Should I Switch Back to Venlafaxine or Stick with Fluoxetine?

Hi all,

As some of you will know I switched from Venlafaxine to Fluoxetine about 7 weeks ago.

I did this because I wanted to see if Venlafaxine was possibly making my tinnitus worse.

Trouble is now the pitch of my tinnitus seems higher but I can't tell if it's better or worse because I can't remember how it sounded when I took Venlafaxine because my tinnitus has always been high pitched.

My hearing also seems more sensitive to plates clanking etc.

So I don't know whether to switch back to the Venlafaxine or stick with the Fluoxetine. The only advantage of being on the Fluoxetine is that I know now that I can come off antidepressants when the time is right. I was convinced I would be on Venlafaxine for life.

Then again these past 3 days I've been hitting the cigars (and inhaling them) again like a fool so perhaps the nicotine is just ramping things up.

I have had a couple of days here and there that have been manageable whilst on Fluoxetine, but I read there was study that suggest SSRIs could make tinnitus worse.

Any wise guidance welcome.

 

Why is inhaling cigars bad?

 

Cancers of various kinds... increased blood pressure etc etc.

 

Stick with the Fluoxetine, it will take a couple of weeks for the increased tinnitus to return back to baseline. Temporary tinnitus increases are normal when starting SSRI.

 

I've been on it nearly 8 weeks @annV and it's been getting worse plus my hearing was getting sensitive.

I've taken one Venlafaxine tablet today and will hopefully catch my normal GP on Monday.

I really don't know what to do for the best.

 

HI @Allan1967

As I have mentioned to you before: worrying over tinnitus and what can make it worse will cause stress and will usually make it more intrusive. Veterans and those seasoned to tinnitus know this. They also know the way a person copes with the condition is 90% mental, as tinnitus is intrinsically linked to the limbic system - the part of the brain that controls our thoughts and emotions.

Try to divert your attention to other things and stop focusing on tinnitus and what might make it worse. Antidepressants help but constantly worrying over them wont.

I wish you well.
Michael

 

It's more a case of I'm noting noteable changes Michael and like everyone does I'm looking for a cause. My tinnitus has become so weird and seemingly reactive it's hard not to focus on it. For 20 years I've lived with tinnitus and I pretty much became accustomed to what to expect. Now it's all new.

 

@Allan1967
I know what you mean as my tinnitus increased in 2008 to insurmountable levels and variable in severity daily. It changed dramatically from what it once was and took 4 years for me to habituate for the 2nd time. Two of those years were spent having TRT which helped but not like the first time I had the treatment back in 1996.

You have to give it time as I have previously advised you. If you are having treatment under the NHS for your tinnitus whatever that may involve, it would be a good idea to keep away from tinnitus forums. Visiting them too frequently whilst undergoing treatment, can undo or prevent any progress that you might make. Whatever treatment you have is only one part of the solution. It has to be backed up and reinforced with positive thinking. By keeping away from tinnitus forums this helps as it keeps negativity at bay. Directing one's focus to other things which I have mentioned in many of my articles and posts on my "started threads" in particular the post: Positivity and Tinnitus, is the way forward and suggest you read it.

Michael

 

Yesterday morning I took one 37mg Venlafaxine tablet. Then I freaked out about if I was doing the right thing and took a Fluoxetine tablet in the afternoon.

This morning I took a Fluoxetine tablet and today my tinnitus has been manageable plus I seriously hit the cigars today, so much so I've got a headache plus my noise sensitivity hasn't felt too bad but I've noticed that when my tinnitus isn't bad neither is the noise sensitivity.

Finally a 12 day tinnitus hell has been broken with one day off. I had two days of manageable tinnitus just before this 12 day run, but hadn't taken Venlafaxine, only Fluoxetine.

Is today just a coincidence or was taking the Venlafaxine beneficial?

This is so hard to figure out at times.

 

HI @Allan1967

If you want to, please send me a PM detailing the treatment (if any) you are having under the NHS for your tinnitus. I advise you not to discuss this in any open forum.

All the best
Michael

 

Spoke to my GP this morning... he thinks yesterday was a fluke and stick with the Fluoxetine for another two weeks and call him again.

 

Why not discuss in open forum?
Daniel

 

@Daniel Lion

It is not a good idea for anyone that is having treatment for their tinnitus to discuss it in an open tinnitus forum. It is best to keep away from them whilst having treatment.

Unfortunately, there is a lot of negative bias towards tinnitus treatment in forums. This can have a detrimental effect on an individual if they are having treatment. Usually (but not always) such a person is in a vulnerable state and can easily be influenced by reading negative posts about tinnitus and treatments for the condition. Therefore, it is a good idea not to mention they are having therapy and better still, stay away from tinnitus forums until treatment is finished.

As I have mentioned in my post above to @Allan1967
Worrying over tinnitus and what can make it worse will cause stress and will usually make it more intrusive. Veterans and those seasoned to tinnitus know this. They also know the way a person copes with the condition is 90% mental, as tinnitus is intrinsically linked to the limbic system - the part of the brain that controls our thoughts and emotions.

Try to divert your attention to other things and stop focusing on tinnitus and what might make it worse. Antidepressants help but constantly worrying over them wont.

Please read my post below and take note of the last paragraph.

Michael


The habituation process.

Habituation is frequently talked about in tinnitus forums and probably comes in at second place to the popular question: when will a cure be found? It seems some people have become quite taken with this word and believe it is the most important thing to strive for when dealing with this condition. Everyone wants to habituate as soon as possible and carry on living their life doing everything that they want to and putting tinnitus firmly behind them.

I can honestly say that I see nothing wrong with that, but wanting something in the speed that we would like it isn’t always achievable, especially with something like tinnitus. A few people that have had tinnitus for a while, have contacted me to discuss just that. They have concerns about the length of time it’s taking to habituate. Similarly, I have heard from those new to this condition that want the habitation process to start as quickly as possible. Both groups tell me they are doing all the right things but it seems patience is giving way to despondency and despair and some are starting to believe habituation might never happen for them.

It is of little comfort to these people when they hear family and friends say, tinnitus is just a minor irritant and something that can easily be ignored. Occasionally, it might be intrusive but this is never more than temporary and they are still able to carry on with their life unperturbed. I often sense the frustration a person is under when they are relaying this to me. Whether I’m talking to them on the telephone, private messenger or answering an email. It is then that I’m often asked: why is it that the habituation process doesn’t seem to be happening for them?

Answering such a question isn’t easy because there is no single answer that I can provide but I will say this. Tinnitus is a common condition that comes in many forms and intensities and no two people experience it the same. It can be very troublesome especially in the early stages of onset, but gradually this gives way and the condition settles down and in time many manage to cope with it when it’s mild or moderate. Sometimes this may involve treatment via a hearing therapist or a person achieves this naturally without being referred to a clinic.

It should be noted that tinnitus can be a complex condition, depending on how loud and intrusive it is for the individual? So what I’ve just outlined won’t apply to everyone. There are other factors that also come into play. A person’s make-up or rather their outlook on life. Whether they are positive or negative thinking can help or delay the habitation process. In addition to this, stress and anxiety are often associated with tinnitus and a person might be taking medication such as an antidepressant to help cope with it. There are a myriad of scenarios that I could relay to you on how tinnitus can affect someone’s quality of life, their well-being and the habituation process. For now I will say this:

When a person habituates to tinnitus it means they are able cope with it but this doesn’t mean they will never hear it. Although some people habituate to a level where the tinnitus is rarely heard or stays at a very low level. Whether the tinnitus is silent for periods of time or remains low, mild, moderate or is occasionally intrusive, it doesn’t really matter, because it all means the same thing. When habituation is reached a person will know, because whatever the level it will not bother you. However, like everything there are exceptions and tinnitus is no different. I believe there are some limitations to habituation. As I have previously said the condition comes in many forms and intensities. Some people have variable tinnitus that can fluctuate from silent, mild, moderate and severe. When it is loud and intrusive (severe) and this level is sustained for long periods it can become very debilitating and a person might have to take medication to cope with it, which is usually supplied by their doctor. This level of sustained intrusiveness shouldn’t be confused with a tinnitus spike, which usually returns to baseline within a short period of time.

I want to say that I believe habituation is achievable for most people with time. In some instances a person might need the professional help of a Hearing Therapist or Audiologist, as there are a variety of treatment options available to help one in the habituation process. One should also try to be realistic. There are some people that will accept nothing less than a complete cure from their tinnitus and this is unfortunate, because they could waste a lot of time being miserable.

I have corresponded with people that have said, their tinnitus is very low and is only heard occasionally or in a quiet room, at night for instance. Yet these people are not satisfied because they want a complete cure and will deliberately seek out quiet surroundings to monitor their tinnitus, checking to see if it has increased or not. It’s as if they have become obsessed with this condition and to the point where is starts to affect their relationship with those that are close to them, and I don’t think this is healthy.

In summing up I want to say one last thing. Those that are having treatment with a Hearing Therapist, Audiologist, or finding that their tinnitus is becoming less intrusive and they are in the habituation process. Try not to read negative posts or associate with negative thinking people who are not in the same place that you are, as their beliefs can prevent your advancement, if you are not careful.

Further reading on habituation:
https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/
https://www.tinnitustalk.com/threads/answers-to-hyperacusis-and-habituation.12058/

 

Wow... pretty long answer... thanks.
You mentioned the NHS... etc...

No worries, thanks for your reply.

Short and sweet would suffice if your reasoning is sound...

I know you are sincerely trying to help a sufferer...good on you.

Thanks for your reply...
Daniel