Effectiveness of Intratympanic Dexamethasone With Lidocaine (Lignocaine) for Alleviation of Tinnitus

I was talking to an ex-auditory/tinnitus researcher over the weekend, trying to pick her brain for some answers as to what the hell is going on with me. While she didn’t give me any real help, she did give me some idea on how tinnitus research is advancing (and retreating) currently. She hasn’t been in the tinnitus research space for 5+ years because she claims that the funding doesn’t exist, especially in Canada. Initially, a lot of funding was coming from the military(ies) but there has been a huge shift to remote combat and withdrawal of forces since Trump took office and I guess less funding is now flowing.

With that being said, she mentioned a successful IT steroid trial out of India’s or Pakistan’s military research that happened a few years back. As mentioned, I have looked it up but don’t find it anywhere on the forums. I was able to find the trials and results from years passed.

Just recently they posted they are conducting Phase 4 trials:

Effectiveness of Intratympanic Dexamethasone With Lidocaine (Lignocaine) for Alleviation of Tinnitus

This study completed 4 years ago by Saad Elzayat seems promising. I looked him up and he is an Egyptian researcher looking mostly at IT injections for the treatment of tinnitus and vestibular disorders. He has some YouTube videos as well but they are in a foreign language though the PowerPoint deck is in English and it seems comprehensive as it relates to tinnitus and IT injections.

I’m wondering if maybe the more lax research laws in these countries might allow for more aggressive trials of treatments that might otherwise take much longer to trial in the western world.

Hopefully this Phase 4 yields some good results.

 

Phase 4 is a post marketing study, meaning they are testing already approved drugs (or combination) for a particular indication. There isn't a question of "research laws." You could do that now in any country if you got a doctor to try it.

There are quite a few threads on Lidocaine (Lignocaine) and it seems to help a lot, though temporarily. It would be nice if the follow up to this study was further out than a few weeks.

 

There is also a study posted by Mass Eye and Ear on their research page that they intend to do a clinical study on Lidocaine but they have not yet started recruiting.

 

Thanks FGG. I wasn’t specifically referring to only this study, just in general. I have seen research for other diseases where it seems they push the limit on ‘safety protocols’. In any case, hopefully this will yield some good results or at least give us some indication for future treatments.

 

I guess the thing here is Dexamethasone and Lidocaine working synergistically. If the safety profile was there (I think it is), I’d be willing to give it a go.

 

It doesn't seem like many in here have tried it. And I certainly don't think it is possible to get done here in my country (Denmark). Treatments here are free in all hospitals and at ENTs, but they decide what treatment you are 'allowed' to get. I don't think I could go and just ask for it...

 

Hi! Even though I only had Dexamethasone ITI treatment recently (2x), I would be against Lidocaine. Isn't it ototoxic? They use it for anesthesia, but to inject it into the middle ear?

 

There is a thread on this where a doctor administered it on himself and got relief.

 

He gave himself an IT injection?

 

Lidocaine. Did It Myself. Twice. Lowered Tinnitus from 7 to 1.

 

Oh IV. Yeah that makes more sense .

If anyone even thinks of trying this at home you will need to dilute it and do it insanely slow. Can cause fatal arrhythmias. FYI.

 

Ya I think that’s the biggest issue. Hopefully IT has no major side effects and is well tolerated. Also, I think IV Lidocaine only gives temporary relief but I could be wrong.

 

Would be nice if he followed up. I wonder if this has been tried the way IV Ketamine has. Even though it can cause heart problems if given inappropriately it can treat others. At least a few people must have gotten it therapeutically IV who had tinnitus so it would be nice if there were data.

Even periodic relief would be better for mental health.

 

Given that Lidocaine has been reliable in helping tinnitus, I really don't think going in for shots of this is a crazy idea and more research is needed as to the mechanism.

Sucks that older off patent drugs barely get investigations because there's no sense in it monetarily.

 

He did follow-up iirc. I think in the end he got on Amitriptyline which helped him and he was fine.

 

Here's recruiting info for the Mass Eye & Ear Study. I'd do it if it didn't involve an MRI.

An fMRI Investigation of the Effects of IV Lidocaine on Tinnitus: Contacts & Locations

 

So they are trialing this for intermittent relief. That's good news.

 

Since Lidocaine is already FDA approved and this is only a treatment, it should go fast, right?

 

I’m calling them tomorrow. I live 40 minutes away.

 

Good luck! Please report back.

 

If you could find a doctor to do this, you could have it done now.

Whether or not the study is successful this isn't really an outpatient procedure, so you would have to find a clinic or hospital willing to do this (or move near one) if it helped.

With the inclusion of the fMRI, it seems less like a "treatment" study but you might still get relief.

 

How do they test middle ear reflexes?

 

Transdermal lidocaine as treatment for chronic subjective tinnitus: A pilot study

 

Results

The average pre-treatment TFI score was 56.2. After 1 month the average TFI decreased to 41 (p < 0.05). The scores dropped to 34 and 35 after 2 and 3 months of treatment respectively. Despite improvement in symptoms of tinnitus, most patients did not continue the study after the first month, dropping out due to the size, discomfort, and appearance of the lidocaine patch, failure to follow-up and lack of perceived benefit from treatment.​

That's really weird, seems like it was successful but they didn't keep up with it. The average TFI score dropped 22.2 points at the all time lowest. The "lack of perceived benefit" makes me curious.

 

So I have something interesting to add. As my first post reads, I was speaking with an ex-researcher a couple of weeks ago. She specifically mentioned knowing that IV Lidocaine works to reduce/eliminate tinnitus. This is not new info as the original study (I think from the 70s?) has been posted here before. That's when she told me about hearing about IT Lidocaine and Dexamethasone. She had high hopes for IT because she felt that IT steroids seemed to work better than the oral/systemic route. She believed the same could be true for Lidocaine. The thing I forgot to mention is that she said that they also know that another IV anesthetic reduces tinnitus, but I forgot to ask her which one. Maybe Ketamine? Either way, in conversation, I didn't think of it much but as an afterthought I realize that she said they know this about Lidocaine and other anesthetics.

The other really interesting info was that she said "over multiple applications" or doses or something to that effect, until it was reduced permanently. I have messaged @tinnitube to see what his take is and how he's faring these days. Hopefully @Gb3 gets into the study and can give us some good info. Personally, I would try to get an IT Lidocaine/Dexamethasone shot if possible.

 

So I just spoke to Mass Eye and Ear about the trial. They basically told me that Lidocaine is not a realistic treatment in the long term but the study will help them identify the areas in the brain that are affected if there is relief with Lidocaine. In future studies they may be able to identify medications that will target those areas.

 

Thank you mate. Lidocaine seems, and is, dangerous.

 

Makes a lot of sense. I would've figured that was their intention. With that being said, who knows, you might be lucky and get some permanent relief...

 

I messaged @tinnitube a few weeks ago. He did not benefit long term from Lidocaine and discontinued injecting it. He still has tinnitus but he is not much bothered by it.

 

Just an update. I completed the screening for the trial. I was not accepted due to being on medication for depression and anxiety. The medications could effect the fMRI results. I also learned why they take right-handed people over left-handed people.