Wellbutrin-Induced Tinnitus Success Story — Dramatic Improvement

After reading this forum when I was at my lowest, I feel morally obligated to post my story to give some hope to other Wellbutrin tinnitus sufferers.

I (29 y/o male) took Wellbutrin for 12 days, titrating up quickly at the following dosages:

150mg
300mg
300mg
300mg
450mg!!! (accidental third dose)
300mg
300mg
300mg
300mg
150mg
150mg
150mg

My ringing started immediately with the drug and increased with the dose - becoming most intense and alarming at 450mg. It was always a higher pitched ring/eeeeeeee noise for me. I was able to make the noise change by bending my head forward, and getting stressed would make it spike for a second, until I calmed down with deep breathing. Bending over quickly once also make it spike for me, but it went back down fast (not gone, just back to normal).

After stopping the drug (and not taking any other ADs), I can confirm dramatic improvement in the ringing after 7 weeks. It is so low currently that I need to plug my ears to hear it, and cannot hear it unless in total silence (even an electric light buzzing will cancel it out). I tracked my progress by comparing the ringing to my fans (1 fan vs 2), and other noises I could rely on to be consistent (bathroom fan, etc). The ringing used to be way worse. There was a time when it very loud and distracting - especially in the afternoon - and I could even hear it over my 2 fans at night. But after all the improvement I have experienced, I have complete confidence it will be fully gone by 3 months. I'm posting this story a bit early (before it's fully gone) because I will forget to do this by then.

After reading some of the horror stories on here, I felt sure I was doomed. But I asked a friend of mine who also had ringing during and after using ADs, and he told me it's totally normal and does go away. I read other forums - especially depression forums - and saw the same thing reported. Get used to the idea that it might take 2-3 months to fully subside or longer, and only if you're off all the meds. Don't panic and stop cold turkey if you can avoid it. I have also been taking vitamins during this time. I took Vitamin 2 at 2500IU, and 400mg of Magnesium to help absorb the Vitamin D and avoid a Magnesium deficiency because of the Vitamin D. Don't OD on vitamins and supplements - be deliberate and be aware that taking one vitamin can cause a deficiency in another one.

Here are some observations I made during the worst of my ringing that helped calm me down. Maybe they can help you too:

1. Moving my head in certain ways made it change (this was comforting because it made me realize I had some influence over the noise. Do the neck exercises and don't dismiss them).
2. Stress/ anxiety made it spike (this was comforting because I could work on reducing stress/ anxiety).
3. It was improving over time (trust in the trend).

It's important to get good sleep to help your brain heal. Stressing and being anxious will hurt that process. Stress literally has negative effects on the brain, and if you have AD-associated tinnitus, its time to focus on brain health, and BE PATIENT. Some days might be worse than others - but the trend with be towards improvement. Hang out with friends. Play video games. Take time off from work. Spend time with your family. GO FOR A RUN. Fixating on the noise will only strengthen the neural pathways that generate it. Stop obsessing. Manage your anxiety with self-talk, and focus on positives.

Remember: tinnitus is super super common when taking ADs and afterwards. Most of what you read on forums like these are people at their worst, but you never see how they turned out in the end. One guy reached out to them, and said 70-80% had their tinnitus go away eventually, but they never posted on this forum about the improvement... And who knows if Wellbutrin actually caused it in the remaining 20-30%. Trust your body to heal itself, and help it by being kind to yourself.

Last note: Controversial opinion time - I am not convinced that Wellbutrin is ototoxic in the traditional sense. Ototoxicity causes physical/structural damage to the systems involved in hearing (i.e. damaging the hair cells), from what I understand. Wellbutrin modifies brain chemical abundances that can impact how excitable the neurons are, but doesn't damage them in any meaningful way. They can reset if given the chance. I suspect that people reporting permanent tinnitus from Wellbutrin are mistaken about the cause of their tinnitus. They may have had loud noise exposure and just didn't realize it, or don't remember. For Wellbutrin to be 100% the cause of your ringing, it must have started immediately after taking the drug or upping the dose. It's possible for it to be the cause in other situations, but I suspect it's much less likely.

