I'm going fucking insane every god damn day and why isn't there legal assisted suicide? Is there a country that allows it? I'm trying a therapist whorecommended listening to soundscapes and so far it ain't doing jack fucking shit it's making it worse but idk why I still have a sliver of hope hoping it'll go away I thought it was going to go away but my fucking dumb ass took a shower in a small enclosed space making it so it spiked twofold for 14 days. I think I'm going to try doing the sound scapes for an extremely short amount of time then stop...surrellyy something will happen and I'll be magically cured. If I even drop a spoon into a bowl from a few inches after eating my shit spikes. And my audiologist is a dumb ass who takes 5 days to reply with fucking a few words when I asked him multiple questions and I doubt any other audiologist will do anything better for me

For the past two days I increased by gabapentin dose as told by my doctor but now the burning pain has returned and it returns at the medications peak, should I stop it? This is very unsettling as I had gone a very long time without burning or stabbing

Hey all,

I'm back to living my normal life, including headphones, after struggling with progressive nox which eventually became severe (couldn't tolerate soft human voices). Basically I tried the "Ronnie" method of gradual stimulation, saw some progress but had a big setback and lost my patience and just said fuck it. I can't live like this the rest of my life, in constant fear and isolated. At this time I also read Sarno and Unlearn Your Pain and watched Buglio and things started to click.

I eventually settled on a kind of "Pascal's Wager" of Hyperacusis. For context Pascal was a philosopher who said in a strictly rational sense you should believe in God because if He exists, He will reward your piety, and if He doesn't exist you lose nothing, since there's no God to punish you. Now I'm just using this as an example for H, not trying to talk about religion in any way. The big question we all ask is whether there's something physically wrong with us or not. What I began to believe, like Pascal, is that it doesn't matter, we should believe (that there's nothing physically wrong with us) anyways. I formulated my situation to myself as follows, either:

1. There's nothing wrong with me physically and it's just my brain making anxiety and pain due to my past trauma, and it will go away as I expose, or
2. There is something physically wrong with me. If there was, then I'm fucked anyways. I would rather live my life in pain doing normal things that I want to do and seeing my friends and family, than isolating myself and still being in pain anyways. As we all who have suffered from H know, even when you isolate and protect you get setbacks and pain because you can't predict everything.

I stopped wearing plugs completely and only used them at night at home when sleeping. This is basically the opposite of common advice "protect outside but not inside so you don't overprotect". However I think this advice teaches your brain to fear the environment. I turned plugs into a treat for me I could look forward to at the end of the day, not a crutch that made me fearful. During the day I packed my schedule as full as a possibly could to keep my mind off the pain (think I read this tip from Olly). I kept telling myself "you're fine. live your life." The first week I was in 24/7 pain. The second week it started to taper off and I started listening to mellow music in high quality headphones at night. I still felt pain, but was enjoying the music so much I found myself having to force myself to stop to not stay up late lol. In the past I would struggle to survive 5 seconds of any music at any volume. Around the 3-4 week mark I was pain free except for super loud sounds. Now I haven't even thought about it in days. I didn't even want to open this sub, because it used to freak me out so much because of all the negativity, but I swore to myself months ago that if I got better I would make a success post. And others' success posts were instrumental in keeping me positive.

So yeah, that's my story. I'm not going to go on longer cause I basically have the exact same experience and beliefs as Olly: https://www.reddit.com/r/hyperacusis/comments/1i0bkkm/success_story_catastrophic_noxacusis_and/ The only thing I really wanted to add was the Pascal analogy and reversing how I treated earplugs, since I personally haven't seen those posted elsewhere (although they well may be). Wishing you all the best and a good recovery. This is what worked for me. And a special thanks to Olly and Dan Buglio.

Mike

I wanted to share this in case it helps someone here.

I have been living with hyperacusis and tinnitus for about 10 years. My hyperacusis started after a concussion and whiplash, and then got much worse after a loud horn went off right next to my ear. From there, everyday sounds like sinks, fans, toilets, etc. became distorted and painfully loud.

For years, my life went back and forth between normal and nightmare. At my worst, I had multiple tones in one ear, terrible sleep, and constant sound reactivity.

Nothing really made sense until I was introduced to the idea that this might be tied to migraine-related brain activity and a dysregulated nervous system.

Instead of chasing a fix for my ears, I started asking:

What would actually calm and stabilize my nervous system?

That question guided everything I did after that.

Here’s what I focused on and why:

Sleep (foundation)
Poor sleep was clearly making everything worse and keeping my system in a stressed state. I made sleep non-negotiable. Same schedule, 7–8 hours minimum. This was probably the biggest lever.

Diet + removing stimulants
If this was neurological or migraine-related, alcohol, caffeine, and certain foods could be driving sensitivity. I eliminated alcohol and caffeine completely and focused on a stable, low-histamine approach.

