• Tinnitus

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BMJ Clinical Evidence - Tinnitus

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Substantive changes at this update

Acamprosate One systematic review[4] and one RCT added.[5] Categorisation unchanged (unknown effectiveness).

Acupuncture One systematic review added,[7] and one additional RCT.[8] Categorisation unchanged (unknown effectiveness).

Antidepressant drugs One review updated,[10] and two reviews added.[4][9] Categorisation unchanged (unknown effectiveness), as there remains insufficient evidence to judge the effectiveness of this intervention.

Benzodiazepines One systematic review added.[4] Categorisation unchanged (unknown effectiveness).

Electromagnetic stimulation Three new reviews added.[4][22][23] Categorisation unchanged (unknown effectiveness).

Ginkgo biloba One review updated,[26] one review added.[27] Categorisation changed from unknown effectiveness to unlikely to be beneficial.

Psychotherapy Two systematic reviews added.[4][35] Categorisation unchanged (unknown effectiveness).

CBT plus tinnitus-masking device Two systematic reviews added.[4][35] Categorisation unchanged (unknown effectiveness).

Carbamazepine One new systematic review added.[41] Categorisation unchanged (likely to be ineffective or harmful).

Abstract

INTRODUCTION: Up to 18% of people in industrialised societies are mildly affected by chronic tinnitus, and 0.5% report tinnitus having a severe effect on their daily life. Tinnitus can be associated with hearing loss, acoustic neuromas, drug toxicity, ear diseases, and depression. Tinnitus can last for many years, and can interfere with sleep and concentration. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for chronic tinnitus? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 33 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acamprosate, acupuncture, antidepressant drugs, benzodiazepines, carbamazepine, electromagnetic stimulation, ginkgo biloba, hearing aids, hypnosis, psychotherapy, tinnitus-masking devices, and cognitive behavioural therapy plus tinnitus-masking device (tinnitus retraining therapy).

Cite as

Savage J, Waddell A. Tinnitus. Systematic review 506. BMJ Clinical Evidence. . 2014 October. Accessed [date].