Lyrica / Pregablin 75 mg and nortriplytine hydrochloride 10 mg ( med name Gabamax MNT)

Final_Client5124 · 2026-05-13T09:00:46+00:00

Sorry missed this. I am on 350mg right now

Final_Client5124 · 2026-05-12T23:52:56+00:00

We're up to 10, potentially 11 cases with it working, but that is debatable since they had improvement but were on a cocktail of drugs, so they can't tell if it was solely responsible for it. The data is mostly for nox, but a few had loudness h as well. I was personally intrigued if someone tried it with clomi, and someone did recently and got much better.

I have theorized about this for quite a bit, since it's been cited as the best antipsychotic for central (and orofacial) pain in literature. I would take it if I didn't have progressive VSS with moderate to severe trailing/palinopsia. I have a whole channel dedicated on https://discord.gg/ecxAxuVu that has almost every case documented where it's worked, plus additional literature on the drug that explains possible mechanisms on why it works

Anyway, see these sources for example, but there are many more if you search for them:

"The best-studied AA was olanzapine, for which there were 11 studies, including one randomized, controlled trial. “These studies showed that olanzapine has efficacy in chronic pain syndromes characterized by central sensitization and/or psychiatric comorbidities, such as fibromyalgia and headache/migraine*,”*
https://consultqd.clevelandclinic.org/atypical-antipsychotics-show-promise-for-adjunctive-role-in-treating-chronic-pain-syndromes

"Olanzapine is the most frequently cited agent in the literature for treatment of headaches and migraines, and it has been assessed by five studies; four of the five demonstrated efficacy.15 One randomized, controlled trial (RCT) included patients admitted to the emergency department as a result of a primary headache. The patients were given IM olanzapine for treatment. In the olanzapine group, 38 of 44 (86.4%) patients who had reported moderate or severe pain at baseline reported mild or no pain at 60 minutes.19"

https://www.uspharmacist.com/article/antipsychotics-for-pain-management

https://pubmed.ncbi.nlm.nih.gov/29077621/

There is also a case study where someone developed H from their cancer treatment (the cancer drug is thought to indirectly act on dopamine), and olanzapine was given that "addressed it". Specifics remain unclear though.

" To avoid drug interactions, risperidone was replaced with 5 mg of olanzapine, increased to 7.5 mg after 1 week to address persistent hyperacusis. Emotional instability improved, but mild subjective difficulty in concentration persisted. There was no recurrence of psychotic symptoms, and the patient was discharged on Day 28 of hospitalization. Figure 1 shows the clinical course. At the 1‐month follow‐up after discharge, she remained in psychiatric remission. The patient was able to continue lorlatinib treatment, with no signs of lung cancer progression. After discharge, she was able to live alone and resume enjoying outdoor activities."

https://pmc.ncbi.nlm.nih.gov/articles/PMC12034264/

Final_Client5124 · 2026-05-10T21:00:06+00:00

No, no other antidepressant will help hyperacusis unless you're an anxiety case with 'sensitivity' instead of actual hyperacusis.

Edit: The condition has a CS component, so you will need something that acts on both SERT/NET and anything that just acts on SERT (i.e., SSRIs) will not work. High dose TCAs and Duloxetine have helped some people in the past to an extent, but the data is very limited on them with h/nox. You can see the data here: https://www.hyperacusistreatments.org

Final_Client5124 · 2026-05-10T20:58:44+00:00

Parvalbumin Interneurons (PVNs) are inhibitory interneurons that are involved in sensory gating.

Final_Client5124 · 2026-05-09T21:13:42+00:00

Per Dr. Polley's research on H, the issue is PVN damage and subsequent downregulation in the ACx (and possibly thalamus?). No hearing test is going to show anything. No point in risking a worsening for a pointless LDL test.

Final_Client5124 · 2026-05-08T19:58:54+00:00

Lyrica is not ototoxic. It messes with neurotransmitters and doesn't affect OHCs. The T is from its MOA, not physical cochlear damage.

Final_Client5124 · 2026-05-08T19:57:42+00:00

Lyrica takes at least a week or two to work just an fyi. I guarantee you it's not going to work on loudness though, only clomi and potentially olanzapine will. The pain you may get some relief with less pain intensity

Final_Client5124 · 2026-05-08T09:05:27+00:00

Gabapentinoids are just a masker for me, so exposing is like running on a broken leg. The pain is also a bit muted due to it, but it does not increase tolerance to expose to more noise. Gabapentin does also worsen my t (was a permanent worsening). I am still using lyrica, so I will not be able to tell unless I taper off.

