Tinnitus Medication Options
Tinnitus is more of a symptom than a health condition. This means that the ringing in the ear is not the exact problem; instead, it signifies that something is wrong with the ears.
The severity of tinnitus and whether it is temporal or permanent is dependent on the root cause. When the root cause is identified and handled, the tinnitus will disappear. The cause of tinnitus is often identified after an audiological exam.
Common Causes of Tinnitus
Since tinnitus treatment is heavily dependent on identifying the root cause of the noise in the ear, let's examine some common causes of tinnitus.
1. Exposure to Loud Noise
This is one of the major causes of tinnitus. Sudden or consistent exposure to loud noise can damage your eardrum or the hairs in your inner ear.
The hair cells can either be bent or broken. If they are bent, the tinnitus will be temporary; once they straighten, the ringing will disappear. But if they are damaged, tinnitus will be permanent because there is no way to restore damaged hair cells.
2. Earwax Blockage
Accumulation of cerumen or earwax in the ear can block the ear canal and cause tinnitus. If the body produces excess earwax over time, it will solidify and form a lump that will block the ear.
Attempting to clean the ear at home by using objects like cotton buds can push the earwax deeper into the ear and affect the flow of sound signals into the inner ear; this results in tinnitus.
In most cases, when the excess wax is removed, the tinnitus will disappear. Earwax removal should only be done by a doctor.
Aging can cause tinnitus which often degenerates to hearing loss. The older you get, the more different parts of your body, including the organs in your ear, begin to wear out. This wearing-out is more pronounced if you have been exposed to loud noise over the years. There is very little or nothing that can be done to handle tinnitus caused by age.
4. Tumors or Trauma
The growth of benign, non-cancerous tumors in the ear can affect the functioning of the ear. In some cases, lumps are formed in the blood vessels close to the ear. This reduces the pathway for blood flow in the affected blood vessel.
To ensure that blood still flows through the blood vessels, the pressure of the blood flow is increased. This increase in blood pressure can cause tinnitus.
Similarly, trauma to the head caused by a punch, kick, or blow can cause tinnitus.
Various diseases like autoimmune inner ear disease and Meniere's disease can affect the ears and cause tinnitus.
For instance, autoimmune inner ear disease makes the body attack the inner ear structures, especially the inner ear hair cells. If it is not given prompt medical attention, all the hair cells can be permanently damaged.
6. Ototoxic Medications
These are medications used to treat various health conditions that have adverse effects on the ears. Many over-the-counter drugs are considered to be ototoxic.
Common examples are antimalarial drugs, Aminoglycoside antibiotics, anti-inflammatory medications, painkillers like ibuprofen and aspirin, and cancer chemotherapy drugs.
Tinnitus caused by ototoxic medications can be cured by discontinuing the medication responsible for the ringing.
Tinnitus is one of the few health conditions that has given doctors, pharmacists, and health care professionals a hard time. Despite how long tinnitus has been around and its prevalence in the population, there is still no FDA-approved drug to treat tinnitus.
A number of factors cause difficulty in finding the appropriate drug or medication for tinnitus. Let's examine them.
1.Limited Understanding of the Biological Basis of Tinnitus
This means that healthcare professionals are yet to understand the mechanism behind tinnitus fully. Not much is known about tinnitus beyond its clinical presentation and description.
Until the underlying mechanism behind tinnitus is understood, healthcare professionals won't be equipped with the knowledge necessary to develop therapies or medications specifically targeted at curing tinnitus.
2. The Heterogeneity of Tinnitus Population
Heterogeneous means unlike and distinct or different from each other. The tinnitus population’s heterogeneity means that the samples, symptoms, causes, or etiology of tinnitus are different.
No two tinnitus cases are alike. The cause of tinnitus in patient A may be different from the cause of tinnitus in patient B. In the same manner, the severity of the ringing in the ear differs from person to person.
The heterogeneity of the tinnitus population makes it hard for a one-size-fits-all medication to be produced. For instance, if a medication is produced to cure tinnitus caused by autoimmune inner ear disease, it will not be effective in curing tinnitus caused by earwax blockage or tumors.
3. Cost of Production
While this may not sound like a tangible reason, it is actually one reason why there is no tinnitus drug yet. The cost associated with developing drugs to treat tinnitus is explicitly high.
This is partly due to the extensive research and test that it entails. Because the causes are different, each will have to be researched independently. Unifying the cures for each independent cause to form a single medication is no small feat, and it will require lots of funds.
4. The Wide Range of Tinnitus Causes
The range of medical conditions responsible for tinnitus is so wide that creating a specific medication to cure it will be very difficult.
Considering the fact that the causes of tinnitus are both external and internal, if a specific medication is to be created to treat it, the drug may be effective in combating some causes like autoimmune disease and other diseases that cause tinnitus. But external factors like sudden exposure to loud noise may be beyond the control of the drug.
5. Lack of an Accepted Tinnitus Nosology
Nosology is the classification of diseases. For a disease to be classified, you need to identify its cause (the cause must be only one), the symptoms it produces, and the effect it has on the body. Nosology makes nosography possible.
Nosography is a description aimed at enabling a diagnostic label to be put on a situation.
As you already know, tinnitus has multiple causes; it also has different symptoms and varying effects on people. All these have made it hard for an accepted tinnitus nosology to be adopted.
No diagnostic label can be put on it in the absence of nosology, and no medication can be created for it.
