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Antidepressants for patients with tinnitus
P Baldo1, C Doree, R Lazzarini
1Centro di Riferimento Oncologico--CRO Aviano (PN) Italy, Hospital Pharmacy, Via Pedemontana Occidentale, 12, Aviano (PN), Friuli-Venezia-Giulia, Italy. pbaldo@cro.it
The Cochrane Database of Systematic Reviews
|October 21, 2006
Summary
Antidepressants do not show sufficient evidence for improving tinnitus. Further research is needed to determine if these drugs offer direct benefits for tinnitus or indirectly help by treating depression.
Area of Science:
- Otolaryngology
- Psychiatry
- Clinical Pharmacology
Background:
- Tinnitus, the perception of sound without external stimuli, is often compared to chronic pain and linked to depression.
- Antidepressant medications are sometimes used for tinnitus, regardless of the presence of depressive symptoms.
Purpose of the Study:
- To evaluate the efficacy of antidepressants in treating tinnitus.
- To differentiate between direct effects on tinnitus and indirect effects from treating comorbid depression.
Main Methods:
- Systematic review of randomized controlled trials comparing antidepressants to placebo for tinnitus.
- Searched multiple databases including Cochrane, MEDLINE, EMBASE, CINAHL, PSYCINFO, and LILACS up to March 2006.
Main Results:
- Five trials (525 patients) were included; four used tricyclic antidepressants (405 patients), and one used a selective serotonin reuptake inhibitor (SSRI) (120 patients).
- Tricyclic antidepressants showed a slight, possibly biased, improvement in tinnitus. The SSRI trial found no overall improvement, though a subgroup at higher doses showed potential benefit.
- Common side effects included sedation, sexual dysfunction, and dry mouth. Only the SSRI trial met high-quality standards; others had methodological limitations.
Conclusions:
- Insufficient evidence currently supports the use of antidepressant drug therapy for improving tinnitus.
- The potential benefit of SSRIs in specific subgroups warrants further investigation.
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