First, please know that there is no OTC or prescription FDA approved drug or medicine for Tinnitus. In other words, finding the best drugs for Tinnitus is largely an experimental endeavor . But, a number of medications meant to treat conditions other than Tinnitus have been helpful in relieving or sometimes even resolving Tinnitus. Let’s explore such off label uses. We will also discuss the best supplements or vitamins for Tinnitus later in the post.
Best Drugs or Meds Meant to Treat or Help Manage Tinnitus (Off-Label Use)
The following information is largely excerpted from this very detailed NCBI article. You will also find links to case studies referred to here in this post at the link mentioned above. Besides summarizing the findings of that paper, we have also tried to make the language easier to read and understand. The original paper has explored more drugs as potential treatment for Tinnitus. But, we have only picked the ones where studies seemed at least somewhat promising. Also, we have ignored drug candidates supported by only animal studies or only by the fact that they are currently being explored by clinical studies. We also ignored drugs that were shown to help with Tinnitus, but caused irreversible damage (Like how Tiagabine (Gabitril®) helps Tinnitus but can cause permanent visual disturbances.)
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Campral® (Acamprosate)
Primary Use
To treat alcoholism
How does off-label use help potentially treat Tinnitus?
How Severe is Your Tinnitus?
Find out by using this THI (Tinnitus Handicap Inventory) Scoring Calculator
It is believed that Acamprosate can help find relief from Tinnitus if Tinnitus was caused by excessive glutamatergic activity through either NMDA receptors or as a result of hyperactivity resulting from loss of GABA-mediated inhibition. It essentially provides a sedative effect.
Study exploring Acamprosate as a Tinnitus drug
87% of subjects with annoying Tinnitus reported an improvement of their symptoms. The results were most telling after 90 days of treatment, with little or no effects at the 30 and 60 day intervals. The double blind study also studied a placebo group in which 44% of participants reported an improvement in symptoms.
Spasmium-R® (Caroverine)
Primary Use
To treat abdominal cramping and IBS symptoms
How does off-label use potentially treat Tinnitus?
The assumption is that Caroverine can curb Tinnitus that arises out of synaptic disturbances caused by NMDA and non-NMDA receptors on spiral ganglion neurons.
Study exploring Caroverine as a Tinnitus drug
An initial study showed that 63% of Tinnitus sufferers treated with Caroverine reported an improvement in Tinnitus symptoms. 0% of the placebo group reported symptom improvement. However, a follow up study found that Caroverine had no effect on improving Tinnitus symptoms.
Xanax® (Alprazolam)
Primary Use
To treat anxiety, depression and panic attacks
How does off-label use potentially treat Tinnitus?
Alprazolam binds to a GABA receptor and reduces excitability. It is essentially a sedative.
Study exploring Alprazolam as a Tinnitus drug
76% of subjects who were treated with Alprazolam reported an improvement in their Tinnitus symptoms. A placebo group only showed a 5% improvement. However, the study was criticized for its small sample size and also for the quality of testing protocols used.
Valium® (Benzodiazepine)
Primary Use
To treat anxiety, epilepsy, insomnia and muscle spasms
How does off-label use potentially treat Tinnitus?
It reduces neuro excitability by hyperpolarizing GABA receptors and also by inhibiting sodium channels, providing a sedative effect that may calm your Tinnitus.
Study exploring Diazepam as a Tinnitus drug
A study of 21 patients made a surprising conclusion that Diazepam had no effect on reducing Tinnitus intensity or volume. The study also concluded that patients found it difficult to discontinue the drug due to its tendency to create a dependency on it.
The conclusion that Diazepam was ineffective as a Tinnitus drug is surprising as the drug’s mechanism is very similar to Alprazolam, which provided rather promising results. Though ineffective, we put down this information on Valium as it is often considered an efficient drug to treat Tinnitus.
Klonopin® (Clonazepam)
Primary Use
Prescribed as a muscle relaxant, anticonvulsant and anxiolytic
How does off-label use potentially treat Tinnitus?
The drug’s mechanism is very similar to that of benzodiazepines like Valium, discussed above. It provides a sedative effect by decreasing neuro excitability.
Studies exploring Clonazepam as a Tinnitus drug
A retrospective study of over 3,000 patients who took Clonazepam for cochleovestibular disorders including Tinnitus revealed that over 32% reported an improvement in Tinnitus. But, there was no control group to compare the results to.
