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Starting 60Mg Duloxetine Taper

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#1 Wantoffthisstuff



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Posted 30 May 2017 - 07:34 AM

Hello All,


I'm very happy this site exists. I've been on 60mgs of Duloxetine for about six years and I'm ready to get off of it. The only reason I've avoided tapering is because of the withdrawal syndrome. So, I have the capsule with the 12 pellets. I took one pellet out yesterday to make it 55mgs. I made myself a weeks worth and imagine that I'll need to stick with 55mgs/11 pellets for at least two weeks total. I'll see how I feel then and if I feel okay then I'll for 50mgs/10 pellets and so on. How does this all sound to people? I know my insurance will not cover brand name-- so I can't do it with the the beads unfortunately. I see some people split the pellets with a pill cutter, which I might try as I get to a lower dose. I really look forward to being SSRI and SSNRI free. I've been taking one for or another for the past ten years.





p.s. already feel mild withdrawal symptoms --spacey, a bit dizzy, and almost like I feel the zaps coming on but they aren't there yet.  

#2 fishinghat



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Posted 30 May 2017 - 08:38 AM

Hello wots. Welcome

That is 5 mg a bead. Too fast a drop for most (over 8% drop per bead). That is a good approach to begin with but I would warn of one thing, once the symptoms set in it may take more than 2 weeks for them to settle down. You may not have an issue until you drop below 30 mg before it gets too rough. Just listen to your body and take it easy on yourself when things start getting bad. Be patient.


Keep us posted.

#3 Wantoffthisstuff



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Posted 30 May 2017 - 09:28 AM

Thank you fishinghat,


I am already feeling slight discomfort. Would you recommend that I split the 5mg into 2.5mgs? 

#4 fishinghat



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Posted 30 May 2017 - 12:51 PM

Good idea. I would do that. You are better off getting ahead of the game. The slower the better. Hang in there.

#5 Wantoffthisstuff



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Posted 03 June 2017 - 07:02 PM

Update: Doing well on 11.5 beads / 57.5mgs of Duoloxetine. It's been six days and I am eager to go down another 1/2 bead BUT I'm going to hold out because I know the long game is better to play in the end. I was thinking I'd go another week and see how I feel. Primary symptoms right now are muscle spasms in my lip area and shoulders. I'm also noticing agitation and irritability, though that could also be PMS. I'm trying to engage in a lot self-care activities like extra yoga, hydrating, journaling, etc. Thanks again.

#6 fishinghat



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Posted 04 June 2017 - 07:57 AM

Doing well WOTS.


Use that extra anxiety/irritability as a guide for when to drop again. You don't want it to get out of hand as it take a long time to fade.


Hang in there.

#7 Wantoffthisstuff



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Posted 08 June 2017 - 05:39 PM

Hello there,

Checking in after 11 days of my first decrease down to 57.5mgs from 60mgs. I continue to do pretty well. Here are some of the symptoms I am experiencing that I don't know whether to attribute to the withdrawal or not:

Muscle and joint pain -- I have Sacroilitis and it feels exacerbated.
Cold Sore
Moderate derealization--feeling like things aren't real though this isn't as bad as I thought it would be as I struggle with this anyway from PTSD.
Manic feeling.
Thank goodness, I haven't had any brain zaps since going back up to 55.7 after dropping to 55 too soon.

I also have a question about tinnitus, that scares me. I'm curious if that is a possible side effect of long-term cymbalta use, or a side effect Cymbalta withdrawal only. And if I develop this side effect and resume cymbalta, would it go away?

For now, I'm going to hang out at 55.7mgs even though I really want to decrease again.

#8 fishinghat



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Posted 08 June 2017 - 06:11 PM

Partial list of entries on this site referring to tinnitus.
You will see a pattern, the faster the withdrawal the worse the tinnitus and the longer lasting the occurrence. It also seems to be more common in those on the generic form.
My website search showed 4 more pages of entries but my patience and time gave out on me. LOL

Bee 11/29/11
I have been on Cymbalta for 6+ years, also taking 60mg 2x day. I have constant tinnitus.

Marcia 1/24/12
On my journey I am a few days off cymbalta and have the brain zaps, inc tinnitus, aches and pains, chills.

Marcia 1/26/12
Not 10 minutes go by without brain zaps of varying degrees as well as severe tinnitus. At times its just the usual ocean sound, but at times it is a whooshing, pulsating pressure feeling/sound that is very disconcerting.

Jenni 1/26/12 (during withdrawal)
My osteopath found that my neck was very seized up which doesn't help with neck/head/sinus/ear pain and tinnitus. All my symptoms felt better after my appt including the whooshing noise. Maybe a back massage or even just lying in a hot, shallow bath.