 

It is in the information that comes with the prescription that says Wellbutrin can cause tinnitus. I developed tinnitus from Wellbutrin during the pandemic when I had not heard loud music for months. I spoke with the pharmaceutical company about my side effects and they acknowledged it’s a documented side effect. Every doctor I have seen knows Wellbutrin to be ototoxic. I’m super glad to hear your tinnitus is getting better. It gives me hope. But it is well documented Wellbutrin can cause tinnitus. Please don’t dismiss other people’s experiences.

 

Hey, my intention was never to dismiss anyone. I fully agree Wellbutrin can cause tinnitus. It definitely caused mine. What I'm saying is that I doubt it causes permanent tinnitus because I'm not sure that altering neurotransmitters can cause damage to the inner ear. Unless someone can tell me the mechanism for how that physical change happens, I will keep to my theory. I've seen clinical research that showed a few cases that took up to 6-9 months to fully resolve. I think the fact that Wellbutrin-induced tinnitus people like me can make the noise change by moving our heads (mine changes if I crane my head to look downwards) shows it might be due to an effect on the neck muscles and the way they interact with the dorsal cochlea thingies. Mine also increases with stress - which is just neurotransmitters and neck tightening again as well - which would mean Susan Shore's Auricle device will be helpful when it comes out. Either way, we should be thankful it hasn't caused physical damage - most likely just temporary scrambling of neurons that takes some longer to fix than others. Again - very common among all antidepressants. I see you joined in May 2021? Still early for us both. We both gotta be patient. The improvement is up and down, but it's trending the correct direction.

 

@Wellbutrin_Case, perhaps worth conferring with @T_Almost_Gone amongst others to see if the symptoms are the same.

 

Happy to chat with @T_Almost_Gone if he wants to post here. I've noticed some interesting variation in my ringing lately. There seems to be two noises - 1 is the high pitched eeeee that seems associated with stress (can control with deep breathing), but the 2nd one is what I call the "Wellbutrin tone" which is deeper sounding and has been trending lower at a fairly consistent rate. This 2nd sound also changes with neck movement to look downwards. Happy to compare notes.

 

I appreciate the positivity in your post, but I have to disagree with your assumption that it cannot be permanent. I have had no improvements since September 2019 and went through the whole ENT, MRI, MRA, massage therapist, chiropractic, NUCCA treatment with no improvements (I also had something on the books with a TMJ specialist as a last resort, but had to postpone due to cost). An audiologist was unable to pitch match me correctly (admittedly, part of this was my fault for not telling him the pitch he matched was incorrect the second time, but my tinnitus is not constant and fluctuates in tone and quality dramatically). I still suspect idiopathic somatosensory tinnitus, but have not found any evidence beyond a moderate correlation (and cannot reproduce on-demand).

In addition, I guarantee it is not acoustic trauma in my case. I've been using earplugs since middle school (I'm late 20s now) and have avoided concerts and clubs at all costs. The few times I went, I was either wearing max-NRR earplugs and far from the source of the sound or refused to go inside. I don't work in a loud environment either. All of my hearing tests have come back normal or about normal from what I've been told. I'm also treating for clinically-diagnosed anxiety and depression, and I admit that helps, but I still have my bad days.

What I do agree with is that my case is incredibly rare and for a large majority of people, it is probably a somatosensory issue that can be treated or will go away on its own.

 

Were you taking Wellbutrin? If you are continuing to take medication for depression/anxiety, the tinnitus is likely to remain. It's very common during and after medicine treatment for anxiety and depression. I had to stop all meds. If you have little or no hearing loss, it's very likely to be the meds you're taking. My friend had ringing all during his medicines for depression, and only subsided several months after he stopped the meds. Obviously the ringing will continue if you're still on the meds.

