Effectiveness of Over-The-Counter Treatments for Tinnitus Symptom Relief: A Systematic Review

To review the effectiveness of over-the-counter (OTC) treatments in reducing tinnitus symptom severity as measured by the Tinnitus Handicap Inventory (THI) in randomized controlled trials.

A comprehensive search was conducted in PubMed, Embase, Cochrane CENTRAL, ClinicalTrials.gov, and WHO ICTRP through March 2025. A systematic review of nine randomized controlled trials (RCTs) including 390 adults was conducted. Eligible studies evaluated oral OTC treatments with pre- and posttreatment THI scores. Because of substantial clinical and methodological heterogeneity and incomplete reporting of variance data required for pooled effect estimation, we performed a qualitative systematic review rather than a meta-analysis.

Nine RCTs comprising 390 participants met inclusion criteria. Investigated agents included melatonin, Ginkgo biloba, α-lipoic acid, açaí extract, and several combination antioxidant or herbal formulations. Several trials reported within-group reductions in THI scores for active treatments; however, findings were inconsistent across agents, placebo responses were common, and most products were evaluated in only a single small study. Variation in dosage, treatment duration, and study design limited direct comparison between trials.

Current RCT evidence shows inconsistent and limited findings, and no firm conclusions can be drawn about whether any OTC therapy provides symptomatic benefit. Future trials should use standardized outcome measures, transparent reporting, and adequately powered designs to clarify which, if any, OTC treatments provide clinically meaningful benefit.

1 (Systematic review of RCTs with low-moderate heterogeneity). Trial Registration: CRD42024549791.