BuzzBuzz 3/23/13 (during withdrawal)
The brain zaps and tinnitus are pretty bad,...

SusanMoore 3/28/13 (during withdrawal)
I have also developed what I now know as Tinnitus and this I am told, does not go away.

Answer from lady Nancy
Don't worry Susan the Tinnitus does go away, it takes awhile but it will go away

THP 3/30/13 (during withdrawal)
I started at 60 mg per day and tried to go to every other day which was a nightmare. Severe tinnitus, nausea, emotions, etc.

Lady Nancy 4/16/13 and many many other times. An excert from section 5.7 of the drug insert for Cymbalta.
"During marketing of other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been
spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including
the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric
shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.
Although these events are generally self-limiting, some have been reported to be severe."

Fishinghat 4/17/13 Posted full excert.
5.7 Discontinuation of Treatment with Cymbalta
Discontinuation symptoms have been systematically evaluated in patients taking duloxetine. Following abrupt or tapered discontinuation in placebo-controlled clinical trials, the following symptoms occurred at 1% or greater and at a significantly higher rate in duloxetine-treated patients compared to those discontinuing from placebo: dizziness, headache, nausea, diarrhea, paresthesia, irritability, vomiting, insomnia, anxiety, hyperhidrosis, and fatigue. During marketing of other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.
Although these events are generally self-limiting, some have been reported to be severe.
Patients should be monitored for these symptoms when discontinuing treatment with Cymbalta. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose maybe considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate [see Dosage and Administration (2.4)].

Zappinist 5/19/13 during withdrawal
No tinnitus right now, which has been bad recently, but zaps are still there.

Tomitsu 6/11/13 dw
I do have tinnitus and I get the odd brain zap here and there.

Dogs Rule 7/2/13 7 weeks off
This withdrawal will not stop. The really hideous days of zaps and sweating and nausea are over, but lingering symptoms remain: dizziness, tinnitus, and milder zaps.

Irish Eyes 3/21/13
I quit taking Cymbalta in June 2012. I had brain zaps, impaired mental processing, the swishing sound when you move your eyes side to side and tinnitus.
By the end of August I felt almost normal. Then my left foot started tingling. Then in October I got tinnitus.
Last week I start having the swishing sound when I move my eyes back and forth but just when I first wake up.
It's been 9 months and I'm having some of the same symptoms I had in July. Anybody else out there experiencing this?

Afg1202 10/4/13
And this tuning-fork-in-my-head feeling is horrible. And there is so little literature on what helps tinnitus

Thismoment 1/5/14
I might describe my own withdrawal experience like this- bead counting from 30 mg over 6 weeks @ 2.3%.
Difficult// weeks 1-2 smooth/ weeks 3-6 coarse/ weeks 7-12 medium/ weeks 13-24 fine + some medium/ weeks 25-48 fine/ weeks 49-52 smooth/ weeks 53-68 smooth and still improving subtly. I still have two symptoms that are probably permanent- a continuous tension-type headache and tinnitus in my right ear.

Thismoment 1/7/14
My last Cymbalta bead was the end of July 2012, which is getting close to a year and a half now. I still have two symptoms I didn't have before I started the drug. I have a constant headache, and tinnitus in my right ear. Both are tolerable, and I consider myself lucky because after 2 years on the drug I was fried...

FiveNotions 2/18/14
I've had severe tinnitus thanks to cymbalta....it had been so bad that I cldnt hear people talking directly to me...now it's faded a bit, and I have periods of time where it's almost gone...last week I was able to hear my kitchen clock tick! Today, it's bad, like a jet engine in my head...I've had it so long, years, that I've trained myself not to notice it....

Clara 2/26/14
I wish I had a cure for this constant tinnitus. It drives me nuts at times. Just another Cymbalta gift that refuses to go away!

BelaLugosisDad 3/5/14
Tinnitus. - non stop in both ears.

ThisMoment 3/14/14

I've been off Cymbalta for nearly 20 months, and I think I'm probably 95% back; I'm still a little achy in my muscles, I have tinnitus in my right ear, and I have a constant (24/7) tension-type headache that no NSAID will touch. These items are probably chronic, but I'll report back when I hit the 2 year mark this summer.

ThisMoment 3/23/14

Currently at 95%+ function with a few residual withdrawal artifacts: tinnitus, chronic headache, low dopamine. I am back to "normal", but I have a palpable 'different' feeling of myself compared to before I started this adventure, but that was 4 years ago and certainly the passage of time alone has an effect

ThisMoment 4/3/14

I have a constant headache, tinnitus, and fatigue. My level of depression is about the same as when I started Cymbalta.

