Therapy target
Improvement of the symptomatology
Therapy recommendations
- Effective tinnitus-specific drug therapy for chronic tinnitus is not available; the 2018 European Guideline also reaches the same conclusion [see Guidelines below].The U.S. Tinnitus Clinical Practice Guideline does not recommend antidepressants, anticonvulsants, anxiolytics, or intratympanic medications for routine treatment of patients with persistent, bothersome tinnitus.Note! No drug has been approved by either the European Medicines Agency (EMA) or the Food and Drug Administration (FDA) for the treatment of tinnitus.
- The therapy of acute tinnitus is based on the therapy of hearing loss, which is presented below:
- Infusion therapy to improve the fluidity of the blood (rheologics) or blood flow-promoting therapy: low-molecular-weight dextrane, pentoxifylline (vasodilator/drug that dilates the vessels); nimodipine (calcium channel blocker) can be given for follow-up treatment (a proven effect is not given!).
- Prednisolone equivalent (glucocorticoids): prednisolone equivalent, 250 mg for 3 days.
- The only procedures that have been proven to be effective are:
- Apheresis (blood washing) to lower fibrinogen levels.
- Hyperbaric oxygenation (HBO; synonyms: hyperbaric oxygen therapy, HBO therapy; hyperbaric oxygen therapy; HBO2, HBOT); therapy in which medically pure oxygen is applied under an elevated ambient pressure.
- Co-treatment of comorbidities (insomnia (sleep disorders), anxiety disorders, depression), including medications if necessary, should be provided.
- Other recommended measures are:
- Tinnitus Counseling
- Tinnitusmasker
- Neuromodulatory therapy
Please see “Further Therapy” for more information.
Supplements (dietary supplements; vital substances)
Suitable dietary supplements should contain the following vital substances:
- Vitamins (A, C, D3, E, B1, B2 B3, B5, B6, B12, folic acid, biotin).
- Minerals (magnesium)
- Trace elements (copper, manganese, molybdenum, selenium, zinc)
- Other vital substances (coenzyme Q10, L-carnitine).
Note: The listed vital substances are not a substitute for drug therapy. Food supplements are intended to supplement the general diet in the particular life situation.