title: [Pharmacotherapy for tinnitus: much ado about nothing].
abstract: BACKGROUND
  Chronic tinnitus affects 5-15% of the general population; in 1% of individuals with tinnitus this condition severely affects their quality of life. Pharmacological treatment is one of the options for the management of tinnitus patients, but their efficacy remains controversial. AIM. To evaluate the level of evidence to support the use of different drugs in reducing the severity of tinnitus.
  
  
  METHODS
  The pharmacological groups that have been investigated for the treatment of tinnitus include anesthetics, anticonvulsants, antidepressants, antihistamines, benzodiazepines, diuretics, corticosteroids, and of other substances. Intravenous lidocaine seems to be effective, but the short duration of the effect and the adverse reactions prevent its use. Compared with placebo, carbamazepine and gabapentine have not demonstrated effectiveness although they may be effective in some patients with auditory nerve vascular compression or myoclonus. Tricyclic antidepressants are no more effective than placebo at reducing tinnitus severity although they may improve comorbid depression. There is insufficient evidence to evaluate the effectiveness of selective serotonin reuptake inhibitors and benzodiazepines. Acamprosate may decrease the severity of tinnitus, but the level of evidence is low. There are no consistent results in the studies with intratympanic gentamicin or steroids in tinnitus associated with Meniere's disease.
  
  
  CONCLUSIONS
  The use of pharmacotherapy in reducing the severity of tinnitus is not well supported by prospective, randomized, placebo-controlled clinical trials. Various drugs have been shown to be effective in some studies, but the clinical evidence is limited. Large randomized clinical trials are needed.
authors: Hospital San Agustin, Linares, Espana.
authors: Juan M
authors: JM
authors: Espinosa-Sánchez
authors: Teresa
authors: T
authors: Heitzmann-Hernández
authors: José A
authors: JA
authors: López-Escámez
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001306:Auditory Pathways / Q000187:drug effects / Q000503:physiopathology; D001307:Auditory Perception / Q000187:drug effects / Q000502:physiology; D015259:Dopamine Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005544:Forecasting; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008012:Lidocaine / Q000627:therapeutic use; D008959:Models, Neurological; D018377:Neurotransmitter Agents / Q000502:physiology; D016032:Randomized Controlled Trials as Topic; D014012:Tinnitus / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000779:Anesthetics, Local; D000927:Anticonvulsants; D000928:Antidepressive Agents; D015259:Dopamine Agents; D018691:Excitatory Amino Acid Antagonists; D006634:Histamine H1 Antagonists; D006993:Hypnotics and Sedatives; D018377:Neurotransmitter Agents; D008012:Lidocaine