I am a 41 yr old who has had mild tinnitus for 25 years but in the last few months is has become very bad in one ear and I am also suffering from hyperacusis in that ear. I have seen my GP and am waiting to see an ENT specialist but wondered if there is any way to relieve the tinnitus which is becoming quite distressing.
Medications that are well accepted in treatment of Tinnitus
* Lorazepam or klonazepam (in low doses). These are “benzodiazepines”, mainly used for anxiety (Gananca et al, 2002; Dobie, 2003)
* Amitriptyline or nortriptyline (again in low doses). These are “tricyclic antidepressants”.
Comment. Benzodiazepines and tricyclics probably mainly change emotional responses to tinnitus. Any sort of relief, however, is important.
We have also had some patients get relief from other antidepressants including the SSRI family.
The anticonvulsants such as mysoline may affect some patients who have tinnitus due to 8th nerve irritation. Mysoline contains phenobarbital, which is sedating.
The effect of local anesthetics on tinnitus was discovered serendipitously by Barany in 1935. Otsuka et al (2003) recently reported administration of Lidocaine to 117 ears over a 24 year period. The method was intravenous infusion, of between 80 and 100 mg. They report a transient (several minutes) response in about 70% of treated ears. As responses are nearly always very temporary, lidocaine does not have a role as a treatment of tinnitus. The mechanism appears to be central (Baguley et al, 2005). According to Dobie (1999), the related drugs tocainamide, mexilitine and flecainamide have not been shown superior to placebo.
Drugs in which it is uncertain whether they are effective
* Atorvastatin (Lipitor)
* Campral (author of this page is not sure — might be a placebo)
* Flunarizine (not available in US)
* Caroverine (not available in US, IV medication)
* Eperisone (not available in US).
Atorvastatin (Lipitor). A recent trial in older people showed that atorvastatin had no effect on the rate of hearing deterioration but there was a trend toward improvement in tinnitus scores over several years.
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