Could Ketamine Cure Tinnitus?

I entered a clinical trial to see if ketamine would stop the constant ringing in my left ear. The catch? I'd have to spend 90 minutes, while tripping, completely immobile in an MRI.

Dr. Diana Martinez (left), who designed the study, and her research coordinator Alex Grassetti (right), pose with a scan of my brain, post-MRI, at the New York State Psychiatric Institute. ©Deborah Copaken

The call to clinical trial, after two years of a high-pitched ringing in my left ear, came via an Instagram ad. Would I be willing to be a data point in a study at Columbia University by lying still in an MRI for ninety minutes, on two separate occasions, if it meant the possibility of quieting my tinnitus? Oh, and during one of those sessions, would I be willing to have ketamine, the dissociative anesthesia with hallucinogenic properties—also known by club kids as special K, super K, and vitamin K—injected into my veins?

It had been nearly four decades since I’d ingested anything hallucinogenic into my body. I’d both enjoyed the wild glimpses into my subconscious back then and was also perfectly content to leave such doors-of-perception explorations in the past. At the same time, by that point, I had nothing to lose.

While my hearing loss allows me to sleep through all of the aural, nocturnal assaults of city life—honking horns, loud music, the beep of a truck backing up, a loud drunken argument on the sidewalk at 2 am—my tinnitus is often loud enough to wake me up. It makes it difficult to concentrate, hear, read, write, converse, enjoy a quiet moment with my morning coffee. Plus I was curious about the whole ketamine part, having heard of several friends and acquaintances who’d found life-altering, mood-restoring relief of chronic depression via ketamine infusions. What would it do for my tinnitus? How would it do this?

I clicked on the link on the ad, emailed the researchers, and offered my body and ears to science.

“It isn’t your ear causing your tinnitus,” Dr. Diana Martinez, the psychiatrist leading the study, explained to me the day we met, as she was taking my vitals and a few vials of blood. It’s my brain, which compensates for damage to cochlear cells by filling in moments of silence with the high-pitched sound. (The video below is a good explainer.)

How did I get this tinnitus-causing damage to the cochlear cells of my ear? Who the hell knows, but I have several worthy candidates. There was the toddler who screamed in my left ear in that enclosed car at the Wellfleet drive-in in the mid-70s, bursting my eardrum; a particularly loud David Bowie concert back in the mid-80s; the bomb that went off in my face in Afghanistan back in 1989, causing temporary hearing loss; my nearly complete loss of hearing to Covid; and the Covid vaccine, which has been linked to the sudden onset of tinnitus.

I recently learned that the onset of menopause, too, can be associated with tinnitus, and that menopause hormone treatment decreases the risk of tinnitus. In other words, had I simply been told to start taking systemic estrogen after my uterus was removed in my mid-forties, I might have avoided this plague.

Of course, the NIH paper cited in the link above also contains the following sentence: “The relationship between tinnitus and menopause has rarely been reported and…no large survey has been conducted to investigate associations between tinnitus and HRT for menopausal women.” Shocking if unsurprising, this lack of a proven correlation, considering how little science cares about or invests in the study of our menopausal bodies. 

Anyway, whatever the cause of my tinnitus or anyone’s, I just wanted the ringing in my ear to stop. And Dr. Martinez, an addiction studies specialist who once suffered from tinnitus herself after a long plane ride during which her eardrum burst, believes that the ways in which ketamine stimulates GABA and glutamate in the brain—the brain’s brakes and accelerator, respectively—might be the key. Why? In a word, plasticity. Ketamine interacts with the NMDA receptor (N-methyl-D-aspartate), our brain’s primary excitatory neurotransmitter. This neurotransmitter plays an integral role in synaptic plasticity, which is the mechanism believed to be at the basis of memory formation. Dr. Martinez explains all of this much better and more simply than I ever could in our interview below.

Martinez’s study, as she also explains above, has been funded—both surprisingly and not—by the U.S. Department of Defense. Why the DoD? Because generations of soldiers exposed to loud explosions and noises currently suffer from tinnitus, which up until now has had no cure, only cognitive behavioral therapy and mindfulness training to (sorta kinda) learn to ignore it. But trust me: I’m as mindful as they come, and it is impossible to ignore tinnitus. So impossible that it has been correlated, especially in women, with a much higher rate of suicide.

So on a frigid January morning, at a loss for any better options, I showed up at the New York State Psychiatric Institute for my first consultation with Dr. Martinez and her lab. I filled out paperwork. I answered questions. I was told I’d be paid actual money to participate. Not a ton, but enough for two nice dinners out. Then I scheduled my dual sessions in the MRI, one during which I’d receive a placebo, the other during which I’d receive the ketamine. And no, I wouldn’t be told which one I’d be receiving.

“Will I be able to play tennis afterward, if I get the ketamine?” I asked the research coordinator, Alex Grassetti. My boyfriend had booked a late afternoon court for us on the same day as my first infusion. I’m as terrible at tennis as he is patient, but still. Ketamine might make the possibility of my hitting the ball within the lines that much more elusive.

Alex laughed. “That might be a challenge.” Ketamine, he told me, is short acting—meaning the drug would mostly be out of my body by the time I left the lab—but I would be woozy enough that the researchers had factored in the cost of an Uber to and from the lab for each of their subjects. “You’ll probably just want to do nothing. Or sleep.”

