Role of acamprosate in sensorineural tinnitus

Abstract

Acamprosate with dual mechanism of action as glutamate antagonist and GABA agonist can be a potential target to decrease the severity of sensorineural tinnitus.Objective:(1)To study the effectiveness of acamprosate in providing subjective relief and objective improvement in patients having tinnitus of sensorineural origin. (2) To evaluate the adverse events related to the use of acamprosate and also determine the change in quality of life (QOL) parameters.Materials and Methods:The study was randomized double-blind, placebo controlled, crossover. Forty adult subjects (>18 years of age), of either sex with tinnitus of sensorineural origin, were administered either acamprosate 333 mg TDS or matched placebo for a period of six weeks followed by a washout period of one week. Drug therapy was switched for another six weeks in consonance with the crossover design. The effect of acamprosate and placebo on subjective relief and objective improvement was evaluated by using modified tinnitus severity, QOL scores and audiometry with tinnitus matching in frequency and loudness.Results:At the end of the study, the drug had shown a statistically significant improvement in reducing the tinnitus score in 92.5% of the patients and placebo with an improvement in 12.5% of the patients. The drug was well tolerated without any serious drug reactions.Conclusion:Acamprosate is an effective drug in treating the severity of sensorineural tinnitus without causing much of the side effects.

Clinical Practice Guideline: 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.…”

Tinnitus

“…Acamprosate was shown to quieten tinnitus in two well-designed studies (Azevedo and Figueiredo, 2005;Sharma et al, 2012) but was said not to be effective in a third as yet unpublished study (Martin, 2011). One of the studies found that at 90 days the tinnitus was not heard in more than 10% of subjects (Sharma et al, 2012).…”

Tinnitus

“…In an RCT (n=40), participants with tinnitus received acamprosate or placebo for 45 days, followed by a washout period of 1 week 23. Acamprosate reduced the tinnitus score in more participants than placebo (any reduction [i.e.…”

“…benzodiazepines) as GABA is thought to be inhibitory in the auditory pathway 1,23. A systematic review found one high-quality RCT comparing alprazolam with chlorphenamine, which reported no significant difference in the THI (d=0.07 [not significant]) 7…”