From the Guidelines
Hydroxyzine can cause tinnitus, as evidenced by its listing as a potential side effect in various studies, including one that notes tremors, irritability, hyperactivity, jitteriness, shrill cry, myoclonic jerks, hypotonia, increased respiratory and heart rates, feeding problems, and clonic movements in infants exposed to the drug in utero 1.
Mechanism and Symptoms
The exact mechanism of hydroxyzine-induced tinnitus is not well understood, but it may be related to the drug's effects on the central nervous system and its anticholinergic properties, which can affect auditory processing. Symptoms of tinnitus can include ringing, buzzing, or other sounds in the ears, and may be accompanied by other side effects such as dizziness, headache, and nausea.
Management and Treatment
If you experience tinnitus while taking hydroxyzine, it is essential to report this symptom to your healthcare provider. In some cases, the symptom may resolve on its own once the medication is discontinued or the dosage is adjusted. However, if the tinnitus persists or is severe, your doctor may recommend alternative treatments, such as switching to a different medication with a lower risk of this side effect.
Key Points to Consider
- Hydroxyzine can cause tinnitus, although it is not a common side effect
- The mechanism of hydroxyzine-induced tinnitus is not well understood, but may be related to the drug's effects on the central nervous system and its anticholinergic properties
- Symptoms of tinnitus can include ringing, buzzing, or other sounds in the ears, and may be accompanied by other side effects
- If you experience tinnitus while taking hydroxyzine, report this symptom to your healthcare provider, who may recommend adjusting the dosage or switching to a different medication.
From the Research
Hydroxyzine and Tinnitus
- Hydroxyzine is an anti-histamine medication that has been used in the treatment of anxiety 2.
- There is evidence to suggest that hydroxyzine may be associated with a decreased perception of tinnitus when used in combination with sulpiride 3.
- However, other studies have found that hydroxyzine may be ototoxic and increase the risk of bilateral hearing loss 4.
- Tinnitus and hearing loss are associated with a large range of drugs, including antimicrobials, anti-inflammatory agents, diuretics, and antineoplastic agents 5.
- Some drugs, such as lignocaine, can temporarily reduce or abolish tinnitus in some patients, while others may aggravate existing tinnitus 6.
Key Findings
- The combination of sulpiride and hydroxyzine decreased tinnitus perception by 81% in patients treated with this combination 3.
- Hydroxyzine was associated with a higher risk of bilateral hearing loss, with an adjusted hazard ratio of 1.31 4.
- Over 130 drugs and chemicals have been reported to be potentially ototoxic 5.
- The mechanism of ototoxicity is unclear, but may involve biochemical and electrophysiological changes in the inner ear and eighth cranial nerve impulse transmission 5.