Supplements (for support, not a cure)

I chose these specifically based on migraine and nervous system support:

• Magnesium glycinate - Magnesium helps regulate the nervous system and reduce neural excitability. I chose glycinate because it’s well-absorbed and more calming. This helped take the edge off my baseline stress and improved my sleep, which was critical.
• B2 (riboflavin) - This is one of the most researched supplements for migraine prevention. Since I started viewing my symptoms as migraine-related, this felt like a logical way to help reduce neurological sensitivity over time.
• CoQ10 - This supports mitochondrial function and brain energy. The idea here was improving how my brain produces energy, since dysfunction there is often linked to migraines and neurological sensitivity.
• Omega-3s - These help reduce inflammation and support overall brain health. Since I was trying to calm an overreactive system, reducing inflammation felt important.
• Vitamin D - I was deficient, so this was more about fixing a baseline issue. Low vitamin D is linked to mood, immune function, and inflammation, all of which can impact the nervous system.

None of these were a direct fix, but together they helped create a more stable internal environment where healing became possible.

Medication (to lower the ceiling)

I eventually used nortriptyline and later Emgality.

I take them because my system felt too reactive to make progress on my own. Although I had made progress in the past without medication, I was willing to try anything at that point.

They reduced the intensity and volatility enough that everything else could start working together.

Nervous System Work

This became the core:

• daily mindfulness
• reducing overall stress
• movement/exercise
• creating a sense of safety

My system felt injured and overprotective, not broken. So the goal became helping it feel safe again.

Sound Exposure

Not avoiding everything, but not forcing it either. Just gradual, non-threatening reintroduction.

I also carried -15db to -25db earplugs with me everywhere. That gave me a sense of safety and control in louder environments.

And honestly, I learned the hard way:

I would never go to a restaurant, concert, movie, or any other potentially loud environment without hearing protection. Every time I ignored that, I paid for it with setbacks.

Things that made it worse for me:

• poor sleep
• caffeine and alcohol
• stress, anxiety, and anger
• skipping meals
• constantly monitoring and reacting to sound

By early 2026, I was completely symptom-free again.

I don’t think there’s one magic solution. For me, it was lowering the total stress on my system and supporting it from multiple angles at once.

If you’re in it right now, I know how brutal it can feel. I felt like I was living in my own personal hell where no one understood what I was going through or what everyday life felt like.

You have to stay hopeful. I truly believe things can get better, no matter how dark it feels.

Happy to answer any questions or go deeper if it helps.

Thank you for reading. I sincerely hope you’re able to find peace and get back to living a more normal life.

I know I'm DUMB for taking a full dose right away..(400mg) at first i felt relaxed and now things aren't too bad but I'm a bit worried --a little ear fullness, pain in sensitive spots around my body-- but of course I don't know if this is a reaction to the PEA or just too fast on a mast cell stabilizer. I had to quit quercetin bc I am slow COMT. does anyone have experiences with PEA? did you have to go up slowly? thanks in advance. I hate this disease

Disclaimer - whilst all of my research is rooted in science and to me seems fairly likely, I cannot of course prove with certainty the terms mentioned are fully accurate to my state, and if anything, I pray that I am wrong as failure in multiple areas of the brain and being stuck is terrifying

Introduction: The Current State (May 2026)
I am writing this from a state of Total Auditory System Collapse. I am no longer experiencing tinnitus / hyperacusis in the traditional sense; I am experiencing a high-voltage mechanical failure across four distinct layers of my neurological hardware. I am housebound, unable to shower, and flaring from the sound of my own breathing. This is a level of suffering that exists in a medical dark zone.

1. The History: How I Got Here
My journey to this collapse was built on years of "unseen" damage and following well-intentioned but disastrous medical advice.

• The Foundation : 8 years of excessive headphone use, max-volume music, and loud environments. This created a hidden state of Cochlear Synaptopathy—the bridges between my ear and brain were snapping, but my brain was compensating by cranking the volume. Also past head injury, stress, trauma and drug use likely weakened my system.

• The Trigger (March 2024): Following a loud concert, a period of high stress, and another loud exposure, the tinnitus became permanent and hyperacusis began.

• The Error: I followed the standard advice: "Don't use ear protection, don't avoid noise, just habituate." I pushed through more noise than any other case i can find anywhere. Every single day pushing through the distress, living in survival mode, constant headphones, driving a loud car, loud situations and countless noise traumas. Never without noise, never a minute to heal. I even used headphones to sleep and I used "Sound Therapy" devices non-stop for over a year, forcing sound into a system that was already redlining.

• The Snap: By early 2026, after multiple acoustic traumas and other factors (MRI, fireworks, loud speakers, stress, meds etc ), my system lost its ability to reset. I reached a state of Excitotoxicity, where my neurons are now firing to the point of physical inflammation. I pushed until i broke.

