Mirtazapine + Tinnitus Spike? Also Taking Betahistine — Anyone Been Through This?

[ErnieRo]

Hi everyone,

I'm hoping to hear from people who've been in a similar situation.

I recently had to start Mirtazapine (7.5–15 mg) because I was dealing with severe insomnia and anxiety. I tried every nonmedication option first, including CBT, breathing and relaxation exercises, sound therapy, and grounding, but nothing was helping. I eventually reached a point where I had no choice but to try something that would let me sleep again.

It's now been 5 days, and my preexisting tinnitus has spiked. It's not a new tone, just a louder version of a sound I already had. I'm also taking Betahistine for suspected cochlear hydrops, so I'm wondering:

• Has anyone taken Mirtazapine and had a temporary spike that went away as your body adjusted?
• How long did it take before things settled?
• Did anyone notice interactions, good or bad, when taking it with Betahistine?
• Should I give it more time, or could Betahistine be contributing?

I'm pretty sensitive to medications, so this spike has me feeling nervous, but I'm really hoping this is only an adjustment phase and not something permanent.

Any experiences, reassurance, or advice would mean a lot.

Thank you all, I really appreciate this community.