Evaluation of Carbamazepine and Oxcarbazepine on Tinnitus Otolaryngology – Head & Neck Surgery Research Center- Guilan University of Medical Sciences

Document Type : Research Paper

Authors

1 Associate professor of Otolaryngology Head & Neck Surgery, Guilan University of Medical Sciences,Rasht, Iran

2 Assistant professor of Neurology, Guilan University of Medical Sciences,Rasht, Iran

3 Assistant professor of Otolaryngology Head & Neck Surgery, Guilan University of Medical Sciences,Rasht, Iran

4 Assistant professor of Biostatistics, Guilan University of Medical Sciences,Rasht, Iran

5 Resident of Otolaryngology Head & Neck Surgery, Guilan University of Medical Sciences,Rasht, Iran

6 Medical Student, Guilan University of Medical Sciences,Rasht, Iran

Abstract

Introduction
Due to multiplicity of tinnitus etiologies and the lack of accurate knowledge about its exact mechanism, it is still a challenge to find an effective treatment. The objective of this study was an evaluation of carbamazepine and oxcarbazepine effect on tinnitus in patients’ reffered to Amiralmomenin Hospital Rasht-Iran.
Materials and Methods
In a randomized double-blind clinical trial, a total of 57 patients (23 to 71 years old) with chronic nonpulsatile tinnitus were treated in three separate groups with carbamazepine (300-600mg), oxcarbazepine (450-900 mg) and placebo for 12 weeks. In the early stages of the study, physical examination and nessecary laboratory tests, audiometry tests, complementation of Visual Analogue Scale (VAS) and Tinnitus Severity Index (TSI) were performed. At the end of 8th and 12thweeks, VAS and TSI questionnaire were completed again.
Results
Among 51 patients (28 male, 23 female) who completed the trial course, according to VAS, carbamazepine, oxcarbazepine and placebo decreased severity of tinnitus in 56.6%, 46.2% and 38.5% of cases respectively. Decrement in tinnitus severity on the basis of TSI in the three mentioned groups were 61.1%, 58.8% and 50% respectively. Carbamazepine and oxcarbazepine were not more effective than placebo in subsiding tinnitus on the basis of VAS and TSI.
Conclusion
Carbamazepine and its analouge, oxcarbazepine are effective in decreasing tinnitus severity, but they are not significantly more effective than placebo.

Keywords


1- Kalcioglu MT, Bayindir T. Objective evaluation of the effects of intravenous Lidocain on innitus . Hear Res 2005;
199:81-88.
2- Shaley TL, Nodar RH. Tinnitus : Present and future. Otolaryngol Head Neck Surg 2001; 9:323-328.
3- Lockwood Alan H , Salvi RJ, Bukard RF. Tinnitus NEJM 2002; 347:904-910.
4- Dobie RA . A review of randomized clinical trails in Tinnitus . Laryngoscope 1999; 109:1202-1211.
5- Simpson J , Davies WE . Recent advances in the pharmacological Treatment of Tinnitus. Trends Pharmacol Sci 1999;
20:12–18.
6- Shulman A, Gold stain B. Subjective Idiopathic Tinnitus and palliative care:A plan for diagnosis and treatment.
Otolaryngol Clin Nourth Am 2009; 42. Issue1
7- Donaldson I. Tegretol : A Double blind trial in tinnitus. J Laryngol Otol 1981; 95:947-951.
8- Hulshof JH , Vermeij P. The value of carbamazepine in the treatment of tinnitus. ORL J Otrhinolaryngol 1985; 47:
262-266.
9- Marks NJ, Onisiphoron C, Tromoce JR. The effect of single doses of amylobarbitone sodium And carbamazepine in
tinnitus. J Laryngol Otol 1981; 95:941-945.
10- She w, Dai Y, Du X. Treatment of subjective Tinnitus: A Comparative clinical study of Intratympanic steroid
injection VS: Oral carbamazepine. Med Sch Monit 2009; 15:135-139.
11- Murai K, Tyler RS, Heerker LA.Reviews of pharmacological treatment of Tinnitus . Am J Otol 1992; 13:454-464.
12- Hoekstra CE, Rynja SP, van Zanten GA, Rovers MM. Anticonvulsants for tinnitus. Cochrane Database Syst Rev 2011
; 7:CD007960.
13- Hoare DJ, Kowalkowski VL, Kang S, Hall DA. Systematic review and meta-analyses of randomized controlled trials
examining tinnitus management. Laryngoscope 2011; 121:1555-64. doi: 10.1002/lary.21825.
14- Sanches TG. Lidocain test in patients with Tinnitus , rational of accomplishment and relation to the Treatment with
carbamazepine. Auris Nasus larynx 1999; 26:411-417.
15- Shiley Sg, Folmer RL, MCMenomey SO.Tinnitus and hyperacusis. In: Cummings CW, Flint PW , Haughey BH ,
Robbins KT, Shuller DE.editors. Otolaryngology Head & Neck Surgery. 4th ed. Philadelphia: Pennysylvania: Mosby,
Inc; 2005.p. 2832-2847.
16- Mardini MK. Ear-Clicking Tinnitus responding to carbamazepine N Engl J Med 1987; 317:542.
17- Kong Ma F, Xin Y, Zhao Y, Li N. Efficacy of carbamazepine combined with flunarizine hydrochloride for treating
Tinnitus. Lin Chung Er Bi Yan Hon Tou Jing Wai Ke Za Zhi 2008; 22:1016-1022.
18- Witsell DL, Hannley MT, Stinnets. Treatment of tinnitus with Gabapentin : A pilot study. Otology Neurotol 2007;
28:11-15.
19- Bauer CA, Brozoski TJ. Effect of gabapentin on the sensation and impact of Tinnitus . Laryngoscope 2006; 116:675-81.