From the Guidelines
Cymbalta (duloxetine) may cause hearing-related side effects, including tinnitus and rare cases of hearing changes, although hearing loss is not among the most common side effects. The provided evidence does not directly link Cymbalta to hearing loss, but rather discusses the screening and treatment of hearing loss in older adults 1. However, it is essential to note that some patients taking Cymbalta have reported hearing-related side effects. If you're taking Cymbalta and experience any changes in your hearing, such as muffled sounds, difficulty understanding speech, or new onset of tinnitus, you should contact your healthcare provider promptly. These symptoms should be evaluated to determine if they're related to the medication or have another cause. The mechanism behind potential hearing effects isn't fully understood but may relate to duloxetine's impact on neurotransmitters like serotonin and norepinephrine, which play roles in auditory processing. Don't stop taking Cymbalta suddenly as this can cause withdrawal symptoms; any medication changes should be supervised by your doctor. Regular hearing assessments might be beneficial if you're on long-term Cymbalta therapy and have concerns about your hearing. Some key points to consider include:
- The prevalence of hearing loss varies depending on the definition used, but population-based estimates range from 20% to 40% in adults older than 50 years to more than 80% in adults aged 80 years or older 1.
- Hearing loss can negatively affect a person's quality of life and ability to function independently 1.
- Available screening tests include physical diagnostic tests, such as the whispered voice, finger rub, and watch tick tests, as well as handheld audiometers and self-administered questionnaires 1.
From the FDA Drug Label
The following adverse reactions have been identified during post approval use of duloxetine delayed-release capsules. ... Adverse reactions reported since market introduction that were temporally related to duloxetine delayed-release capsules therapy and not mentioned elsewhere in labeling include: ... tinnitus (upon treatment discontinuation)
- Hearing loss is not directly mentioned in the label, but tinnitus (a symptom often associated with hearing problems) is reported as an adverse reaction upon treatment discontinuation.
- Based on the information provided, it can be inferred that Cymbalta (duloxetine) may be associated with tinnitus, but there is no direct evidence to support a causal relationship between Cymbalta and hearing loss 2.
From the Research
Cymbalta and Hearing Loss
- There is no direct evidence in the provided studies that links Cymbalta (duloxetine) to hearing loss 3, 4, 5, 6, 7.
- The studies mention various drugs that can cause hearing loss, including anti-infectives, cancer drugs, loop diuretics, and phosphodiesterase 5 inhibitors 3, 4, 7.
- However, duloxetine is not listed among the drugs known to cause hearing loss in these studies.
- One study reports a case of dysosmia and dysgeusia associated with duloxetine, but it does not mention hearing loss 6.
- Another study discusses sensorineural hearing loss associated with phosphodiesterase-5 inhibitors, but it does not mention duloxetine 7.
Ototoxicity and Hearing Loss
- Ototoxicity is a potential cause of hearing loss, and it can be caused by various drugs 3, 4.
- The mechanism of ototoxicity is unclear, but it may involve biochemical and electrophysiological changes in the inner ear and eighth cranial nerve impulse transmission 4.
- Prevention of drug-induced ototoxicity is generally based on consideration and avoidance of risk factors, as well as monitoring of renal function, serum drug concentrations, and cochlear and auditory functions before and during drug therapy 4.