Placebos for Tinnitus:

Timothy C. Hain, MD. •. Page last modified: October 1, 2022 •.See also: "how to lie with statistics", a book by Daryll Huff.

New: Desyncra device. The data so far does not prove that it is not a placebo.

Homeopathic
Homeopathic preparation for tinnitus -- contains aspirin ! Most if not all homeopathic preparations are placebos.

Some medical authorities seem to get pleasure from "bashing" tinnitus drugs, and writing papers that show that they are indistinguishable from placebo. We suspect that this comes from a combination of righteous indignation about groups attempting to exploit tinnitus sufferers, a general and reasonable suspicion that there is currently no method of replacing damaged or lost sensory systems. Vendra et al (2018) stated:

"A wide array of unproven OTCTR exist on today's market. All make unfounded claims of relief from ear ringing. Most of the products considered in this study consist of mixtures of inexpensive and common vitamins, minerals, and/or herbs sold at a premium compared to similar preparations not expressly advertised for tinnitus. Certain brands, most notably Arches Tinnitus Formula (Arches Natural Products Inc., Salt Lake City, UT) and Lipo-Flavonoid (Clarion Brands Inc., Solon, OH), target otolaryngologists by advertising in specialty journals and prominently featuring supposed endorsement by "Ear-Nose-and-Throat Doctors" in their marketing." (Bold added by author of page)

We find it interesting that they mention Lipo-Flavonoids in particular, as many of our patients that see us for tinnitus are taking this version of vitamin C.

On the other hand, tinnitus is extremely distressing, and our position is that it is often worth the effort to attempt treatment with medications that are reasonably safe, and have some rationale for use. 

Tinnitus is a difficult disorder to study and it seems likely to us that almost all tinnitus drug studies are "underpowered" -- i.e. unable to detect small effects, due to rare efficacy of medications. There is an essential intractability of studying disorders that have diverse causes, most of which are undiagnosed without an autopsy. 

Without a way to separate out tinnitus into causal subcategories, we think that almost any controlled study of a reasonable size (i.e.. 100 subjects) is bound to report failure. In other words, we think that all controlled tinnitus drug studies of moderate size should report that the drug is a placebo (or worse). 

We think that smaller studies -- between 1-30 patients, will be "all over the map", but with more positive studies being reported than negative studies, as it is easier to get positive studies accepted in peer reviewed journals.  We think that these are generally likely to be overly enthusiastic, as they have taken chance improvements as response, and managed to get it published.

Response to anything, including placebo, is still a response.  Also, we think there is some value to having hope that a successful intervention may be eventually found.

Some medications below may actually work via psychological mechanisms -- mood stabilizers for example.  Others might be modulating other diseases, such as anticonvulsants and migraine. Again, what is important is a response, not the mechanism.

This list is an attempt to rank medications according roughly as to whether they are clear placebos (such as homeopathic drugs), or just probable placebos for most, but possibly not all tinnitus patients.

Drugs that are probably (or certainly) placebos for idiopathic tinnitus

Comment: Some of these drugs may be worth considering depending on ones personal situation. The ones with the least adverse effects would seem most logical. If one understands the mechanism of one's tinnitus, it seems more likely that a drug like this might work.

Dubious, non-drug treatments

References  (also see tinnitus page)