Phillyguy1 4/24/14
....being off in that 8-10 week window. I pretty much went off cold turkey. I've experienced similar with good and bad days. My biggest issue has been acute vertigo and tinnitus in my right ear. Some days it's been better than others for sure.

Sodone61 4/24/14 Off 5 weeks
No more paresthesia and headaches and the tinnitus (both ears, bad) is gone.

FiveNotions 4/24/14
Tinnitus...I hadn't thought about it in weeks....which meant I haven't had much of it (cymbalta gave it to me big time)....then, just this afternoon, kaboom....it's back, and with a vengeance....sounds like I've got a toilet flushing, sink running, and crickets chirping simultaneously inside my head....when I had it all the time I learned to ignore it....then, when it went away, I was astonished at being able to hear clocks tick and birds sing....now it's driving me nuts because Ive forgotten how to ignore it....it's gonna keep me awake tonight for sure....

Xman 4/25/14
Mine is much better, although I still have it in my right ear intermittently. I am intrigued that there is a pattern forming regarding the right ear tinnitus...
My tinnitus started during crapalta. Never had it before and have no inner ear problems whatsoever. My right ears--
Hickupp 5/8/14
Sorry Clara but at least for me it has never gone away and I've been off for several years. It doesn't happen every day but it still happens.
Clara 6/18/14 6 to 8 months off.
FINALLY coming alive again! And the tinnitus seems to have mostly GONE AWAY!!!!! So grateful about that!!!!
Xman 5/25/14
Thankfully. Also the buzzing in my ears and tinnitus like noise is less in severity. I am a little over 3 months post crapalta.

ThisMoment 5/5/14
After 42 days of tapering off by bead-counting, I swallowed my last bead on July 31, 2012. That was 22 months ago (approximately 660 days)!
I have two lingering side-effects that are probably permanent-- tinnitus in my right ear, and a constant (24/7) tension-type headache that I've had since i began the withdrawal more than two years ago

Must read...

Downtongirl 6/29/14 dw
Lots of ear pressure, pain, and the already existing tinnitus that I have developed from benzo tolerance/withdrawal was worse.
Downtongirl 7/3/14 dw
I developed tinnitus/hyperacusis last summer from what I believe to be tolerance withdrawals from klonopin but this Cymbalta makes it much worse. Anyone else experience this?
Answer by FiveNotions
As for the tinnitus, oh yeah, that was one of my long lasting effects....it got much much worse during the first weeks of withdrawal...then it almost disappeared, and I got all excited because I could hear my kitchen clock ticking....never knew it did that!....but then it came back.....it's faded a bit, and comes and goes....
MichB 7/7/14 dw
Oh yes! I have tinnitus too. If there is other noise around me it's not so bad but I can still hear it. Anytime it's quiet it sounds like an attack of locusts!! It's irritating but sadly I'm used to it. If its one of the few lasting permanent effects from getting off this poison I'll be fine.
Gail 7/21/14 5 months off
Tinnitus, which I can tolerate and on and off headaches that I can handle.

brzghoff 7/30/14 11 weeks off
For me getting off C has been rough, for the first month and a half or so it was a lot of physical stuff, joint and muscle pain - lots - serious gastro issues, nausea, the runs, etc, confusion, tinnitus.

Guest_Notsureaboutit_* 8/2/14 1 week off
Ears Whirring, Like A I Have A Helicopter In Them.

Response by Donewithcrap 8/2/14 Off
I have ringing in both ears and have had this for years now. I gets worse at tines but never goes away. I have tried "Ring Stop" but it didn't help me.

Response by ShadyLady 8/3/14 Off
I had the 'whirring swooshies' (great description!) for about 3 weeks after stopping the C-dope!

Pheobster 8/3/14 dw
Tinnitus has set in. Not super loud but enough to be another irritant.

tomitsu 9/2/14 off
I have anxiety and depression I didn't have before taking cymbalta. I have tinnitus and suicidal ideation is a reality. I have memory loss. I believe my symptoms are permanent as they have not gone away. I'm deeply disturbed by the symptoms.

Gail 10/7/14 off
tinnitus here also

nerdluvin 10/13/14 3 days off
For the past couple of weeks, I get intense migraine-level headaches (no brain zaps) and tinnitus in my ears.

FiveNotions 10/13/14 Off 10 months
I had tinnitus ... actually, after 10 months off, I still have it ... think it's permanent, due to the cold turkey

Thread Titile - Off Crapalta 6 Mos. Or More - What Symptoms Do You Still Have? 10/15/14
FiveNotions - 8 months off - The tinnitus returned several months ago, and is even louder and more constant than ever.
Clara - Tinnitus comes and goes, much less intense.
Gail - 8 mths - Tinnitus

ThisBetterPass 10/17/14
Looking back, I did start having problems with tinnitus when they switched me over to generic probably about two years ago.

