Posted by Robert_Burton_1621 on July 21, 2015, at 18:01:22
In reply to Stopped Cymbalta due to tinnitus, posted by crushed on July 20, 2015, at 23:04:54
> I was on Cymbalta for about five years, tried to go off, got depressed, went back on a higher dose than before, developed tinnitus (probably from the Cymbalta increase), then tapered off Cymbalta onto Prozac. Then a few weeks later went off the Prozac also because my pdoc said that could be causing tinnitus also (they just don't know).
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> She said all A/Ds have potential to cause tinnitus so she thought it was reasonable for me to try to go without any A/Ds for awhile in hopes that tinnitus would go away.
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> It's been two months since it started, and almost that since I went off Cymbalta. Five weeks without any A/Ds. I still have tinnitus for now (and I may always, although I'm not ready to accept that), and my depression is awful. I'm hoping I can soldier through it and start to feel better on my own. I'm not sure how long I wait before I cave in and try to go back on an A/D (definitely NOT Cymbalta but maybe something else). I really don't want to. I'm so scared of them now. But I'm also terrified of this depression which feels like it will swallow me up.
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> How long do I wait to see if I get better?
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> I also have terrible anxiety.
>Crushed, sorry to hear of this disabling symptom. It must indeed have been, and be, significant given it prompted your doctors to stop your medication.
May I contribute a couple of thoughts?
While some antidepressants can cause tinnitis, anxiety and stress are also culprits. Is it possible that the tinnitis was a sign that your antidepressant regime was not fully working to ameliorate anxiety symptoms?
You state that the tinnitis came on when you resumed cymbalta at a higher dose. This suggests it could have been the more potent noradrenergic effects of the medication which triggered the tinnitis, if indeed medicaion is the primary cause.
If you did not have tinnitis while on a lower dosage of cymblata (predominantly acting as an SRI), it is odd that, after ceasing high dose cymbalta, you continued to suffer from tinnitis while taking SRI monotherapy with fluoxetine.
I would be inclined to assume that the withdrawal of the NRI would resolve the tinnitis if high dose cymbalta was the direct and primary cause. Because it hasn't, I do wonder if the primary cause is related to the re-emergence of your anxiety and depression, a re-emergence which may suggest that the medication you were on was no longer optimal for you. Note that the move to a higher dose of cymbalta was preceded by your relapse back into depression after stopping cymbalta at a lower dose. Relapses can have the effect of making depression intrinsically more entrenched and difficult to treat.
The solution you have been advised to follow - stop all ADs - seems a bit precipitous to me, and not good for your mental health. Have you been, for instance, referred to cognitive behaviour therapy?
Finally, has your doctor considered prescribing amitryptiline? This TCA is excellent for a number of pain and somatic syndromes. It may not be a magic bullet for your tinnitis, but it could help both that and your depression.See, e.g.:
http://www.ncbi.nlm.nih.gov/pubmed/11771024
Cyclobenzaprine, a muscle relaxant with a tricyclic pharmacological structure, has been investigated successfully, too:
http://www.ncbi.nlm.nih.gov/pubmed/22541838
There is also a theory that tinnitis is connected to low zinc levels. Have you had your blood level tested? See:
http://www.ncbi.nlm.nih.gov/pubmed/12544035
It's a tough situation you're in, because antidepressants can both cause and treat tinnitis; and it's very difficult to determine whether the antidepressant is the cause or whether your depression and anxiety have re-emerged because the antidepressant is no longer effective.
I wish you the best and keep us informed if you like.
poster:Robert_Burton_1621
thread:1080666
URL: http://www.dr-bob.org/babble/20150629/msgs/1080684.html