From the Guidelines
No specific medications are recommended for the treatment of tinnitus.
Medication Overview
- The use of antidepressants, anticonvulsants, anxiolytics, and intratympanic medications is not recommended for treating persistent, bothersome tinnitus due to a lack of evidence supporting their efficacy and potential for harm 1.
- The evidence suggests that these medications may have no benefit and can have significant side effects, making their use not justified in the management of patients with tinnitus 1.
Alternative Treatments
- Instead of medications, other management strategies such as education and counseling, hearing aid evaluation, sound therapy, and cognitive-behavioral therapy (CBT) may be recommended for patients with persistent, bothersome tinnitus 1.
- These alternative treatments have shown promise in alleviating tinnitus symptoms and improving quality of life for patients, and are recommended by clinical practice guidelines 1.
From the Research
Medications Used to Treat Tinnitus
- Various medications are used in the treatment of tinnitus, including anesthetics, antiarrhythmics, anticonvulsants, antidepressants, antihistamines, antipsychotics, anxiolytics, calcium channel blockers, cholinergic antagonists, NMDA antagonists, muscle relaxants, vasodilators, and vitamins 2
- Pharmacologic interventions with brain-acting effect, such as amitriptyline, acamprosate, and gabapentin, and those with anti-inflammation/anti-oxidant effect, such as intra-tympanic dexamethasone injection plus oral melatonin, are associated with superior improvement in tinnitus severity and response rate compared to placebo/control 3
Specific Medications and Their Effects
- Antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), have been used to treat tinnitus, but the evidence is limited and the effects may be attributable to methodological bias 4
- Amitriptyline, an antidepressant, was associated with the highest improvement in tinnitus severity and the fourth highest response rate in a network meta-analysis of randomised controlled trials 3
- Gabapentin, an anticonvulsant, has been used to treat tinnitus, but its effectiveness is unclear 5
Challenges in Treating Tinnitus
- There is currently no FDA-approved drug for the treatment of tinnitus, and the pathophysiology of tinnitus is poorly understood 2, 5
- The lack of clinical trials and preclinical studies to investigate novel agents has hindered the development of effective treatments for tinnitus 6
- Animal models of tinnitus may be used to screen potential anti-tinnitus drugs as a preliminary step before conducting clinical trials 6