Hanyang Med Rev.  2016 May;36(2):113-119. 10.7599/hmr.2016.36.2.113.

Pharmacological Treatments for Tinnitus

• Park SY

• KMID: 2164669
• DOI: http://doi.org/10.7599/hmr.2016.36.2.113

Abstract

Pharmacotherapy has been constantly chosen by the clinician among the available treatment options for tinnitus. Medications that have been prescribed off-label to treat tinnitus can be grouped into several categories: benzodiazepines, antidepressants, anticonvulsants, N-methyl-D-aspartate (NMDA) receptor antagonists, dopamine receptor modulators, muscle relaxants, and others. In this article, a wide variety of compounds once used in the treatment of tinnitus and evidenced by clinical trials are reviewed with respect to the mechanisms of action and the drug efficacy. Only a few of the various pharmacological interventions investigated have some beneficial effects against tinnitus: clonazepam, acamprosate, neramexan, and sulpiride. Sertraline and pramipexole were effective in subgroups of patients with psychiatric symptoms or presbycusis. However, no agents have been identified to provide a reproducible long-term reduction of tinnitus in excess of placebo effects. In rodent tinnitus models, L-baclofen, memantine, and KCNQ2/3 channel activators have been demonstrated to reduce tinnitus development. Limitation of the use of an effective high dosage during a longer treatment duration due to dose-dependent side effects of the centrally acting drugs may influence the results in clinical studies. More effective and safer innovative agents should be developed based on the further understanding of tinnitus neural mechanisms and valid animal models, and should be supported by improved clinical trial methodology. The management of tinnitus patients through a tailored treatment approach depending on the detailed classification of tinnitus subtypes will also lead to better treatment outcomes.

Keyword

Anticonvulsant; Antidepressants; Benzodiazepines; Dopamine Receptor Agonist; NMDA Receptor Antagonists

MeSH Terms

Anticonvulsants
Antidepressive Agents
Benzodiazepines
Classification
Clonazepam
Dopamine Agonists
Dopamine Antagonists
Drug Therapy
Humans
Memantine
Models, Animal
N-Methylaspartate
Placebo Effect
Presbycusis
Rodentia
Sertraline
Sulpiride
Tinnitus*
Anticonvulsants
Antidepressive Agents
Benzodiazepines
Clonazepam
Dopamine Agonists
Dopamine Antagonists
Memantine
N-Methylaspartate
Sertraline
Sulpiride

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