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Can pharmacologically-induced tinnitus actually damage your hearing?

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n3ophy7e

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This may seem like a really basic query but I cannot find any conclusive literature to answer my question. I have been on Cymbalta for 4 months now, currently at 90mg sid. Tinnitus is listed as a rare side effect and sure enough, I've got it. I've had tinnitus several times before so it's nothing totally out of the ordinary. But this current bout of medication-induced tinnitus is really high-pitched and can be quite deafening, especially when I'm trying to sleep. Sometimes I actually need to listen to music in order to fall asleep. But mostly it's just annoying, not so much invasive.

Anyway I am really curious to know if this could possibly cause any damage to my acoustic nerves long-term. Does anyone have any idea about this?
 
n3ophy7e said:
This may seem like a really basic query but I cannot find any conclusive literature to answer my question. I have been on Cymbalta for 4 months now, currently at 90mg sid. Tinnitus is listed as a rare side effect and sure enough, I've got it. I've had tinnitus several times before so it's nothing totally out of the ordinary. But this current bout of medication-induced tinnitus is really high-pitched and can be quite deafening, especially when I'm trying to sleep. Sometimes I actually need to listen to music in order to fall asleep. But mostly it's just annoying, not so much invasive.

Anyway I am really curious to know if this could possibly cause any damage to my acoustic nerves long-term. Does anyone have any idea about this?
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That's a good question, and if I had to guess I would say that any SNRI induced hearing changes should be reversible when you discontinue the drug. But that's all it is, a guess.

There's a lot more research on using SSRI/SNRI's to TREAT tinnitus, than on tinnitus caused by those drugs. "SNRI tinnitus" "Cymbalta tinnitus" "Duloxetine tinnitus" turn up goose eggs on pubmed.

This paper though, mentions two cases of Venlafaxine (another SNRI) induced tinnitus, and in both cases all hearing changes reversed with cessation of the drug.
 
I would suspect that it would be dependent upon how long you lived with the condition, and the mechanism by which it arises. If it's caused by something your body can adapt to, if you stay on it long enough, you may develop some permanent hearing changes.
 
I have had terrible hearing loss the first time I took adderall or concerta I forget, but it was profound and long lasting. Never happened again, fortunately
 
Thanks so much for your input guys. Hammilton, interesting to hear about your stim-induced hearing loss. How long did it take to subside?

I also asked my brother who is studying medicine about my tinnitus and he said some drugs can certainly cause permanent tinnitus and/or hearing loss. He recommended I go off this current med and try something else for my depression/anxiety. I appreciate his advice however I really cannot afford to try anything else. I've tried SO many other anti-depressants (SSRIs, SNRIs, NRIs, DRIs, MAOIs, tricyclics, I've tried them all) that either had no effect or gave me intolerable side effects. Cymbalta (an SSNRI) is the only one that I've tolerated well that has also given me adequate relief. So I guess I just have to put up with the tinnitus and deal with any potential hearing loss...
 
It was a sustained release drug (I'm pretty sure it was Adderall XR, but it may have been concerta. I actually had one previous amphetamine exposure, but I don't remember whether I had the temporary deafness that time), so it probably impacted it, but it probably lasted 6-10 hours.
 
Oh okay, so it wasn't days or weeks? That's good :) Must've been scary though :\
 
There are some drugs that can do damage to your hearing, but I don't think there's any evidence that Cymbalta causes damage. Not that it necessarily matters -- tinnitus can be a serious quality-of-life problem. Unfortunately, there's no way to really predict how this will play out for you. I was recently looking up anecdotes of drug-induced tinnitus with Wellbutrin, although I ran into a few from other antidepressants (including Cymbalta). I'll share what I could find, FWIW.

People who had this problem usually got it either when they started the drug or increased the dose. There appears to be a dose-dependent effect. In many cases, it went away within a few days of stopping the drug. But usually the people who were posting were the ones that had longer-term problems. Most people who stopped the drug said that the tinnitus lessened or went away with time (ranging from weeks to months -- there was one report of someone who got better after 2 years). Most of these people had discontinued the drug shortly after they developed tinnitus.

Other people found it to be manageable, or manageable at a lower dose, and continued their medication. Some of them had less tinnitus after taking the drug for a long time, and others had no change.

Out of the 35 reports I documented in my spreadsheet, four people had said they'd had their hearing tested. One said their hearing had been affected, and the other three said hearing was normal (but the tinnitus itself was agonizing). There was another person who said their hearing was worse but had not been tested.

The practical thing I was able to find, though, was that there are things that aggravate it -- particularly anxiety, alcohol, and caffeine/stimulants. (Other things reported to make it worse were NSAIDs, Ambien, loud music/noise, raised blood pressure, headache, lack of sleep, and lying down.) People found that avoiding those things when possible was helpful.

Again, I wasn't actively searching for anything other than Wellbutrin, but perhaps something here helps in some way.
 
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