Can Amitriptyline cause tinnitus? (7+ remedies)

In this article, we will discuss whether Amitriptyline can cause tinnitus. We will also talk about the possibility of this side effect, who is more susceptible to tinnitus, what does research suggests and some treatment regimes used by medical professionals

Can Amitriptyline cause tinnitus?

Yes, Amitriptyline can cause tinnitus, however, it is a rare side effect of using this widely prescribed antidepressant. Tinnitus is a feeling of ringing in the ears, which can be upsetting for many patients.

There are various causes of tinnitus, including exposure to loud noises, earwax blockage, and age-related hearing loss. Some patients think that certain medications, such as Amitriptyline, and other antidepressants like Escitalopram, Sertraline and Mirtazapine can trigger tinnitus.

Amitriptyline is an antidepressant that is used to treat depression, anxiety, and types of chronic pain. It changes the levels of neurotransmitters in the brain, which can help relieve symptoms of these disorders. While it can be an effective medication for many individuals, like any drug, Amitriptyline also has its potential side effects.

What does research suggest?

There is limited research data available for establishing a direct relationship between Amitriptyline and tinnitus(2,3). Most of the clinical studies have not listed tinnitus as a common side effect. According to research studies, only a few patients have experienced tinnitus while taking Amitriptyline, suggesting that it may be a rare adverse reaction(6).

Tinnitus can be exaggerated by drugs that affect the central nervous system or the auditory system. While the exact mechanisms behind Amitriptyline-related tinnitus are still unclear, it is expected that alterations in neurotransmitter levels in the brain could potentially initiate such side effects(4,5).

Who is more likely to experience Amitriptyline-induced tinnitus?

Different patients respond to medications differently depending on their physiological responses. What triggers tinnitus in one person may not do so in another. Some patients may be more prone to developing tinnitus while taking Amitriptyline due to a history of hearing problems or sensitivity to medications.

Patients who have hearing problems, which might depend upon age or other factors such as genetics or medical conditions, are more susceptible to tinnitus. There are a few illnesses, such as Meniere’s disease, otosclerosis(8), and temporomandibular joint (TMJ) disorders(7) which can also be the underlying cause of tinnitus. Moreover, poor heart health can also increase the risk.

It has also been observed that men are more susceptible to tinnitus than women, although it can occur regardless of gender. This highlights the importance of personalized medical assessment and monitoring when considering or using Amitriptyline(5,6).

What to do if Amitriptyline causes tinnitus?

If you experience tinnitus while using Amitriptyline, please follow the following steps to cope with them:

Contact your healthcare provider

You should immediately talk to your healthcare provider if you think Amitriptyline is the main reason for causing tinnitus. He will examine you and confirm that either tinnitus is caused by Amitriptyline or due to some other underlying medical condition.

Medication adjustment

Your doctor will adjust the dose by reducing it at first, to give your body some time to recover from the side effects. However, if you continue to experience that ‘ringing’ sound in your ears, he may suggest Amitriptyline discontinuation which will be tapered down slowly. He may also switch you to a different medication depending on your condition and the severity of tinnitus.

Lifestyle modifications 

  • You should avoid noise pollution.
  • Use noise-cancelling devices, which will help you to manage the ringing sound in the ears.
  • You may also use white noise machines or soothing sounds especially when you are trying to rest or sleep.
  • You should get your ear wax removed as this can help to reduce the symptoms of tinnitus. If you have more ear wax, your tinnitus symptoms usually get more dominant.
  • You can also use a few therapies which will help you to deal with the symptoms associated with tinnitus like Tinnitus retraining therapy (TRT) and Cognitive behavioural therapy (CBT)(1).
  • Incorporate stress relaxation techniques like yoga, meditation etc. in your daily routine.
  • Reduce the intake of alcohol and caffeine as it can exaggerate tinnitus in some people.

Conclusion

If you are concerned about the possibility of Amitriptyline causing tinnitus, consult with your healthcare professional. They will examine you including your current condition, medical history and medications, to determine the most appropriate course of action.

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References

1.-

Theodoroff SM, McMillan GP, Zaugg TL, Cheslock M, Roberts C, Henry JA. Randomized Controlled Trial of a Novel Device for Tinnitus Sound Therapy During Sleep. Am J Audiol. 2017 Dec 12;26(4):543-554. doi: 10.1044/2017_AJA-17-0022. PMID: 29090311. https://pubmed.ncbi.nlm.nih.gov/29090311/ 

2.-

Robinson SK, Viirre ES, Stein MB. Antidepressant therapy in tinnitus. Hear Res. 2007 Apr;226(1-2):221-31. doi: 10.1016/j.heares.2006.08.004. Epub 2006 Sep 14. PMID: 16973315. https://pubmed.ncbi.nlm.nih.gov/16973315/

3.-

Robinson S. Antidepressants for treatment of tinnitus. Prog Brain Res. 2007;166:263-71. doi: 10.1016/S0079-6123(07)66024-5. PMID: 17956790. https://pubmed.ncbi.nlm.nih.gov/16973315/

4.-

Mendis D, Johnston M. An unusual case of prolonged tinnitus following low-dose amitriptyline. J Psychopharmacol. 2008 Jul;22(5):574-5. doi: 10.1177/0269881107082126. Epub 2008 Feb 28. PMID: 18308819. Available from: https://pubmed.ncbi.nlm.nih.gov/18308819/ 

5.-

Langguth B, Landgrebe M, Wittmann M, Kleinjung T, Hajak G. Persistent tinnitus induced by tricyclic antidepressants. J Psychopharmacol. 2010 Aug;24(8):1273-5. doi: 10.1177/0269881109106929. Epub 2009 Oct 13. PMID: 19825900. Available from: https://pubmed.ncbi.nlm.nih.gov/19825900/ 

6.-

Feder R. Tinnitus associated with amitriptyline. J Clin Psychiatry. 1990 Feb;51(2):85-6. PMID: 2298710. Available from:https://pubmed.ncbi.nlm.nih.gov/2298710/ 

7.-

Edvall NK, Gunan E, Genitsaridi E, Lazar A, Mehraei G, Billing M, Tullberg M, Bulla J, Whitton J, Canlon B, Hall DA, Cederroth CR. Impact of Temporomandibular Joint Complaints on Tinnitus-Related Distress. Front Neurosci. 2019 Aug 22;13:879. doi: 10.3389/fnins.2019.00879. PMID: 31548840; PMCID: PMC6736614. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736614/ 

8.-

Skarzynski PH, Dziendziel B, Gos E, Wlodarczyk E, Miaskiewicz B, Rajchel JJ, Skarzynski H. Prevalence and Severity of Tinnitus in Otosclerosis: Preliminary Findings from Validated Questionnaires. J Int Adv Otol. 2019 Aug;15(2):277-282. doi: 10.5152/iao.2019.5512. PMID: 31418718; PMCID: PMC6750799. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750799/ 

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