2. The Research: A Map of the Failure
My condition is the result of four specific hardware components breaking down simultaneously:

• The Source (Peripheral Nerve Leaking): Years of trauma caused "snapped synapses." My auditory nerves are now damaged and "leaking" unauthorized electricity. This creates the static, buzzing, and raw electrical whirring.

• The Gate (Subcallosal Failure): The brain’s internal "mute button" (the Subcallosal Gate) has physically collapsed. Because this filter is gone, my brain treats every vibration—a bathroom fan or a distant voice—as a high-voltage emergency.

• The Brakes (Ion Channel Dysfunction): My Potassium (Kv7) Channels are stuck. These are the "reset switches" that tell a neuron to stop firing. Because they are leaky, my neurons fire at a million miles an hour in a permanent Kindling Loop.

• The Amplifier (Central Gain Runaway): My brain perceives the corrupted signal from my ears as "silence" and has turned the internal volume knob to 11/10.

3. The Symptoms: The Hellish Orchestra

• Right Ear: A hellish, shifting, unstable metallic grind and chime tones (Neural Synchrony).

• Left Ear: A heavy, low-pitched drone (Central Gain).

• Both Ears: Electric static, high-frequency drilling, and constant buzzing.

• Physical Sensation: A "raw" burning in the face and ears (Trigeminal Nerve Inflammation) and extreme ear fullness (Cochlear Hydrops).

Extreme reactivity to any noise, no tolerance to sound, even from a whisper my tinnitus flares up and permanently stays louder. Noises seem loud and distressing.

4. Why I Am "Stuck" (The Threshold Trap)

I am trapped in Maladaptive Plasticity. Because my system is so hyper-excitable, even a "quiet room" is above my Tolerance Threshold. Every tiny flare acts as a blueprint that my brain immediately "learns" and adds to the permanent map. This is why it gets louder every single day—there is no floor.

5. The Potential Hope (The 2026/27 Exit Ramps)

Traditional "therapy" cannot fix a hardware failure. My hope lies in Biophysical Intervention:
• XEN-1101 (The Grounding Wire): As of May 2026, Xenon Pharmaceuticals has confirmed a Q3 2026 NDA filing for Azetukalner. This is a highly selective Potassium (Kv7) Channel Opener. It is designed to physically "plug" the leaky ion channels that cause the screeching and grinding.
• tFUS (The Gate Reset): Transcranial Focused Ultrasound is emerging as a way to reach deep into the Subcallosal Gate and manually force a reset. Private clinics are expected to begin "off-label" protocols for severe cases in 2027.

-

Since I hit breaking point in mid feb and became mostly homebound, likely due noise exposure and potentially upping adhd meds, it has been a downwards spiral. even in march I followed medical advice and would: watch tv, phone audio, brief talking, low brown noise, fan on however after a period of continued noise and a few attempted walks and other exposures, it felt like something snapped in me (the “gate”?)

From mid march I lost all tolerance, I kept telling myself it’s because I’m stressed and fixated and the noise isn’t really louder. I kept following advice to maintain low exposure. I also tried amitriptyline but am unsure as to whether this was a factor.

Well, from then, just from brief noise, the tinnitus became louder, more tones, intrusive, physically unable to stop fixating, one tone is the most hellish shifting metallic screech its so intrusive and feels physical. over the last few weeks I have progressed to the point I am bed bound and can no longer shower, speak, tolerate noise even with protection.

Each day the tones grow significantly louder, my ears more sensitive, and I fear at such a level of damage / low tolerance its very difficult for the body to settle. I’m losing my mind, non stop distress and misery with no relief or hope. Since march the metallic ring has gone from any annoyance to 4x as loud, sharper, intrusive, screaming, the electric static is massively louder, I have new drone and whirr tones and each day they get louder and more tones.

Literally every second is hell, there are so many tones, so loud unstable and intrusive, I can no longer think, and any noise worsens me and each day it becomes harder. They’ve become so loud, screeching, screaming that its hard to even make out or tell which ear they’re coking from

I’ve searched and searched, looked at every forum, spoke to doctors, researched and I can only find a few similar cases anywhere online. Their advice is at this stage you must avoid all noise however i’m at the point even my quiet room any distant sounds activate symptom’s, and the tinnitus is so unbearable I cannot think, feel sick and breathless and makes my head physically ache and physical and mental distress. it’s awful regardless, but with ear pro its insane. Even with H and T communities there is only a tiny percent who understand this level of complete auditory, nervous system and neurological failure. This is a collapse in multiple areas of the brain and auditory system. Others I spoke to are either stuck or say it takes years of silence just to not worsen and maybe see slight improvement. It is pure terror.