Another smaller study of just 10 patients concluded that Clonazepam was able to significantly reduce Tinnitus intrusiveness and volume. However, this smaller study was criticized for its small sample size and the lack of a double-blind testing protocol.
Xylocaine® (Lidocaine)
Primary Use
Used as a local anesthetic or to treat cardiac arrhythmias
How does off-label use potentially treat Tinnitus?
It’s a fast acting sodium channel blocker. It can also affect calcium, potassium and glycine induced chloride currents. It is not known why or how exactly Lidocaine can help with Tinnitus though.
Studies exploring Lidocaine as a Tinnitus drug
Various clinical studies have reported Lidocaine to cause Tinnitus suppression rates between 40% to 70%. A significant 30% also reported an increase in Tinnitus after Lidocaine treatment. Studies also concluded that benefits, if any, were usually very short lasting.
Tegretol® (Carbamazepine)
Primary Use
Prescribed as an anticonvulsant and mood stabilizer
How does off-label use potentially treat Tinnitus?
The drug binds to voltage gated sodium channels to then stabilize neural firing. It may also affect calcium and potassium channels as well. Regulation of sodium and potassium levels may help alleviate Tinnitus.
Studies exploring Carbamazepine as a Tinnitus drug
Studies showed that Carbamazepine in low doses (<=200 mg/day) were ineffective in treating Tinnitus. At higher doses (600-1,000 mg daily), some studies showed a 56% response rate to Tinnitus improvement. Studies also showed that Carbamazepine was particularly effective in patients who also positively responded to Lidocaine treatment.
Carbamazepine is an excellent and proven treatment drug for Typewriter Tinnitus. Typewriter Tinnitus is a ringing in the ears that is caused by compression of one’s auditory nerve.
Aventyl® (Nortiptyline)
Primary Use
A tricyclic antidepressant used to treat chronic pain, fatigue and migraines
How does off-label use potentially treat Tinnitus?
Nortriptyline inhibits the reuptake of norepinephrine, a neurological signal passing hormone. It also potentially inhibits the production of 5-HT, a neuro transmitting mediator. Reduced neural excitation can then help subside Tinnitus intensity.
Studies exploring Nortriptyline as a Tinnitus drug
Clinical studies showed that Nortriptyline was able to reduce Tinnitus volume by as much as 10 dB in patients who suffered from severe Tinnitus loudness and also severe depression. Studies also found a strong correlation between the drug’s effectiveness and the intensity of Tinnitus and depression suffered from. The more the intensity of depression or Tinnitus, the better the drug performed.
Zoloft® (Setraline)
Primary Use
Prescribed to treat severe depression, anxiety, panic attacks and obsessive-compulsive disorders
How does off-label use potentially treat Tinnitus?
It’s a serotonin transporter that increases serotonin or the ‘feel good’ hormone. But, it also inhibits dopamine, another ‘feel good’ hormone. It is unclear how the drug’s mechanism can potentially help with Tinnitus.
Studies exploring Setraline as a Tinnitus drug
A good clinical study concluded that Setraline was able to reduce Tinnitus loudness by as much as 12 dB in patients who were depressed, anxious and at risk of developing very severe Tinnitus. It is important to note that these patients did not suffer from severe hearing loss.
Cytotec® (Misoprostol )
Primary Use
To prevent gastric ulcers
How does off-label use potentially treat Tinnitus?
The drug is a synthetic prostaglandin that helps injured or damaged tissue heal itself. It does so by reducing inflammation and regulating blood flow and blood clotting. It is possible that Misoprostol can alleviate Tinnitus by helping repair damaged cells and tissue in the ear structures.
Studies exploring Misoprostol as a Tinnitus drug
Three small subsequent studies showed that Misoprostol was able to significantly reduce Tinnitus volume (>15 dB) in patients while a control group that received a placebo showed little or no improvement. Misoprostol dosage used in the studies was 800 μg/day.
Prednisone
To treat allergic reactions
How does off-label use potentially treat Tinnitus?
Prednisone can reduce or reverse Tinnitus when it is provided as a treatment for Sudden Sensorineural Hearing Loss. While it can reverse Tinnitus and sudden deafness, it can also exacerbate Tinnitus in some cases, especially when it is not tapered down properly.
You can learn more about Tinnitus and prednisone here.
Flonase
To treat allergies
How does off-label use potentially treat Tinnitus?
