Tinnitus During Pregabalin Taper: Withdrawal Symptom
Your tinnitus or "roaring" sound is most likely a withdrawal symptom from tapering pregabalin, and you should slow down or pause your taper immediately. The FDA drug label explicitly warns about "Increased Risk of Adverse Reactions with Abrupt or Rapid Discontinuation" 1, and multiple case reports confirm that pregabalin withdrawal can cause significant symptoms even with gradual tapers and regular therapeutic doses.
Why This Is Withdrawal
Pregabalin withdrawal is well-documented and can occur even with:
- Regular therapeutic doses (not just abuse situations) 2
- Relatively short treatment durations (as brief as 2 months) 2
- Gradual tapers over several weeks 3
The withdrawal syndrome includes psychiatric symptoms (insomnia, anxiety), vegetative symptoms, and neurologic/physical complications 2. While tinnitus is not the most commonly reported withdrawal symptom in the FDA label, case reports and clinical experience confirm it occurs during benzodiazepine and gabapentinoid withdrawal 4.
What You Should Do
Immediately slow or pause your taper:
- If symptoms are mild: Hold at your current dose for 2-4 weeks until tinnitus resolves
- If symptoms are moderate to severe: Consider increasing back to your previous dose where you had no symptoms
- Once stable, resume tapering at a much slower rate (reduce by no more than 10-25% every 2-4 weeks)
Contact your prescribing physician to discuss:
- Your current taper schedule and whether it's too aggressive
- Whether you need to temporarily increase the dose
- A revised, slower taper plan
Important Caveats
Rule out other causes if tinnitus persists despite dose adjustment:
- The ACR guidelines note that tinnitus described as "roaring" can indicate various etiologies 5
- However, the temporal relationship with your taper strongly suggests withdrawal
- If tinnitus is unilateral, pulsatile, or associated with hearing loss or neurological symptoms, you need urgent ENT evaluation 5
Do not abruptly stop pregabalin - the FDA label specifically warns against this, as it increases risk of adverse reactions including seizures in susceptible individuals 1.
The Evidence Context
While pregabalin has been studied for treating tinnitus in fibromyalgia patients (with some benefit shown 6), and the FAERS database doesn't list pregabalin among the top drugs associated with tinnitus as an adverse effect 7, the withdrawal literature is clear that discontinuation symptoms are real and can be debilitating 2, 3. The key is distinguishing between drug-induced tinnitus (which would worsen with continued use) versus withdrawal-induced tinnitus (which appears during dose reduction).
Your symptom timing during taper is the critical diagnostic clue pointing to withdrawal rather than a direct drug effect.