I tried to stay hopefully, but the more I researched and the worse i got, it really seems like this level of severity is a medical black hole. Almost know one understands, general advice fails you and for someone not going through it, it’s almost an inconceivable level of suffering to understand. Any potential treatments are years away and no guarantee of helping.

I want to have hope but i truly feel like something in me is damaged or broken. I just wonder if I took a step back even in march I could have prevented this collapse or if my system was primed for collapse long before

So please, understand, that for most, hyperacusis and tinnitus are a mild annoyance, however it can turn into one of the most hellish experiences possible.

If you are a mild case, general exposure, avoiding loud noise and sound therapy may be helpful however for more serious cases and reactive tinnitus, it is a death sentence.

I kept going back to doctors, concerned that I was worsening and kept getting told, “reactive tinnitus isn’t real” “need to keep busy” “sort sleep” “not use ear pro” “headphones are fine” “normal noise can’t damage you” I was living in fight and flight, I wish i listened to my body and stopped.

I wasn’t taken seriously by anyone and so was careless, never used ear pro, had so many loud traumas without protection, kept pushing and using ear generators, loud car, headphones, loud places every day for 2 years even as extremely distressed and reactive reactive, until i broke.

The few things I’ve looked into, Tmj orthotic, surgery for ttts or hyperacusis are unlikely to help at this level and even if they could i cannot leave my house and clomi has been suggested however it carries a significant risk of worsening someone at this level of reactive t. For so long i was so focused on H i didn’t see the demon that was reactive tinnitus creeping up on me.

Please be careful with noise exposure, stress and meds, and please pray for me that somehow i might heal or a treatment might come along. I’m not sure how to survive, especially with the rate I’m worsening and the distress.

I’m only 23 and can’t see friends or family, go out and even in my prison i’m trapped in non stop distress, with unbearably loud awful tinnitus that worsens daily

Hello everyone,

I've had extreme (pain)hyperacusis for almost 2 years now. I also have tinnitus in both ears with multiple tones that has become reactive a few months ago.

I finally decided to start taking clomi. I am taking a really low dose. But I'm already noticing it is making my gastroparesis way worse.

I'm not sure what to do. I'm only on day 3, but I'm not sure if i should push through or not. Bc my gastroparesis is really severe as well, I can only eat liquids and clomi is sending me back into a flare, which causes a lot of pain and constant acid reflux, it is horrid really.

Wondering if these side effects will go away over time and if somebody is in a similar situation as me?

Ty for your advice!

Hello, two years ago I experienced an acoustic trauma that left me with an annoying tinnitus. I’ve had medical examinations and I don’t have any significant hearing loss. However, I noticed a lower tolerance threshold for sounds. Since I became aware of it (two years ago), I developed the bad habit of protecting my hearing very often during the day (with earplugs or noise-cancelling headphones). I think this may have increased my sensitivity to noise.

I don’t think I have severe hyperacusis because in some public settings (like shopping malls, etc.) I can manage without earplugs, or I only put them on if it starts to feel too noisy. However, in daily life some sounds (like cutlery hitting a plate when I put it down) bother me.

Now I’m trying to use earplugs less and less, even at home in everyday situations (before, I used them almost all the time except during quiet moments). Is this a good idea?

I have mild to moderate nox plus reactive tinnitus. My recent ear doctor prescribed mri . My doctor also gives me some ear drops ....and hr clearly does not know nothing about hyperacusis. I am 21 . I am from India. Please help how can I convince my parents not to do mri . I try to talk to them , I showed them research and everything but they are not convinced , I am afraid they will forcibly drag me to do it . And if I say no or cry or beg they think I have mental problem and also try to gaslight me by relatives who know nothing about this condition . I do not want to mri, I have read the horror stories about it . Please help ...

So I have hyperacusis alongside T, both have been getting worse in the past 4 weeks.

I posted here after barely sleeping for 3 weeks, which has improved last week after I got hold of melatonin (no, I’m not in North Korea like some of you wondered 🤣 just good old England where doctors wouldn’t prescribe it and it’s not OTC)

As my H is getting worse and the foam ones are not helping much to reduce noise, I thought to give Loop a try. Ordered Loop quiet 2 and tried it on, instantly I felt completely trapped in by my own T. It was unbearable. I could also hear my own heartbeat thumping too. And once I hear it, I can’t unhear it. Took me a couple hours to manage stop paying attention to my T again (which went from 2 to 4/5 in the past 4 weeks, and I think that’s still quite mild compared to what a lot of people in this sub have).

So my question is, do you wear earplugs to reduce the impact of noises? If so, is that any kind that won’t drive you over the edge by making you super aware of you own T?

