Tinnitus Treatments and Medications

What is tinnitus?

Tinnitus, which can be pronounced either TIN-a-tus or tin-EYE-tus, is a ringing sound in one or both ears, and is not caused by an external source. It affects 2.6 billion people worldwide. It is more prevalent in the older age population since it is often associated with hearing loss. Besides ringing some people with tinnitus may hear:

• Buzzing
• Roaring
• Hissing
• Chirping
• Clicking
• Humming
• Whistling
• Pulsing
• Whooshing

How is tinnitus diagnosed?

Tinnitus is not a disease, but rather a symptom of an underlying condition. Tinnitus will be more frequently found in older populations and those with jobs and lifestyles that lead to loud noise exposure. There are many things that can cause tinnitus, such as:

• Hearing loss
• Vestibular disorders, such as Meniere’s disease
• Migraines
• Exposure to loud noises, such as at a concert or on a construction site
• Head and neck injury or traumatic brain injury
• Medications harmful to hearing (i.e., aspirin or certain antibiotics)
• High blood pressure
• Anemia
• Ear wax build-up
• Tumors
• Temporomandibular joint disorder (TMJ)
• Ear infection
• Vascular malformation
• Eustachian tube dysfunction
• Excess caffeine
• Smoking

• Do you hear ringing in both ears or just one ear? Right or left ear?
• How often do you hear the ringing and how long does it last?
• Do you notice it more at certain times, such as day or night?
• What does the ringing sound like? Is it high or low pitched?
• Does the loudness vary or does the pitch change?
• Are there any things that make the ringing worse or better?
• Is it affecting your everyday life? Is it causing you anxiety or causing you to lose sleep?

What are the treatment options for tinnitus?

There are several options for treatment of tinnitus, however, treatment depends on the underlying condition. The majority of tinnitus cases will clear up on their own. However, cases of chronic tinnitus do not currently have a cure. There are some pharmaceutical options, but most will be non-pharmaceutical. These options may include:

• Medication If tinnitus is caused by an ear infection, antibiotics may be prescribed. Occasionally other drugs are prescribed to help with symptoms experienced, but there is no current FDA-approved drug for tinnitus. Medications may also be changed if they are ototoxic, meaning they cause damage to the inner ear. Ototoxic drugs can cause tinnitus.
• Other treatment There are a variety of non-medical treatments that have shown to be successful with tinnitus, such as biofeedback and hypnosis. Therapies to cope with tinnitus or lifestyle changes may also be helpful in managing tinnitus.

What medications can treat tinnitus?

Currently, there is not an FDA-approved medicine specifically to treat tinnitus, likely due to the fact that the cause of tinnitus is often unknown. However, there is research currently being done dedicated to trying to find a cure. Research is also being done to find drugs to cure hearing loss and Meniere’s disease, which may indirectly help cure tinnitus. However, there are some medications your doctor may prescribe if you need relief from tinnitus, they may include:

• Antibiotics If an ear infection is causing tinnitus, this can be cleared up with antibiotics. The common antibiotic given for ear infections is amoxicillin. Common side effects are nausea, indigestion, or vomiting.
• Antidepressants A certain type of antidepressants called tricyclic antidepressants, are sometimes prescribed to help relieve the depression symptoms that come alongside chronic tinnitus. Depression can sometimes happen with chronic tinnitus due to poor quality of life. This is because chronic tinnitus can cause inability to focus at work, make it hard to sleep, or cause distractedness. Since negative emotions can increase the severity of tinnitus, antidepressants may on occasion improve tinnitus. Tricyclic antidepressants that may be prescribed include Anafranil (clomipramine), Norpramin (desipramine), Pamelor (nortriptyline), and Tofranil (imipramine). Antidepressants also come with many side effects, such as fatigue, weight gain, and nausea.
• Anti-anxiety medications Anti-anxiety medications also are meant to manage the stress and anxiety caused by tinnitus. In addition, sometimes decreased stress improves the severity of tinnitus. Medications your doctor may prescribe could include Xanax (alprazolam), Valium (diazepam), or Ativan (lorazepam). These drugs can be habit-forming, so they should be taken with caution.
• Campral (acamprosate) is a drug that treats alcoholism but has been found in multiple studies to decrease the severity of tinnitus in some patients. It is not widely used to treat tinnitus at this time and is not FDA-approved to treat tinnitus, but some doctors may consider it as a treatment. Common side effects of Campral are nausea, diarrhea, and vomiting.
• Misoprostol is a medicine used to treat stomach ulcers has been found to help tinnitus in diabetics and people with hypertension. Large studies have not been done at this time, so it is not a common treatment. Overall, it has limited benefit and more research is needed.
• Lidocaine is a local numbing medication, has been used in the past to treat tinnitus, however, due to excessive adverse effects, it should not be used.
• Dexamethasone is a steroid which has been used with some success in patients with tinnitus who also have an ear disease (e.g., hearing loss, Meniere's disease, or autoimmune inner ear disease).

What are the best medications for tinnitus?