Severe allergies or a sinusitis condition can cause eustachian tube dysfunction. This is a condition where the tube that connects one’s nasal cavities to the ear cavity is blocked. When blocked, the eustachian tube cannot optimize the air pressure inside of the ear. This can then present itself as problems like Tinnitus, vertigo and compromised hearing. Flonase can in this case be used as a nasal corticosteroid spray to relive the eustachian tube, thereby potentially providing relief from Tinnitus as well. Similarly, antihistamines may be able to help with Tinnitus as well.
A Note About Ototoxicity – Drugs that can cause or make your tinnitus worse
As you can see from the list of medicines for Tinnitus above, there are a lot of anti-anxiety and anti-depressants that can potentially provide Tinnitus relief. But, most anti-depressants and anti-anxiety pills are also ototoxic drugs. Oto means ears and toxic of course means harmful. So, while some of the above medicines can help with Tinnitus, some can actually make it worse or even cause it. Read more about antidepressant ototoxicity here.
Prednisone is another steroid drug that is commonly used to treat sudden hearing loss, Tinnitus and other conditions. But, it is also a drug that can cause or worsen Tinnitus. Read about prednisone ototoxicity here. Also, learn more about oral steroids and Tinnitus here.
NSAID Pain relievers like Aspirin can be ototoxic as well. Some antibiotics, beta blockers, diuretics, chemotherapy pills and quinine based medications (to treat malaria) are all ototoxic. If you think your Tinnitus might have come on as a result of ototoxicity, talk to your doctor about stopping said ototoxic medication or switching to an alternative non-ototoxic or less-ototoxic medication.
Supplements and Vitamins for Tinnitus
A number of supplements or vitamins can also help alleviate or even resolve Tinnitus. However, there is an overwhelming supply of OTC drugs for Tinnitus, with many providing little, nil or just a placebo effect. I personally am able to keep Tinnitus dormant with a natural supplement called Synapse XT. I have written more about how I stumbled on this all natural drug after struggling with Tinnitus for more than 2 years, in my Tinnitus success story here. If not for this supplement, you can also try the other supplements and vitamins suggested below.
Melatonin
Melatonin is a natural hormone that is produced by the body. It’s production is affected by exposure to blue wave light. When the sun goes down and you continue to expose your eyes to blue light from digital devices, Melatonin production is disrupted. Since melatonin regulates your sleep, your sleep suffers. Your Tinnitus gets worse as a result. It’s a downward spiral.
Taking synthetic melatonin can therefore help you cope with Tinnitus better. Read more about Melatonin for Tinnitus here.
Vitamin D
Poor vitamin D levels can adversely affect the health of ear bones and muscles. Yes, you read that right. Your ear has both bones and muscle that need to be in good health to ensure you hear well, without problems like ringing in your ears. People with very low levels of Vitamin D have reported a reduction in Tinnitus symptoms after receiving Vitamin D booster shots or after taking oral supplements over a few weeks. Learn more about Vitamin D and Tinnitus here.
Vitamin B 12
Vitamin B 12 is a key vitamin that ensures that your nerve endings have a healthy and protective myelin sheath around them. Chronic Vitamin B 12 deficiency can cause demyelination of the auditory nerve that can then result in hearing loss and Tinnitus. Learn more about Vitamin B 12 deficiency and Tinnitus here.
Ginkgo Biloba
Ginkgo Biloba is probably the most popularly touted Tinnitus drug in the OTC market. We wrote a post investigating Ginkgo Biloba’s effects on Tinnitus. The supplement is a hit or miss with anecdotal evidence claiming that it is both useful and useless. Several studies have also provided contradictory results, making this TCM medicine quite a confusing choice as supplement to help treat Tinnitus.
Thyroid Medication
Erratic thyroid levels can affect your Tinnitus by disrupting blood pressure, hormonal production, electrolyte channel transmission and also by affecting your body’s ability to efficiently absorb nutrients needed for optimal hearing health. Read about the Thyroid Tinnitus connection here.
Your Diet
Does your Tinnitus get worse after eating? You don’t have to look at drugs or medicines but rather at what you are eating. Diets high in salt, sugar, flavor enhancers, fats and caffeine can all make Tinnitus worse. Simply cleaning up your diet can possibly give you profound relief from Tinnitus.
If any of these medications work to make your Tinnitus go away, you will first experience these Tinnitus going away signs.