Downtongirl 11/20/14 Off
I have developed tinnitus about 1 1/2 years ago and don't want to take anything to make that worse and nsaids are listing as being ototoxic...

FiveNotions 12/6/14 1 yr off
I am (so far) left with some apparently long-lasting after effects ... severe tinnitus,....

Shouldclean 3/31/15 3 mths off
Over a years time I weaned from 60 mg to 0. I was due to finish the end of January and was weighing the microscopic beads of 20 mg pills. I was in so much muscle pain that my husband suggested I go cold turkey, which I did on Christmas Day. My pain almost immediately was cut by 75%. I also had dizziness and tinnitus.

Sfava987 6/18/15
But after stopping the 20mg, I had the full blown discontinuation syndrome and could not drive or function. So, I went back on the 20mg and stayed there for a couple months, but the Tinnitus and some brain fog remained along with burning pain in my heels and the bottom of my feet.

ThisMoment 8/1/15 3 years off
I still have short-lived events that feel like ripples of withdrawal, and I still have a few symptoms that continue to fade: tinnitus, headache, unsteady balance, and GI instability

Things that list tinitus as a common symptom during dicontinuation;
Bath Salts
Dilantin and more...

Seven complete articles on treating tinitus.
Each link is followed by the title of the article in bold.
Articles concerning rTMS have the word "note" in front of the title.

Note - Efficacy and Safety of Repeated Courses of rTMS Treatment in Patients with Chronic Subjective Tinnitus.
"Repeated application of rTMS seems to be useful in tinnitus management and should preferentially be offered to patients who experience a worsening of their tinnitus during the intertreatment interval, irrespective of their response to the first treatment course."

Note - Combined rTMS treatment targeting the Anterior Cingulate and the Temporal Cortex for the Treatment of Chronic Tinnitus.
"This pilot study demonstrated the feasibility of combined mediofrontal/temporoparietal-rTMS-stimulation with double cone coil in tinnitus patients but failed to show better outcome compared to an actively rTMS treated control group."

Noten- Triple-site rTMS for the treatment of chronic tinnitus: a randomized controlled trial.
"We report a tendency towards a modest, sustained long-term effect of the triple-site stimulation protocol in comparison to the single-site protocol."
Table 2
Adverse events for both treatment groups.

single-site rTMS
triple-site rTMS
transient adverse events
muscular tension
blurred vision
increase in tinnitus loudness
mood swings
feeling of heaviness in the legs
ongoing adverse events
increase in tinnitus loudness
broadening of the frequency range of the tinnitus
*One of those three patients dropped out after two days of treatment.

Emerging pharmacotherapy of tinnitus
Summary og medicines used for tinitus.

Note - rTMS Induced Tinnitus Relief Is Related to an Increase in Auditory Cortical Alpha Activity
"Several studies indeed show tinnitus relief after rTMS, however effects are moderate and vary strongly across patients."

Treatment options for subjective tinnitus: Self reports from a sample of general practitioners and ENT physicians within Europe and the USA
"A structured online questionnaire was conducted with 712 physicians who reported seeing at least one tinnitus patients in the previous three months. They were 370 general practitioners (GPs) and 365 ear-nose-throat specialists (ENTs) from the US, Germany, UK, France, Italy and Spain."
"Despite a large variety of treatment options, the low success rates of tinnitus therapy lead to frustration of physicians and patients alike. For subjective tinnitus in particular, effective therapeutic options with guidelines about key diagnostic criteria are urgently needed."

Sensorineural Tinnitus: Its Pathology and Probable Therapies
"The most common form of treatment of tinnitus is pharmacological agents and behavioral treatment combined with sound therapy. Less common treatments are hypnosis and acupuncture. Various forms of neuromodulation are becoming in use in an attempt to reverse maladaptive plastic changes in the brain."

Summaries of articles on treating tinitis.

Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study.
"This pilot study highlights the significant prevalence of Vitamin B12 deficiency in North Indian population and improvement in tinnitus severity scores and VAS in cobalamin-deficient patients receiving intramuscular Vitamin B12 weekly for 6 weeks further provides a link between cobalamin deficiency and tinnitus thereby suggestive of a therapeutic role of B12 in cobalamin-deficient patients of tinnitus. "
Vitamin B12 deficiency in patients with chronic-tinnitus and noise-induced hearing loss.
"These observations suggest a relationship between vitamin B12 deficiency and dysfunction of the auditory pathway. Some improvement in tinnitus and associated complaints were observed in 12 patients following vitamin B12 replacement therapy. The authors recommend that routine vitamin B12 serum levels be determined when evaluating patients for chronic tinnitus."
The Role of Plasma Melatonin and Vitamins C and B12 in the Development of Idiopathic Tinnitus in the Elderly
"Comparing the plasma levels of the markers between elderly with and those without tinnitus, the plasma levels of melatonin (p=0.01) and vitamin B12 (p=0.03) were significantly lower among the elderly with tinnitus compared to those without, while the difference in the plasma level of vitamin C (p=0.6) was not.)
Tinnitus: Is there a place for brain stimulation?
Nothing "to support or discourage the application of brain stimulation in tinnitus."

