Mirtazapine from Cipralex (Escitalopram) for Tinnitus and Visual Snow

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Hello, I'm wondering if I could get some thoughts on my condition? 


2.5 months ago, I experienced a full on panic attack (hyperventilating, tingles in my extremeties, heart palpitations etc.) I went to the Emergency Room and eventually calmed down after being given an Ativan (Lorazepam). The next few days, I was fine--I returned to work and felt good. On the fourth day after this occurred, I was at work and felt a weather headache coming on. I took two extra strength tylenols and washed them down with my green tea (which I drink everyday along with a Vitamin B Complex). 15 minutes later, my ears began to ring and I felt disoriented. I began to experience visual snow and thought that I was having another panic attack. Over the next two days, I was in emerge 4 times thinking this; however, these episodes were not the same as the originaly panic attack (marked tinnitus, pale skin colour, visual snow, nervousness due to the condition and recent panic attacks). My ears have now beeng ringing for 2.5 months. I experience pressure in my face/sinuses/head, tinnitus, and the visual snow all the time. My doctor originally prescribed me on Cipralex. I thought that I would try the natural route first (increased exercise, better diet, zero alcohol, L-Theanine, Magnesium--I stopped the Vitamin B Complex thinking that it may have been involved). After another ER visit 3 weeks or so later, I decided that Cipralex was my only choice (even though I was hesitant as the so-called anxiety was only manifesting itself via these physical symptoms). I took Cipralex at 10 mg for the first 21days. The first week was a complete nightmare with Lorazepam being the only reason that I survived. My doctor then increased my dose to 20 mg and I took that for 11 days before finally stopping as the medication was causing me a lot of problems (I had to take lorazepam all the time to function, I had brain zaps for hours at a time in my sleep). My appetite returned after 8 days on Cipralex and my resting heart rate dropped significantly from being in the 80's to the 50's bpm. 9 days ago my doctor switched me from Cipralex to 15 mg of Mirtazapine which I started immediately. I took 10 mg of Cipralex for the first 3 days and then stopped it completely as per his orders. For the first 6 or 7 days on Mirtazapine, I actually felt good. I was sleeping better, the volume on the tinnitus was way down. Then on day 7, I had a total meltdown--could not stop crying over nothing, felt depressed, felt like I got hit by a bus (flu-like symptoms), shivering with chills and sweating in my sleep, pressure headaches, mild dizzyness. Where Lorazepam was working previously, it was not for these feelings leading me to believe that they are withdrawal from the Cipralex. That's fine, I can endure the withdrawal. The problem is that now that I'm on day 10 of Mirtazapine (7 days removed from Cipralex) the tinnitus volume is back up along with the visual snow. I guess I'm wondering that now that I'm between Cipralex and Mirtazapine actually kicking in and working, is it still anxiety that is causing the visual snow and tinnitus? I fear that the anti-depressants are not working for this condition and this might be something else? Has anybody ever experienced tinnitus and visual snow constantly? I don't feel panic with it anymore and it seems to get worse at completely random times. Do you think that I should just continue with the Mirtazapine to give it an honest go at it as well? What if the Mirtazapine doesn't help this either? I can endure a lot (and have been for over 2 months now) but I'm really worried that my condition is something else. I guess the trial and error is necessary in making a diagnoses but it sure is a long and difficult road to this point. If anybody has any sort of ideas about what could possibly be wrong with me, I would greatly appreciate your thoughts. I strongly feel that the tinnitus and visual snow are the manifestation of the same problem via the auditory and visual senses. Are they somehow related to the original panic attack? Are they the result of taking two tylenols with a green tea?Whether it is anxiety is where understanding stops and again I greatly appreciate you taking the time to read this and provide your thoughts. Thank you.