 

Update: I've been doing research and I think I understand how Wellbutrin causes tinnitus. Dopamine and norepinephrine are increased in the brain by Wellbutrin. These two neurotransmitters affect potassium ion channels which are used to reduce neuron excitability. Too much excitability = tinnitus.

This is interesting because neuron excitability is also the cause of epilepsy/ seizures - another Wellbutrin side effect...

My theory is this: reducing neuron excitability by reactivating potassium ion channels should reverse the excitability causing AD-induced tinnitus. There are already drugs approved that treat epilepsy using this idea. Neurotransmitter GABA is responsible for opening potassium ion channels and lowering excitability. So in theory, epilepsy drugs that increase GABA should fix tinnitus caused by ADs. Does anyone know if this has been tried?

One last note: Even people with epilepsy can eventually become resistant to the medications used to treat them. This suggests the brain is constantly changing and I take as a positive sign that - given time and without any drugs - our brains can change. Have faith.

 

Hi @Wellbutrin_Case. I'm glad you've shared here. There's so little research so every bit helps. if anything please update us in the future so at least we have some more data points.

How are you doing? What volume is your tinnitus currently at? And is it in one or both ears? Also I'm curious to know if you took the COVID-19 vaccine & if it impacted your tinnitus?

We have some similarities.

- I can change the volume just a little bit by changing neck positions. If I twist all the way to the left I can hear pulsatile tinnitus.

- Mine started as 2 sounds; 1 high pictched eeeeee and then a lower tone that was somewhat vibrational.

On your theory: I agree, I don't think Wellbutrin causes hair cell damage. I think it's irregularity in brain neurotransmitters > too much excitatory neurons as the reuptake is stopped by the medication > somehow that excitement means we start hearing tinnitus.

As per my thread, my volume reduces approx every 2-4 months. tiny improvements but I've moved from thinking about ending it all in constant hell with no peace - to (almost) getting my life back. Not sure if you've seen this:

Bupropion Induced Tinnitus — Reduced by 70%!

I'm choosing to trust in the trend & that the tinnitus will eventually stop.

Any theories as to why some people's tinnitus stops in weeks and others', like mine, in months/years?

 

Hey there @T_Almost_Gone.

Glad you posted, and happy to hear from you. I'm eager to compare notes. Yes I've read your saga. It was encouraging but also not... 2 years is a long time... I'm sorry. I hope silence returns for all of us.

I do have an update. It's past month 4 now, and things seem to have worsened from where they were before, or maybe I'm just getting better at noticing my tinnitus characteristics. I also got bad sleep the last few nights, so factor that in.

UPDATE: Month 4.5.

I can now confirm 4 tones.

Tone 1: high pitched eeee that is almost constantly changing. Spikes with stress and anxiety, neck maneuvering and jaw clenching. I also experimented and was able to spike it slightly by squeezing my fingers... which seems to confirm this tone exists in the Cochlear nucleus that Dr. Susan Shore is targeting with Auricle. This tone actually started before Wellbutrin. I was working an incredibly high stress/anxiety job for years in a high stress country (Middle East, FML). I first had small eyelid twitches, then that stopped, replaced by small face twitches all when stressed. Then this tinnitus tone happened once before I later took Wellbutrin a couple months later. It has since become constantly up and down. I have learned how to influence this one by concentrating and can even make it jump from left to right sometimes. I can consciously reduce it through concentration, but it always pops back up again, sometimes louder if I've suppressed it for a few merciful seconds. This one is the most annoying because it is so variable that I can't ignore it. Sometimes it will spike really loud and cause sudden sharp pain, but only rarely is it ever that loud. This one I can hear most commonly in my day-to-day because it seems better at piercing through background noise.

Tone 2: An electric eeee noise that is similar to tone 1, but constantly, with minor wavering in the volume. This tone started with Wellbutrin and grew very loud when on the high dose. It has been steadily lowering in volume, however, to the point that it manifests more like static when my ear is against the pillow and not at all when I'm walking around outside. I need total silence or near silence for this static to become a solid tone and this one has made the most progress. Easily drowned out by normal street noise. Constant in the head (doesn't move from side to side).