Electroacupuncture for Tinnitus: A Systematic Review.
"Due to the poor methodological quality of the primary studies and the small sample sizes, no convincing evidence that electroacupuncture is beneficial for treating tinnitus could be found. "

Randomized Controlled Trial of a Perceptual Training Game for Tinnitus Therapy
"The results suggest that the attention training game may have reduced focus on the tinnitus, potentially through improved selective attention. "Terrain" was superior to "Tetris" in the population tested and therefore shows promise as a management option for tinnitus. Further testing in a larger, more general, population would be enabled through improving the game's accessibility."

Cortical Reorganisation during a 30-Week Tinnitus Treatment Program.

Neuronavigated left temporal continuous theta burst stimulation in chronic tinnitus.
"In our study, verum cTBS was not superior to sham which highlights the persistent need for improving non-invasive brain stimulation techniques for the treatment of tinnitus."

Maladaptive plasticity in tinnitus - triggers, mechanisms and treatment
"Maladaptive neural plasticity seems to underlie these changes: it results in increased spontaneous firing rates and synchrony among neurons in central auditory structures, possibly generating the phantom percept. This Review highlights the links between animal and human studies, and discusses several therapeutic approaches that have been developed to target the neuroplastic changes underlying tinnitus."

Internet-Delivered Cognitive-Behavior Therapy for Tinnitus: A Randomized Controlled Trial
"Using a randomized controlled trial design, we replicated prior findings regarding positive effects of Internet-delivered CBT on tinnitus-related distress and associated symptoms."

Note -Long-Term Distributed Repetitive Transcranial Magnetic Stimulation for Tinnitus: A Feasibility Study.
"Our study demonstrated that rTMS can be delivered in a distributed schedule that is well-tolerated, feasible and may prove to be clinically beneficial. A long-term distributed rTMS schedule for tinnitus may warrant investigation as an alternative to the short-term aggregated treatment schedules more frequently used previously. For the many varied therapeutic uses of rTMS (established and investigational), treatment schedules are relatively unexplored, and deserve further attention."

[Deep needling and shallow needling at three acupoints around ear for subjective tinnitus: a randomized controlled trial].
"Acupuncture at the three acupoints around ear deeply could apparently improve tinnitus, and reduce tinnitus sound levels for subjective tinnitus. The effect is better than that by shallow needling at the three acupoints."

Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: Results of a randomized controlled trial.
"Virtual Reality appears to be at least as effective as CBT in unilateral subjective tinitus patients."

Feasibility and Safety of Transcutaneous Vagus Nerve Stimulation Paired with Notched Music Therapy for the Treatment of Chronic Tinnitus.
"After 10 treatment sessions, 15/30 patients (50%) reported symptom relief."
"This study has demonstrated the feasibility and safety of tVNS paired with notched music therapy in patients with chronic tinnitus, with the use of a pad-type electrode attached to the auricular concha."

Tinnitus and its current treatment-Still an enigma in medicine.
"As yet, there are no Food and Drug Administration approved drugs available and the quest for a new treatment option for tinnitus focus on important challenges in tinnitus management. A number of options have been used to treat patients with tinnitus, but outcomes have been limited."

Clinician-Supported Internet-Delivered Psychological Treatment of Tinnitus
"For the 6 studies comparing Internet treatment against a no-treatment control condition, a moderate effect size was found (Hedges's g = 0.58). The 3 studies comparing Internet treatment against face-to-face group treatments showed a small difference."

The efficacy of individual treatment of subjective tinnitus with cognitive behavioural therapy.

[Therapeutic perspectives in the treatment of chronic subjective tinnitus].
"There are no effective therapies for the treatment of chronic subjective tinnitus. The present study aims to compare two therapeutic approaches: Tinnitus Retraining Therapy (TRT) and a Biopsychosocial Approach (BPS). Results show no difference in evolution of tinnitus' perception between the beginning of the study and after 12 months of treatment in both treatment groups."
Potassium channels as promising new targets for pharmacologic treatment of tinnitus: Can Internet-based 'crowd sensing' initiated by patients speed up the transition from bench to bedside?

