Tinnitus — Possible Treatments — Modern Medicine

Information presented in this post serves only for a basic orientation in the problem of tinnitus and they may or may not be either complete or relevant. It is only a mere overview of my own findings which I gathered together in the past. Your medical treatment must be under supervision of your medical doctor. I also do not guarantee that they will lead to a complete cure of your tinnitus. However, nobody can guarantee to you such a thing in the present day. Unfortunately, in this day and age there is no 100% effective way to cure tinnitus.

TINNITUS – POSSIBLE MEDICAL TREATMENTS &/OR ITS ALLEVIATION – MODERN MEDICINE

Vasodilatation medication and medication to support vascular system​

For noise induced tinnitus, inflammation of the middle ear, degeneration of auditory ear hair cells, insufficient neck or brain blood supply – it is imperative to start the medical treatment immediately.

• Enelbin – improves blood perfusion, oxygenation and tissue nourishment

• Ginkgo Biloba – improves blood perfusion, oxygenation and tissue nourishment

• Betahistine – relaxes muscles of the vessels in the inner ear, this way there is a better blood perfusion of these vessels

• Betaserc - relaxes muscles of the vessels in the inner ear, this way there is a better blood perfusion of these vessels

• Cinnarizine lessens a tonus of lean muscles in the vessel’s walls and this way it improves a supply of oxygen and glucose to the cells

• Stugeron – dampens down the effects of various hormones that cause vasoconstriction. Suppresses the onset of vessel spasms and betters the blood flow and supply of tissues including brain tissues.

• Cavinton – it is intended to use for the treatment or to dampen down symptoms connected with circulatory issues in the brain area. It is also used to affect both psychological and neurological symptoms associated with blood flow circulation problems in the brain area.

• Corticosteroids – anti-inflammatory effects.

• Microwick + corticosteroids – anti-inflammatory effects of corticosteroids are applied straight into the middle or inner ear with the help of silicone vent-tube Microvick.

https://www.earsinus.com/silverstein-microwick

Vasodilatation intravenous therapy​

It is used for tinnitus that is a result of a noise-induced trauma, middle-ear infection, degeneration of the hairs inside cochlea, insufficient neck or head blood supply. It is imperative that the treatment is started immediately. It has the same effect as the above-mentioned drugs, it is just delivered intravenously.

Hyperbaric Oxygen Therapy (HBOT)​

For noise-induced tinnitus, middle ear infection, degeneration of the hairs inside cochlea, insufficient blood supply of the neck and/or brain and the like – yet again, it is necessary to start the treatment immediately. From to afore-mentioned possible treatments this one seems to be the most effective.

On the basis of various physical processes and characteristics of each sessions comes an increased oxygen supply to the organism. The supply of oxygen may be up to 15x more increased as opposed to breathing an air oxygen under normal circumstances. The effect is in full saturation of haemoglobin, red blood cells by oxygen and particularly in many-times increased dissolved oxygen in blood plasma. As many as 4 times more of the oxygen will extend into the tissues.

Medication for treatment of hairs inside cochlea
​

For tinnitus that was caused by damaging microscopic hairs that form a fringe on the surface of each auditory cell, where vasodilatation medication, intravenous therapy, or hyperbaric oxygen therapy did not help – meaning that our body cannot help repair itself, there are specifically aimed and still under development drugs to the inner ear.

• AM 101 – 3rd. phase of testing. Also known as Keyzilen

• OTO 311 – still under development and testing

• Inception 3 – pre-clinical development

• SPI 1005 – 2nd. Phase of testing

• HPN-1010 – unknown phase of testing

• SENS 401 – 1st. phase of testing

Medication based on controlling Ion channels, and in particular potassium channel activities, antiepileptic drugs, and receptor antagonists.​

For tinnitus that is localized in the middle and inner ear and is centralized in the individual parts of brain, these calm down the ‘unsolicited’ activity of neurons in the auditory cortex and its close parts.

• Retigabine (Trobalt, Potiga) the control of ion potassium channel activities, it was developed for epilepsy, but demonstrably works for tinnitus too, it has negative side effects

• SF0034 – controlling the Kv7.2/3 ion potassium channels, it is in a phase of testing

• AUT00063 – phase 2 testing, controlling the Kv3 ion potassium channels, primarily developed for tinnitus, in September 2015 the testing was stopped.

