[Tinnitus therapy with lidocaine and tocainide]

A randomised clinical cross-over study was performed to evaluate the therapeutic value of lidocaine, tocainide infusion and oral application of tocainide against placebo in the treatment of tinnitus. 40 patients with sensory hearing loss of different origin and otherwise not treatable constant tinnitus were included. Lidocaine infusion showed a tinnitus suppression of more than 50 per cent in about 70 per cent of patients; in comparison, tocainide infusion in 55 per cent of the patients. Oral tocainide therapy was successful only in about 35 per cent of patients. This fact depends partially on the high proportion of side effects. Therefore, tocainide therapy should be used in such patients only, who suffer severely from their tinnitus. Patient selection can be done by the lidocaine test. Oral tocainide therapy is advisable only if the lidocaine test result is positive. The methodical problems in the assessment of the value of drugs in tinnitus treatment are discussed: Evaluation and elimination of placebo effects and spontaneous fluctuations of tinnitus intensity, as well as selection of patients included in the study.