Note - Repetitive transcranial magnetic stimulation induces oscillatory power changes in chronic tinnitus.
"This is the first study to show tinnitus-related alterations of neuroplasticity that were specific to stimulation site and oscillatory frequency."
"Moreover our findings confirm the role of the left temporal and the right frontal areas as relevant hubs in tinnitus related neuronal network. Our results underscore the value of combined TMS-EEG measurements for investigating disease related changes in neuroplasticity."

Antioxidant therapy in the elderly with tinnitus.
Prospective, randomized, double-blinded, placebo-controlled clinical trial. The sample consisted of 58 subjects aged 60 years or older, with a complaint of tinnitus associated with sensorineural hearing loss. The treatment regimens were: Ginkgo biloba dry extract (120mg/day), α-lipoic acid (60mg/day)+vitamin C (600mg/day), papaverine hydrochloride (100mg/day)+vitamin E (400mg/day), and placebo.There was no benefit from the use of antioxidant agents for tinnitus in this sample.
Effectiveness of sound therapy in patients with tinnitus resistant to previous treatments: importance of adjustments.
"There was improvement in quality of life (Tinnitus Handicap Inventory), with good response to sound therapy using customized settings in patients who did not respond to previous treatments for tinnitus."

Repeated sessions of transcranial direct current stimulation for treatment of chronic subjective tinnitus: a pilot randomized controlled trial.
"No statistically significant difference was found between anodal and sham stimulation regarding either immediate or long-lasting effects over the 2 weeks follow-up period. Deterioration of symptoms and alteration in tinnitus characteristics were reported by a few patients. There were no significant long-term beneficial effects following tDCS of the left temporoparietal area. "

The Management and Outcomes of Pharmacological Treatments for Tinnitus.
Table 1.
Pharmaceutical treatment effects on tinnitus.
Placebo Controlled
Side Effects
et al. (1978)
1-2 mg per kg of body weight intravenously for 3-4 minutes
Highly effective in patients with Organ of Corti damage
et al. (1989)
Maximum 50 to 150 mg per day
Tinnitus loudness and severity decreased
Dry mouth, dyspepsia, constipation, orthostatic hypotension

et al. (1993)
Placebo controlled
50 to 150 mg/mL for six weeks
Depression and tinnitus loudness decreased
Anticholinergic side effects, sedation
et al. (1995)
Placebo controlled
10 mg 3x/day for 10 weeks
Improvement in more than 40%

Bayar et al. (2001)
Placebo controlled
50 to 100 mg daily for six weeks
Decreased tinnitusintensity and subjective relief
Sedation, dryness of mouth

et al. (2008)
Case study
10 mg for three days
Neurologic foot pain resolved
et al. (1987)
Chart review
150 to 250 mg per day
Depression improved

Evans et al. (1981)
Case study
15 to 45 mg per day
No improvement in depression
Zoger et al. (2006)
Placebo controlled
25 to 50 mg daily for 16 weeks
Improved loudness, severity
Sexual side effects
et al. (2005)
Placebo controlled
Maximum of 50 mg per day for 100 days
No better than placebo
Sexual dysfunction, drowsiness,
dry mouth, sweating,
insomnia, gastrointestinal distress, tremor, headache
et al. (1993)
Placebo controlled
0.25 or 0.5 mg for one week, increased to maximum of 1.0 mg for some for 56 days
Reduction in loudness
Excessive drowsiness; more dreams

Jalali et al. (2009)
Placebo controlled
0.5 mg 1-3 times per day for 8 weeks
No improvement
Ginkgo biloba
Han et al. 2012)
0.5 mg Clonazepam; 4.0 mg GB increased from 1 to 4 doses per day for 5 weeks
Clonazepam more effective than GB; tinnitus annoyance, duration, and loudness decreased
Bauer et al. (2006)
Placebo controlled
Maximum 2,400 mg for 20 weeks
Decrease in annoyance
Dizziness, fatigue

Witsell et al. (2006)
Placebo controlled
1800 mg daily for five weeks
No significant difference
Mouth sores, decreased libido
Amino-oxyacetic Acid
Reed et al. (1985)
Placebo controlled
50 to 75 mg four times a day for one week
Subjective lessening of tinnitus in 3/10
Worsening of tinnitus upon withdrawal; dizziness, lightheadedness, disequilibrium, nausea, and headache at higher doses (400 mg/day)
et al. (1999)
Placebo controlled
25 to 100 mg daily for 8 weeks
No significant difference
Nausea, vomiting, headache
Donalson I (1981)
Placebo controlled
100 mg
No significant difference
Tinnitus returned rapidly post-injection
et al. (2008)
Placebo controlled
5 to 10 mg 1-2 times per day for 90 days
No significant difference
Dizziness, high blood pressure, insomnia, stomachache
et al. (2006)
100 mg twice a day for three weeks
No significant difference
Amnesia and concentration disorders
Suckfull et al (2011)
Placebo controlled
25 to 75 mg daily for 16 weeks
Decreased annoyance and impact on life at higher dosage
Dizziness, headache, vertigo, fatigue, hypertension
Azevedo et al. (2007)
Sharma et al. (2012)

