Can gabapentin withdrawal cause tinnitus?

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In this blog post, we are going to answer the question, “Can gabapentin withdrawal cause tinnitus?”. Gabapentin is a gamma aminobutyric acid (GABA) analog and is used for a number of conditions. 

However, it is not an easy medication and can become extremely difficult to discontinue. This blog will cover the possibility of tinnitus while trying to stop using gabapentin. 

Can gabapentin withdrawal cause tinnitus?

Yes, gabapentin withdrawal can cause tinnitus, but it is not a common withdrawal symptom. Every human body reacts differently to gabapentin withdrawal. Some people may experience mild to moderate ringing in the ears, while others battle with different kinds of withdrawal symptoms. 

It is impossible to predict how your body will react once you start tapering down gabapentin. However, it is not recommended to stop using gabapentin right away and you need to taper down this medication if you wish to avoid withdrawal syndrome. 

When does this tinnitus go away?

The time taken by tinnitus to resolve depends on the severity of your symptoms and on what withdrawal stage you are on. Mild ringing in your ears may start to go away within 2 to 3 weeks of your gabapentin withdrawal. 

If you are too early in the withdrawal process, it may take longer or as long as gabapentin takes to completely wash out from your system. However, if it does not resolve, there are few treatment options to go for after you have stopped taking gabapentin. These include:

Noise cancelling devices

It is difficult to treat tinnitus itself. The best approach is to deal with the underlying condition that causes it in the first place, but your doctor may recommend some noise cancelling device to tone down ringing in your ears. 

This really helps to relieve some of the symptoms and irritability that comes with them.. 

Get your earwax removed 

You can try removing your earwax. Clearing up your ears can sometimes reduce the symptoms of tinnitus, as the built-up wax adds pressure to your ear canal and makes you hear unwanted rigning sounds. 

Therapies for tinnitus 

There are no known medications to treat tinnitus but several therapies are available to help reduce the symptoms. 

For people who can’t seem to get away with it, therapies like Tinnitus retraining therapy (TRT) and Cognitive behavioural therapy (CBT) are used to learn how to cope with tinnitus. 

Cut back on excessive caffeine and alcohol 

Make sure you don’t use any such thing that can contribute to your tinnitus. Limit the intake of alcohol and caffeine, as they can have an impact on your already existing tinnitus. 

What other medications can cause tinnitus? 

Some other medications can also cause tinnitus or may make your tinnitus much worse if you take these meds during the time period of your gabapentin withdrawal. These meds include:

Non-steroidal anti-inflammatory drugs (NSAIDS) 

Non-steroidal anti-inflammatory drugs and aspirin can cause tinnitus. This is more common when you’re taking a high dose of these drugs. 

Do not use these for a longer period of time as they not only cause ototoxicity but can also cause several other side effects like gastric pain, diarrhoea, acid reflux, etc. 

Antibiotics 

Antibiotics are antibacterial agents which are used to treat moderate to severe kinds of bacterial infections. These agents are known to cause tinnitus, including azithromycin, tobramycin, clarithromycin, gentamicin, streptomycin etc. 

These drugs are well known for producing ototoxicity, hepatotoxicity and nephrotoxicity. Fluoroquinolones (moxifloxacin, levofloxacin, ciprofloxacin) can also cause tinnitus. 

High ceiling loop diuretics

Diuretics are used to remove excess sodium and water from your body. This class of diuretics include the most commonly used med, furosemide (lasix). They can cause tinnitus and loss of hearing. 

Beta-blockers

Beta-blockers are antihypertensives. They are also used to manage cardiac activity in patients with coronary artery diseases (CAD). These agents are also known to produce tinnitus or ringing in the ears. 

Why does gabapentin withdrawal syndrome occur? 

Gabapentin is a gamma aminobutyric acid (GABA) analog. Gabapentin mimics the actions of GABA, which is an inhibitory neurotransmitter. GABA works by inhibiting the excessive neuronal firing in the brain which reduces the frequency of epileptic seizures. 

Gabapentin is also used to reduce the intensity of neuropathic pain by inhibiting nociceptors (pain receptors). This medication is a prescription medication and should be taken only at doses determined by your healthcare professional. 

It is not recommended to start or stop using any medication, especially while you’re being on any medication that can affect your brain, with your doctor’s approval.

Experts believe that people who misuse gabapentin are more likely to suffer from terrible withdrawal symptoms as compared to the people who stick to their doctor’s recommended prescription and take their gabapentin properly. 

Several surveys have indicated that withdrawal symptoms are more commonly found in people who have been taking 400-800 mg for more than a month. Some experts believe that these withdrawal symptoms are similar to the symptoms caused by abrupt benzodiazepine withdrawal. 

This may be due to the fact that both of these meds act either on GABA or mimic its activity. Make sure you stick to your doctor’s recommended dose and take it carefully in order to prevent your body from being physically dependent on the medication. 