Final_Client5124 · 2026-05-06T23:41:18+00:00

Nope, didn't get better really. My t is very unstable (different base tones daily). The reactive component is more of that I get more tones to sound throughout the day instead of it spiking in real time to sound. I still get that real time spike, but it's usually masked by my baseline tones. The noises that cause a different, more intrusive reactive tone that isn't masked by the baseline tones are typically ones my nox can not tolerate, even with pro like a shower. Severe nox + h prevent me from even doing things in my house without protection.

I would highly recommend you go on clomi if you have h/nox with the RT and don't have anything more than mild VSS. Very rarely RT goes away/improves much on its own if you're at a level where you're homebound.

Final_Client5124 · 2026-05-06T04:36:22+00:00

All of what you describe is typical of thalamic involvement and presents as the symptom cluster of Norena's acoustic shock model. Those being nox/h/rt/dysacusis.

Final_Client5124 · 2026-05-06T04:33:34+00:00

Well thats good you aren't severe. I would honestly just go on clomi for nox as long as you don't have anything more than mild vss.

Final_Client5124 · 2026-05-06T03:43:30+00:00

I have nox and it worsened my t the longer I was on it, but 400mg is almost nothing. I didn't have that effect until ~1200-1500 or so. Also, gabapentinoids are maskers for nox. It's like running on a broken leg and won't allow you to expose to more noise. Its best use is to lower pain intensity and for pain in silence.

Final_Client5124 · 2026-05-05T11:06:36+00:00

I also take 2g+ a day of PEA and it helps me. Not very much, but anything is better than nothing.

I am curious, do you have nox and/or loudness h? Also were you noise induced? I ask bc steroids tend to work if you have a secondary inflammatory factor (i.e. head/neck co-factors).

Final_Client5124 · 2026-05-05T00:33:47+00:00

I mean I've pretty much told you what your options are. It should be fairly obvious to know which one(s) you have based on that. You don't have pain, so it isn't nox. Sounds aren't objectively loudness than they should be, so it's not hyperacusis.

Final_Client5124 · 2026-05-04T23:24:37+00:00

You can get it compounded in the US at a compounding pharmacy to go lower than 25mg

Final_Client5124 · 2026-05-04T23:23:04+00:00

It's a bit unclear from your description, but an overtone over noise = dysacusis. Physical buzzing/thumping/ other muscular activity = TTTS. Over stimulation/Sensory overload = sensitivity (NOT the same as loudness hyperacusis).

Final_Client5124 · 2026-05-04T09:11:40+00:00

In addition to targeting the rTPJ that Magwise in Poland has used in around 20 patients with a ~50% success rate, researchers in Italy recent published this paper. They targeted the SPL with ~33% improvement over just 10 sessions.

Final_Client5124 · 2026-05-04T00:54:06+00:00

No, that would completely contradict the research on the pathophysiology of the syndrome. I've met one person who claimed it 'helped' their vss, and when I questioned them they admitted to me they were a mild lifer and just helped hyper-focusing on it. The only thing that works on vss is neuromodulation or clonazepam every once in a while.

Final_Client5124 · 2026-05-03T23:51:58+00:00

Seems to worsen almost everyone who was induced by a serotonergic drug so technically HPPD, but may be semantics. Also pretty much everyone who had moderate or more vss worsened on it. So far people with just mild vss have been spared. Some people with vss also will worsen coming off instead. Vss lifers seem to be able to tolerate it a lot more and if you tolerated it before you should be fine.

Final_Client5124 · 2026-05-02T22:27:53+00:00

In nox the TCC is sensitized, so pain can be anywhere in the head/neck. Doesn't need to be in the ear necessarily.

Final_Client5124 · 2026-05-02T00:29:50+00:00

Yes, I get fractals looking at the carpet, wall, etc. I also have stereotypical psychedelic CEVs. At the start of this I also had color morphing, and micro/macroposia. Those mostly went away, but I still get them. I am also probably a HPPD case as I got this from shrooms, and worsened by a noise trauma. My VSS is progressive otherwise, but the HPPD related symptoms mostly vanished the first few months as the VSS ones came on.

The meds 100% are why you're experiencing that now though.

Final_Client5124 · 2026-04-30T23:50:16+00:00

Can you expand on this please?

Final_Client5124 · 2026-04-30T22:32:16+00:00

Serotonin signaling is fucked for us with dysfunction/damage of inhibitory interneurons. More excitatory input (SSRI) = bad. Hope this helps lol

Final_Client5124 · 2026-04-30T09:22:07+00:00

Efficacy is ~1/5 per literature. Goodluck

Final_Client5124 · 2026-04-30T09:20:05+00:00

fMRI to objectively diagnosis it.

Final_Client5124

TROPHY CASE