Tinnitus Control by Dopamine Agonist Pramipexole in Presbycusis Patients

Discussion in 'Research News' started by rogerg, Mar 30, 2011.

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    1. rogerg

      rogerg Member

      Tinnitus control by dopamine agonist pramipexole in presbycusis patients: A randomized, placebo-controlled, double-blind study

      Objectives/Hypothesis:
      Since the concept of tinnitus dopaminergic pathway emerged, studies have been proposed to investigate if dopaminergic agents influence tinnitus. We hypothesized that pramipexole, an agonist on D2/D3 receptors, may antagonize tinnitus in the presbycusis patients (in the frequency range of 250 to 8,000 Hz) in a dose schedule accepted for the treatment of Parkinson's disease in elderly people.

      Study Design:
      We designed a randomized, prospective, placebo-controlled and double-blind trial.

      Methods:
      Forty presbycusis patients aged 50 years or older with subjective tinnitus were randomized to two groups (20 patients in both). Patients in the drug group took pramipexole over a period of 4 weeks according to a treatment schedule as follows: week 1, 0.088 mg t.i.d.; week 2, 0.18 mg t.i.d.; week 3, 0.7 mg t.i.d.; week 4, 0.18 mg t.i.d. over 3 days and 0.088 mg t.i.d. the rest of the week. Patients in the second group received placebo. Determination of subjective grading of tinnitus perception, the tinnitus handicap inventory (THI) questionnaire and electrocochleography (ECOG) examinations served as the end points. Subjective audiometry was used to produce secondary data. A significant improvement in tinnitus annoyance is found in the group treated with pramipexole versus placebo with respect to inhibition of tinnitus and a decrease of tinnitus loudness greater than 30 dB. However, neither ECOG nor subjective pure-tone threshold audiometry revealed any change in hearing threshold in response to either pramipexole or placebo.

      Conclusions:
      Pramipexole is an effective agent against subjective tinnitus associated with presbycusis at a dose schedule used for the treatment of Parkinson's disease. The drug did not change hearing threshold.
       
    2. rogerg

      rogerg Member

      What you think? This is INTERESTING..
       
    3. bertson

      bertson Member

      Parkinson drug... I dont think my doc is willing to prescrive this :D
       
    4. rogerg

      rogerg Member

      True! And what are the long term effects of dopamine agonist for a healthy person?? But their tinnitus imrpoved a lot.. over 30db!
       
    5. Jim
      Happy

      Jim Member Benefactor

      Location:
      San Francisco
      Tinnitus Since:
      04/2007
      Pramipexole is also used by bodybuilders and for treating erectile dysfunction. Maybe I could kill two birds with one stone.:cool:
       
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    6. Gene Graves

      Gene Graves Member

      My doctor has really tried to help me with my tinnitus. I showed him the article in the Tinnitus magazine and the research to back it up and he said I cannot see that it would hurt to try pramipexole 0.125 mg at the dosage used for someone with Parkinson disease. That was about a month ago. I do believe it has helped reduce my tinnitus. I will continue to take it for a month or two to see what kind of results I may get.
       
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    7. Jim
      Happy

      Jim Member Benefactor

      Location:
      San Francisco
      Tinnitus Since:
      04/2007
      Gene, thanks for the report. I'm interested to see how this goes for you in the longer term. Is your doc an ENT? Please keep us updated with your outcome.
       
    8. Jim Fletcher

      Jim Fletcher Member

      What does "hearing threshold" mean? Gene, have you had any side effects from taking the drug?
       
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    9. calin
      Inspired

      calin Member Benefactor

      Tinnitus Since:
      Oct 2011
    10. BOB3000

      BOB3000 Member

      Tinnitus Since:
      2002
      Any news about this one?
       
    11. sticky
      Sunshine

      sticky Member

      Location:
      Australia
      Tinnitus Since:
      07/1997
      I just stumbled across this thread.

      A few years ago (2012) I spoke to someone who has had T for around 13 or so years.

      they started taking mirapax and had their T reduce by a large amount on a low dose. This effect lasted around 3 months.

      Reason for stopping was to allow the body to have a break, and unfortunately I am not sure whether they started again.

      Has anyone recently looked into this drug?

      I assume this drug still available?
       
    12. Carlos1

      Carlos1 Member Benefactor

      Location:
      Boston
      Tinnitus Since:
      08/2013
      Cause of Tinnitus:
      Root Canal
      HHHmmm Very interesting
       
    13. sticky
      Sunshine

      sticky Member

      Location:
      Australia
      Tinnitus Since:
      07/1997
      For whatever reason I did not follow up. I must have habituated around that point.

