Hostname: page-component-6766d58669-h8lrw Total loading time: 0 Render date: 2026-05-17T14:12:25.121Z Has data issue: false hasContentIssue false
  • English
  • Français

The use of benzodiazepines for tinnitus: systematic review

Published online by Cambridge University Press:  10 April 2015

N E Jufas  and
R Wood
N E Jufas*
Affiliation:
Kolling Deafness Research Centre, University of Sydney and Macquarie University, NSW, Australia Discipline of Surgery, Sydney Medical School, University of Sydney, NSW, Australia
R Wood
Affiliation:
Sydney Local Health District, Sydney Medical School, University of Sydney, NSW, Australia Discipline of Psychiatry, Sydney Medical School, University of Sydney, NSW, Australia
*
Address for correspondence: Dr Nicholas Jufas, Kolling Deafness Research Centre, Kolling Building, Royal North Shore Hospital, St Leonards, NSW 2065, Australia E-mail: drnicholasjufas@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To investigate the effectiveness of benzodiazepine use for subjective tinnitus and to consider this in the context of the concomitant side effects.

Methods:

A systematic search of several databases using the terms ‘tinnitus’ and ‘benzodiazepines’ was conducted to find clinical trials of benzodiazepines and comparators in tinnitus patients. These studies were then assessed for risk of bias.

Results:

Six clinical trials were included. Clonazepam was found to be effective in three studies, but these studies had limitations regarding adequate blinding. The effectiveness of alprazolam was equivocal. Diazepam was not effective in two studies and oxazepam was effective in one study.

Conclusion:

Benzodiazepine use for subjective tinnitus does not have a robust evidence base. Clonazepam has the most evidence to support its use and is relatively less likely to lead to abuse because of its longer half-life, but caution is still needed given the other serious side effects.

