Reactions 1318 - 11 Sep 2010

SAmitriptyline/trimipramine

Tinnitus: case reportA 39-year-old man developed tinnitus while receiving

trimipramine for depression. His tinnitus was laterexacerbated by a switch to amitriptyline.

The man presented with intense bilateral tinnitus 3 daysafter initiating treatment with trimipramine 50mg[frequency and route not stated] in April 2008. He had atinnitus frequency of 7000Hz and a minimal masking levelwith narrow band noise of 68dB hearing level. His medicalhistory was notable for short transient episodes of tinnitus8 years earlier. Trimipramine was initially continued at100mg as it was deemed unlikely to have caused histinnitus. A subsequent audiogram revealed no change inauditory function.

Six weeks later, trimipramine was discontinued andamitriptyline 50mg [frequency and route not stated]initiated. However, amitriptyline exacerbated the tinnitusand was replaced by citalopram in July 2008. The man’sdepression and severe tinnitus persisted. A variety oftherapeutic strategies were implemented, including drugreplacement with mirtazapine and hearing aids with asound generator. However, all approaches had only limitedefficacy. In March 2009 he began augmentation therapywith lithium, and he developed strategies to manage theongoing tinnitus.Langguth B, et al. Persistent tinnitus induced by tricyclic antidepressants. Journalof Psychopharmacology 24: 1273-1275, Aug 2010. Available from: URL: http://dx.doi.org/10.1177/0269881109106929 - Germany 803036477

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Reactions 11 Sep 2010 No. 13180114-9954/10/1318-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved