The drug managing your depression could be worsening your tinnitus, affecting up to 14% of the global population. In severe cases, tinnitus drives psychiatric distress. New research has connected what clinicians have long suspected, affecting how doctors prescribe.
Why it matters
Scientists at Oregon Health & Science University and Anhui University published findings in PNAS showing serotonin, the neurotransmitter that selective serotonin reuptake inhibitors (SSRIs) boost to fight depression, worsens tinnitus through a brain circuit in the auditory system. For millions managing both conditions, this changes the conversation with their doctor.
“We’ve suspected that serotonin was involved in tinnitus, but we didn’t really understand how. Now, using mice, we’ve found a specific brain circuit involving serotonin that goes straight to the auditory system, and found that it can induce tinnitus-like effects. When we turned that circuit off, we were able to ameliorate the tinnitus significantly. This gives us a much clearer picture of what’s going on in the brain — and points toward new possibilities for treatment.”—co-author Zheng-Quan Tang, PhD, Anhui University, China
Yes, but
This study was conducted in mice, not humans, and included no dosage thresholds or head-to-head comparisons between SSRIs.
A difficult truth
Millions take SSRIs, a proven therapy for depression and anxiety. They reduce suffering in life-changing ways. For years, however, some reported their tinnitus worsened after starting SSRIs, but their reports weren't taken seriously.
Co-senior author Laurence Trussell, PhD, called on doctors to take patients seriously when they say their medication worsens tinnitus. Dr. Zheng-Quan Tang, who worked in Trussell's lab, explained their discovery of a specific brain circuit linking serotonin directly to the auditory system. This finding proves patients' experiences are real, not imagined.
The takeaway
- Patients on SSRIs with worsening tinnitus should raise it with their prescribing physician and push back if dismissed.
- Doctors should weigh psychiatric benefits against tinnitus burden when managing drug regimens.
- Abandon SSRIs? No. It's finding the right balance.
The big picture
The researchers noted that the future is developing drugs that preserve the antidepressant effect while leaving the auditory system untouched. No such drug exists yet. But researchers know exactly which circuit to target.
“People with tinnitus should work with their prescribing physician to find a drug regimen that gives them a balance between relief of psychiatric symptoms like depression and anxiety, while minimizing the experience of tinnitus." —Co-senior author Laurence Trussell, PhD, Oregon Health & Science University