Tone 3: I hadn't noticed this for some time because I've rarely been without white noise lately. This one is a softer, less electric noise than the previous two. It is very easily confused for a fan for me, even thought the sound is different. The best way I can explain it is it's like a ghostly, lower tone/ vibrational musical note that wavers slightly sometimes. I only recently was able to distinguish it from the others when I deliberately sat in silence last night. That said, its easiest to ignore because it is less piercing than the tone 1. Also started with Wellbutrin and was much much louder in the beginning. It is constant but easily drowned out by street noise. Can't hear it at all in the morning now, normally. Sometimes seems to disappear, but always present in silence. Seems left sided unless its silent... I hate this one the most because in silence it seems to expand and fill every space in my head like a balloon, and if I stay in silence it seems to get louder and louder.

Tone 4: I very rarely hear this one anymore. Only when I'm sleep deprived, at night. Manifests as an isolated 'ping' noise that might happen 2 or 3 times in succession, spaced a few seconds apart. Then stops. This has only happened a couple times, by my count.

When in perfect silence, tones 1,2 and 3 are pretty overwhelming at night. They seem less bad in mornings, which seems to be a common experience. I walk out of my room where there is no white noise and I barely hear anything most mornings, even tone 1 seems better behaved.

As I've read more about tinnitus, and drawing from my own experience, I have some more theories. I suspect that the reason for the gradual increase over the course of each day is because of the impact of the stress-hormone Cortisol on increasing neuronal excitability. Sleeping triggers GABA which down regulates excitability, but the stress of the waking day causes Cortisol release. I have noticed that there is a delayed tinnitus reaction to stress. I'll get stressed and know a spike is coming before it arrives. I think this is because Cortisol is acting on inhibitory neurons. Less inhibition allows more excitation, and because the impact is indirect, this might explain the slight delay in tinnitus spike. So far, researchers have identified L and D type inhibitory neurons, but this is still very recent work. I suspect that chronic stress/ anxiety via cortisol may deplete them. Alternatively, maybe Wellbutrin interferes with potassium ion channels, which would prevent the neuron from reducing from an excited state.

I am still trying to understand how the hell Wellbutrin causes tinnitus. I remain convinced that it isn't ototoxic in the normal sense, where hair cells die in the cochlea. We know that Antidepressants cause small brain architecture changes in non-depressed people that are undesirable, but neuro-plasticity should be able to adjust that, I'd think, which may explain how many people go on to recover and improve over time. This plasticity may explain the gradual reduction in tone 2 volume over time. Assuming Wellbutrin doesn't cause neuron damage or cell death, tinnitus may just be a result of the architectural changes combined with interference in the inhibitory process. But I'm just guessing, clearly. What angers me more is that our experience clearly demonstrates that Wellbutrin has effects that persist well beyond the treatment period or the half-life time. Conventional wisdom says that the effects end with treatment, which has justified casual prescriptions. This is clearly an error, and in my darker moments, I suspect a deliberate error by the manufacturer to boost sales numbers.

Last theory: just spitballing this one, but it occurred to me that when I used to go clubbing I'd always go home with some ringing in my ears. It was always gone the next morning, however. My uneducated theory for this is that loud noise expose from the club cause some hair cell death and tinnitus as consequence, but that the brain knows how ti "switch off" those damaged channels naturally. Is it possible that Wellbutrin disrupted those pre-existing "off-switches", which effectively unlocked tinnitus that was previously silenced? I do not have evidence of hearing loss as defined by normal audiogram, but there are subclinical forms of hearing loss. If this theory is accurate, Wellbutrin tinnitus victims might benefit from regenerative hearing loss therapies for damaged hair cells, because it would resolve the cause if the original tinnitus from noise exposure at a concert or whatever. Food for thought.

