Which of My Meds (Nortriptyline, Doxycycline, Topomax) Is Most Likely Ototoxic?

Well, it's Monday and my hearing is still dipping dramatically in both ears as the hours go by, and I have had more T spikes than I have ever counted. Can barely hear anything low frequency sounds that were loud and terrifying to me just two weeks ago, and the waterfall noise in my ears has not died down in intensity. Guess this is the living the worst nightmare part of my life; I don't even know what wasteland of an earth I woke up to this morning when everything was so beautiful just 2 days before. I'm pretty much losing hope as the local ENT's are not taking my sudden hearing loss seriously, and my ear doctor out in California is also not helping me or replying to my urgent messages since 'a very long time ago'.

Right now I am now more convinced than ever that one of my prescription medications is to blame for the rapid hearing loss I have been experiencing, given that all of this started around the time I took certain medications. My doctor, who prescribes two of the medications, has also not replied to any of my questions regarding the potential ototoxicity of the drugs I am on, and none of his staff have called me back for the 3-4 messages I have left them with, which has made me very suspicious that something really is up.

That being said, if there is anyone who can help me sort through some of this, I will greatly appreciate it.

These are the 3 suspect drugs I take or had taken, all of which I have ceased to take as of this morning.
I've read anecdotal stories of all of these drugs causing ototoxic reactions in people, but I can't exactly tell which one it is:

-50 mg of nortryptyline every night (I used to be on 100 mg around mid August) starting around July 27
-300 mg of doxycycline/day-Started them Saturday morning and have stopped as of this morning.
-25-75 mg topomax/day-Started on 25 mg Sept. 3, and then 50 mg Sept 9-15, and then 25 mg again Sept. 17-22

Do any of these drugs have an ototoxic potential, and given my time spent taking them, do they look like they could have done lasting damage to me?

Thanks again for any help you guys can offer. It means a great deal right now...

 

Lucky you, I've got all 3 of those meds myself right now. Well I did have the topomax but got yanked off it after a week because I was reacting quite badly to it - my fam doc was away and this was proscribed at a walk-in, he was pretty angry about that. Why are you on it? Unless it's for migraines, epilepsy, or intercranial hypertension you should stay away from it. Have you been seen by a neurologist yet?

Doxycycline (are you using just that or Doxycycline Hyclate?) is definitely ototoxic. However it's reversible and not all that bad. It does increase intercranial pressure which can temporarily increase tinnitus but shouldn't be too dangerous- according to my neurologist told to me this very day. I got a 10 course of 100mg at 2 per day myself. Like everything else it's a crap shoot. I've seen people claim they got T from it, or made it worse, some better, I even found one post from a guy that said after his regimen his T went away - and his circumstances are a lot like mine, so... I haven't started my course yet because of the same trepidation. Mine was prescribed because my doc thinks I may have a sphenoid sinus infection - which is likely given my medical history which is too long to get into. Also, there may be some major differences because your T sounds as if it's physically related to your ears, whereas mine isn't - started with a dental insult and major BP spikes - tests are coming in the next 2 weeks but neurologist feels it's temporary and will pass, fingers crossed. So with the MRIs, CTAs, etc. all coming they'll be able to get a detailed look at my sinuses and have a much better idea if they're infected and then it can be treated directly or I can risk taking the course - which I will. Who knows, may even get lucky like that one guy claimed to.

I just started nortrip myself - 10mg for 5 days - than increase to 20mg after that. My doc always prefers to err on the side of caution and keep prescriptions low. It's much easier to add if it isn't effective than dealing with bad results from too much. That's something everyone should always keep in mind. I think it's spiked my T a bit but I've seen people here and other T forums say the same thing that it may happen for a week than subside as your brain adjusts to the chemicals. I suspect part of it's psychosomatic and tied to anxiety as well. And nortrip is considered one of the least ototoxic ADs which is why it's favored over some of the older tricyclic ADs.

There have been recent studies that claim SSRIs can definitely make T worse - google it and you can find the studies on Pubmed and the like - so I would tread mighty cautiously along that path.

And ultimately we're all a mixed genetic bag. Somethings are going to work well for some people and be bad for you. I don't like popping pills anymore than the next guy but when you're in crisis you need to take some risks and do whatever it takes to try and level out so you can move forward. It's about calculated risk. If you paint yourself into a corner where you're afraid to take anything that might make you better because it might make you worse than you're never going to make any headway. I know it sucks, and I hate it too, hell that's why I'm waiting to take my Doxy. But if I didn't have those tests lined up I'd just cowboy up and do it - seeing as I've done a lot of penicillans over the years and had zero problems with them I doubt one more is going to kill me and if it does than no more T problems, right?

Do your homework, question the docs when they prescribe and how much. If you're really uncomfortable than go get a second or even third opinion. Just be careful about self-diagnosing with Dr. Google because of all the aforementioned reasons. Search for any drug associated with T on these forums and you're bound to see half the replies stating what a horror show it is and others that it was a huge help. Much like benzos. I hear all the horror stories all the time but I've been able to use them off and on over the years for a week or two - you just have to be smart about this stuff - with zero problems afterward and feeling much better adjusted and level. I've never had an addictive personality either, so....