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5 Replies

  • Posted

    I've just been reading up side effects for you of the suspect "Tylenols",  Anxiety is clearly listed, and the 15 minutes later, my ears began to ring and I felt disoriented. I began to experience visual snow and thought that I was having another panic attack could well be the result of the 2 extra strength tablets that you took ...   I found this.here you go:

    Nervous system side effects associated with IV acetaminophen (the active ingredient contained in Tylenol) have included headache (10%), insomnia (7%), and fatigue.


    Psychiatric side effects associated with acetaminophen (the active ingredient contained in Tylenol) IV have included anxiety.

    The only thiong left that is unexplained (maybe) is the first panic attack that you had in the first instance, are you sure you hadn't taken one or two of these tablets then??

    Having experienced panic attacks we live in fear of having another, which in turn can make us more anxious and thus bringing about another P.A.  So, work on overcoming the fear with CBT (Cognitive Behavious Therapy) with your doc' or Google it, don't let this rule you and ruin life for you for months/years to come, knowing a few simple techniques, like counting and watching your breaths can aleviate anxiety.

    You took Cipralex for 31 days and then stopped after 3 days of 10mg, no further  taper, just off, your doctor told you wrongly, this was a recipt for withdrawal symptoms which can be very frigthening and that's why you experienced, understandably "meltdown" - what do doctors know about slowly withdrawing from Anti Depressents - NOTHING, so annoying!  No wonder you had the sweats, crying, total awful withdrawal symptoms.

    I think I have the slight "snow" that you speak of, but it is very slight in one eye, and it is in the eye, not in the distance.  I don't know if the tittinus and snow you describe is related to your original panic attack but I'm gussing it is.

    If you can overcome the nasty WD effects and brain zapping now, and get settled on the 15mg Mirt' to help with calming any anxieties for the time being, I would do that.  Mirtazapine contains a slow release sedative that lasts pretty much all day, so you shouldn't need the Lorazepam.  When you feel you can, sit comfortably and reflect on what has been happening around you over the last 3 months; usually when anxiety attacks occur it is more likely for a variety of reasons and may not be for one single issue, or worry.  

    You may need a little therapy to help you whilst the sticking plaster of Mirt' helps you override the waves, I hope you can find the underlying factor that is causing the dis-ease.

    Please feel free to chat any time ~ like you, I had to have Mirt' for insomnia, anxiety that finally lead to depression, I've been taking it for a year and am tapering very slowly off it now (trying to avoid the nasty WD that Mirt' can bring).

    Wishing you well smile


    • Posted

      the source I read of the side effects:  

        drugs . com    / sfx / tylenol-side-effects

      join us the spaces, other web addresses aren't allowed on this forum

    • Posted

      Thank you very much for your reply! I agree 100% about the withdrawal. It has not been fun. I also agree that the Mirtazapine has definitely reduced the need for me to take Lorazepam. Ideally, I give it some time and the withdrawal effects subside and the Mirtazapine kicks in and helps. Thank you again smile 
  • Posted

    Another update. The withdrawal effects are subsiding, but I'm once again experiencing the original condition. I have tremendous pressure in my face (where my sinuses are). Visual snow and tinnitus come on strong. The only thing that helps to illeviate it is the Lorazapam. I'm increasingly frustrated. I think that I need to see an ENT as the pressure in my sinuses seems to be increasing. I tried a netty pot twice over the past 24 hours. I've also been reading about fungal infections causing similar symptoms. I'm miserable sad
    • Posted

      haha the good old netty pot ... you might be better trying a 

      Medipaq  ®    -   Steam-Inhaler 

      glad to hear the wd is calming; that pressure pain on your face does sound like sinusitus ~ sometimes hurts moving the head, or pain at the back of the head?    

      I think you may get the steam inhaler at a large Boot(are you UK ?)  or Amazon, quite cheap.  I just searched for "Visual Snow" ... there's quite a bit to read through.  Sometimes linked with Interesting that its onset was at the time of the "weather headache", are migrains present?  Yes, I agree, would be well worth seeing the ENT if only to rule out.  

      Keep posting, you can beat this, just need to untangle the threads that lead to this.

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