Can Cymbalta cause tinnitus? (+ management strategies)

This article will explore the topic of Cymbalta-induced tinnitus. It will discuss its occurrence, potential causes, and factors that may influence its development.

Furthermore, the article will provide recommendations and management strategies for individuals who are experiencing tinnitus symptoms while taking Cymbalta.

Can Cymbalta cause tinnitus?

Cymbalta may cause tinnitus in some people. However, it is very rare for Cymbalta to cause tinnitus, with only a small number of people experiencing this side effect.

Nevertheless, addressing this side effect is still crucial because tinnitus can be highly unpleasant. Tinnitus causes ringing, buzzing, or other sounds in the ears or head, which can significantly impact daily life and well-being.

Furthermore, while Cymbalta is unlikely to cause tinnitus, it can be used in the treatment of tinnitus, especially in patients suffering from fibromyalgia.

Since people react to medications differently, it is crucial to tell your doctor about any unusual symptoms or hearing disturbances that you experience while taking Cymbalta.

How can Cymbalta cause tinnitus?

Cymbalta contains duloxetine, which is a serotonin-norepinephrine reuptake inhibitor that increases the availability of both serotonin and norepinephrine in the brain. The exact mechanism by which duloxetine may cause tinnitus is not studied enough and is not fully understood.

However, since serotonin receptors are abundant in the auditory cortex and auditory nuclei, there may be a potential link between antidepressants acting on serotonin, such as Cymbalta, and the auditory system [1].

On the other hand, Cymbalta can improve tinnitus, especially if it is associated with fibromyalgia. This is due to Duloxetine’s effectiveness in treating neuropathic pain or general pain.

To illustrate, increased pain may occur due to an imbalance between pro-pain chemicals, such as substance P and glutamate, and anti-pain neurotransmitters, such as serotonin and noradrenaline.

Since duloxetine increases both serotonin and noradrenaline, it helps regulate the ratio between pro-pain substances and anti-pain neurotransmitters [2].

Additionally, tinnitus is one of the associated symptoms of fibromyalgia, a condition that duloxetine is efficient in treating. Thus, duloxetine may improve tinnitus in patients with fibromyalgia [2].

What does research suggest?

There have been limited studies reporting tinnitus as a side effect of Cymbalta. However, there is a case study in which a patient’s tinnitus improved after taking low doses of Cymbalta [3].

This case study involves a patient with a 5-year history of tinnitus. Unfortunately, the patient’s symptoms started to worsen, leading to severe depressed mood and suicidal thoughts. As a result, a daily dose of 30 mg of duloxetine was prescribed to address the depressive symptoms [3].

Just two weeks after starting duloxetine, the patient reported a significant improvement in tinnitus symptoms. Furthermore, after 2 months of duloxetine treatment, the patient reported complete remission of both tinnitus and depression symptoms [3].

Even after 6 months of receiving duloxetine, the patient remained free of tinnitus and depression manifestations [3].

Another case report involved a patient who suffered from tinnitus along with postherpetic neuralgia. She was prescribed duloxetine at a dosage of 60 mg per day to alleviate the pain caused by postherpetic neuralgia [4].

The patient reported that her tinnitus pain subsided 16 days after starting the duloxetine treatment. After 5 months, she decided to reduce her dosage to 30 mg per day [4].

Unfortunately, this led to the recurrence of both tinnitus pain and postherpetic neuralgia. Therefore, it can be concluded that Cymbalta may potentially be effective in treating tinnitus pain at certain doses.

What factors influence Cymbalta-induced tinnitus?

While this is a rare side effect, it may occur in people with high sensitivity to medications, especially if they’re taking high doses of Cymbalta. Moreover, jumping to a high dose without properly applying dose escalation can increase the risk of experiencing side effects like tinnitus.

Furthermore, some factors may increase the risk of experiencing Cymbalta-induced tinnitus. To illustrate, people who are frequently exposed to very loud noise, such as those who work in factories or as musicians, or those who listen to loud music, are at higher risk of suffering from this side effect [5].

Moreover, old age can also increase the likelihood of Cymbalta-induced tinnitus, as the number of functioning nerves in the ear decreases with aging. Additionally, men are more likely to experience tinnitus.

Smoking and drinking alcohol can also increase the possibility of suffering from Cymbalta-induced tinnitus [5].

Certain comorbidities, such as obesity, diabetes melittus, migraines, heart diseases, anemia, thyroid disorders, hypertension, and arthritis, may increase the chance of experiencing tinnitus while taking Cymbalta.

To illustrate, some of these conditions impact the blood vessels, leading to more difficult and aggressive blood flow, which can cause tinnitus [5]. People who suffer from a head or neck injury and people with ear infections are also at an elevated risk of getting this side effect.

Furthermore, patients who concurrently administer certain medications, including NSAIDs like Ibuprofen, certain antibiotics, diuretics, and other antidepressants (like fluvoxamine, sertraline, citalopram, Pristiq, and Effexor), are additionally more likely to suffer from Cymbalta-induced tinnitus.

What to do if Cymbalta causes tinnitus?

If you’re taking Cymbalta (duloxetine) and experiencing tinnitus symptoms, such as ringing in the ears, as a side effect, here are some recommendations and management strategies to consider:

Treatment adjustments

It’s essential to report to your doctor before making any changes or adjustments to your treatment plan. Your doctor may start by reducing your Cymbalta dosage and monitoring your response to the dose adjustment.

If the symptoms of tinnitus persist despite the dose reduction, they may suggest that you discontinue Cymbalta. However, it is crucial to gradually taper down the dose under medical supervision before stopping the drug to avoid any withdrawal symptoms.

Management strategies to address tinnitus

The table below provides some tips that may help improve Cymbalta-induced tinnitus. It also mentions some medications that have shown effectiveness in treating this condition [6].

Based on my research, I concluded that, while it is rare, Cymbalta can cause tinnitus in some individuals. It is worth noting that Cymbalta can also be used in the treatment of tinnitus for certain individuals. 

In my perspective, factors such as high sensitivity to medications, exposure to loud noise, old age, certain comorbidities, head or neck injuries, and concurrent use of certain medications can influence the likelihood of experiencing Cymbalta-induced tinnitus. 

If you are experiencing tinnitus as a side effect of Cymbalta, I recommend discussing it with your doctor. They may consider adjusting your treatment plan or gradually tapering down the dosage under supervision. 

Additionally, I believe that limiting exposure to loud noises, incorporating stress reduction activities, and avoiding substances like caffeine, nicotine, and alcohol may help manage tinnitus symptoms. Moreover, tricyclic antidepressants, benzodiazepines, gabapentin, pregabalin, and memantine may be helpful.

References