Placebo controlled
Placebo controlled
333 mg 3x daily for
three months
333 mg TDS 3x daily
for 45 days
over placebo
Significant improvement over placebo
Epigastralgia, choking

Worsening intensity
(2 participants)
Coelho at al. (2011)
max high dose: 30 mg; max low dose: 10 mg
high dosage saw a reduction in THI
dry mouth, sleepiness, constipation

Vanneste et al. (2013)
10 mg 2x/day for 4 weeks
reduction in distress and intensity
worsening intensity
Vanneste et al. (2013)
up to 50 mg for four weeks
tinnitus distress reduced in some
Meeus et al. (2011)
1 mg per day for three weeks
3/28 report tinnitus improvement
Sonmez et al. (2013)
48 mg per day for three months
slight improvement in loudness and on THI
pyrosis, nausea
Sziklai et al. (2011)
maximum dosage: 0.7 mg 3x/day for 4 weeks
35% of pramipexole group improved
dizziness, allergic reactions
De Azevedo
et al. (2009)
50mg daily
No difference from placebo
Nausea, dizziness
Canis et al. (2011)
40 mg/day for 4 months
reported improvement but not significant
worsening tinnitus
Vitamin B12
Berkiten et al. (2013)
1 g/mL injected daily for 5 days, then once a month for 12 months
no significant change
Coelho et al. (2013)
220 mg zinc sulphate daily for 4 months
no significant change

Slow Cortical Potential Neurofeedback in Chronic Tinnitus Therapy: A Case Report.
Cannabinoids, cannabinoid receptors and tinnitus.
Note - A Pilot Study of EEG Source Analysis Based Repetitive Transcranial Magnetic Stimulation for the Treatment of Tinnitus.
"Low-frequency rTMS decreased tinnitus significantly after active, but not sham, treatment. Responders in the EEG source analysis-based rTMS group, 71.4% (5/7) patients, experienced a significant reduction in tinnitus loudness, as evidenced by VAS scores. The target site of neuronal generators most consistently associated with a positive response was the frontal lobe in the right hemisphere, sourced using high-density EEG equipment, in the tinnitus patients. After left temporoparietal rTMS stimulation, 42.8% (3/7) patients experienced a decrease in tinnitus loudness."

The effect of noninvasive brain stimulation on neural connectivity in Tinnitus: A randomized trial.
"Sixteen patients received active rTMS treatment; 14 patients received sham treatment. There were no differences between the active and sham groups in baseline functional connectivity. Neither treatment with rTMS nor sham therapy resulted in statistically significant functional connectivity changes in the examined brain networks."

The Effect of Korean Red Ginseng on Symptoms and Quality of Life in Chronic Tinnitus: A Randomized, Open-Label Pilot Study.
"Fifty-nine patients completed the planned protocol. Significant improvements were observed between initial and post-treatment THI scores in patients receiving 3000 mg/day KRG. Treatment with 3000 mg/day KRG for 4 weeks significantly improved role emotional and mental health scores in the SF-36 survey.These results suggest that KRG may improve tinnitus symptoms and mental wellbeing in chronic tinnitus patients."

An evaluation of the Reltus ear massager for short-term tinnitus relief.
'Supression of tinitus loadmess to auditory stimulation was found in 87% of participants and to tactile stimulation in 83%. No significant differences were found in the effectiveness between the four vibration stimulation points, or between the left and right ear of the participants. The Reltus produced a sound that resulted supression of tinitus.'
"It is the auditory artifact of the Reltus that was responsible for short-term tinnitus suppression."
This device rates a 2.5 out od 5 stars on Amazon.

The Development of Acceptance of Chronic Tinnitus in the Course of a Cognitive-Behavioral Group Therapy.
"CBT is considered an effective treatment for tinnitus distress in patients with chronic tinnitus. Acceptance of chronic tinnitus clearly improved within a CBT group therapy."

Treatment of tinnitus.

The effectiveness of psychological interventions among tinnitus sufferers: A review.
"Psychological interventions were more effective in reducing psychological impacts of tinnitus than non-psychological interventions such as the use of tinnitus maskers. Nevertheless, the combination of the treatments yielded more superior outcomes."


