Citalopram Tinittus

[StressedEric]

Has anyone experienced tinittus when starting Citalopram. I am on my 3rd time on it. I am on day 5 on 10mg and experiencing loud white noise in both ears. I do suffer from lifetime tinittus and I think the drug has made it lot worse. Difficult to function. Thinking of stopping the cit as it is unbearable.

[nomorepanic]

I don't think it is related to be honest

[panic_down_under]

Has anyone experienced tinittus when starting Citalopram. I am on my 3rd time on it. I am on day 5 on 10mg and experiencing loud white noise in both ears. I do suffer from lifetime tinittus and I think the drug has made it lot worse. Difficult to function.

Tinnitus is a strange condition in that many things can set it off including many medications, anything from aspirin to zit meds, probably compounded in your case by an existing susceptibility. Discontinuing medications may also trigger it.


Thinking of stopping the cit as it is unbearable.

I suggest you get advice from your GP before doing so. There may be a remedy and if there isn't switching straight to another antidepressant would be better than quitting and restarting. Anecdotally, a few people have reported success taking a benzodiazepine for a few days.

One additional note of caution given this is your third time on citalopram. There is growing evidence antidepressants, especially the SSRIs, may become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control, or not working at all. They may also produce progressively more severe, and/or different, initial side-effects each time too. Two studies, Amsterdam JD (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123793/), 2016 and Amsterdam JD (http://www.karger.com/Article/FullText/226611), 2009, found the likelihood of antidepressants working after each restart drops by 19-25% (see also: Bosman RC (https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30041180/), 2018; Amsterdam JD (http://www.ncbi.nlm.nih.gov/pubmed/18694599), 2009; Leykin Y (http://www.ncbi.nlm.nih.gov/pubmed/17469884), 2007; Paholpak S (https://www.ncbi.nlm.nih.gov/pubmed/12501907), 2002). In light of this there is a strong argument for staying on whatever AD you settle on, imho.

[nomorepanic]

Hi

This is just a courtesy reply to let you know that your post was moved from its original place to a sub-forum that is more relevant to your issue.

This is nothing personal - it just enables us to keep posts about the same problems in the relevant forums so other members with any experience with the issues can find them more easily.

Please also read this post:

http://www.nomorepanic.co.uk/showthread.php?t=213239

[Scissel]

I hear ya (no pun intended) I also have it and it can be annoying when its too quiet.

[StressedEric]

I seriously wish I never went back on it now. The tinittus is horrendous now. My normal tinittus was never this bad. I just want to get off it and never go on it again.
If I def go ahead would you suggest a taper off or just stop. 6 days in now.

[stars1976]

I get bad tinittus when starting meds. will settle mate. just takes up 8 weeks

[panic_down_under]

If I def go ahead would you suggest a taper off or just stop. 6 days in now.

No, you don't need to taper if you've only been on citalopram for 6 days. However, I still think you should talk to your GP first.

[Scissel]

Perhaps, is it possible you have high blood pressure that isn't controlled? When my bp goes up it does get worse.

[StressedEric]

I have had a terrible night the tinittus has been awful loud and it has continued into this morning. I have got in contact with GP and awaiting a phone call this afternoon about safety stopping the citalopram. I haven't taken it at the usual time I do this morning. If I knew that Citalopram caused this I would have never gone back on it. I dont think I can cope with having this level of tinittus if permanent.

[Scissel]

I'm sorry you're having such a rough time, I hope it will subside and perhaps your doctor will be able to help you.

[StressedEric]

Have spoken to Dr. As the tinittus has become worse as a result of citalopram and I understand that this may not improve when on it then the best course of action would be to stop the citalopram and see if things improve.

I would also be interested in anybody else's experiences with tinittus while being on Citalopram and if this side effect diminishes over time or permanent when still on it.

[StressedEric]

The tinnitus did not subside in fact it went louder. After talking to doc decided to wean off the citalooram by taking it every other day. I have started this 4 days ago. Today is one day without it and the anxiety has been increasing throughout the day and now it is unbearable. I feel very dizzy, very tired fatigued as well. My head is spinning and terrified I losing my mind.I just feel like just going to bed. Surely this is unusual for withdrawal on such a low dose and I haven't completely stopped it yet. I only on 10mg!

[Scissel]

Hang in there, it will pass - you're not losing your mind even though it feels like it. You'll make it through this and I hope both you and your med provider will come up with a solution. Hate to say this (we'll pretend I didn't) sometimes sleep is the best medicine.

[panic_down_under]

After talking to doc decided to wean off the citalooram by taking it every other day.

Not the best way of doing it, imo. Tapering by missed dosing is an idea that seems to have started in response to some short half-life ADs in extended-release formulations which can't be cut, particularly duloxetine, but this doesn't apply to citalopram and the yo-yo effect this may produce can be very disturbing.


I have started this 4 days ago. Today is one day without it...

So you missed a dose 4 days ago, took 10mg 3 days ago, missed yesterday and again today? I would have advised halving the 10mg tablets and taking 5mg for 7-10 days and then stopping. It takes about 7-8 days for citalopram plasma levels to stabilize after a dose decrease (or increase).


and the anxiety has been increasing throughout the day and now it is unbearable. I feel very dizzy, very tired fatigued as well. My head is spinning and terrified I losing my mind.

