Randomized Placebo-Controlled Trial of a Selective Serotonin Reuptake Inhibitor in the Treatment of Nondepressed Tinnitus Subjects

Abstract

These results suggest that the majority of individuals in this study did not benefit from paroxetine in a consistent fashion. Further work remains to be done to determine if subgroups of patients (e.g., those who tolerate higher doses, those who are depressed) may benefit.

Tinnitus Patients Suffering from Anxiety and Depression: A Review

“…SSRI treatment has also been shown to be effective in treating both tinnitus and depression 44 . Most notably, the use of SSRI's in non-depressed tinnitus patients has not shown any benefit, further illustrating the interconnected relationship between tinnitus and depression 45 . Effective non-medical options also exist, most notable cognitive behavioral therapy (CBT).…”

Clinical Practice Guideline: Tinnitus

“…The most recent Cochrane review included 4 trials of tricyclic antidepressants, 1 trial of trazodone, and 1 trial of a selective serotonin reuptake inhibitor (paroxetine). 170,171,[180][181][182][183][184] Of these trials, 4 are double blind, 1 is single blind, and 1 does not clearly state blinding. Three of the tricyclic antidepressant trials showed modest improvement of tinnitus, but the treatment effects may have been related to modulation of depression and anxiety rather than any change in character or intensity of tinnitus.…”

“…36 Whereas the review identified 6 studies that favored treatment over control for tinnitusspecific QOL outcomes [169][170][171][172][173][174] and 5 studies that favored treatment over control for subjective tinnitus loudness outcomes, 169,[173][174][175][176] selection and other bias, small sample sizes, and imprecise effect estimates led to an assessment of low or insufficient strength of evidence for these outcomes.…”

“…171,182,183 Methodological concerns in these trials included dosing issues, failure to use validated tinnitus questionnaires, and small numbers of subjects. [169][170][171][181][182][183][184] Commonly reported side effects of antidepressants include sexual dysfunction, drowsiness, and dry mouth; more subjects dropped out of the treatment groups than the placebo control groups of trials. It is also concerning that tinnitus is listed as a rare side effect of all available antidepressants.…”

Treatments for Tinnitus

“…If a combination of treatments designed to improve mood is effective in that regard, it cannot be too surprising that the degree of distress in connection with tinnitus experience is diminished also. There is certainly no basis from the literature for a proposal that distressing tinnitus absent psychological problems such as depression and anxiety will be effectively managed by use of antidepressants (Robinson et al, 2005).…”