#9 bronxbomber


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Posted 10 June 2017 - 11:28 PM

fishinghat, that is a tremendous amount of research.  Scaringly impressive.  Maybe you should publish all those references in a separate "Tinnitus" reference post, so it can be located more easily by others who have this problem.


wantoff, good luck to you in your ongoing withdrawal.

#10 gail



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Posted 11 June 2017 - 07:30 AM

How right you are about a special post on Tinnitus, easier located.
It's such a commun complaint and fear goes with it.

Fishingbrain, this way, you could take care of all there is to do at your Mansion. Those leopard bikini strings that I made for you, need to be shown off!

BB has a good suggestion, I second that.

About the bikini strings, BB, it can be found in the Word game. Need distraction? Thats the place to go, and participate if you wish!

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Posted 11 June 2017 - 07:55 AM

There is much in my library of research that could be posted on specific subjects in a specific easy to find location but I am not that computer savvy. I am lucky just to be able to post.  lol


It is all saved on my computer so all I have to do is cut and paste. (I can do that, lol).

#12 Wantoffthisstuff



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Posted 11 June 2017 - 06:25 PM

Wow, thanks so much Fishinghat. I definitely affirms the need to taper slowly.

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Posted 12 June 2017 - 11:06 AM

Hello WOTS,


ive just read your post about tinnitus. Ive been weaning down the bead method and am now down from 90mg to 4mg.  I have been suffering from tinnitus for the last 5 weeks. At the beginning it was quite loud and i found it hard to fall asleep. Because i had never experienced it before i was very anxious and fearful , and the worry of it not going away ever.  However, after reading lots of posts on here and the Great Fishinghat posting articles for me to read, five weeks on, i still have it but you kinda get used to it. Its very alarming in the beginning, but i read on one post, rather than keep fearing it, welcome the sound and be curious what sound it is today and how it changes. I know it seems a bit silly, but i have to say by accepting it, it is not bothering me so much.


I have tried to keep my mind occupied on something, ive been doing jigsaws, and with music or TV on in back round i can at times forget about it. At night ive been trying to liken the sound to the ocean and visualize a sea sunset on a memorable holiday. Again may sound silly but anything to stop the panic and fear i had when i first got it. Sorry if its a bit boring but if its of any help then thats good.


Good wishes on your continued journey  :)

#14 gail



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Posted 12 June 2017 - 11:28 AM

Good post NB!

#15 Wantoffthisstuff



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Posted 19 June 2017 - 07:46 PM

NB, thanks so much for your post, great approach.
Just a quick update, I'm a week into another 2.5 mg drop, which brings me to 55mgs. I got the brain zaps for a moment and then I have this reccuring sore throat and cold sore like thing on the corner of my lips. Am I making up that I read that could be related to the withdrawal? How much magnesium is recommended? I also happen to take Zinc, B-12, Tumeric on occasion and Ashwaghanda, all for pre-menstrual dysphoric disorder. I also take 200-400mgs of magnesium anyway and have been for about a year. Shall I increase the dose for the zaps? I just hope no one can tell that I'm zappy. I'm a social worker and need to be present to people.

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Posted 20 June 2017 - 06:57 AM



I too have read about the sore throat and cold sore thing  quite a few times ( i seem to spend most of my time reading posts i find it reassuring ), so you are not making it up, sometimes its difficult to know whats real and whats not or if it was a dream :unsure:


i just wanted to say since i posted on here a week ago my tinnitus has quietened a fair amount and last night i didnt hear it at all :D thought id let you know as you were worried about it, and many of the posts ive been reading it does seem to fade even while still reducing. i hope that is the case for you too and it begins to ease soon as i know how irritating and scary it can be.


sorry cant help on the other questions, im sure someone with the knowledge will reply soon.


take care x 

#17 fishinghat



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Posted 20 June 2017 - 08:47 AM

Magnesium and calcium are both regulated by what is called magnesium channels and calcium channels in the cell membranes. Therefore the form of the magnesium is important. Amino acid chelated magnesium is the one with the least risk of this complication. This phenomena is most frequently developed in those who have taken magnesium too long and have developed low calcium as a result or have been taking Vitamin D3 for a period of time and the D3 levels are elevated. It is recommended that anyone taking a magnesium supplement should have their magnesium and calcium levels checked every 6 months and if taking vitamin D3 then that level should also be checked every 6 months. High vitamin D3 is at almost epidemic proportions in the US due to it becoming a popular supplement. I have not only read the research literature on this but have also been told this by endocrinologist as well as the various primary care drs I have had over the years. I use to take magnesium supplements. By the way, if serum magnesium levels are high it can take a few months for them to come down. When mine finally reached the high limit it took nearly 6 months foe it to return to normal. You really need to get some blood work done to see where you are dealing with.

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