• Bivaracetam – phase 2 and 3 testing – it affects synaptic apertures 2A (SV2A), primarily developed for epilepsy

• Neramexan – an antagonist of NMDA receptors, during the phase 3 of testing were not achieved significant effects on tinnitus, nevertheless the tests continuous in Japan

• Gebapentine (Neurotine) – inhibition of glutamate synthesis, inhibition of release of excitatory neurotransmitters (noradrenaline and dopamine), increase in the concentration and synthesis GABA, some say it did have a positive effect on their tinnitus.

• Flupirtine – the control of the Kb7 ion potassium channels, it has a positive effect on tinnitus, however, it is important to upper intake the dosing, and with prolonged periods of time liver toxicity has been proven

• RL-81 the control of the Kv7 ion potassium channels, initiation of a pre-clinic study, it is supposed to be 15x more effective than Retigabine and 3x more effective than SF0034 and it should also has less side effects

Direct influence of a neural activity
​

For tinnitus that is centralized in the area of the middle and inner ear and affecting parts of brain, these methods help to calm down the unsolicited activity of neurons in the auditory cortex and its close parts.

• rTMS - repetitive transcranial magnetic stimulation

• tDCS transcranial direct current stimulation (still in the phase of testing, non-invasive)

• DBS deep brian stimulation – only intended for testing, it is invasive

• HIFU - High Intensity Focused Ultrasound – in the phase of testing on humans (the research is carried out in Switzerland and the USA, for neurosurgery it is a combination of transcranial magnetic stimulation and a high intensity focused ultrasound

Antidepressants
​

For the type of tinnitus that originates from the imbalance of hormones (in particular serotonin, noradrenaline, dopamine, GABA) in body (in the brain). For a different type of tinnitus, these then act as an antianxiety and antidepressive mediators.

• SSRI

• SNRI

• SARI

• others

Neuromodulation methods and a musical type of a therapy
​

The treatment depeneds on the reason as to how you acquired your tinnitus.

• TRT – as of now the most reliable method, it is estimated up to 90 % success rate

• ACRNM – as of now used only for one frequency tone, available in the EU

• Neuromonics – available in the USA

• Tinnitracks

• Notched Music Therapy

• Others – XinoTinnitus, Serenade, Beyond Tinnitus, UltraQuiet therapy, therapy Mozart

Nerve Stimulation​

The treatment is dependent on the cause of your tinnitus.

• VNS therapy – The Serenity System – phase III of testing, the principle lies behind a stimulation of the vagus nerve and a musical therapy, it is invasive type of a treatment

• Mute Button – it is in the phase of testing, the principle lies behind a stimulation of the trigeminal nerve and a musical therapy, it is a non-invasive type of a therapy

Psychotherapy​

The treatment in this case isn’t dependent on the cause of tinnitus

• Cognitive behavioral therapy

• Biofeedback

• Gene therapy

• Optogenetics

• CGF166 phase 1 and 2 testing. Activation of a gene that causes the tiny hairs inside cochlea to grow again.

• SPI5557 – a preclinical study

Electronic equipment​

• Tinnitus maskers

• Players

• Hearing aids – for tinnitus associated with minor, moderate and severe hearing loss

• Cochlear implant – for tinnitus when one is completely deaf

Surgical solution​

• Stadeoplasty – a replacemant of the strirrup bone in certain types of otosclerosis

Disclaimer: I hereby declare that I do not own the rights to this article. All rights belong to the author. I am not a professional translator or interpreter so please excuse possible grammar mistakes or misinterpretations.

Author: michal from itinnitus.cz

Translation: Jiri

References:

1. Výzkum, studie a nové metody léčby tinnitu: Tinnitus - možnosti léčby - klasická medicína. Itinnitus.cz - Diskuzní forum [online]. 7th May 2015 [cit. 2018-01-07]. Retrieved from: http://www.itinnitus.cz/forum/viewtopic.php?f=19&t=699

 

GREAT summary of practically everything in this section of the forum. Thanks!

 

No problem, I'm happy you found it helpful. Sorry for the minor grammatical errors I made. I usually have someone to proofread it after me but nobody was around this time. I hope it is coherent.

