Triamterene for Tinnitus
Triamterene should not be used for the treatment of tinnitus, as there is no evidence supporting its efficacy and it is not recommended by any clinical practice guidelines.
Evidence Against Pharmacotherapy for Tinnitus
The American Academy of Otolaryngology-Head and Neck Surgery explicitly recommends against medical therapy, including medications, for treating persistent, bothersome tinnitus 1. This recommendation is based on:
- Insufficient evidence from systematic reviews and randomized controlled trials to justify routine pharmacological use in managing tinnitus 1
- Known potential harms, including the risk that some medications (such as antidepressants) may actually worsen tinnitus 1
- Cost considerations without demonstrated benefit 1
Specific Evidence on Diuretics
While triamterene is a potassium-sparing diuretic, diuretics as a class have been investigated for tinnitus treatment but lack evidence of efficacy 2. The comprehensive review of pharmacotherapy for tinnitus found no consistent results supporting the use of diuretics for reducing tinnitus severity 2.
What Actually Works
Instead of triamterene or any pharmacological agent, the evidence-based approach for persistent, bothersome tinnitus includes:
- Cognitive Behavioral Therapy (CBT) - the strongest evidence-based treatment for improving quality of life 3, 4
- Hearing aid evaluation for patients with any degree of hearing loss, even if mild or unilateral 3, 4
- Education and counseling about tinnitus management strategies for all patients 3, 4
Clinical Pitfall to Avoid
Do not prescribe medications without clear evidence of benefit, as they may cause side effects or potentially worsen tinnitus 4. The disconnect between patient desires for pharmacological solutions and the lack of effective drug treatments is well-documented 5, but this should not lead to prescribing unproven therapies like triamterene.