Past, Present, and Future Pharmacological Therapies for Tinnitus

Abstract

Tinnitus, the perception of a sound that has no external acoustic source in the environment, is a challenging condition to manage clinically because its etiology, perceptual characteristics (e.g., pitch and loudness), and accompanying symptoms (e.g., insomnia, anxiety, and/or depression) vary greatly among patients. Despite the long history of tinnitus, its considerable prevalence, and economic burden, there currently exists no approved drug or widely accepted treatment. As such, previous pharmacological attempts to manage tinnitus have used drugs that are approved for other medical conditions in what is considered an "off-label" approach. Broadly, these drugs have included anesthetics, antidepressants, anxi-olytics, anticonvulsants, glutamate-receptor antagonists, and muscle relaxants. This chapter provides readers who are new to the field an introduction to the specific off-label drugs that have been administered for tinnitus management as well as the associated experimental rationale, patient outcomes, and relevant animal research. Furthermore, the results and recommendations of systematic reviews are summarized. Finally, where possible, discussion on each drug concludes with the treatment recommendations of the