A medical condition wherein you hear a buzz or a ringing noise inside your ears is known as tinnitus. It is most commonly referred to as a “ringing inside ears” condition. In some cases, people with tinnitus have complained of hearing whistling sounds or roaring noises; in a few one-off instances, hissing sounds have also been heard inside ears. These sounds are actually heard when there is no source to emit such noises. Owing to this, these noises are also termed as phantom sounds. Can you use drugs such as nortriptyline to treat this condition? It is a vital thing to know more about such use, prior to starting your medication plan.

There are two broad categories of tinnitus namely, objective and subjective types. In the objective type, people near you (including yourself) may hear a few noises. For example, several people near you may hear your heartbeats. If such pulsating noises are heard by many, it can be due to changes in blood vessels near the ears. On the other hand, an objective form of tinnitus is a condition in which you alone may hear a ringing sound or a hissing noise.

In general, damages experienced in the inner or middle ears are considered as a leading cause of tinnitus. You need to know that it is the mid portion of your ears that detects noise waves. Once these are detected, the inner portion of the ear helps transmit the electrical signal to the brain. People who have a damaged inner ear may witness improper processing of sound waves. At times, damaged eardrums may distort the processing of sounds. People working with heavy machinery like chainsaw, jackhammer, etc. are also more likely to witness these inner ear conditions.

In a few instances, a larger dosage of drugs such as aspirin (for a longer span of time) or a few antibiotics, water pills (or diuretic meds) and antimalarial medications may also cause inner ear problems. You may also need to be aware of age-triggered loss of hearing, spike in blood pressure level, injuries sustained in your neck or head, excessive build-up of wax inside ears, etc. can also cause tinnitus.

What is nortriptyline?

This med is an antidepressant of the tricyclic genre. It is widely used for the treatment of depression. It is available as a generic variant, which costs lesser than several branded counterparts. This med is also taken along with a few other medications; such combinatorial treatments are more common among people with mental health conditions like depression, bipolar disorders, etc. The active ingredients of this drug work to boost a few natural substances in the brain. As a result, you may witness a marked relief from mental health conditions such as being depressed or staying anxious. The drug is known to work on your central nervous system (CNS) to bring about needful improvements in your mental wellbeing. This drug’s primary line of action however is to decrease depression; it is important to know that inner ear ailments are more pronounced among depressed people.

This drug is likely to cause a few adverse side effects such as dizziness as well as drowsiness. You are hence advised not to drive your vehicle or work with heavy machinery soon after taking this med. It is a safe practice to stay away from activities needing a high level of mental concentration. Apart from the above, this medication may also trigger a few other adverse reactions such as blurring of eyesight, difficulties to pass stools, sweating profusely and / or abdominal discomforts such as indigestion, vomiting or diarrhea.

Most of the aforesaid side effects may go away if you are using nortriptyline for a few days. However, if one or more of these adverse reactions persist for long, it is a good practice to consult with your treating physician without much delay. As a safety measure, users are advised to monitor their blood pressure on a periodic basis. This is mainly because of the risks of sudden changes in blood pressure levels; these can be either hypertensive or hypotensive spells.

Nortriptyline for tinnitus

Tinnitus is known to affect as high as 1/8th of adults; those who have this inner ear condition hear a buzz or a sharp ringing sound deep inside their ears. In some rare cases, a few adults have reported very severe or acute signs of this medical condition. It is common to seek needful care from a neurologist or an otologist to seek needful remedy. Care from a psychiatric professional is also taken at times so as to regain silence inside the ears.

In this milieu, nortriptyline – a tricyclic antidepressant – is used for slowing down the reabsorption of a neuro transmitting chemical called norepinephrine. Key chemicals of this med are used for decreasing depressive spells as well as lessen the loudness of tinnitus. Controlled studies indicate an effective case management of tinnitus among severely depressed people. However, the efficacy of nortriptyline on people who are less depressed or not-depressed is yet to be fully ascertained.

In terms of loudness associated with tinnitus, scientific studies showed an almost 45% drop of noise levels. In a calibrated assessment, a drop of a mean level of 10 dB was witnessed among people with tinnitus. Nortriptyline was thus helpful in reversing a supposedly irreversible inner ear medical condition; treatment this drug offered to the psychiatric condition is considered as the real cause for the relief it brings about from inner ear problems.

Precautions associated with the use of nortriptyline

Those with suicidal instincts or aggressive thoughts must tell their caregiving team of such conditions. Also, if mental health conditions such as depressions or phobias are part of your clinical history, your treating physician must be aware of these disorders. The active chemicals of this medication may lead to erratic heartbeats or heart failure. Hence, those who experienced a recent heart attack or have a track record of cardiac ailments must consult with their doctor of such prior ailments.

This med may also cause a condition called serotonin toxicity; key signs of this syndrome include harmful thoughts, convulsions, fits, seizures, stiffening of muscles as well as abdominal conditions such as nausea or vomiting. Active chemicals used in this med may cause a spike in inner eye pressure level. Owing to this risk, those living with open angle or closed angle glaucoma are advised to tell their pharmacist / physician of ocular problems.

Nortriptyline may cause a few allergies in some one-off cases. You are advised to tell your doctor if you are witnessing allergic reactions such as increase in body temperature, inflammation of facial organs and / or oral parts such as tongue, gums or throat. This med may seldom trigger severe allergies like rashes on skin, itchiness and hives. A few users may turn extra sensitive to sun’s rays; it is highly recommended to wear a sunscreen or protective garments while stepping out of your home.

Women who are pregnant and those who are nursing infants

Medical studies have not drawn conclusive results about how safe this drug is for women who are already pregnant. Hence, this medication is prescribed only when its benefits outweigh the risks of side effects. Among women who are planning to become pregnant, it is highly recommended to use suitable birth control techniques to avoid unplanned pregnancies. It is a safe practice to talk to your treating doctor and use non-hormonal contraceptives such as rings, skin patches or other such measures.

Women who are nursing a baby may also need to understand how safe this drug is for their infants and for them. Evidences are available only to a limited extent on this front. In most cases, you may either be asked to wean away your infant or stop taking safer alternatives.

Safety of elders and children

Among elders, this drug may cause a few severely adverse reactions such as excessive level of dizziness and drowsiness. Due to such risks, older patients (especially, those above 55 years of age) may witness accidental falls. The risks of incidence of dementia are also high among elders; as side effects of nortriptyline resemble a lot with a class of meds known as anticholinergics. If you notice signs such as confusion, abrupt changes in pressure levels or erratic heartbeats, etc., your caregiving team must be made aware of all such signs without much delay.

It can be extremely unsafe to administer this drug onto children. As an overarching precautionary measure, never give this drug to those aged below 24 years. Younger people are more likely to nurse suicidal thoughts or may harm themselves upon taking this med.

In sum, nortriptyline is a tricyclic antidepressant used for the treatment of depression, bipolar disorders, etc. It works on your central nervous system to decrease inner ear conditions such as tinnitus or ringing inside ears. Medical studies underscore a better management of tinnitus in people living with depression or other mental conditions. This drug is known to reduce loudness linked with tinnitus; a drop of ~ 10 dB has been noticed in people living with tinnitus. It is however a safe practice to talk to your doctor about tinnitus and how effectively can nortriptyline manage this middle / inner ear condition.

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