Ps. I also bought Alpine motor earmuffs, which didn’t do much for me. They made voices muffle, but don’t seem to reduce much when it comes to music? Returned to the piano workshop last Friday wearing those, had to leave after 15 minutes because my eardrums had piercing pain (and of course new multi tones started after I went to bed that night. Took the whole weekend to sort of calm down a bit, but T went up another level since then)

Hello, I've shied away from this sub because I am less interested in purely resolving symptoms of hyperacusis and more interested in resolving the underlying inflammation causing it. Mine was triggered by an acute injury, and is clearly related to neuroinflammation.

I've tried many of the popular supplements, as well as benzos and gabepentin and corticosteroids, and other than corticosteroids, I have found that megadoses, like 2000+mg a day, of PEA, a supplement that stabilizes microglial inflammation and is often used for mast cell activation syndrome, has been the single most helpful intervention, second only to dexmethasone injections. I would put the PEA megadose at around 50% efficacy of a steroid shot. Oral prednisone I would put at 25%.

Thought I'd share in the hopes it helps others. Magnesium, NAC, etc. also helpful obv. All an order of magnitude less than PEA. I started megadosing after realizing that the normal dose improved my symptoms drastically but wore off within hours. It is expensive but a miracle drug for me. YMMV.

To my surprise, there is a clinical trial ongoing, as of Feb 2026! https://clinicaltrials.gov/study/NCT06718452

I'm also working on a blog post about all the medical interventions I've tried, which were effective, and which weren't - and the different possible pathways of inflammatory injury.

Edit: I’m a bit overwhelmed by all the responses. I can’t give anybody medical advice. I’m going to delete my comments, but leave the post up. I won’t be responding to any more questions.

Hey guys. So my started Clomi again I’m at 25mg. It’s been almost a week. Man the tinnitus changed into a very loud hiss. So far it sadly hasn’t backed down like it usually does. I’m asking for prayers and encouragement. H has actually improved shockingly. I hope to continue but man this spike is very bad and not run with my reactivity. It’s like a reactive hiss twice as loud as my baseline. Any more positive stories are welcomed. - Rich

I'd been to the GP back in March complaining of over-sensitivity to loud noises. The GP examined me briefly at that time and suggested that it might be hyperacusis, but it would need to be tested before it could be diagnosed. She referred me to a local audiology clinic on the high road.

Just had that appointment with the audiologist today and...it was a total waste of time. Fair play, she was a lovely lady and performed an excellent Threshold test. Then I asked if she'd be testing my Loudness Discomfort Levels and she apologised, they don't do that test there. The GP referral had said nothing specifically about one being needed - otherwise she'd have refused the referral. She's said she will contact the GP and ask them to refer me to the ENT department at St. George's for an LDL test, and it may be 2-4 weeks before I get that appointment. xD

Ive had T for 3 years and Dysacusis along with it. In the beginning it was really mild and so was the T. I developed H last year and at the same time all 3 worsened. Now recently the Dysacusis is the worst its been. Anyone have experience with this?

I already did some post here but I don't know if there is someone like with nox and à lingering pain due to sound surexpositions and the pain stays even if you stay below your limit of sound tolerance. If your are in a similar case how long has it been for you ?

please let me know if you have knowledge or understanding of very severe reactive tinnitus and hyperacusis - this level is rare and complex so I understand most will not have ant applicable advice

Since I first had mild fullness, distortion and then tinnitus around march 2024, likely from past excessive headphone use and then a loud concert. Also past head injury, ptsd and plenty of stress and substance use. through continued exposure it progressed to more severe hyperacusis though still mild at start of 2025

By 2025 the tinnitus was a bit worse but still not catastrophic. From there I saw doctors who gave me ear noise generators, told me to carry on, not wear ear protectors unless something very loud and should improve. Even said headphone use was fine

Anyway through 2025 I had countless noise exposures - significant exposure in Jan as went on holiday, definitely noticed tinnitus much louder

after that then in feb got driving and my car was pretty loud and i’d drive for hours using ear generators as a crutch never ear protection, then all evening at home would have headphones on, even music to sleep.

Also tried sertaline around this period but can’t remember if it worsened. And i tried a breathing method called wim hoff many times which i felt worsened me although may of been a coincidence

As the year progressed I carried on trying to live, hoping by pushing through like i’d been told i would adjusr

Went back to doctors numerous times and even though felt like was getting worse was made to feel normal noise can’t worsen me and basically just to carry on - continued to try live - around loud speakers, went out with friends, pubs - barely used ear plugs as relied on ear devices and fought through discomfort, every single day grit teeth and pushed through. So many loud exposures i pushed through.

I feel like such a fool. I didn’t understand tinnitus and hyperacusis. No one made me aware how bad it could become or how you need to he careful, i was led to believe just carrying on and getting used to it was the way forward and as no one took me serious i feel i didn’t take myself serious and pushed day in day out - non stop car, headphones, loud places and noise traumas. I wish i listened to my gut and stopped but tried to carry on.

