Short-Term Effect of Gabapentin on Subjective Tinnitus in Acoustic Trauma Patients

Document Type: Original


Department of Otolaryngology, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.


Although several treatment approaches have been proposed for tinnitus, there are currently no Food and Drug Administration (FDA)-approved agents available to treat this condition. In this study, we evaluated the effect of gabapentin on the sensation of subjective tinnitus in patients with acoustic trauma referring to the ear, nose and throat (ENT) clinic of Taleghani Hospital during 2014.
 Materials and Methods:
In this double-blind, randomized clinical trial, 103 patients with tinnitus due to acoustic trauma who were referred to the ENT clinic of Taleghani Hospital during 2014 were randomized to the gabapentin (300 mg bid, n=55) or control (n=48) groups. The two groups were then compared before and after 6 weeks of treatment using a visual analog scale (VAS). At least a 30% reduction in VAS was considered a response to treatment.
Differences between the two groups regarding sex, age, duration of disease, and audiometry results was not significant (P>0.05). After 6 weeks’ treatment, the VAS significantly decreased in both groups (P<0.001), but the reduction was significantly greater in the gabapentin group compared with control (P<0.001). Forty-nine patients (89%) in the gabapentin group and 28 control patients (58.3%) responded to treatment (≥30% reduction in VAS), with the difference between the two groups being statistically significant (P<0.001).
We conclude that gabapentin 300 mg bid for 6 weeks is an effective treatment for acoustic tinnitus.
In addition, the placebo effect in relieving tinnitus is remarkable.


Main Subjects

1. Snow JB. Tinnitus Theory and Management. Ontario: BC Decker Inc; 2004:255–6.

2. Hall DA, Láinez MJ, Newman CW, Sanchez TG, Egler M, Tennigkeit F, et al. Treatment options for subjective tinnitus: Self reports from a sample of general practitioners and ENT physicians within Europe and the USA. BMC Health Serv Res. 2011; 11(302): [15 screens].

3. Mihail RC, Crowley JM, Walden BE, Fishburne J, Reinwall JE, Zajtchuk JT. The tricyclic trimipramine in the treatment of subjective tinnitus. Ann Otol Rhinol Laryngol. 1988; 97(2, Pt. 1):120–3.

4. House JW. Management of the tinnitus patient. Ann Otol Rhinol Laryngol. 1981; 90(6, Pt. 1):597-601.

5. Ireland CD, Wilson PH, Tonkin JP, Platt-Hepworth S. An evaluation of relaxation training in the treatment of tinnitus. Behav Res Ther. 1985; 23:423–30.

6. Simpson JJ, Davies WE. Recent advances in the pharmacological treatment of tinnitus. Trends Pharmacol Sci. 1999; 20(1):12–8.

7. Majumdar B, Mason SM, Gibbin KP. An electrocochleographic study of the effects of lignocaine on patients with tinnitus. Clin Otolaryngol. 1983; 8(3):175–80.

8. Den Hartigh J, Hilders CG, Schoemaker JH, Hulshof JH, Cohen AF, Vermeij P. Tinnitus suppression by intravenous lidocaine in relation to its plasma concentration. Clin Pharmacol Ther. 1993; 54(4):415–20.

9. Arnold W, Bartenstein P, Oestreicher E, Romer W, Schwaiger M. Focal metabolic activation in the predominant left auditory cortex in patients suffering from tinnitus: A PET study with [18F] deoxyglucose. J Otorhinolaryngol Relat Spec. 1996; 58:195–9.

10. Lockwood AH, Salvi RJ, Coad ML, Towsley ML, Wack DS, Murphy BW. The functional neuroanatomy of tinnitus: Evidence for limbic system links and neural plasticity. Neurology. 1998; 50(1): 114–20.

11. Taylor CP, Gee NS, Su TZ, Kocsis JD, Welty DF, Brown JP, et al. A summary of mechanistic hypotheses of gabapentin pharmacology. Epilepsy Res. 1998; 29(3):233–49.

12. Bauer CA, Brozoski TJ, Holder TM, Caspary DM. Effects of chronic salicylate on GABAergic activity in rat inferior colliculus. Hear Res. 2000; 147(1–2):175–82.

13. Milbrandt JC, Holder TM, Wilson MC, Salvi RJ, Caspary DM. GAD levels and muscimol binding in rat inferior colliculus following acoustic trauma. Hear Res. 2000; 147(1–2):251–60.

14. Bauer CA, Brozoski TJ. Assessing tinnitus and prospective tinnitus therapeutics using a psychophysical animal model. J Assoc Res Otolaryngol. 2001; 2(1):54–64.

15. HaefeliM,Elfering A.Pain assessment. Eur Spine J. 2006; 15(supplement 1):17–24.

16. Meikle MB,Stewart BJ, Griest SE, Henry JA. Tinnitus outcomes assessment. Trends Amplif. 2008; 12(3):223–35.

17. Taylor CP. Mechanisms of analgesia by gabapentin and pregabalin-calcium channel alpha2-delta [cavalpha2-delta] ligands. J Pain 2009; 142(1–2):13–6.

18. Figueiredo RR, Azevedo AA, Oliveira Pde M. Correlation analysis of the visual-analogue scale and the Tinnitus Handicap Inventory in tinnitus patients. Braz J Otorhinolaryngol 2009;75(1):76–9.

19. Guimarães AC, Carvalho GM, Voltolini MM, Zappelini CE, Mezzalira R, Stoler G, et al. Study of the relationship between the degree of tinnitus annoyance and the presence of hyperacusis. Braz J Otorhinolaryngol. 2014;80(1):24–8.

20. Zapp JJ. Gabapentin for the treatment of tinnitus: A case report. Ear Nose and Throat J. 2001; 80(2): 114–6.

21. Shulman A, Strashun AM, Goldstein BA. GABAA-benzodiazepine-chloride receptor-targeted therapy for tinnitus control: Preliminary report. Int Tinnitus J. 2002; 8(1):30–6.

22. Bauer CA, Brozoski TJ. Effect of gabapentin on the sensation and impact of tinnitus. Laryngoscope. 2006; 116(5):675–81.

23. 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(4):150–8.

24. Piccirillo JF, Finnell J, Vlahiotis A, Chole RA, Spitznagel E JR. Relief of idiopathic subjective tinnitus: Is gabapentin effective? Arch Otolaryngol Head Neck Surg. 2007;133(4):390–7.

25. Witsell DL, Hannley MT, Stinnet S, Tucci DL. Treatment of tinnitus with gabapentin: A pilot study. Otol Neurotol. 2007;28(1):11–5.

26. 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. Eur Arch Otorhinolaryngol 2008; 265(5):525–30.

27. Bahmad FM, Venosa AR, Oliveira CA. Benzodiazepines and GABAergics in treating severe disabling tinnitus of predominantly cochlear origin. Int Tinnitus J. 2006;12(2):140–4.

28. Aazh H, El Refaie A, Humphriss R. Gabapentin for tinnitus: A systematic review. Am J Audiol. 2011; 20(2):151–8.

29. Otsuka K, Pulec JL, Suzuki M. Assessment of intravenous lidocaine for the treatment of subjective tinnitus. Ear Nose and Throat J. 2003;82(10):781–4.