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Pharmacotherapy of Tinnitus

  • Tobias KleinjungEmail author
  • Berthold Langguth
Chapter
  • 78 Downloads
Part of the Current Topics in Behavioral Neurosciences book series

Abstract

Tinnitus is a common symptom for which there is in most cases no causal therapy. The search for an improvement of tinnitus through pharmacological interventions has a long tradition. The observation that tinnitus can be transiently suppressed by the use of lidocaine has shown that the symptom is susceptible to pharmacotherapy. So far, however, no medication has been found for either acute or chronic subjective tinnitus that reliably leads to a long-term reduction or even complete disappearance of the symptom for the majority of tinnitus sufferers. Nevertheless, in everyday clinical life, drugs are frequently used, usually off-label, to relieve tinnitus or tinnitus-associated symptoms (e.g. sleep disturbance, depression, anxiety disorder or hearing loss). This chapter shows the different approaches to acute and chronic subjective tinnitus by means of pharmacotherapeutic interventions. Furthermore, this review reports on the scientific studies carried out in this area in recent years and explains the difficulties in finding a suitable medication for most forms of tinnitus. In addition, it reports on the pharmacotherapeutic options for objective tinnitus and describes the development of tinnitus as a side effect of certain drugs. Finally, possible target structures are mentioned, which should possibly be addressed in pharmacological studies in the near future.

Keywords

Acute tinnitus Chronic tinnitus Drug therapy Local Objective tinnitus Pharmacology Subjective tinnitus Systemic 

Abbreviations

ACE

Angiotensin-converting enzyme

AMPA

α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid

BT

Botulinum toxin

EMA

European Medicines Agency

FDA

US Food and Drug Administration

GABA

Gamma aminobutyric acid

GABAA

Gamma aminobutyric acid type A

HMG-CoA

3-Hydroxy-3-methylglutaryl-coenzym-A

MEM

Middle ear myoclonus

NAC

n-Acetyl-l-cysteine

NMDA

n-Methyl-d-aspartate

NSAID

Non-steroidal anti-inflammatory drug

PM

Palatal myoclonus

SM

Stapedial myoclonus

SNRI

Serotonin-norepinephrine reuptake inhibitor

SSRI

Selective serotonin reuptake inhibitor

TCA

Tricyclic antidepressants

THI

Tinnitus Handicap Inventory

TTM

Tensor tympani muscle

TVP

Tensor veli palatini

Notes

Acknowledgements

Conflict of interest: Nothing to declare.

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich, University of ZurichZurichSwitzerland
  2. 2.Department of Psychiatry and Psychotherapy, Interdisciplinary Tinnitus CenterUniversity of RegensburgRegensburgGermany

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