Keywords

BenzodiazepinesTinnitusReview

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Supplement S3 , July 2015 , pp. S14 - S22
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1Fioretti, A, Eibenstein, A, Fusetti, M. New trends in tinnitus management. Open Neurol J 2011;5:12–17CrossRefGoogle ScholarPubMed
2Heller, AJ. Classification and epidemiology of tinnitus. Otolaryngol Clin North Am 2003;36:239–48CrossRefGoogle ScholarPubMed
3Goebel, G, Kahl, M, Arnold, W, Fichter, M. 15-year prospective follow-up study of behavioral therapy in a large sample of inpatients with chronic tinnitus. Acta Otolaryngol 2006;126:70–9CrossRefGoogle Scholar
4Kaltenbach, JA. The dorsal cochlear nucleus as a contributor to tinnitus: mechanisms underlying the induction of hyperactivity. Prog Brain Res 2007;166:89–106CrossRefGoogle ScholarPubMed
5Han, S-S, Nam, E-C, Won, JY, Lee, KU, Chun, W, Choi, HK et al. Clonazepam quiets tinnitus: a randomised crossover study with ginkgo biloba. J Neurol Neurosurg Psychiatry 2012;83:821–7CrossRefGoogle ScholarPubMed
6Sismanis, A. Tinnitus. Curr Neurol Neurosci Rep 2001;1:492–9CrossRefGoogle ScholarPubMed
7Dobie, RA. Depression and tinnitus. Otolaryngol Clin North Am 2003;36:383–8CrossRefGoogle ScholarPubMed
8Coroners Court of Victoria. Finding into Death with Inquest: Inquest in the Death of David Andrew Trengrove. Melbourne: Coroners Court of Victoria, 2012Google Scholar
9Lloyd, B, Matthews, S, Gao, CX. Trends in Alcohol and Drug Related Ambulance Attendances in Victoria 2012/13. Fitzroy, Victoria: Turning Point, 2014Google Scholar
10Australian Government, Department of Health, Therapeutic Goods Administration. Final decisions and reasons for decisions by delegates of the Secretary to the Department of Health and Ageing, June 2013. In: https://www.tga.gov.au/scheduling-decision-final/reasons-scheduling-delegates-final-decisions-june-2013 [5 March 2015]Google Scholar
11MIMS Australia: MIMS Online. In: http://www.mimsonline.com.au [15 July 2014]Google Scholar
12Moher, D, Liberati, A, Tetzlaff, J, Altman, DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 2010;8:336–41CrossRefGoogle ScholarPubMed
13Higgins, JPT, Altman, DG, Sterne, JAC, eds. Chapter 8: Assessing risk of bias in included studies. In: Higgins, JPT, Green, S, eds. Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 (updated March 2011). The Cochrane Collaboration (online), 2011Google Scholar
14Bahmad, FM, Venosa, AR, Olivieira, CA. Benzodiazepines and GABAergics in treating severe disabling tinnitus of predominantly cochlear origin. Int Tinnitus J 2006;12:140–4Google ScholarPubMed
15Lechtenberg, R, Shulman, A. Benzodiazepines in the treatment of tinnitus. J Laryngol Otol 1984;98:271–6CrossRefGoogle Scholar
16Kay, NJ. Oral chemotherapy in tinnitus. Br J Audiol 1981;15:123–4CrossRefGoogle ScholarPubMed
17Jalali, MM, Kousha, A, Naghavi, SE, Soleimani, R, Banan, R. The effects of alprazolam on tinnitus: a cross-over randomized clinical trial. Med Sci Monit 2009;15:P155–60Google ScholarPubMed
18Johnson, RM, Brummett, R, Schleuning, A. Use of alprazolam for relief of tinnitus. Arch Otolaryngol Head Neck Surg 1993;119:842–5CrossRefGoogle ScholarPubMed
19Aparecida de Azevedo, A, Mello de Oliveira, P, Gomes de Siqueira, A, Figueiredo, RR. A critical analysis of tinnitus measuring methods. Braz J Otorhinolaryngol 2007;73:418–23CrossRefGoogle ScholarPubMed
20Basile, C-É, Fournier, P, Hutchins, S, Hébert, S. Psychoacoustic assessment to improve tinnitus diagnosis. PLoS One 2013;8:e82995CrossRefGoogle ScholarPubMed
21Meikle, MB, Vernon, J, Johnson, RM. The perceived severity of tinnitus. Some observations concerning a large population of tinnitus clinic patients. Otolaryngol Head Neck Surg 1984;92:689–96CrossRefGoogle ScholarPubMed
22Baguley, DM, Humphriss, RL, Hodgson, CA. Convergent validity of the tinnitus handicap inventory and the tinnitus questionnaire. J Laryngol Otol 2000;114:840–3CrossRefGoogle ScholarPubMed
23Langguth, B, Goodey, R, Azevedo, A, Bjorne, A, Cacace, A, Crocetti, A et al. Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006. Prog Brain Res 2007;166:525–36CrossRefGoogle ScholarPubMed
24Gopinath, B, McMahon, CM, Rochtchina, E, Karpa, MJ, Mitchell, P. Incidence, persistence, and progression of tinnitus symptoms in older adults: the Blue Mountains Hearing Study. Ear Hear 2010;31:407–12CrossRefGoogle ScholarPubMed
25Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Panic Disorder and Agoraphobia. Australian and New Zealand clinical practice guidelines for the treatment of panic disorder and agoraphobia. Aust N Z J Psychiatry 2003;37:641–56CrossRefGoogle Scholar
26Dassanayake, T, Michie, P, Carter, G, Jones, A. Effects of benzodiazepines, antidepressants and opioids on driving: a systematic review and meta-analysis of epidemiological and experimental evidence. Drug Saf 2011;34:125–56CrossRefGoogle ScholarPubMed
27Royal Australian and New Zealand College of Psychiatrists. Practice Guideline #5: Guidelines for Use of Benzodiazepines in Psychiatric Practice. Melbourne: Royal Australian and New Zealand College of Psychiatrists, 2008Google Scholar
28Howard, P, Twycross, R, Shuster, J, Mihalyo, M, Wilcock, A. Benzodiazepines. J Pain Symptom Manage 2014;47:955–64CrossRefGoogle ScholarPubMed
29O'Brien, CP. Benzodiazepine use, abuse and dependence. J Clin Psychiatry 2005;66(suppl 2):28–33Google ScholarPubMed
30Bliding, A. The abuse potential of benzodiazepines with special reference to oxazepam. Acta Psychiatr Scand Suppl 1978;274:111–16CrossRefGoogle Scholar
31Shulman, A, Strashun, AM, Seibyl, JP, Daftary, A, Goldstein, B. Benzodiazepine receptor deficiency and tinnitus. Int Tinnitus J 2000;6:98–111Google ScholarPubMed
32Bauer, CA, Brozoski, TJ, Holder, TM, Caspary, DM. Effects of chronic salicylate on GABAergic activity in rat inferior colliculus. Hear Res 2000;147:175–82CrossRefGoogle ScholarPubMed
33Simpson, JJ, Davies, WE. Recent advances in the pharmacological treatment of tinnitus. Trends Pharmacol Sci 1999;20:12–18CrossRefGoogle ScholarPubMed
34Darlington, CL, Smith, PF. Drug treatments for tinnitus. Prog Brain Res 2007;166:249–62CrossRefGoogle ScholarPubMed
35Malakouti, SK, Nojomi, M, Mahmoudian, S, Alifattahi, N, Salehi, M. Comorbidity of chronic tinnitus and mental disorders. Int Tinnitus J 2011;16:118–22Google ScholarPubMed
36Gananca, MM, Caovilla, HH, Gananca, FF, Gananca, CF, Munhoz, MSL, Garcia da Silva, ML et al. Clonazepam in the pharmacological treatment of vertigo and tinnitus. Int Tinnitus J 2002;8:50–3Google ScholarPubMed
37Shulman, A, Strashun, AM, Goldstein, BA. GABAA-benzodiazepine-chloride receptor-targeted therapy for tinnitus control: preliminary report. Int Tinnitus J 2002;8:30–6Google ScholarPubMed