To your question about the vaccine, if it did cause some tinnitus, it was minor and transient. I have had two doses of Pfizer with the second given 3-4 months before I was aware of tone 1 for the first time after a very stressful situation after 2 solid years of stress. There might have been a faint hissing initially, but I don't remember really. Which suggests to me that it went away if it was there.

And lastly, to your question about why tinnitus stops for some but not for others after taking Welly... I have a couple. First, we know the effects of ADs in general are different in depressed brains vs non-depressed brains. I'd be curious to know if Wellbutrin tinnitus sufferers were commonly not depressed when they took it. I know I was not clinically depressed. And I know you took it for smoking, so there could be something there. Otherwise, failing that theory, I'd guess differences in neural plasticity. The fact that some get better means that recovery is technically possible. The only question is how. It might be as simple as some brains are able to restore the disrupted "off-switches" faster than others - if at all.

Thoughts? Sorry for the thesis. There's been a lot on my mind. I'm sorry to say I was overly optimistic in my initial post - its been more than 3 months total now.

 

Posting this here for future reference. The use of general anesthesia seems to reliably reduce or end tinnitus for 1-4 hours after treatment. Others in this community have experienced the same.

I.V. ropivacaine compared with lidocaine for the treatment of tinnitus

My hypothesis is that repeated treatments using general anesthesia might lead to longer periods without tinnitus. Understanding why this worked in the study might help unlock the reason for tinnitus occurring and might suggest a method to end it. I increasingly suspect that neuronal tinnitus is caused by an impairment of natural excitability inhibition. Meaning the neuron excitability is not the problem, but rather our reduced ability to down-regulate the excitation. I woke up this morning without any buzzing at all, but it started in a few seconds as I became anxious about it returning - remember that anxiety = cortisol = neuronal excitation. Healthy brains can naturally reduce this excitation in real time thus preventing the tinnitus sounds. Something about our ability to reduce excitation has been compromised. I woke this morning to zero tinnitus, but it returned as I got anxious about it returning. Remember that anxiety = cortisol = neuron excitation. Something about our ability to down-regulate neuron excitability has been compromised. Will research more about how the brain naturally does this.

last note: this would also explain why welly causes seizures more commonly. It appears to be compromising the brains ability to down-regulate neuron excitability.

 

Update - End of month 5:

Tone 2 (the Wellbutrin tone) seems to have improved. It's gone from nearly constant during the day, down to a static sound - like sand pouring onto a beach. Even in near silence. In perfect silence (or plugging ears) it seems to become more tonal in nature again, until I stop plugging.

Also, I have noticed that plugging my ears and listening to the ring for a while (say 1-2 minutes) and then unplugging appears to make the volume lower temporarily. Not sure why this happens.

 

Update: Beginning of Month 5, February 2022

Plugging my ears and listening for tone 2 (welly ring) has improved. Continues to degrade from solid, electric tone noise into gentler static.

Tone 1 (stress/ neck tone): Decreased significantly, now seems more like the occasional crackle sound.

Tone 3 (the whistle): Gone.

Tone 4 (the occasional pings): gone

Theory:

I believe the improvements are caused by my brain returning to baseline state slowly. Overly excited/uncontrolled neurons are one by one being dragged back into line by inhibition neurons that were either depleted or disrupted. More numbers of excited neurons = more to tone and loud sound. As the neurons settle, the noise becomes more static-like because fewer messages are being sent to the audio processing center if the brain.

 

Update - Month 5.5

3/4 ringing tones have essentially stopped. When I plug my ears, all I can hear is tone 2 - the stubborn one.

6 months is the current threshold to be diagnosed with chronic tinnitus. Hoping to avoid that, but I'm doubtful. I will continue to update this as time goes on. The next milestone after 6 months is 9, based on the report I saw. Fingers crossed.

Currently thinking of increasing my cardio exercise to boost BDNF.

