Does Pristiq cause tinnitus? (1+ case reports)

In this article, we will discuss the link between Pristiq and tinnitus. We will explore research studies and case reports along with the factors that can contribute to tinnitus. 

Does Pristiq cause tinnitus? 

Yes, tinnitus is a possible side effect of Pristiq. However, it is important to note that Pristiq-induced tinnitus is infrequent and occurs in a small percentage of individuals who take the medication. (1)

Tinnitus is a ringing sound heard in the ear without any external source. The symptoms of tinnitus include hearing sound in one or both ears, which may sound like a ring, buzz, whistle, hum or click, which can be soft, loud, low-pitched or high-pitched. (1) 

Antidepressants are known to cause tinnitus but in a small population. Pristiq (desvenlafaxine) is an active metabolite of venlafaxine, which belongs to a class of serotonin-norepinephrine reuptake inhibitors (SNRI), which inhibits the reuptake of both serotonin and norepinephrine and, to some extent dopamine. (1)

If you are experiencing tinnitus after starting your therapy with Pristiq, consult your physician for further management. Do not stop taking Pristiq suddenly, as it may worsen your condition. 

What does the research suggest? 

There are very few research studies about Pristiq-induced tinnitus. However, there is evidence that antidepressants cause tinnitus. Antidepressants such as escitalopram, sertraline, venlafaxine, mirtazapine, paroxetine, etc can cause tinnitus. (3,4)

Desvenlafaxine is an active metabolite of venlafaxine, and they both have similar properties. Few of the case reports have reported tinnitus induced by discontinuation of venlafaxine. (2,4)

A 32-year-old woman experienced tinnitus and other withdrawal symptoms within 36 hours after suddenly discontinuing her medication (venlafaxine). When venlafaxine was administered again, all the withdrawal symptoms, along with tinnitus, were resolved. (5) In another case study, a patient experienced severe tinnitus after starting his therapy with venlafaxine, and when the drug was discontinued, the side effects subsided in 7 days. (6)

What to do if Pristiq causes tinnitus? 

The first priority if you are experiencing tinnitus after taking Pristiq, is to visit your physicain. Avoid abrupt discontinuation of the drug as it may cause withdrawal symptoms and increase the risk of worsening your condition. 

Underlying conditions can also cause tinnitus. Get yourself evaluated for any underlying condition that contributes to tinnitus. You can try sound therapies such as tinnitus retraining therapy and white noise therapy to help you manage tinnitus. Tinnitus retraining therapy trains the brain to habituate to tinnitus. (1)

Listening to pleasant sounds of waves, waterfalls, rain, etc., can help you distract yourself from the sounds of tinnitus and help you sleep better. Behavioural therapy, such as cognitive behavioural therapy, will help you manage your negative thoughts and help you focus on the positive ones, making it easier to deal with your condition. (1)

If you are taking any other medications, make sure to check for side effects and interactions between the drugs, which may cause tinnitus. Clean your ears once a week to avoid wax buildup in the ears.

Avoid swabs, ear candles and other things to remove ear wax, as they can push the wax deeper into the ear canal. Avoid inserting any object in your ear. Use OTC ear drops to soften the wax and a bulb syringe filled with warm water to rinse the ear. Remember, while doing this process, you may feel a little dizzy, which is normal.

You can also use a warm cloth against the outer ear, which will help soften the earwax, or you can visit a healthcare professional to help clean your ear.  

What are the alternatives to Pristiq-induced tinnitus?

If Pristiq is causing tinnitus, you can switch to other antidepressants, such as

• Selective serotonin reuptake inhibitors (SSRI): citalopram, fluoxetine, and fluvoxamine.
• Serotonin-norepinephrine reuptake inhibitors (SNRI): duloxetine and milnacipran.
• Tricyclic antidepressants: imipramine, amitriptyline, nortriptyline.
• Atypical antidepressants: bupropion, trazodone.

Selecting a suitable antidepressant depends upon your condition and should be decided by a qualified physician.

When switching antidepressants, it is important to gradually decrease the dosage of the current drug before discontinuing and then introducing the new drug. Which should be done under the guidance of a physician to avoid withdrawal symptoms. 

What are the factors that contribute to Pristiq-induced tinnitus? 

Tinnitus caused by drug use is rare. However, other factors can contribute to tinnitus, such as (7)

• Age: The older population are more susceptible to tinnitus due to ageing. Damage to the cochlea can cause tinnitus and hearing loss.
• Inner ear damage: Damage to the inner ear by head trauma or other means can cause tinnitus. 
• Buildup of ear wax: An increased amount of wax deposition in your ear can block your ears and contribute to a tinnitus-like condition. 
• Fluid buildup: Excess fluid buildup in the middle ear can cause tinnitus. 
• Diseases: Meniere’s disease, which affects the inner ear, is accompanied by symptoms such as vertigo, tinnitus, and sometimes hearing loss. Otosclerosis, a condition of abnormal bone growth in the middle ear, can cause tinnitus.
• Other conditions: Other conditions such as anemia, high blood pressure, thyroid-related disease, diabetes, and acoustic neuroma rarely cause tinnitus. 
• Medications: Drugs such as NSAIDs, anti-cancer drugs, antibiotics, etc., can cause tinnitus. 
• Infection: A fungal or bacterial infection in an ear can contribute to tinnitus. 

In my experience, antidepressant-induced tinnitus is rare, and not all individuals can get it. If you are experiencing tinnitus, make sure you consult your physician and get evaluated for its cause. Do not stop taking Pristiq because you are experiencing tinnitus. Abruptly stopping your medication will cause withdrawal symptoms and worsen your symptoms. 

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