What is the best way to stop using gabapentin?

The best way to stop using gabapentin is to taper the dose gradually. Abrupt withdrawal can lead to the symptoms which can become too hard to bear. Make sure you talk to your doctor and follow the taper schedule properly in order for safe withdrawal. 

Pfizer, the company which manufactures gabapentin, advises to stop using this medication over a period of one week minimum. The exact schedule is determined according to the conditions of the patient and the duration of his or her treatment. 

The current dose of the drug also plays a major role. If someone is on higher doses, he or she will have to go for different tapered doses in order to achieve the lowest effective dose, after which the drug is discontinued. 

Age and underlying health conditions can also make a huge difference. If the condition for which gabapentin has been prescribed is not getting any better then the treatment should not be discontinued, unless you suffer from an allergic reaction or unusual side effects. 

Unnecessary withdrawal can lead to exacerbation of your condition. Age is a factor because the process of withdrawal should proceed slowly in  elderly patients who can be affected when the dose is reduced as their bodies are much more sensitive to the concentration of medications. 

If you are taking gabapentin and you wish to stop using it, ask your healthcare provider. Do not stop this medication on your own. If you have been misusing gabapentin and want to stop doing so, ask your healthcare provider. 

You can also get help from rehabilitation, where you can safely taper off gabapentin and learn new lifestyle changes to help you deal with your addictions. 

Immediately talk to your healthcare provider if you experience unusual side effects while taking gabapentin. Do not recommend this drug to someone else and use it as long as your doctor has advised. 

Inform your doctor if you’re pregnant or trying to conceive. It is extremely important to ensure safety of your meds during your pregnancy. Some meds can cross placenta and are capable of causing unwanted side effects in the growing fetus. 

Inform your doctor if you’re a breastfeeding mother. Gabapentin may be capable of passing into the breastmilk and may cause side effects in newborns. 

Do not stop gabapentin abruptly. If it’s time for you to stop this med, your doctor will simply recommend a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 

Make sure you use this medication or any other medication only when your doctor has advised it. Using medications which can affect your brain is not something ideal and should not be encouraged unless it is absolutely necessary to do so. 

Conclusion 

In this blog post, we have discussed the tinnitus caused by gabapentin withdrawal. The withdrawal of this medication is extremely difficult, especially for those who have been using this medication for a long time. 

It is also one hell of a task for people who misuse gabapentin. Make sure you ask your healthcare provider if you wish to stop this medication. Abrupt withdrawal can make your condition worse. Do not stop gabapentin abruptly. 

If it’s time for you to stop this med, your doctor will simply recommend a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 

FAQs: gabapentin withdrawal tinnitus 

Is tinnitus a gabapentin withdrawal symptom?

Yes, gabapentin withdrawal can cause tinnitus, but it is not a common withdrawal symptom. Every human body is different and it responds differently when you stop using gabapentin. Some people may experience mild to moderate ringing in the ears, while others battle with different kinds of withdrawal symptoms. 

How can I stop tinnitus immediately?

  • Your doctor may recommend some noise cancelling device to tone down ringing in your ears. 
  • You can try removing your earwax. Clearing up your ears can sometimes reduce the symptoms of tinnitus, as the built-up wax adds pressure to your ear canal. 
  • Tinnitus retraining therapy (TRT) and Cognitive behavioural therapy (CBT) are used to learn how to cope with tinnitus. 

What medications make tinnitus worse?

  • Non-steroidal anti-inflammatory drugs (NSAIDS) 
  • Antibiotics, including azithromycin, tobramycin, clarithromycin, gentamicin, streptomycin etc. 
  • High ceiling loop diuretics like furosemide
  • Beta-blockers 

Do you get withdrawal symptoms from gabapentin?

Gabapentin is associated with withdrawal syndrome when you abruptly stop taking this medication. The symptoms include:

  • Nausea
  • Vomiting
  • Restlessness
  • Dizziness or lightheadedness
  • Headaches
  • Palpitations
  • Fatigue 
  • Insomnia or inability to sleep
  • Photosensitivity 
  • Pain 
  • Excessive sweating
  • Tremors
  • Hypertension

Is it difficult to get off gabapentin?

It can be difficult to get off gabapentin because it might produce dependence, especially in people who have been taking this medication for a long time now. It is advised to not stop this medication abruptly. Sudden withdrawal can lead to the relapse of epileptic seizures and you can also suffer from tremors and other psychological symptoms. 

How long does it take for gabapentin to wear off after stopping?

It is quite difficult to give an exact amount of time taken by gabapentin to be eliminated from your body completely because of its variable effects in different individuals. Withdrawal symptoms may last up to 7 to 14 days.

However, this too depends on the duration of your treatment and the dose at which you were. Make sure you ask your healthcare provider if you wish to stop this medication.

References 

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