Tinnitus Medication Options
Even though there has been no specific tinnitus medication, drugs developed for other health conditions have been studied and examined to determine whether they can relieve tinnitus.
In this section, we will be examining some drugs that doctors prescribe to relieve tinnitus. Notice that we said to relieve, not cure. This is because all these drugs will reduce the severity of the ringing and give you relief.
There is no guarantee that the tinnitus will be cured by taking these medications. You will, however, be able to go about your daily activities without much difficulty when taking these drugs.
Antibiotics are used to treat tinnitus if an ear infection causes the tinnitus. The antibiotics are not taken to cure the tinnitus; rather, it is for treating the ear infection responsible for the tinnitus. The most common antibiotic given for ear infections is amoxicillin.
The tinnitus will stop when the ear infection has been treated. You may experience some side effects like indigestion, nausea, or vomiting when taking the drug.
2. Antidepressants and Antianxiety Drugs
These are psychoactive drugs used to treat behavioral issues related to tinnitus. Chronic tinnitus can cause psychological problems like anxiety and depression.
This is due to the drastic effect tinnitus has on their life. They may not be able to sleep well, engage in conversations or go about their daily activities normally. All this gives rise to negative emotions, which can increase the severity of the tinnitus.
The relationship between tinnitus and negative emotions is circular; tinnitus causes anxiety, anxiety worsens tinnitus, the worsen tinnitus causes more anxiety.
Antidepressants and antianxiety drugs relieve the anxiety and depression symptoms, and in some patients, the tinnitus becomes less noticeable.
Common antidepressant drugs prescribed to tinnitus patients are Anafranil (clomipramine), Imipramine (Tofranil), Vivactil (Protriptyline), Desipramine (Norpramin), Nortriptyline (Pamelor). Side effects of antidepressants include nausea, fatigue, and weight gain.
Common anti-anxiety drugs prescribed to tinnitus patients include Valium (Valium), Clonazepam (Klonopin), Alprazolam (Xanax), and Lorazepam (Ativan).
Antidepressants and antianxiety drugs should only be taken on prescription as some of them can be addictive.
Misoprostol is used to treat stomach ulcers in hypertensive and diabetic patients. But it is used to relieve tinnitus. Some studies have shown that Misoprostol reduces the loudness of tinnitus.
It is often prescribed for chronic tinnitus, especially those with hypertension and diabetes. However, large studies have not been conducted to ascertain whether or not Misoprostol should be recommended as a treatment for tinnitus, neither is it approved by the FDA.
Side effects of using Misoprostol include stomach upset, diarrhea, gas, stomach pain, and nausea.
Lidocaine is a local anesthetic used to treat abnormal heart rhythms. Studies have shown that lidocaine can relieve tinnitus, especially those caused by various inner ear diseases, especially those that affect the inner ear hair cells.
For lidocaine to be effective, it must be given intravenously or injected directly into the labyrinth through the middle ear.
The side effects of lidocaine often outweigh its potency in reducing the severity of tinnitus. It is therefore not recommended.
Dexamethasone is a steroid used to treat tinnitus caused by Meniere's disease, hearing loss, or autoimmune inner ear disease.
Dexamethasone for tinnitus is intratympanic.
An intratympanic injection is one that is administered by an ear surgeon in an in-office awake surgical procedure. The surgeon passes a long narrow bore needle through the ear canal and the eardrum into the middle ear. The dexamethasone into the space in the middle ear, where the inner ear absorbs it.
While dexamethasone may not totally eliminate tinnitus, it relieves the symptoms and enables tinnitus to carry out their daily activities without difficulty.
Campral is also known as Acamprosate, is used to treat alcoholism. Several studies have suggested that Campral is effective in reducing the severity and annoyance of tinnitus. This is especially true for tinnitus related to increased excitatory spontaneous brain activities.
Acamprosate helps restore the inhibitory/ excitatory balance in the brain, thereby reducing tinnitus severity. Campral has also been linked to the electrophysiological improvement of the distal portion of the auditory nerve and the cochlear.
The FDA does not approve Campral, but some doctors prescribe it to tinnitus patients. Side effects of Campral include diarrhea, nausea, and vomiting.
7. Off-label Medications
Off-Label Medications are medications used for purposes that they are not originally intended for or approved by the FDA. Many off-label medications are used to relieve tinnitus symptoms, but these have not been scientifically proven to relieve tinnitus symptoms. Some off-label medicines used to treat tinnitus are anticonvulsants and antihistamines.
Side Effects of Tinnitus Medications
Most of the medications that are used to treat tinnitus have varying side effects. Some of the common side effects of these medications are dry mouth, fatigue, nausea, memory impairment, and vomiting.
It is important to take these drugs under the supervision of a healthcare professional.
In some cases, the side effects far outweigh the benefits of the medication in handling tinnitus. For instance, some of these medications, especially psychoactive ones, reduce the brain's ability to change and adapt; this makes it difficult for the patient to ignore tinnitus noise.
Some of these medications may also counteract other medications that the tinnitus patient is taking for another medical condition.
Considering the side effects of some of these medications, it is advised that you only take them when prescribed by your doctor. You must also ensure that you adhere to the dosage prescribed by the doctor.
Asides from these medications, there are other tinnitus treatments that can relieve tinnitus symptoms. Your doctor will help you identify which of these other tinnitus treatments you should use.
Have you tried using any of these tinnitus medications? Were you relieved? Leave a comment below.