What Is The Best Tinnitus Medication?

This article has been audited and reviewed by Dr. Ben Thompson, an audiologist and tinnitus expert. For more information about Dr. Thompson, click his name or read his bio below the article!

Tinnitus describes the sensation of hearing either an intermittent or continuous noise that has no outside source. This can come in the form of ringing, buzzing, hissing, whining, clicking, chirping, or whistling. It is associated with damage to the inner ear and noise-induced hearing loss.

Although tinnitus is relatively common (affecting an estimated 15% of the U.S. population in some form), it is a condition that has been baffling medical professionals for years, mainly due to its unknown pathophysiology.  

Unless it naturally goes away on its own, tinnitus is currently incurable (or rather, there are no medications proven to reverse the neural hyperactivity at the root of tinnitus).

Understandably, there is a great demand for a any kind of tinnitus medication from sufferers wanting relief from this aggravating condition.

Can You Get Over The Counter Tinnitus Medication?

Currently, there are no FDA-approved drugs specifically for tinnitus. Despite this, there are a number of over-the-counter substances that are misleadingly marketed as remedies for tinnitus. While these products may display claims of the medicines effect, there is still no reliable clinical evidence that these substances can relieve tinnitus symptoms. Anecdotal evidence is, in the end, merely anecdotal.

These products tend to play on people’s desperation and willingness to ‘try anything’. To avoid potential disappointment, it’s best to stay away from these products.

There are, however, pharmacological options that may help ease the stress, anxiety, and depression that are caused by tinnitus or are making it worse.

What Medication Can I Take For Tinnitus?

There are a few different medications recommended for tinnitus, but they’re not all guaranteed to be effective. As we’re still learning about tinnitus, the efficacy of various drugs is still being evaluated in clinical studies.

Not all drugs are appropriate for all patients, so it’s important you consult your healthcare practitioner to ensure you’re choosing the right treatment for your case.

Tricyclic Antidepressants

To manage the anxiety, stress, and depression associated with tinnitus, many people decide to take psychoactive drugs. For many, this eases the psychological strain of the condition and provides a sort of mental relief from its sometimes overbearing symptoms.

Some common tricyclic antidepressants (TCAs) used in cases of tinnitus include:

• Clomipramine (Anafranil)
• Desipramine (Norpramin)
• Imipramine (Tofranil) 
• Nortriptyline (Pamelor)
• Protriptyline (Vivactil)

Some people may want to avoid antidepressants as they don’t treat the tinnitus itself. This frustration is completely understandable, but it’s worth considering the connection between negative emotions like stress and the worsening of tinnitus.

When the anxiety and stress that comes with tinnitus is under control, some sufferers even report a perceived reduction in their actual symptoms. Still, it should be noted that research confirms that antidepressants have extremely limited efficacy in reducing tinnitus in patients without anxiety or depression.

Limitations of Tricyclic Antidepressants

If you’re thinking about taking antidepressants you should be aware that they can have some nasty side effects. In the case of TCAs, side effects can include nausea, dry mouth, weight loss, constipation, increased pressure in the eye, and insomnia amongst others. Because of the severity of these side effects, such medications are generally only used for severe cases of tinnitus related symptoms.

Furthermore, some research suggests that antidepressants and antianxiety medications can make it harder for patients to naturally habituate (learn to ignore) the sound of tinnitus over time as they might lead to a reduction in neural plasticity.

Some people even claim that taking TCAs caused their tinnitus in the first place. 

Above all, while these medications can have powerful effects they should only be used after the consultation and under the supervision of a trained healthcare practitioner. 

Alprazolam

Alprazolam, a benzodiazepine, is thought to work by enhancing the activity of specific neurotransmitters in the brain. It is used as a treatment for anxiety disorders, panic disorders, and symptoms of depression.

You should not take Alprazolam when pregnant, if you’re taking itraconazole or ketoconazole, or if you have a history of allergic reactions to any benzodiazepine. 

You should not take it with alcohol, drugs that slow your breathing or cause drowsiness, or opioid medicine.

Limitations of Alprazolam

Alprazolam is sometimes used to treat tinnitus, however, there is limited evidence as to whether it actually has any beneficial effects.

Jalali MM et al. sought to measure the efficacy of alprazolam for the relief of tinnitus in this cross-over randomized clinical trial. The study’s primary outcome variables were tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS) – a psychometric response scale often used in questionnaires – and tinnitus loudness.

 It found that although alprazolam did not improve the THI score or sensation level of loudness significantly, it has a desirable effect on VAS. 

The drug may have some positive effect on tinnitus, but further work still needs to be conducted on the extent of alprazolam’s benefit for distressed or depressed patients. It should also be noted that alprazolam can be habit-forming and misuse can form an addiction.

Aspirin

Some informational sources list Aspirin as a medicine to relieve tinnitus, but Aspirin is NOT a medication for tinnitus. Large doses of aspirin (along with some other drugs) have even been recognized as a potential cause of tinnitus. Salicylate, the active component in aspirin, is sometimes even used to induce tinnitus in animals.

Small doses are unlikely to cause any tinnitus symptoms and large doses that may cause issues are prescribed much more sparingly. Nevertheless, even when people do experience tinnitus after taking aspirin, they often find it to be reversible as it quickly goes away once they stop taking the medication. A small number of people are unusually sensitive to aspirin and develop reversible tinnitus at very low doses. In these cases, aspirin should be avoided and they should talk to a doctor about their situation.

Other Options for Tinnitus Relief

As of today, there is no drug, herb, or supplement that has been found to be a medication for tinnitus that is more effective than a placebo. No single approach has the same effect on everyone and you might need to try a few different techniques or a combination of approaches before you find the one that helps your symptoms. 

Many people find it disheartening that there is no FDA approved drug for tinnitus, but there are other effective strategies. People have found success with behavioral approaches such as Cognitive Behavioral Therapy (CBT) which works on changing the way the patient thinks about their tinnitus, making it less bothersome. Tinnitus Retraining Therapy (TRT), masking, and biofeedback and stress management have also had some success.

In addition, there are a number of home remedies that one can try at little or no cost.

If you have age-related hearing loss, a hearing aid that amplifies outside sounds can make tinnitus less noticeable.

If you have tinnitus and would like to find out more about your treatment options, contact a specialist. Take a look at the American Tinnitus Association (ATA) website where they offer lots of useful information and don’t forget to consult your doctor before taking any new medications. 

Article edited by Dr. Ben Thompson – Au.D. (Audiologist)

Dr. Ben Thompson is an audiologist and tinnitus expert. Dr. Thompson is the founder of Treblehealth.com. He decided to specialize in tinnitus management because of his interests in mindfulness, music and psychology. He completed his residency at University of California at San Francisco (UCSF) and is a past board member of the California Academy of Audiology. 

Via telehealth, Dr. Thompson provides tinnitus retraining therapy online. He hosts a YouTube channel, podcast, and tinnitus group coaching program to help individuals with hearing loss and tinnitus.

The information in this guide has been written using the following reliable sources:

https://pubmed.ncbi.nlm.nih.gov, www.ata.org, www.drugs.com, www.sps.nhs.uk, www.rxlist.com, www.tinnitus.org.uk

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