm still on. All it did was increase the high pitched tinnitus sound in both my ears. I tried it for about 3 weeks & then stopped. It didn't do anything positive for me.

For those that have ear pain, I would recommend taking Pregabalin.

 

Did it go away once you got off?

 

I've read that Pregabalin is one of the nastiest drugs to come off from. Some people begin to have withdrawal symptoms even while on the same dose.

 

Good luck getting an appointment with Dr. Djalilian. He seems to have a lot of creative ideas. I'd imagine UCI takes most insurance plans, as it's a university hospital.

 

I have an appointment with Dr Djalilian at the end of July. If anything eventful comes from it, I'll let everyone know.

 

My experience is not definitive, but I've been on 25 mg Nortriptyline for sleep since the start of this (no Topiramate). It helps me sleep but that's about it. I've seen accounts of it helping centralized (head tinnitus) for others.

 

My head tinnitus is what is really bothering me right now. It's like a dental drill... or maybe a dog whistle. Moves all around my head... center, left, right. It's unbearable.

 

That’s what I’m experiencing after the vaccine. It’s low volume but you can’t not pay attention to it.

 

Yep, I developed it after the vaccine. It cuts through everything. It doesn't get louder around sound, but just feels worse.

 

Bingo! Mine is intermittent though. Ours should hopefully die out within months.

 

I really really hope so.

 

Hope is all we got. I just had a mini spike after walking today that lasted for 3 hours. It literally just stopped right now, then the dog whistle started up lol. I wonder if a low histamine diet would help, along with supplements and antihistamines.

 

How often do you take Xanax and at what dosage?

Thanks in advance.

 

I think antihistamines are ototoxic. You should doublecheck before taking them. That's why I took Flonase, I thought it was the only safe allergy medicine. It wasn't on the list as far as I remembered, but a Google search proved otherwise.

 

I really doubt they are ototoxic. Certainly no moreso than benzos.

 

Neither of these drugs are actually ototoxic. Benzodiazepine withdrawal can cause vestibular damage, especially if it's handled too quickly or improperly, but if there's actual damage to the hearing apparatus from simple use of benzos no one has ever been able to demonstrate it.

Antihistimines definitely do not cause vestibular damage, but, you're manipulating, minimally, acetylcholine, and additionally many of the older, common antihistamines like Benadryl, are actually not very specific and exert pretty notable serotonin reuptake inhibition (in fact, SSRIs were developed after looking at this mechanism and trying to create drugs which would exert the serotonin action without the antihistamine effect).

Drugs which mess with serotonin function are well known to, on a temporary basis, impact tinnitus perception.

People often use the word "ototoxicity" to relate to "any drug that I think might have caused me a temporary spike". This is just wrong; there are all sorts of drugs that can spike your tinnitus short to mid term without actually doing any damage to the hearing apparatus or the brain.

 

Sorry yea, I'm just throwing stuff out from my terrible memory. I remember being at the store looking for antihistamines and having a list of 'ototoxic' medicine on my phone. My memory is telling me it was on the Merck Manuals website, but I cannot find the list anymore. It was a huge list and every antihistamine was on it, so from then on I just avoided them. Could be it only has a temporary effect. I haven't looked into it after that.

 

What is your opinion on Nortriptyline? Do you believe that the withdrawal could cause vestibular damage or is it more akin to traditional SSRIs?

 

I don't think TCAs do the excitotoxicity thing that benzos do, but any of this stuff can do really weird stuff in unusual cases, especially if it's used for a long time and then stopped suddenly.

I've never heard of *triptyline withdrawal causing tinnitus but I bet if I started googling I'd find some stories, because so many people have been on these drugs, and so many people get tinnitus in general... discerning correlation vs causation is very hard, and I am not aware of any formal studies.

Sorry, it's all a bit of a crapshoot.