      Will try and find out more.
       
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    14. rtwombly
      Bookworm

      rtwombly Member

      Location:
      Southeast USA
      Tinnitus Since:
      01/2014
      Cause of Tinnitus:
      Unknown
      Interesting. Looks like Gene isn't around anymore....

      Doesn't look like the side effects are too bad for this drug. Certainly not a patch on Retigabine! Maybe worth a try.
       
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    15. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      This study looked at tinnitus from hearing loss associated with aging. It might not work for other types of hearing loss, such as noise-related--but it would not hurt to try the drug.

      If anyone tries this drug, please tell us and note what caused your tinnitus (noise, aging, barotrauma, a combination of factors, etc.)
       
    16. sticky
      Sunshine

      sticky Member

      Location:
      Australia
      Tinnitus Since:
      07/1997
      Indeed, seems much affordable than Retagabine too.

      Bit more research required to educate myself on it, and a month holiday from work. I am thinking of pursuing this.

      I need to read more on it because I don't understand how it works.

      Anyone with a simplified view for my poor noggin! :p
       
    17. Viking
      No Mood

      Viking Member Benefactor

      Location:
      Italia
      Today a neurosurgery doctor advice me to try Selegiline. I think that is similar. both are for parkinson without the most side effects that i have unfortunally experienced of retigabine. After the actually tDCS cicle i will try! Anyone has tried similar?
       
    18. rtwombly
      Bookworm

      rtwombly Member

      Location:
      Southeast USA
      Tinnitus Since:
      01/2014
      Cause of Tinnitus:
      Unknown
      I did some research on this recently. The theory I read, dating back to 2009, is that as we get older, a change occurs to our ability to deal with oxidative stress affecting the DCN. The study specifically stated that the change makes the voltage-gated potassium channels subject more susceptible to dysfunction. It suggested that there might be a way to fix the sensitivity chemically. It wasn't a tinnitus study, just something about presbycusis, but it suggests to me that aging-, stress-, and noise-induced tinnitus are all really just STRESS-induced.

      Doesn't really suggest that pramipexole will be effective, but in my mind, the cause of tinnitus may not be as important a factor.
       
    19. Champ
      Woot

      Champ Member Benefactor Team Tech

      Location:
      Boston, MA
      Tinnitus Since:
      1/2013
      Cause of Tinnitus:
      Acoustic trauma from headphones
      I wholeheartedly agree. The common theme is overexcited neurons.

      Quell the neurons that need quelling and the tinnitus will be lowered.
       
      • Agree Agree x 1
    20. Viking
      No Mood

      Viking Member Benefactor

      Location:
      Italia
      Is selegiline an analogue of pramipexole? I'm thinking that my worsening could be caused by thc abuse (it is only hypotesis). Thc and cbd long term use alter the dopamine system in the basal ganglia. it could be related with abnormal neuron firing. Today i have the last tDCS stimulation. in 7 days I will start with selegiline as suggested by De Ridder hoping to restore the previuos state (probably dopamine release disfunction...antidepressants no gave relief). hs ayone tried it? thanks
      Ivan
       
    21. Danny Boy
      Cheerful

      Danny Boy Member Benefactor Hall of Fame

      Location:
      England
      Tinnitus Since:
      7/2014
      Cause of Tinnitus:
      Ear infection
      Take it not many people have tried this?
       
    22. Joan A.
      No Mood

      Joan A. Member

      Tinnitus Since:
      2000/ spike 2006/ massive 2009
      Cause of Tinnitus:
      unknow
      I have tryed a similar drugs called selegiline (Jumex) without significant effects on tinnitus. It act mainly on the thalamus reducing the neuron firing that is the cause of tremors in parkinson disease. The mirapexin (pramipexole) is not suggested for tinnitus alone.
       
    23. Danny Boy
      Cheerful

      Danny Boy Member Benefactor Hall of Fame

      Location:
      England
      Tinnitus Since:
      7/2014
      Cause of Tinnitus:
      Ear infection
      Have you tried it though?
       
    24. Joan A.
      No Mood

      Joan A. Member

      Tinnitus Since:
      2000/ spike 2006/ massive 2009
      Cause of Tinnitus:
      unknow
      yes. first week 1 pills at morning and after 5 days 1 pills morning and another at noon. no improvements. only side effects expecially nausea, mania and some others unplesant.
       