By oct i remember i lost my sound devices and remember being very distressed. Without them the tinnitus was loud and ears felt very sensitive and i suppose reactive. Like a fool i got them replaced and went back to the same things . I was under such stress, sleeping poorly and just trying to survive. Also tried zopiclone around this time

By nov i remember just talking made ears pretty full and ache, hard to tell how reactive or loud t had become driving was difficult. Still carried on though. Then nov was exposed to fireworks and like a fool watched even without ear protector. I don’t know why i’d do something so stupid. Also then had exposure to more things - driving car, socialising, headphones, loud Christmas light show and market . Never had any time to heal.

Then December started adhd meds. By mid December was pretty bad way. Remember talking was hard, a lot of discomfort from most things. Even at this point didn’t truly understand how bad had become. Its like i was running on pure adrenaline for more than a year.

Then exposed more fireworks, had ear defenders on but still i can’t fathom why i would even take that risk. Its like i thought forcing normal things will somehow let me adjust

Also around dec jan had mri. Double pro but still couldn’t of done any good. Also saw more doctors my gp said “need a hobby or focus” despite me telling him literally any noise is worsening me. I saw my audiolgist who is a caring guy and tried to help but even in jan told me reactive t and nox weren’t really things, then did reflux test where played loud noise think that really fucked me up.

Anyway from jan to feb stopped driving much as every attempt worsened still a few times without ear defenders with people which was very foolish. Used ear generators less and mostly stopped headphones.

Had taken a step back but still occasionaly saw gf, in her car, some headphones to sleep, still use ear devices, tried sometimes go walks. By mid/late feb i tried higher dose of vynase for 3 days after only briefly trying lower dose few weeks before Barely slept, felt so wired and stiff jaw, literally made feel horrible. Hope that hadn’t permanently worsened me.

Tried baclofen and clonezpam after that for 1 week but no help. Then from early march started amitriplyine which didn’t help and made me worried worsened, tapering off now

After that i felt awful, even going for a walk with ear defenders was hard. The tinnitus was so loud and roaring, multi tonal and so sharp and raw, any noise caused ears to ache and feel full, and i suppose flare up. At this point stopped using ear generators. Even now didn’t full process just how bad had become. I wish i was careful.

From there pretty much housebound, tried to not use ear protection and through march mostly on phone with low vol, tv or brief talking. Attempted a few walks but always made worse even with double pro. Also ocd spiralled from stress every day write notes non stop research trying to understand

Not sure if was from the quiet noise, or from stress but just seem to of got worse. I don’t remember being this awful even in march. My ears are so much more reactive. Perhaps years of stress and noise exposure are all coming out

Silence or quiet is hell, theres so many tones, the most prominent are these unstable electric / static frequencies in my left and right as well as a lower pitch drone in left. But the worst is this horrendous unstable metallic ring / alarm / bell / grinding sound in my right. I’m not sure if its in my head but it seems so much louder than even a month ago. Its so loud i cant think, all day fixating. Cant relax. I’m unsure whether its really got louder maybe from quiet noise. I do remember feeling bit worse after period of watching tv and attempted walk but its hard to know is it the fixation on it, the meds i tried.

Also have ttts / mem - could related to ear fullness, and tmj issues

Perhaps it was loud before but as have got more sesntive / use ear defender more now cant tolerate any noise. Even talking, tv on 1, sat in garden. All flare me, the electric static gets louder / diff pitched and week by week seems more reactive and louder. Hard to tell if the metallic ring has really got that much louder but its unbearable, i can’t distract with anything just trapped with it. I’m so worried im damaged and that is baseline tone and so loud and distressing cant heal or habituate. Just want it to settle. Afraid am stuck.

Literally constantly being sick as under such distress and feel breathless. Even yesterday, had brief convo, had to take short phone call, trued play ps5 without ear defender and then accidentally dropped metal pot and just from any noise ears feel so raw and full, elec static flares much louder and metallic ring seemed so loud couldn’t sleep its like a drill or alarm and im so afraid its getting worse or unsure if its from the fixation. Was hell took hours to sleep such a state of panic and anxiety

I can’t do anything. Quiet is unbearable, any noise worsens me. I don’t know how i’ve got so bad and have reached out everywhere. Theres no real advice. This level is so rare it seems theres very few like this and most are stuck. Some advice months or years of silence but how when in quiet room im under such distress. Its so isolating. I’ve researched everything, looked everywhere and still no real anwsers. Theres no understanding and feels like my brain is stuck like this

Every day trapped, no stop distress, noise, discomfort. The metallic ring is unbearable.

