From the Guidelines
The latest treatment for tinnitus involves a combination of approaches, with cognitive behavioral therapy (CBT) being a recommended treatment option, as stated in the clinical practice guideline: tinnitus executive summary 1.
Key Treatment Approaches
- Sound therapy is currently considered most effective, using devices that produce white noise, nature sounds, or customized tones to mask or distract from tinnitus.
- Cognitive behavioral therapy (CBT) helps patients manage their emotional response to tinnitus, as recommended by the clinical practice guideline: tinnitus executive summary 1.
- For medication options, while no drug is FDA-approved specifically for tinnitus, some physicians prescribe antidepressants like amitriptyline (10-100mg daily) or nortriptyline (25-100mg daily), or anti-anxiety medications like alprazolam (0.25-0.5mg as needed) to address associated stress and anxiety.
- Newer treatments include neuromodulation techniques, however, transcranial magnetic stimulation is not recommended for routine treatment of patients with persistent, bothersome tinnitus, as stated in the clinical practice guideline: tinnitus executive summary 2.
- Hearing aids are recommended for those with hearing loss alongside tinnitus.
Personalized Treatment
These approaches work by either masking the tinnitus perception, redirecting neural pathways in the brain, or addressing the emotional and psychological impacts of the condition. Treatment is typically personalized based on the individual's specific tinnitus characteristics and underlying causes, as emphasized in the acr appropriateness criteria® tinnitus: 2023 update 3.
Recent Guidelines
The American Academy of Otolaryngology and Head and Neck Surgery Foundation (AAO-HNS) guidelines recommend targeted history and clinical examination as the initial evaluation and determination as to whether the tinnitus is bothersome or not, before any imaging, as stated in the acr appropriateness criteria® tinnitus: 2023 update 3.
Quality of Life
The effects of tinnitus on health-related quality of life (QOL) vary widely, with most patients less severely affected but some experiencing anxiety, depression, and extreme life changes, as noted in the clinical practice guideline: tinnitus executive summary 4. Patients who have tinnitus accompanied by severe anxiety or depression require prompt identification and intervention, as suicide has been reported in patients with tinnitus who have coexisting psychiatric illness, as stated in the clinical practice guideline: tinnitus executive summary 4.
From the Research
Latest Treatment Options for Tinnitus
- Sound therapy is a commonly used treatment for tinnitus, with various options available, including ear-level sound generators, hearing aids, and tinnitus treatment devices 5
- Cognitive behavioral therapy (CBT) has been shown to be effective in reducing tinnitus-related distress and improving quality of life, and can be used in combination with sound therapy 6, 7, 8
- Repetitive transcranial magnetic stimulation (rTMS) has been used in combination with CBT to treat tinnitus, with promising results 6
- Notched sound therapy (NST) has been shown to be effective in reducing tinnitus loudness, and can be used as an alternative to CBT 7
- Smartphone-based applications providing CBT and customized sound therapy have been developed, and have been shown to be effective in reducing symptom severity and improving anxiety, sleep, and mood in tinnitus patients 8
Key Findings
- A study published in 2024 found that CBT was more effective in decreasing tinnitus-related distress, while NST was more helpful in reducing tinnitus loudness 7
- A randomized controlled trial published in 2025 found that a smartphone-based application providing CBT and customized sound therapy was effective in reducing symptom severity and improving anxiety, sleep, and mood in tinnitus patients 8
- A study published in 2017 found that the combination of rTMS and CBT was effective in treating tinnitus and insomnia in a single patient 6
Treatment Approaches
- Device-based clinical treatments for tinnitus, including sound-based treatments and hearing aids, are available for patients with bothersome tinnitus 5
- CBT and sound therapy can be used in combination to treat tinnitus, with the goal of reducing symptom severity and improving quality of life 6, 7, 8
- rTMS and CBT can be used in combination to treat tinnitus, with promising results 6