 

Update: Month 6.5-ish

interesting developments to report. Tone 2 remains the stubborn tone, but has dimmed considerably. I can now sleep without a fan, with just the window open. Sometimes I can even close the window and in silence I'm not extremely bothered. So improvements continue.

However, the stress ring seems to come and go. For a period it was gone, but did come back in periods of anxiety of stress - and persisted long after the trigger ended. I am getting better at controlling this one.

An odd thing happened last night. It felt like something clicked in my brain, and tone 3 appeared suddenly after a long absence and persisted into the morning when I woke. Usually it doesn't behave like that. This seems to indicate that changes continue to take place in my brain which have both good and and negative effects.

To emphasize: I can sleep now without a fan. When I plug my ears, the sounds are audible but just. The improvement has been staggering. I have a Neuromod appointment to measure what brain waves are responsible for influencing the stress tone. I want to get this data before all the tinnitus shuts down completely.

 

lI love that you're continuing to report out and glad to see you're doing well.

 

@Wellbutrin_Case, would love to know how are you doing now?

 

I don’t think the poster was being dismissive of other people, or their experiences. But I can tell you that anti-depressants are not ototoxic in the definition the poster used. And any ENT and otologist worth their weight in salt will tell you that. While psychotropic medications may have an association with tinnitus, they are not ototoxic. By the way there are over 200 meds including over the counter medications that have some association with somebody reporting to have experienced tinnitus while taking them. And they are not ototoxic. There are actually very few medications that actually damage your hearing which is what ototoxic means. I think that’s the point the poster is making.

 

You seem to have a somatic component to your tinnitus. Perhaps you have more than one etiology at play.

Do you have neck issues? TMJ? Perhaps that’s a contributing factor to some of the noise. Typically tinnitus caused by medications or by sensorineuronal hearing loss does not change with movement.

 

Hey,

I read your thread. Very interesting. I have tinnitus, very probably mainly from SSRI intake.

It changed over time. I will not describe right now all. At this time it is a faint ringing further away, something similar to white noise and a tone that is bothering most, a screeching electrical like tone... I seldom hear all the sounds at once.

It changed in the last few days, so I am still trying to find the right description for the last tone.

But a tone I heard so far in the last weeks, until the lately changes, was about 16000 Hz - that was the result I got very often with a tinnitus matching program.

Nevertheless, I am here to ask if your tinnitus goes away for a short time when you hear 100 ms of a frequency of ca. 12000-15000 Hz? I can inhibit one of the tones (the most bothering one) by hearing this tone every 30 seconds. Sometimes when I am stressed, I need to make the interval smaller and/or the tone louder. When I am relaxed, I can go down with volume. It wasn't possible to test a longer interval than 30 seconds so far, because something is wrong with the app my husband wrote for me for the purpose of inhibiting the sound. (I found about the inhibition during the audiogram and frequency matching). So, I achieve almost the absence of the most stressful tone as long as I play a ton out of the range given above every 15 seconds at least.

Lying down and sitting makes it worse. Lying down especially... But this improved so far. It also has a somatic component, but I don't think it is the thing that is the main problem here in my case. The main problem is also as I think an overexcitement of neurons triggered by SSRI, stress and often sound exposure through headphones (I seldom heard something loud...) As far as I know I didn't have any normally measurable hearing loss.

@T_Almost_Gone, I also read your thread. So, of course, same question here.

I can imagine this might be a similarity in the case of tinnitus caused by psychopharmacological meds.

Well, I hope for all of us, it will end.

 

@forum_user, do you mind telling what SSRI you took that may have contributed to the tinnitus? And how are you getting on now?

Best wishes.

 

It was Amitriptyline. I took a very low dose (10 mg) for pain management.

I am doing better now. It got quieter and the tones changed (a few days ago again). I hope it stays like this and continues to improve until silence.

My last spike was a few weeks ago and was terrifying, the fear of a relapse is exhausting.

 

Not sure where this information came from but from my personal experience I saw continued improvement even after 12+ months. However, my tinnitus was from acoustic trauma.