Lying completely still in an MRI for ninety minutes definitely does a number on the brain no matter whether any drugs are involved or not, plus you’re forced to watch nature videos of Iceland. Lots of pretty fjords and swans. Inescapable, unless you close your eyes and sleep, as I was able to do, if beautiful. After my first infusion I felt woozy but intact enough to instruct the Uber driver to take me to the tennis bubble, where I promptly—if incorrectly—told my love that I was sure I’d received the ketamine. I even bragged about being able to hit the ball within the lines from time to time, all things and hallucinogens ingested considered.

But did my tinnitus go away? No. It did not. Though I dutifully answered all of the clinical questions in the daily online survey sent to me by Grassetti over the next ten mornings after my infusion, I was so frustrated by the still-loud volume of ringing in my ear, I nearly didn’t go for my second infusion—the placebo, I was sure—because what was the point?

I’m so glad I did not bail. Because within ten minutes of the second infusion, I realized what a doofus I’d been. This time I was tripping. Hard. Not as hard as with LSD or mushrooms, and in a completely different, more mellow way, but my brain was opening up in that familiar hallucinogenic manner, and I could definitely feel it. All those pretty images of Iceland and swans? My eyes were too sensitive to light to watch them. Instead, I shut them and allowed my brain to make both its own beautiful images plus whatever random connections it wanted to make.

Because I was in the coffin-like enclosure of the MRI while tripping—definitely a first and truly odd—naturally I began to ponder my own death. The idea of this did not scare me. Quite to the contrary, it brought me to a kind of easy acceptance, even euphoria. In fact, that I made my peace, in that small space, with my own mortality was worth the entire trip, I decided, even if my tinnitus remained.

“How do you feel?” Dr. Martinez asked, as she pulled me out of the MRI.

I felt like a human brain with the ridiculous annoyance of a body as its scaffolding. “Completely disconnected from my limbs,” I said.

My brain. The large spike is the NAA molecule.

This was normal, Martinez and Grassetti assured me. They gave me several minutes to lie there in the dark, reintegrating my body with my brain. How was my tinnitus?, they wanted to know.

Still loud, alas, I told them. I filled out more questions, drank some water. After I felt steady enough to leave, Dr. Martinez herself escorted me to the Uber. Had I had to do this by myself, I might have been able to, but given the state of my still-fragile internal ecosystem, it was nice not having to find an exit or read a license plate. I stared out the window of the Uber on my way home, both giddy from the experience and frustrated by the ongoing ringing in my left ear. “Give it a few days,” Dr. Martinez had told me. She’d assumed, when designing her study, that the tinnitus relief might be immediate, but this had not, in her limited experience, been the case thus far.

Though the ketamine was now out of my bloodstream, the euphoria, acceptance, and delight remained. Biting into a ripe strawberry that night after dinner, overwhelmed by the ecstasy of its color, texture, and taste, I said to my love, “Imagine a world in which there are strawberries and swans!”

On the one hand, I’ll never live that one down. On the other? I can still tap into the joy of that moment whenever I feel like it. And easily, at that.

Then, it happened. Three days after my infusion of ketamine, the loud buzzing in my left ear went silent. Not completely silent, but silent enough, after two years of constant ringing, that I immediately sent the researchers an email: “Radical change in tinnitus today. It's still there, for sure, but it's much quieter.” That quiet lasted two weeks, which thankfully coincided with my vacation, during which I was not awoken even once by any loud ringing in my ear. Then, recently, the tinnitus starting gradually growing louder again.

Both elated by this overnight transformation and distraught by its apparent end, I asked Dr. Martinez what I could do to help push forward her study as well as how I might continue getting ketamine infusions to keep the silence going. Regarding the former, she told me she’s been stymied by a lack of participation in her study from females, particularly middle-aged women like me. In fact, most of her subjects have been youngish male musicians whose ears have been damaged by performing loud gigs and whose familiarity with the chemical properties of ketamine had, in many cases, already been—shall we say—well-established.

Regarding the latter—where might I get more ketamine, cheaply, legally, and fast—that’s a different story. While ketamine clinics have been popping up all over the U.S., the cost is still prohibitive (between $400 and $2000 per infusion, depending on the dosage and time) and not covered (surprise surprise!) by insurance. And while ketamine was approved in 1970 as an anesthetic, using it for any other purpose is still considered off-label. Meaning, doctors can legally prescribe it for depression, PTSD, eating disorders, OCD, postpartum depression, bipolar disorder, and now tinnitus, but its use is not officially approved by the Food and Drug Administration for these conditions, despite ample and long-standing evidence of its efficacy for the relief of many of them.

The only way to move the needle forward on ketamine therapy, in other words, is more proof. More studies. More clinical trial subjects like me, clicking on Instagram ads fed to them by algorithms primed by desperate google searches (“How to get rid of my tinnitus,” “Treatment for tinnitus,” “Cure for tinnitus,” “Will I ever hear silence again,” “Fuck this shit”), who show up in various labs across the U.S. and then shout into the void, “Eureka! Ketamine works! This matters!”

To that end, this is my shouting into the void. If you are a woman in the New York City metropolitan area reading this, and you have tinnitus, and you are interested in being part of Dr. Martinez’s study, please contact her team at (646) 774-7654 or email Alex.Grassetti@nyspi.columbia.edu. She—and I, and everyone else suffering from tinnitus—would greatly appreciate it.

Ladyparts will be published in paperback on October 24, 2023