Can Mirtazapine cause tinnitus?

In this article, we will discuss tinnitus associated with Mirtazapine – an antidepressant. We will discuss some research studies and treatment strategies to help make it go away.

Can Mirtazapine cause tinnitus?

Mirtazapine may cause tinnitus in some individuals. Some people have reported ringing in the ears associated with Mirtazapine use, but such cases are rare. Tinnitus, although it is listed as a side effect of Mirtazapine, is rare and not reported commonly (1,2). 

It is important to note that people are different and they can respond differently to medications. Some people may have different factors affecting their health which may make them more sensitive to Mirtazapine-induced tinnitus. 

If you’re experiencing this side effect while taking Mirtazapine, it is important to discuss this with your doctor. Other antidepressants, including Sertraline, Escitalopram, etc may also cause this side effect.

What does research suggest?

There is limited research on tinnitus associated with Mirtazapine specifically. However, antidepressants in general are known for this side effect. 

The incidence of tinnitus caused by Mirtazapine is not very high, but it’s important to be aware of it if you’re considering or currently using this medication. The exact mechanism through which Mirtazapine may lead to tinnitus isn’t fully understood (3,4). 

However, it’s believed to be related to how the medication affects certain neurotransmitters in the brain, particularly serotonin and norepinephrine. These neurotransmitters play a role in regulating sensory perception, including hearing (3). Changes in their levels could potentially contribute to tinnitus in some cases.

It’s important to note that not everyone who takes Mirtazapine will experience tinnitus. If you do, make sure you discuss it with your doctor. 

Who is more susceptible to Mirtazapine-induced tinnitus?

Individual susceptibility to Mirtazapine-induced tinnitus can vary due to several patient-specific factors. One important factor is an individual’s unique physiology and genetics. People react differently to medications because of their genetic makeup and how their body processes the drug.

Underlying health conditions can also play a role. Some medical conditions may increase the risk of experiencing tinnitus as a side effect of Mirtazapine. Additionally, the use of other medications alongside Mirtazapine can contribute to the susceptibility.

For example, combining Mirtazapine with other antidepressants or medications known to have tinnitus as a side effect may increase the likelihood of tinnitus occurring (5).

Healthcare providers must consider these individual factors when prescribing Mirtazapine or any medication. They can assess your medical history, current health, and the medications you’re taking to determine the most suitable treatment plan while minimising the risk of side effects like tinnitus.

What to do if Mirtazapine causes tinnitus?

If you experience tinnitus while taking Mirtazapine, it’s essential to communicate with your doctor about it. They may first consider reducing your dosage to see if the tinnitus improves. 

However, in some cases, this reduction might not be enough, and the best course of action could be discontinuing the medication. 

Never decide to stop taking Mirtazapine on your own; it should always be done under your doctor’s guidance. When the medication is discontinued, the tinnitus symptoms usually subside over time.

In the meantime, if tinnitus is causing discomfort, your doctor may suggest using noise-cancellation devices or other strategies for symptomatic relief (6). These devices can help reduce the perception of the tinnitus sound and make it more manageable.

Remember, open communication with your healthcare provider is crucial in managing any side effects or concerns related to your medication.

Conclusion

In this article, we have discussed tinnitus associated with Mirtazapine – an antidepressant. We have also discussed some factors that may make some people more sensitive to this side effect and what treatment strategies can help overcome these symptoms.

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References

1.-

The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. Remeron (Mirtazapine) tablets, for oral use. Available from:  https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020415s035lbl.pdf

2.-

National Library of Medicine. Mirtazapine: MedlinePlus Drug Information [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from: https://medlineplus.gov/druginfo/meds/a697009.html

3.-

Jilani TN, Gibbons JR, Faizy RM, Saadabadi A. Mirtazapine. 2022 Sep 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30085601. https://www.ncbi.nlm.nih.gov/books/NBK519059

4.-

Tinnitus treatment with mirtazapine. J Neuropsychiatry Clin Neurosci. 2012 Spring;24(2):E36. doi: 10.1176/appi.neuropsych.11040086. PMID: 22772695. https://pubmed.ncbi.nlm.nih.gov/22772695/

5.-

Golden RN, Evans DL. Antidepressants and tinnitus. Arch Intern Med. 1994 Jun 27;154(12):1411. doi: 10.1001/archinte.154.12.1411a. PMID: 8002694. https://pubmed.ncbi.nlm.nih.gov/8002694/

6.-

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/

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