The assessment of lamotrigine, an antiepileptic drug, in the treatment of tinnitus.
OBJECTIVE
Tinnitus is an extremely prevalent condition that currently has no satisfactory clinical treatment. Development of therapy has been hampered by the diversity of underlying conditions that give rise to the symptom of tinnitus. A drug that has multiple actions may have an improved chance of being effective. One such drug is lamotrigine, a recently developed antiepileptic agent that has both glutamate release inhibition and sodium channel antagonist activity.


METHODS
Lamotrigine was evaluated in a double-blind, placebo-controlled, crossover clinical trial. Patients initially were tested with an intravenous infusion of lidocaine (10 mg/mL) to a maximum of 100 mg or until a reduction in tinnitus. Lamotrigine or placebo tablets were taken once daily (25 mg) for 2 weeks, 50 mg for 2 weeks, and 100 mg for 4 weeks.


METHODS
Patients were chosen from among volunteers from the tinnitus clinic in the local hospital without reference to underlying pathology.


METHODS
Those patients whose tinnitus had been present for less than 6 months or whose tinnitus was likely to vary spontaneously were excluded.


METHODS
Perceived intensity and intrusiveness of tinnitus was assessed before entry onto the trial and at 4-week intervals throughout the trial.


METHODS
Assessment comprised questionnaires, visual analog scales, and a battery of audiologic measurements.


RESULTS
There was no correlation between the response to lidocaine and the response to lamotrigine. There was good agreement between the questionnaires and visual analog scales in the reporting of perceived changes; however, this was not reflected as changes in the audiologic tests.


CONCLUSIONS
Of the 31 participants who completed the trial, questionnaires indicated that lamotrigine was effective in a very few of these persons.
Simpson
J J
JJ
Department of Pharmacology, The Medical School, University of Birmingham, United Kingdom.
Gilbert
A M
AM
Weiner
G M
GM
Davies
W E
WE
D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001298:Audiology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008144:Loudness Perception; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D026941:Sodium Channel Blockers; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000175:diagnosis / Q000188:drug therapy*; D014227:Triazines / Q000493:pharmacokinetics / Q000627:therapeutic use*
D000927:Anticonvulsants; D018691:Excitatory Amino Acid Antagonists; D026941:Sodium Channel Blockers; D014227:Triazines; D000077213:Lamotrigine