This article summarises potential medications that could be used to treat tinnitus and the evidence behind their use. Effective medications to eliminate tinnitus remain elusive but treatment could be divided into two broad categories: treatment to reduce perception of tinnitus and treatment to reduce the negative impact of tinnitus on patients’ mental health. There is a higher prevalence of anxiety and depression in patients with bothersome tinnitus although it is unclear if patients with anxiety and depression are more likely to develop tinnitus or if they are more likely to find tinnitus bothersome. Nevertheless, screening for anxiety and depression in patients with tinnitus is vital as untreated depression can affect coping ability with tinnitus. There is mixed evidence on the effectiveness of benzodiazepines in the treatment of tinnitus and this is not recommended by the author. An area of interest is looking at use of anti-epileptics in the treatment of tinnitus with the theory that tinnitus occurs secondary to an ‘auditory seizure’. Several placebo-controlled trials found improvement in tinnitus following treatment with Gabapentin. The doses varied from 600mg to 3600mg a day and treatment courses varied between two and six weeks. In all studies, patients reported improvement in tinnitus symptoms from two to eight weeks of treatment compared to placebo. However, a study comparing tinnitus outcomes between patients with noise-induced tinnitus and presbycusis-related tinnitus only found significant improvement in the former. This appears to show that there is no single medication that could treat all types of tinnitus. It was also not mentioned if the improvement following treatment with Gabapentin continued in the long term. Overall, there appears to be promising pharmacological options for patients with tinnitus in selected cases.
Pharmacologic treatment options for tinnitus
Reviewed by Sam Cho
Current validated medical treatments: pharmacologic interventions.