...Surely this is unusual for withdrawal on such a low dose and I haven't completely stopped it yet. I only on 10mg!

Because of that longish citalopram half-life - around 36 hours - and the short time you've been on it at only a low dose I suspect this has more to do with anxiety than withdrawal, probably exacerbated by the stress of the tinnitus flaring. Withdrawal isn't only a matter of chemistry. Psychology is at least as important and may often be the main driver. An anxious mind is very capable of delivering the worst 'withdrawal symptoms' imaginable if given free reign. :sad:


I just feel like just going to bed.

Probably not a bad idea.

[StressedEric]

Many thanks for your advice-much appreciated. Yeah maybe there is a bit of a yo-yo effect with me doing the tapering every other day. The anxiety been very bad again today.
The 10mg tabs are very small so cutting them in half will be difficult but I have a pill cutter so it may work ill have to give it a go.
I think you may be right about the symptoms are more anxiety than withdrawal. I have been concentrating on the side effects and that never going to get better. It very difficult to distract from it. The tinittus is still bad and also one if my ears has now blocked up completely due to wax. Not a good day by any means.

The only reason I made the decision coming off the cit is the tinittus. I did have high anxiety before starting it that was the whole reason why I made a decision to go on it again.

[StressedEric]

Just tried cutting down a 10mg tab in pill cutter. Got a clean cut and two good complete halves so going to taper off this way now for a couple of weeks max and see how I am.

[panic_down_under]

Cool. So have you discussed what comes after you're off citalopram?

[StressedEric]

All the doc said is could try something else. I have taken half tab today (5mg). The half tab was tiny hardly noticed swallowing it! My anxiety very high again and feel dizzy. Gone to visit bro to try and calm me down. Could this be the yo yo effect you mention I.e. 10mg one day then nothing for a day and repeat.

In all of this the only reason I coming off cit was the tinittus. I did feel less anxious on it but the tinittus was a big concern for me. Worrying now I made the wrong decision coming off so soon without giving it more time. I feel stupid and panicking that the doc has already stopped my citalopram prescription and I only have one month supply. I feel I been messing her around saying coming off then changing my mind then deciding to come off again but the way I was feeling with the anxiety and the tinittus I was making rash decisions without really giving time for things to settle. I am afraid to call doc again now. I will try and continue on 5mg half tabs for a week or two and see if it levels out and feel any better. God I am a mess.

What made it harder is that I live alone so got noone at home for support.
.

[panic_down_under]

All the doc said is could try something else. I have taken half tab today (5mg). The half tab was tiny hardly noticed swallowing it! My anxiety very high again and feel dizzy. Gone to visit bro to try and calm me down. Could this be the yo yo effect you mention I.e. 10mg one day then nothing for a day and repeat.

Maybe. The anxiety is probably just anxiety, but the dizziness could either be the yo-yo effect, or anxiety.


I feel I been messing her around saying coming off then changing my mind

...I am afraid to call doc again now.

I wouldn't lose any sleep over it. In the end it is your call. She's just the hired help. Don't go putting doctors on pedestals. They don't need any help in that regard, ime. Despite what some of them believe their degree doesn't elevate them into the pantheon of the gods.


I will try and continue on 5mg half tabs for a week or two and see if it levels out and feel any better.

A week, or two would be okay, but it would be unwise to remain on such a low dose any longer as prolonged sub therapeutic dosing can increase the risk of the med pooping-out and not working at any dose. Either start ramping up the dose over a few weeks to at least 20mg, or pull the plug and try something else.

[StressedEric]

Thank you panic_down_under for all the advice. Ok, I'll stick to the half tab every day just for just another week. My head is scrambled I need to get back into control as jumping from one solution to another.
I dont have a psychiatrist or counsellor for support as getting access to those services is very difficult so essentially all I got is GP who has limited mental health experience, my bro who understands as he going thru similar situation and advice on here and what I can piece together from Internet.

[panic_down_under]

Cool. I forgot to add that if the tinnitus persists while taking citalopram then you could try a switch to escitalopram. Citalopram contains two isomers of citalopram, the bioactive 'S' isomer, aka escitalopram, and the 'R' mirror image (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314378/) form which is a poorer fit biologically and so is mostly inactive. While the difference is small it can create a difference in the side-effects each produces. I can't guarantee switching would help, but doing so shouldn't cause any issues so is worth a shot if needed.

[StressedEric]

Thanks for that. Really appreciate your help.

[StressedEric]

It has been nearly two weeks since stopped Citalopram. Since stopping my anxiety has been high and it has been a daily struggle but I am putting steps in place to try and manage it. I get daily very foggy head almost constant and head pressure and negative thoughts but I have gathered support from various sources like forums like here, WhatsApp groups and even twitch streams. All these things help. I starred taking magnesium supplements and this has helped with my sleep and takes a slice off the anxiety in evenings.
Yes it going to be a very bumpy road and got a long way to go to managing the anxiety but I gotta start somewhere.
I can't do to much mentally as it overwhelms my head quickly but I gotta just work within my limits. Even after writing this I will have to take a break and relax before doing anything else as the brain fog is intense but I will learn to manage it. Just take it one day at a time.

[panic_down_under]

It has been nearly two weeks since stopped Citalopram.

Has the tinnitus stopped, Eric?

[StressedEric]

It def not as bad as when I was on it.

[Scissel]

That's good to know.