Tinnitus: When the Ears Ring

Joshua J. Pray; W. Steven Pray

US Pharmacist. 2005;30(6) 

In This Article

Treatment of Tinnitus

If an underlying condition or medication is a potential etiology for tinnitus, it should be addressed. For instance, all aspirin-containing products and nonsteroidal anti-inflammatory drugs should be discontinued.[1] For more serious potential causes, expert care must be sought in most cases.

For tinnitus that is subjective, however, there is usually no identifiable cause, eliminating cure as a possible outcome.[11] Rather, the physician must focus on management of symptoms. Medications may be helpful. Some experts suggest supplementation with vitamin A, vitamin C, cyanocobalamin, and nicotinic acid, or with magnesium, zinc, or copper.[1,11]

Patients may be advised to avoid foods and medications that worsen tinnitus. These include caffeinated drinks and high-sodium foods and beverages (the latter often worsens Meniere's syndrome, one component of which is tinnitus).[1] Cessation of smoking may help.[4]

Prescription medications may be effective. The use of clonazepam 0.5 mg at bedtime has been suggested. Another suggested medication has been alprazolam in a beginning dose of 0.5 mg at bedtime for two weeks, increasing if needed to twice per day for weeks 3 and 4, and to three times per day for weeks 5 and 6, tapering off gradually to avoid insomnia if there is no relief at this level.[4,11,12] Tricyclic antidepressants help some patients with more severe tinnitus, perhaps through alleviating the depression that often accompanies this severe hearing disorder.[1]

Use of a hearing aid in the affected ear of a patient with unilateral tinnitus may help, especially if the tinnitus appeared with the onset of moderate deafness.[11]

Tinnitus masking is growing in popularity. Many patients do not notice tinnitus if there is some background noise in the room. Using this fact, the concept of tinnitus masking consists of instructing patients to use another tone or noise to mask the tinnitus.[12] Patients with a form of tinnitus that prevents the onset of sleep may turn an FM radio to the space between stations to generate "white noise" that can make tinnitus less noticeable. Alternatively, the patient may opt to purchase sound generators (e.g., producing the sound of ocean waves).[4] Specific tinnitus-masking devices are also marketed that allow the patient to produce a range of frequencies, allowing them to mask tinnitus with the smallest noise possible. Some devices are worn in the ear, working in conjunction with hearing amplification devices.[4]

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