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Clinical Question:
Does selective serotonin reuptake inhibitor effective in patients with
nondepressed tinnitus?
Bottom Line:
Results suggest that the majority of individuals in this study did not
benefit from paroxetine in a consistent fashion.
Reference:
Randomized placebo-controlled trial of a selective serotonin reuptake
inhibitor in the treatment of nondepressed tinnitus subjects.Robinson SK,
Viirre ES, Bailey KA, Gerke MA, Harris JP.Psychosom Med. 2005
Nov-Dec;67(6):981-8.
Study Design:
Randomized placebo-controlled trial
Synopsis:
To assess the efficacy of a selective serotonin reuptake inhibitor (paroxetine)
for relief of tinnitus. DESIGN: One hundred twenty tinnitus sufferers
participated in a randomized double-blind placebo-controlled trial.
Paroxetine or placebo was increased to a maximally tolerated dose (up to 50
mg/day), and patients were treated for a total of 31 days at the maximal
dose. Patients with chronic tinnitus were recruited from our
university-based specialty clinic by referral from otolaryngologists and
audiologists in the local community and by advertisement. Patients with
psychotic or substance use disorders or suicidal ideation were excluded, as
were those using psychoactive medications (this resulted in only 1 subject
with major depression in the study) or any other medications that interact
with paroxetine and those with inability to hear at one's tinnitus sensation
level. Fifty-eight percent of patients were male, 92% were Caucasian, and
the average age was 57. Tinnitus matching, the Tinnitus Handicap
Questionnaire, the question: How severe (bothered, aggravating) is your
tinnitus? Quality of Well-Being and other psychological questionnaires.
Paroxetine was not statistically superior to placebo on the following
tinnitus measures (tinnitus matching, 5- or 10-db drop, Tinnitus Handicap
Questionnaire, quality of well-being measures, how severe, how bothered,
positive change). There was a significant improvement in the single item
question, How aggravating is your tinnitus? for those in the paroxetine
group compared with the placebo group. |