Your doctor should always determine the best medication for your tinnitus based on your symptoms, medical history, and current prescriptions. Some potential medications may include:

What are the common side effects of tinnitus medication?

Side effects of tinnitus medication vary depending on the drug prescribed. Some of the common side effects may include nausea, vomiting, fatigue, weakness, memory impairment, or dry mouth. Before taking any medication you should talk to your healthcare professional about any potential side effects that may happen or interaction with any drugs you may currently be taking.

Can tinnitus be cured naturally?

There are many options to help resolve or cope with tinnitus, depending on the underlying cause of the tinnitus. These options may include:

• Removing earwax or even foreign objects from ears can resolve or decrease tinnitus.
• Electrical stimulation of cochlea with electrode placement has shown some improvement in tinnitus in patients with hearing loss.
• Changing medication can help stop the cause of tinnitus when a medication is ototoxic (causing damage to the inner ear).
• Hearing aids have been shown to give tinnitus relief to 60% of people in a 2008 study. This is possibly due to the fact that the correct sounds are now heard, masking the tinnitus. Cochlear implants may also be an option, but this is very rare.
• Hearing protection is important to decrease tinnitus from loud noise exposure. Wearing earplugs or headphones when going to concerts, construction sites, or sporting events can help protect your inner ear.
• Sound masking is another way to relieve tinnitus. Sound maskers include fans, white noise sound machines, music, etc., may help with tinnitus, especially when in quiet environments.
• Neuromodulation is a device worn in the ear that is said to minimize the overactive neurons causing the tinnitus. It a safe treatment, but at this time it is not clear if it is effective.
• Repetitive transcranial magnetic stimulation (rTMS) has shown modest effectiveness. One study showed that its benefits were sustained during the six-month follow-up period. It is safe for short-term treatment, but its long-term safety has not been studied.
• Habituation treatment typically performed by an audiologist, allows a patient to cope with life with tinnitus and helps shift their focus on other things.
• TMJ treatment by a dentist, such as dental orthotics, may help treat the underlying cause of tinnitus and help the tinnitus resolve.
• Ginkgo biloba a Chinese herb, is said to help with blood flow and some people have claimed it has helped manage tinnitus.
• Acupuncture has been suggested to reduce tinnitus discomfort, however, its success has been questionable. During acupuncture for tinnitus, needles are placed in the hands and affected side of the face.
• Hyperbaric oxygen therapy where a person sits inside a pressurized chamber of 100 percent oxygen, is said to help tinnitus formed from sudden hearing loss. During this process, oxygen is delivered to the inner ear.
• Tinnitus retraining therapy (TRT) is sound therapy and counseling that is said to help 80% of people see relief in their tinnitus.
• Neuromonics tinnitus treatment is another type of sound therapy and counseling that always has high effectiveness for patients.
• Behavioral therapies which focus on the patient’s behavioral reactions, has been shown to help reduce anxiety and depression in those with tinnitus. There are a few therapies that can help cope with emotions and feelings about tinnitus, including:
  • Acceptance and commitment therapy
  • Cognitive behavioral therapy
  • Mindfulness-based stress reduction
  • Progress tinnitus management
  • Tinnitus activities treatment
• Hypnotherapy has been helpful to relieve symptoms of tinnitus for some patients.
• Biofeedback is a way for those with tinnitus to manage stress and relax, potentially reducing some of the cause of tinnitus.
• Lifestyle changes such as eating a proper diet, exercising, and socializing can help treat depression and anxiety sometimes caused by tinnitus. Diets low in salt can also benefit those with tinnitus from Meniere’s disease.
• Counseling is important for helping those who have strong negative emotions about tinnitus, usually in cases of severe tinnitus.
• A clinical trial for tinnitus can be a way to help treat tinnitus and help scientists develop a cure.

Does tinnitus ever go away?

There are treatments available to help tinnitus go away, such as medications and hearing aids. However, not all cases of tinnitus go away.

Can tinnitus go away on its own?

Most cases of tinnitus go away on their own. Such as from loud noise exposure the day before or an ear infection.

Do antihistamines help tinnitus?

Antihistamines are sometimes prescribed for tinnitus, but at this time results for the effectiveness of antihistamines for tinnitus patients is inconclusive.

Can tinnitus be cured naturally?

Some people have found relief for tinnitus using acupuncture or ginkgo biloba, a Chinese herb.

Who is the best doctor for tinnitus treatment?

A general practitioner should be your first step in diagnosing the cause of tinnitus. The doctor can then refer you to an audiologist or otolaryngologist depending on their medical advice.

Resources

• ASHA tinnitus overview
• ASHA infographic
• List of ototoxic drugs
• Researching a cure for Meniere’s disease
• Researching a cure for hearing loss
• Botox for objective tinnitus
• Botox study for tinnitus
• Acamprosate for tinnitus treatment
• Misoprostol for tinnitus
• Hearing aids for tinnitus
• Neuromodulation for tinnitus
• William Shatner interview
• Evaluation and treatment review
• Tinnitus rehabilitation therapy
• Neuromonics tinnitus treatment
• Tinnitus and its current treatment