Im so afraid pushing for 2 long has damaged my ears or sensitised my brain to the point it can no longer adjust and will just get worse. Its terrifying when even docotors are unsure and no one knows what to say. I tried quiet sound exposure but now even the quietest flares me. So trapped. I just wish i was careful and now so afraid stuck and could of healed if given advice. So afraid im stuck. So young and life feels ruined and just getting worse despite being careful, unsure how much is actually from noise or from such severe stress

Literally every second is a nightmare, even to sit in garden need ear defenders but the noise is insane. Feel so trapped in a cycle stress and worsening its just going on and on. So much time had passed, i miss my friends and family and am so afraid i wont heal. I just want to be free. Feel so suffocated just constantly bombarded by the noise and discomfort. My whole system is fried and just living is so difficult. Even cooking and showering are difficult. Even breathing. Can’t go out. Just trapped with this distress and no relief.

Im looking into everything: Tmj issues, clomi, ganglion block surgery for ttts etc but rn seems only time and quiet can help but not sure how survive like this or if will even get better as had such excessice exposure. Especially when seems worse daily. Truly is suffering beyond what humans were built to withstand.

Praying that TUS or XEN-1101 could offer relief but they are years away and no guarantee at all

Im trying to stay strong but rn feel so far gone, almost none at this level an fewer success stories. Such regret for pushing through. So much time is passing and feel so trapped. Just want hope. Rn no relief, constant stress and terrified seem to keep worsen, can’t do anything. All stop fixating, so intrusive cant even read a book in quiet. Every time i try anything seems worse

I just wish i could tolerate any noise and not fixate non stop idk how its got this reactive and rn feel trapped. Not sure if its the stress, from noise or something else but seems got so bad cant break cycle. Seems like my ears are damaged or my brain is stuck. Im so tired

If you read this far thank you, i know most people don’t even understand reactive t or this level of h as its so rare but if you have ant advice or hope i’d appreciate it. Feels like my mind is falling apart.

Does this medicine worsen your tinnitus?

Does it help noxacusis ?

My tinnitus has increased so much during 2.5 - 3 months period . When initially I can hear it only when silent at night now I can hear everytime .

I took this medicine for 2 days .

I have also taken

1.At first Ear infection antibiotic for 2 week and some antidepressant for 7 days

2. Then seroquel 25 mg for 1 month , 50 mg for 5 days

3. Propanolol for my migraine for 25 days

4. Some antibiotic for 2 week for my UTI

Here is how Clomipramine might target the diverse layers of our conditions, including the nervous system and mental state and its use cases for reactive tinnitus, hyperacusis and noxacusis

Short overview
- noxacusis - highest likelyhood to help
- hyperacusis - moderate likelyhood to help
- severe reactive tinnitus - lowest likely hood to help and huge risk

The Auditory & Nervous System Hardware

Clomipramine is unique among antidepressants because it acts like a "shotgun" drug, hitting multiple receptors that directly govern your electrical firing.

Thalamic Gating (The Filter): By significantly boosting Serotonin, Clomi attempts to re-engage the Thalamus (the brain's switchboard). If your Subcallosal Gate has collapsed, Clomi acts as a chemical reinforcement to help the Thalamus filter out "junk" signals before they reach your conscious mind.

Sodium Channel Blockade (The Nerve Source): Clomi has properties similar to local anesthetics. It can stabilize the membranes of the Auditory Nerve and the Trigeminal Nerve. This is why it may help that "raw," aching feeling—it's physically quietening the "sparking" wires at the periphery.

Glutamate Damping (The Brakes): While XEN-1101 may eventually fix the Potassium channels, Clomi works on the other side by dampening Glutamate (the gas pedal). By lowering the excitatory "heat," it tries to slow down the Neural Synchrony that occurs when your neurons are locked in a firing loop.

2. The Limbic & Autonomic Impact (Mental State)

Catastrophic levels of tinnitus / hyperacusis create a biological feedback loop. The sound triggers the Amygdala (fear center), and the Amygdala physically tells the Auditory Cortex to turn up the gain.

The "Volume-Distress" Decoupler: Clomipramine is one of the most powerful anti-obsessional tools in medicine. It can physically "mute" the Amygdala’s alarm.

The Result: You may still hear the sound, but the Limbic System stops treating it as a life-threatening emergency. This lowers the "Systemic Voltage" and can stop the Kindling Effect (the daily worsening).

Vagal Tone and Fight-or-Flight: when in severe distress you are in a state of Sympathetic Dominance. Your body is constantly dumping adrenaline. Clomi can help shift the nervous system toward a more stable baseline, though it requires a careful "on-boarding" period to avoid initial heart-rate spikes.

