Tinnitus Treatments and Medications

Tinnitus, or a ringing sound in the ears, can be distracting and make it difficult to cope in everyday life. Tinnitus is typically caused by an underlying condition. You must first understand the causes of tinnitus before you can take steps to treat it with either medication or natural cures. Let’s explore tinnitus and what can be done to best treat and manage tinnitus symptoms.

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

Treatment for tinnitus depends on the underlying condition. Many causes of tinnitus are unknown. Some known causes of tinnitus include hearing loss, Meniere’s disease, vascular disease, or a head injury. Some cases of tinnitus may be treated with the help of an audiologist performing biofeedback or masking devices. Medications may be discontinued if they are the cause of tinnitus. Lifestyle changes such as reducing salt intake and avoiding loud areas may also prevent tinnitus. Medication has also been shown to help some cases of tinnitus, such as antibiotics when tinnitus is caused by an ear infection.

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

It is important to visit a healthcare professional when experiencing tinnitus since it can be due to a serious condition. A general practitioner should be your first stop, who will then direct you to an otolaryngologist (ear-nose-throat doctor), audiologist, or neurosurgeon due to the suspected cause of tinnitus. During the visit, your doctor will likely examine your ears, head, and neck and possibly send you to the audiology department for a hearing test. On rare occasions, a doctor may order a CT/CT angiography or MRI to find the root of tinnitus symptoms. Your doctor may ask you questions such as:

• 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 an 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): This drug 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: This medicine is used to treat stomach ulcers and has been found to help tinnitus in people with diabetes and people with hypertension. Large studies have not been done at this time, so it is not a common treatment. Overall, it has limited benefits, and more research is needed.

• Lidocaine: This local numbing medication has been used in the past to treat tinnitus, however, due to excessive adverse effects, it should not be used.

• Dexamethasone: This steroid 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.

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Best medications for tinnitus