Anyway, sorry for the ramble, just trying to introduce some common sense into the topic of using prescription meds. Dunno if that helps, but good luck, CH!

 

From memory, you have lyme? Can this in itself not be associated with tinnitus/hearing issues/hyperacusis?

I dont know the dose, but I know Glynis takes noratryptaline and has said that this gets rid of her head noise. I have read ancedotal reports of others, who blame their t on ADS, so I am sorry I cant say anything definative there.

I can say I had to stop doxy for suspected babesia/lyme because it definately worsened my t (temporarily) on 2 occasions. I was taking 200mg doxy per day, and it wasnt till the 3rd day that i noticed a definate increase in my t along with the return of my H and ear pain. I personally think it is ototoxic, even though i havent been able to find anything definate to confirm this either way. It did settle back to base line after a few days. I had the same problem with artemesia, and had to discontinue this one after day 3 also. Again, it settled back to baseline, with no perceivable effect on my hearing threshold.

I have never taken topamax, but I think there are threads about this on the forum.

Have you actually had a hearing test up to 12000khz to ascertain that you have experienced a hearing loss?

That is what I would do first, along with taking NAC; if you arent already.

If you are worried about ototoxicity, the best thing you can do is take an antioxidant to help deal with free radical damage. Consider IV glutathione. There are blood tests (eg. www.nutripath.com.au) available that can tell you if you have glutathione depletion, which obviously will predispose you to oxidative stress.

I will tell you that my stem cell dr at Mcquarie Stem cell centre told me that they have had the best results for tinnitus that is caused by ototoxicity. Have you thought about this option?

If you are dealing with lyme still or at all, have you thought about the following?

. ozone
. vit c/glutathione iv
. cryptolepsis, alchornea, bidens pilosa etc as per Buhner
. hyperthermia treatment
. could try artemesia (mediherb)
I am currently do this protocol:

. 4 days stealth formula (artemesia and sarsparilla)
. 15 days viruimmune, echinacea, and cryptolepsis

I think your ears will settle down. I know how scary it is having to take substances to get well, only to find they interact with the tinnitus. My ears do settle eventually, but like you, am unwilling to take the risk of causing a permanent spike. There are always alternatives.

Hang in there.

 

If they were ototoxic, then the damage has been done. If they were just increasing your tinnitus, then it may go down soon and you may feel like you can hear better. You probably should have a hearing test just to see if there has been any significant changes in your hearing.

Recently, a dr told me that I could really get the attention of the medical community if my hearing was in the 30-40 db range. If my hearing was in this range, then I would be a candidate for a hearing aid. I could never have any other treatments, due to only having one hearing ear, so it doesn't matter what is wrong with me anyways. He also told me that he doesn't understand why I am having problems hearing. This is what we are up against.

 

@Jkph75

In all honesty I wish we could throw these people out of buisness and boycott their practices; they are lying to you and me and may be gaslighting the situation. They know they can't appease hearing aid companies because neither you nor I could be helped by those devices, so that's why they leave people like us to disintegrate long past the point of being too late. My audiogram is showing loss for sure now, not somewhat ambiguous like it was in 2016; but everyone I go to claims false and tries to convince me that the hearing is getting better, and that 2+2 =5.

I also don't have high levels of tinnitus. It sounds like a quiet sparkler but it's extremely rare that it gets unbearable. It is definitely not blocking out sounds for me.

 

@DebInAustralia

Thank you for all of this information; but I do not have lyme and never did apparently. I was being affected by previous inner ear injuries and benzodiazepine use at the time....still am.

 

Just an update. I checked with doctors, pharmacists, etc. and the ototoxicity of Doxy isn't even worth mentioning so don't worry about it. It's less than a .02% chance it can worsen T.

I started my course 8 days ago - 100mg twice daily - with 2 more days to go and I my sinuses feel better. T is fluctuating as normal - but again I'm pulsatile so mine it most likely neurological damage - just did CTA and still have 2 weeks to gp for MRIs, sigh so a while before I have answers yet - but on the whole it's calmed down, and I've calmed down - the nortripalyne and valium helped level me off immensely.

I'm pretty much done with the benzos now but my doc and the neurologist want me to keep on with the nortrip for now. Otox for the others is a non-issue as well from what they told me. I personally know my pharmacist and trust him. He scoped it out thoroughly using the Canadian Drug Product Database - https://www.canada.ca/en/health-can...ucts/drug-products/drug-product-database.html - and said not to worry.

So, like I said before, yeah be cautious but don't paint yourself into a corner being afraid to take something that will likely help you on the minute chance it might make things worse. So I think you're pretty safe to take them. Just be careful with the Topomax - at least it didn't work well for me, but that was psychological - dark thoughts and all that - not physical.