Tinnitus and anticonvulsants
Name of treatment |
Anticonvulsants |
Type of treatment |
Pharmaceutical |
Claims for treatment |
Potentially suppress central auditory hyperactivity that may be related to tinnitus[1]. Anticonvulsants are believed to reduce tinnitus by augmenting the action or levels of neurotransmitters, or via blocking voltage gated sodium channels[1]. |
How treatment is delivered |
Capsules or tablets. |
Potential negative consequences |
Common side effects from clinical trials included nausea, dizziness, headache, tiredness.[2] |
Evidence offered: |
|
Papers available |
7 in the Cochrane review [2] 8 RCTs considered by the Clinical Practice Guideline [1]. |
Drugs mentioned in the literature |
Gabapentin[3][4]; amino-oxyacetic acid[5]; lamotrigine (Lamictal)[6]; carbamazepine (Tegretol)[7][8]; flunarizine (Sibelium)[9]. |
Conclusions drawn |
There is no evidence to show that anticonvulsants have a large positive effect in the treatment of tinnitus.[2] Carbamazepine and oxcarbazepine are not more effective than placebo in decreasing tinnitus severity.[10] Therapeutic use of these drugs for epilepsy may result in tinnitus and other auditory dysfunctions.[11] |
Quality of evidence [12] |
A |
Does the BTA recommend this treatment? |
No |
BTA opinion on this treatment: |
There is no evidence to show that anticonvulsants have an impact on tinnitus. Side effects were experienced by 18% of patients in the trials reviewed.[1] |
Would the BTA support further studies into this treatment? |
Yes, if high quality study |
Verdict: Safety – is this treatment harmful? |
Some potential for harm |
Verdict: Efficacy – does this treatment work? |
Evidence that they are not effective |
Comments |
Studies seldom used appropriate outcome measures and had high risk of bias |
For further information
The BTA Tinnitus Support Team can answer your questions on any tinnitus related topics:
Telephone: 0800 018 0527
Web chat: – click on the icon
Email: [email protected]
Text/SMS: 07537 416841
We also offer a free tinnitus e-learning programme, Take on Tinnitus.
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Feedback
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References
[1] Tunkel DE, Bauer CA, Sun GH, et al. Clinical Practice Guideline: Tinnitus. Otolaryngology–Head and Neck Surgery. 2014;151(2_suppl): S1-S40. doi:10.1177/0194599814545325
[2] Hoekstra CEL, Rynja SP, van Zanten GA, Rovers MM. Anticonvulsants for tinnitus. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD007960. DOI: 10.1002/14651858.CD007960.pub2.
[3] Bakhshaee M, Ghasemi M, Azarpazhooh M, Khadivi E, Rezaei S, Shakeri M, et al. Gabapentin effectiveness on the sensation of subjective idiopathic tinnitus: a pilot study. European Archives of Oto‐Rhino‐Laryngology 2007;265(5):525‐30.
[4] Dehkordi, MA, Abolbashari, S, Taheri, R, Einolghozati, S. Efficacy of gabapentin on subjective idiopathic tinnitus: a randomized, double-blind, placebo-controlled trial. Ear Nose Throat J. 2011;90:150-158.
[5] Reed HT, Meltzer J, Crews P, Norris CH, Quine DB. Guth PS. Amino oxyacetic acid as a palliative in tinnitus. Arch Otolaryngol. 1985; 111: 803-805
[6] Simpson JJ, Gilbert AM, Weiner GM, Davies WW. The assessment of lamotrigine, an antiepileptic drug, in the treatment of tinnitus. American Journal of Otology 1999;20:627‐31.
[7] Donaldson I. Tegretol: a double blind trial in tinnitus. Journal of Laryngology and Otology. 1981; 95: 947-951
[8] Hulshof JH, Vermeij P. The value of carbamazepine in the treatment of tinnitus. ORL: Journal of Oto‐Rhino‐Laryngology and Its Related Specialties 1985;47:262‐6
[9] Hulshof JH, Vermeij P. The value of flunarizine in the treatment of tinnitus. ORL: Journal of Oto‐Rhino‐Laryngology and Its Related Specialties 1986;48:33‐6.
[10] Gerami H, Saberi A, Nemati S, Kazemnejad E, Aghajanpour M. Effects of oxcarbazepine versus carbamazepine on tinnitus: A randomized double-blind placebo-controlled clinical trial. Iran J Neurol. 2012;11(3):106–110.
[11] Sherifa A Hamed (2017) The auditory and vestibular toxicities induced by antiepileptic drugs, Expert Opinion on Drug Safety, 16:11, 1281-1294, DOI: 10.1080/14740338.2017.1372420
[12] A = Systematic review/meta analysis. B = Randomised control studies. C = Cohort studies. D = Case control studies. E = case studies/reports. +/- to be used to indicate quality within bands
Author: Nic Wray
Version 2.0
Updated: 17 May 2022
To be reviewed: May 2025
Photo by Myriam Zilles on Unsplash