Cheers,

Jiri

 

Physiotherapy for somatic tinnitus is worth adding in my opinion. Trigger point massages + individualised exercises and stretches brought it way down for me and someone in my family was completely cured of tinnitus after months of physio.

 

That's a very nice presentation of information. I still argue that in most cases there is no real effective treatment of tinnitus and that most of us who have are going to die with it.

 

I agree that there aren't a lot of effective treatments for most of us. But there are positive changes in research that suggest a possibilty of cure for chronic tinnitus or at least make it milder.

When I was at university I've learned that there is nothing that can help tinnitus. But now I'm getting treated myself thanks to more recent insights.

Although I think that tinnitus will always be a difficult thing to address since it has many etiologies. I believe it can be efficiently treated in the future. If you look at the history of medicine there are a lot of illnesses that were considered untreatable and are now easy to fix.

The biggest hurdle I see at the moment is lack of funding to find a real cure. Why? Because pharmaceuticals love chronic illness.

 

Something a little off topic.

If you are considering to support a good cause, then please, visit this thread:
Power Up Tinnitus Talk! and make a small donation. More info in the intro post.

Thank you.

 

This is more for new users but I found a paper from 2010-2011 recently that reviewed various drug related therapies designed to treat tinnitus, and shared my attitude of frustration at being told to "just live with it".

This paper gives a highlight of various medications in case you were looking for a more formal opinion on the matter beyond anecdotal experience.

https://www.sciencedirect.com/science/article/pii/S1359644609003948

 

There is no medicine/cure for tinnitus. This is the most profound fact scattered around this forum and this entire site.

Very useful post by the original poster and kudos to him/her - but nothing works. Take it from someone who has tried almost 95% of what's written above. And find the posts from that poor Italian guy (can't even remember his name) who did HIFU. He had tried 100% of what's written above, even heroine. Where's he now? I can't / won't even think about his case, because he was a cool guy, always helpful (hopefully he STILL is).

We are not a market that makes financial sense. That fact alone will ensure that researchers will rave about "THE CURE" just to grab government and other funds and then come up empty (AM-101, that trobalt derivative etc).

Only benzos can cut it for some people and for a small period of time.

 

I’m trying to synthesize all of the different novel treatments currently being clinically studied. Please comment with other clinically studied research that I’ve forgotten to include.

1. OTO-413–locally administered BDNF injections—hidden hearing loss—Phase 2? Not accepting tinnitus patients for clinical studies.

Nonclinical studies by Otonomy and other research groups have demonstrated that local administration of BDNF repairs ribbon synapses damaged due to noise trauma or exposure to ototoxic chemicals and restores hearing function

2. PIPE-505–gamma secretase inhibitor—SNHL & cochlear synaptopathy—phase 1a/2b. Enrolling patients in fourth quarter of 2019. Quoted to treat tinnitus so hopefully won’t be an exclusion for trial entry:

https://patentscope.wipo.int/search/en/detail.jsf?docId=WO2018111926&tab=PCTCLAIMS

3. FX-322–intratympanic stem cell injections for hair cell regrowth—hearing loss—phase 2a. Not taking tinnitus patients for trials.

4. Hough Hearing Loss Pill—pill for hair cell/nerve ending regeneration. Phase I complete, ready for phase 2. Speculated to be safe; unclear on participants. I believe Justin deMoss will be coming on the Tinnitus Talk Podcast.

info@houghear.org

5.RL-81–modified potassium pump channel opener (pill) for tinnitus—preclinical trials. Should take tinnitus patients?

The lead researcher Thanos Tzounopoulos will also be on the Tinnitus Talk Podcast.

Donate here. 98% goes to research. https://eyeandear.thankyou4caring.org/DonateNow

6. OTO-313–gacyclidine, NMDA receptor antagonist for (likely) acute tinnitus—phase I/II.

7. REGAIN/Audion (???)

Please let me know if I’m missing anything major here.

 

This may be premature but Patricia White's lab also appears to be working on erbb2 signaling pathways for regeneration after NIHL. It appears to proliferate supporting cells and regenerate hair cells. I suspect there is probably something pre-clinical here but I'm not sure it's advanced far enough to add to the list.

 

Where is P. White’s lab?

 

University of Rochester.