Medicines for Tinnitus

What it is

Tinnitus is the term for hearing sounds that come from inside the body rather than from an outside source. It is very common, and most people experience it at some point. The sound is often described as ringing, but it can also be buzzing, humming, whooshing, hissing, throbbing, or other noises, and it may be in one or both ears, or seem to come from inside the head; it can be constant or come and go, and vary in loudness. Tinnitus is not a disease in itself but a symptom, and it is very often associated with some degree of hearing loss (for example age-related hearing loss or noise-related hearing loss); other associations include exposure to loud noise, ear problems (such as earwax build-up or ear infections), certain medicines, and, less commonly, other conditions. In many cases no specific cause is found. Importantly, tinnitus is usually not a sign of anything serious, and for many people it is mild or something they get used to over time. However, it can be distressing for some, affecting sleep, concentration, and mood, and support and techniques can make a real difference. Certain features should prompt medical assessment — for example tinnitus in only one ear, tinnitus that pulses in time with the heartbeat, tinnitus with significant hearing loss, dizziness, or that comes on suddenly — as these may need further investigation. While there is often no simple "cure", there are effective ways to help people manage tinnitus and reduce its impact, and understanding it (and knowing it is usually harmless) is itself reassuring and helpful.

How it is treated

Tinnitus is assessed and managed by GPs and hearing/ENT services, and although there is often no single cure, a great deal can be done to help people manage it and reduce its impact, and understanding it is an important first step. Assessment involves looking for any underlying or contributing cause — for example checking for and removing earwax, treating any ear infection, reviewing medicines, and checking hearing (a hearing test is often helpful, as tinnitus commonly goes with some hearing loss) — and identifying any features that need further investigation (such as one-sided or pulsatile tinnitus). Treating a contributing cause (such as earwax) may help. Where tinnitus persists, management focuses on reducing its impact and helping the person habituate (get used to it so it becomes less noticeable and less bothersome). Helpful approaches include: sound therapy and background sound (using gentle background noise to make the tinnitus less noticeable, for example at night); hearing aids for those with associated hearing loss (which often help by improving hearing and reducing the contrast of the tinnitus); relaxation techniques and good sleep habits (as stress and tiredness can make tinnitus feel worse); and psychological approaches such as cognitive behavioural therapy (CBT) or tinnitus-specific therapies, which are effective at reducing the distress and impact of tinnitus. Information, reassurance, and support (including tinnitus support organisations) are valuable, as understanding that tinnitus is usually harmless and that it can become less intrusive over time helps many people. Protecting hearing from loud noise, and managing stress, also help. The reassuring messages are that tinnitus is very common and usually not serious, that many people find it becomes less bothersome over time, and that effective ways to manage it and reduce its impact are available — while certain features (one-sided, pulsatile, sudden, or with significant hearing loss or dizziness) should be assessed.