Q:  Extreme Sensitivity to Sounds

Hi Dr. Phelps,
I'm currently on Lamictal and Seroquel.  For the last month and 1/2 I've been having intense high volume hearing problems. cars driving by ,dogs barking, doors slamming, someone coughing, tearing up papers, and even our clock ticking. I've been taking Lorazepam for the shaking inside and the high anxiety. also I've been wearing earplugs so I can sleep.  I did go to my primary care doctor and she found nothing wrong with my ears.  I've been taken these meds for a long time. Can you shed some light on this. It's driving me crazy.

Thanks
 

Dear JA' -- 
Haven't heard this one.  So to speak; very bad joke, not intended.  Let's see if I can recover from there.  I am not aware of formal descriptions of this problem, how's that.  But...  I have had several patients describe going through phases of profound sensory sensitivity that was driving them crazy too.  One women said when this was happening she would be aware of something like the seam in her pants leg, and she could not stop noticing each movement.  But this, for her, would last only a few days.  She seemed to have a rapid cycling bipolar disorder and was on no medications when she reported this. 

Other folks have reported extreme sensitivity to sounds, very much like I hear people report when they're having a migraine headache:  they want to be in a dark room, with no sensory stimuli.  A stereo three apartments away would really bother them.  Being around people is even worse, these people tell me, and a crowd, especially a crowd of strangers, is the worst (especially a noisy one).  It's as though there's a sort of social as well as sensory sensitivity going on with this. 

Now, I understand you might not be describing this at all; but just in case some of that strikes a chord, I thought I'd pass it along as otherwise I'm drawing a blank on what you describe.  Notice that for these other folks, there was something to do about it, in that they also at the same time seemed to be having symptoms of cycling. In particular, like you, they had symptoms that lorazepam would help with in the short run: an agitation, a sense of "too much" thought and energy as well as sensation.  So there too what you're describing sounds similar to what I've seen. 

So in those cases the thing to do was to target their cycling.  It doesn't sound so clear that you're cycling.  If you were, I'd just go after that.  If you're not -- or even if you are -- one would have to wonder if somehow the medications could be doing this, even if you've been on them quite a while.  For example, lamotrigine seems to have antidepressant power enough to induce manic symptoms in some people:  is there any way what you're describing could be something like that?  (rhetorical question)  If you were responding well to the lamotrigine in other respects, it would be a shame to try to get rid of the sound-sensitivity and then end up losing the good things it's doing (with no absolute guarantee that you could turn around and get it back by going back on the medication).  But at some point the medications have to be considered possible culprits, even if when you search the PDR and elsewhere you do not find sensory phenomena listed as side effects (it's late or I'd do that now for you myself).  

I hope that might help a little.  For example, if the sound sensitivity is really a "bipolar symptom", I would predict that a little tiny test dose of Zyprexa, perhaps instead of or maybe even in addition to the Seroquel, would damp it down.  That doesn't clinch anything, but might strengthen the idea that this is a symptom you can target, which sounds like would be helpful at this point. 

Dr. Phelps
 

Published May, 2003