Misoprostol is commonly used to prevent gastric ulcers caused by non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. It is also used for the induction of labor in pregnancy. There may be some grounds for thinking misoprostol would have a role in tinnitus therapy, as it is an E1 prostaglandin analogue, possibly exerting its therapeutic effect on tinnitus by reducing blood pressure.

Clinical Trials

A clinical trial study in 2004 found that of 28 patients treated with misoprostol for four months, 18 showed tinnitus reduction. This was double the improvement rate for the control group of tinnitus sufferers who received placebo for four months. Further statistics showed that misoprostol was most effective in those who had sudden-onset tinnitus.

These results have been supported by further research by the same scientific group, which has found that out of 28 high blood pressure and diabetes sufferers who suffered with chronic tinnitus treated with misoprostol, 13 showed dampening of tinnitus loudness. This was three times more than tinnitus patients who received placebo [[i]][[ii]]. 

There is little data on the effectiveness of misoprostol for tinnitus reduction, but the few studies on the subject show encouraging results and warrant further research. Diarrhoea is a commonly- reported side-effect of heavy misoprostol consumption.

Depression and anxiety is commonly associated with tinnitus, so it seems logical to assume that if you can treat depression and anxiety, you can reduce the impact tinnitus has on the sufferer’s quality of life. A number of these drugs can also manage the obsessive compulsive nature exhibited by some tinnitus sufferers who cannot stop ‘checking’ their tinnitus.

Sertaline

Sertraline has been touted as an effective tinnitus therapeutic. Sertraline, known by its trade name Zoloft, is a member of the SSRI (Selective Serotonin Reuptake Inhibitors) anti-depressant family, which is used by many millions to treat depression, anxiety, panic attacks and obsessive compulsive disorders.

A recent study showed that sertraline reduced the annoyance and loudness factor of tinnitus after 16 weeks of use, and this reduction was significantly linked to improvement in depressive symptoms [[i]].

SSRI for Tinnitus

Despite these good results, a scientific literature review which investigated the results of five trials involving 525 patients found no conclusive proof that SSRI or Tricylcic antidepressants improved tinnitus. It also found that sedation, sexual dysfunction and dry mouth were common side effects of SSRI therapy [[ii]].  If tinnitus is a significant cause of depression and anxiety, the use of anti-depressants may be warranted, but the evidence is currently not conclusive. Furthermore, both tricylcic and SSRI classes of anti-depressants carry a number of side effects, and contraindications.

 The Neuromonics Tinnitus Treatment Process is a six-month long audio therapy course designed to reduce tinnitus awareness, disturbance and the impact that tinnitus has on a patient’s life.

Central to the process is the use of a sound generating device which delivers spectrally modified, custom-designed music tracks embedded within neutral sounds. These neural sounds are designed to match the tinnitus profile of each patient and soothing music is used as a therapy medium to induce positive emotions and promote relaxation.

The patient listens to the device using high-quality special headphones. The device is advertised by the Neuromonics website as ‘not a masking device, noise or sound generator, hearing aid, or MP3 player’. Counseling and support from trained tinnitus clinicians is also an important part of the program.

The first stage of the course lasts two months when the device is worn for at least two hours per day particularly when the tinnitus is most disturbing. After this the use of the device is reduced incrementally until it is no longer required. At this point they claim that the brain has created new connections trained to ‘filter out tinnitus disturbance’. Essentially they are describing the process of habituation, or getting used to your tinnitus.  

Clinical Trials 

One study with 42 patients showed that after six months of therapy 80% of patients reported a level of tinnitus disturbance that was no longer clinically significant i.e. tinnitus levels were reduced to an extent which no longer bothered the patient. In a larger study 90% of 400 patients exceeded the minimum threshold for clinical success and only 3% of patients asked for refunds on the device highlighting some degree of success.

In addition, they were recently awarded $1million by the US Department of Defence to study the treatment of tinnitus among military service members, which does indicate some high repute. The Neuromonics device has also been cleared by the Food and Drug Administration (FDA).

However, it must be added that the results of these clinical trials do come from the same research team led by Audiologist Dr Paul Davis who is employed by Neuromonics as Chief Scientific Officer. As a result there is a need for independent studies where there are no potential conflicts of interest.

Additionally, there is anecdotal evidence at the tinnitus forum www.dailystrength.com where some users have complained that they found it is difficult to listen to the same four music tracks for six months.

Conclusion

In general, the Neuromonics Tinnitus treatment does have a good deal to commend it, in that it has been tested in a number of clinical trials reporting good results. Although these clinical trials have been conducted by researchers affiliated to Neuromonics, raising questions about the legitimacy of their results, the facts that they have conducted clinical trials and that the device is FDA-approved confers some credibility. However, the Neuromonics device is expensive at around $5000 and generally not covered by medical insurance as the therapy is still in experimental stages