Posted by Lupercal on July 5, 2001, at 10:25:50
In reply to Re: Remeron - less sedation at higher dose? » Lupercal, posted by Elizabeth on July 4, 2001, at 21:45:06
> > I should stress that I had _great_ success with the AD qualities of SSRI's - just that the screaming tinnitus was unbearable.
>
> Hmm. What about Effexor?Haven't tried it, but too similar to SSRI's for me to be willing to risk it. I know at least one person who developed permanent tinnitus while taking it.
Clomipramine?
Not familiar with that one. Brand name (probably be different here anyway)
> Any idea what the tinnitus is related to?In theory, noise-induced hearing loss, however it was most certainly triggered by Prozac. Prior to that it had only ever been a slight nuisance. A couple of days after taking prozac it went ballistic and stayed there.
>Did you talk to a GP about it?
It seems like I do little else sometimes.
> > Luvox in particular had a magic bullet effect, improving my mood substantially within 8 hours!
>
> When I hear stories like this, I am always weirded out. That's not *supposed* to happen!When you think about, it's really more weird that it _doesn't always_ happen like that. SSRI's dp start increasing the levels of serotonin straight away, and that is the action which is supposed to relieve the depression. In my case, Prozac _always_ had a very noticeable mood elevating effect within 18 hours. The first time I took Luvox it hit me the same night (the second time I took Luvox I got serotonin syndrome, so that wasn't exactly a fair trial). Cipramil (Celexa) took a bit longer - about 5 days. But by then the tinnitus was driving me so nuts I had to stop. That's the story with all SSRI's. The very first time I ever took prozac was also the very first time I ever noticed my tinnitus other than when I was trying to sleep at night. On that occaision I stuck it out, and discovered that it's initial mood-boost was precarious. A week later a great deal of stress between two people I was staying with (8,000 miles from home) preciptated a dramatic relapse of the severe depression, which I then gradually recovered from over the next 3 or 4 weeks (more standard AD pattern). I think in my case the SSRI's have an initial effect, but it's shakey. It's definately not placebo, because I never got it with pamelor, serzone, mianserin or aurorix (I never got _anything_ with Aurorix))
> Remeron isn't an SSRI, and it has antagonist effects at some types of serotonin receptors -- in some cases, it reverses side effects of the SSRIs, such as sexual dysfunction and nausea. Tinnitus is not so common, but it might be that even if Remeron didn't work by itself, you could add an SSRI and the Remeron would prevent the tinnitus.
You might think I'm being over-cautious or even paranoid, but despite the fact they are the most salubrious AD's for my depression, the tinnitus toll is so severe with SSRI's, I'm not willing to risk them again, alone or in combination. The only thing which _might_ persuade me otherwise is if I can be onvinced that one oif the upcoming new breed of SSRI's (ones which target specific serotonin receptors) might be free of that side effect. However since no-one knows which receptor (if any) is responsible for the tinnitus effect, it would be rather hard to convince me.
NB ST John's Wort has the same effect on my tinnitus as SSRI's, and the same next-day mood improvement (though I would say with St John's Wort it was more of a calmative than an anti-depressant effect)
Tim
poster:Lupercal
thread:68802
URL: http://www.dr-bob.org/babble/20010701/msgs/69038.html