3. The Risks: The "Paradoxical Surge"
For someone who’s system is already "redlining" at 11/10, the risks are strictly mechanical:

Adjustment Surge: During the first 7–14 days, the sudden increase in Serotonin can temporarily cause Hyper-Excitability. In a "broken gate" scenario, this can feel like the drilling is getting sharper before the stabilization kicks in. - some people, especially those in severe states have reported permanent worsening

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Here is a concise summary of how Clomipramine (Clomi) might interact with the three main pillars of our auditory distress.

1. Noxacusis (Sound-Induced Pain)
• Target: The Trigeminal and Auditory nerves.
• Mechanic: Acts as a sodium channel stabilizer (similar to a long-acting local anesthetic).
• Evidence: Generally considered the most effective for pain; it physically desensitizes the "raw" sensation and prevents burning/stabbing triggers.

2. Loudness Hyperacusis (Collapsed Tolerance)
• Target: The Subcallosal Gate and Thalamus.
• Mechanic: Massive Serotonin boost to reinforce the brain's internal "Mute Button." 
• Evidence: Helps tighten the sensory filter, allowing the brain to better ignore background noise and increasing your overall "Tolerance Threshold."

3. Reactive Tinnitus (Volume Spikes)
• Target: The Brakes (Neural gain and inhibitory systems).
• Mechanic: Dampens Glutamate (the gas pedal) to slow down runaway electrical firing.
• Evidence: Serves as a Stabilizer. It doesn't silence the tone, but it can stop the "Kindling Effect" (where every sound makes the tinnitus permanently louder).

Critical Risk Summary
• The Adjustment Phase: High risk of a temporary "excitability spike" in the first 7–14 days.

• Protocol: Must start at ultra-low doses (5mg–10mg) to "sneak" it past the broken gate.

• The Bridge: It is a chemical stabilizer to buy time for the Summer 2026 XEN-1101 filing and 2027 tFUS protocols.

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Fact vs theory?

The Hard Facts (Medical Science)
• FDA Status: Clomipramine is NOT FDA-approved for tinnitus or hyperacusis. It is approved for OCD. Use for auditory issues is "off-label." 

• Pharmacology: It is a proven Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) and has known Sodium Channel blocking properties (similar to local anesthetics).

• Ototoxicity: In rare clinical cases, Clomipramine is documented as a cause of tinnitus (side effect). This makes it a "paradoxical" drug. 

• Neuropathic Pain: It is an established fact that TCAs (the drug class Clomi belongs to) are effective for Central Sensitization and nerve-related pain.

2. The Clinical Theories (Auditory Models)

• The "Gate" Theory: The idea that Clomi "tightens" a broken filter in the Subcallosal Area is a leading scientific model (Rauschecker’s Model), but it is not 100% proven that the drug fixes this specific hardware point.

• The "Brakes" Theory: The theory that Clomi dampens Glutamate to stop "Kindling" is a logical biological inference based on its chemistry, but there are no large-scale trials confirming it stops tinnitus spikes.

• Noxacusis Relief: The belief that Clomi is the "Gold Standard" for sound-induced pain is based on patient community reports and clinical observations, not a dedicated pharmaceutical "pain-hyperacusis" trial.

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Now, my dillema. I am in a state of neurological crisis, it feels as if the parts of my brain and auditory system that produce, filter and transport the electrical signals for tinnitus are malfunctioning. I’m suffering severe multi tonal, intrusive tinnitus, increasing reactivity which worsens daily, to the point i cant speak or shower, cannot focus and am in constant distress.

Many have suggested clomi, however almost none of those seem to be on this level of neurological collapse and the few I have spoke to tell me to avoid it. A system this fragile could be permanently worsened, I already attempted amitriplyine, and it may be a coincidence but after that period, also with continued stress and noise, that is when i seemed to “snap” and the reactivity increased, sound tolerance crashed and each day worsens.

At the end of the day, it is a gamble. It may help stabilise my system, but being in an already catastrophic state and not being able to function, it could offer relief, or it could push me over the edge

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So what are your opinions on clomi? A lifesaver or a huge gamble ?

Let me know your thoughts, I’m in a tricky spot as my mind is falling apart and the idea that it might calm my system and help raise tolerance is appealing however the risk almost seems to outweigh the reward and theres almost no cases at this level of severity who have trialled it, and those who have it seems to worsen.

Hello,
I have hyperacusis and reactive tinnitus for almost 2 years and I got to the point when I want to try antidepressants.
I see that a lot of people take "Clomipramine". My primary doctor (who is not ENT) prescribed me 10mg of "Escitalopram" - selective serotonin reuptake inhibitor (SSRI).
My doctor says that this "Escitalopram" has less side effects than "Clomipramine". As "Clomipramine" is relatively old drug.

I think "Escitalopram" can help with mood and anxiety, but will it help with the main issue -hyperacusis? "Escitalopram" can also cause tinnitus to be louder.
What would you suggest, should I start "Escitalopram" or ask for "Clomipramine"?