    25. Danny Boy
      Cheerful

      Danny Boy Member Benefactor Hall of Fame

      Location:
      England
      Tinnitus Since:
      7/2014
      Cause of Tinnitus:
      Ear infection
      This is all I could really find-

      Dopamine
      Tinnitus perception takes place in prefrontal, primary temporal and temporoparietal associative areas, as well in the limbic system. Dopamine (DA) neurotransmission acts through prefrontal, primary temporal, temporoparietal associative areas and the limbic system. Tinnitus perception and DA-ergic pathway share the same cerebral structures, which control attention, stress, emotions, learning, memory and motivated behavior. Distress from tinnitus emanates from these same cerebral functions, and could therefore be potentially modulated by either DA-blockers (ie, typical and atypical antipsychotics) or DA-agonists (eg, buproprion, a norepinephrine/DA reuptake inhibitor, antidepressant and by many anti-Parkinson drugs such as levodopa, bromocriptine, pramipexole and others).
       
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    26. Joan A.
      No Mood

      Joan A. Member

      Tinnitus Since:
      2000/ spike 2006/ massive 2009
      Cause of Tinnitus:
      unknow
      I tryed also the Solian (amisulpiride) in the morning + 0,5 clonazepam at night an atypical antipsichotic without significant relief. Side effects: cold feets and hands, hyperarousal.
       
    27. Goldilocks
      Lonely

      Goldilocks Member

      Location:
      Sydney Australia
      Tinnitus Since:
      08/1995
      Cause of Tinnitus:
      Original T 1995, aggravated T 2014, increase 2016
      • Good Question Good Question x 1
    28. Nick Pyzik
      Depressed

      Nick Pyzik Member

      Tinnitus Since:
      6/23/15
      Cause of Tinnitus:
      Listening to in-ear headphones & playing in a band
      Noise induced hearing loss is basically the same as age related hearing loss. Noise induced just speeds up the process of what age related hearing loss is. The only way it's different is if the person who had noise induced hearing loss basically lost all of the hair cells in their cochlea. Age related hearing loss is greatly in conjunction with nerve fiber loss and which occurs with noise induced hearing damage in a younger patient. Why do the elderly have trouble hearing still in a noise-filled environment even with the help of hearing aids which amplifies sound for the hair cells? It's because their auditory nerves are not functioning correctly like their original nerve fibers were before they were replaced over time.

      Here's an article explaining what happens http://m.hopkinsmedicine.org/news/m...y_new_contributor_to_age_related_hearing_loss
       
      • Informative Informative x 1
    29. Alue

      Alue Member

      Tinnitus Since:
      01/2016
      Cause of Tinnitus:
      Acoustic Trauma
      Yes but for the cascade of neurological changes that appears to happen with tinnitus might be different. The hyperactivity of auditory neurons in response to a loss of auditory input may be more severe or more 'shocking' if it comes on in a short time frame from an acoustic trauma as opposed to a gradual loss.
       
      • Agree Agree x 1
    30. Nick Pyzik
      Depressed

      Nick Pyzik Member

      Tinnitus Since:
      6/23/15
      Cause of Tinnitus:
      Listening to in-ear headphones & playing in a band
      I'm not sure how tinnitus works if the applicant believes that they haven't had any interactions with a noise-inducing event that could cause the hidden hearing loss that is talked about ever so slightly by organizations but I do support and understand the fact that tinnitus caused by noise is the result of a lost connection between the original nerve fibers of the inner ear to the hair cells that they were in relation to. Like I said I have no idea how it works for people who have Eustachian tube dysfunctions, is caused by stress, medication, etc....but anyone that has been introduced to noise can easily lose their nerve fibers without realizing it and soon enough over time the patient will have lost enough to start hearing a ringing in their ears/head and won't know why. That's why tinnitus is associated with hidden hearing loss because of noise. I've read many online research studies explaining that these nerves are WAY more susceptible to damage than the hair cells themselves. That can definitely be understood because of the excitatory neurotransmitting factors that happen between the hair cells and nerve fibers themselves. There are also many articles I've read explaining that too much sound interacting with the hair cells can cause damage to them but more likely the noise with cause a disconnection between the hair cell and nerve fibers thus causing HYPERACUSIS and in the end tinnitus that will not go away until this lost connection is secured back again. The Hyperacusis can go away because of the brains gain amplifier being able to go through an adaptation to what happened to its inner ear hearing function and noise induced tinnitus can only go away if the neurons in the brain themselves die or the brain changes its plasticity so the applicant doesn't hear the sound anymore. I only can get so far with this information because I'm not a researcher yet in this field but it just all makes sense to me. Especially with everything I've experienced within the last 5 months up to now. It just 100% backs up everything I've read because it's exactly what they are talking about.
       
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