Wednesday, April 09, 2008

Tinnitus Treatment and Therapy FAQ

What about anti-depressants?

I think after Mark Sullivan, I was the first person to wave the anti depressant flag. Of course! In my opinion, an excellent choice for moderate to severe tinnitus suffering, if there are no contraindications. Some people say to start with Pamelor, but I would disagree and go with the SSRI’s like Zoloft, Paxil, Effexor, Celexa or Lexapro. Please read that last sentence again. I've had a lot of email from people who didn't get it right the first time.

Some of my clients have experienced tinnitus elimination with Prozac. But, prozac may have a small tinnitus side effect that is larger than placebo, granted not significant, but I’m conservative. I’d start with Zoloft or Lexapro, but I’m not an MD. MD's have no problem prescribing anti-depressants because they are not "tracked" thus you will have no problem here.

Pamelor has a proven track record. (I no longer encourage using it because of significant side effects.) The vast majority of my clients who have used tricyclics do get benefits from the tricyclics and even more from the SSRI’s... and of course you don't use them at the same time.
BUT Pamelor also has more impressive side effects than SSRI's and say, Effexor which is very helpful and has few side effects.

Antidepressants probably don't cause tinnitus to go down by themselves. It appears two things happen with these medications. First the "anti-OCD" effect of the medication seems to cause people to "quit checking" their tinnitus. Secondly, the medications do succeed in reducing depression which can be profound...and allow the person to return to normal life as quickly as possible.

NOTE: For most people that are going to improve, tinnitus will INCREASE when you take an antidepressant for the first few days or maybe even week or two. It comes back down. (You can try and keep the volume up by attending to it and avoiding the other things necessary to cause reduction!) This means the medication is doing it's job in the brain. Don't become upset when the volume increases. Assume it will. The medication is "plowing snow from the highways" in your brain. It takes time to clear paths so they are neat and clean. Give it a few days. I remember these few days myself...they drove me nuts and weren't easy...and they were worth every second.

More FAQ's Coming Soon!