TY - JOUR
T1 - A Randomized Trial of Nortriptyline for Severe Chronic Tinnitus
T2 - Effects on Depression, Disability, and Tinnitus Symptoms
AU - Sullivan, Mark
AU - Katon, Wayne
AU - Russo, Joan
AU - Dobie, Robert
AU - Sakai, Connie
N1 - Funding Information:
Acceptedfor publication February 16, 1993. This researchwas supported by the National Institutes
PY - 1993/10
Y1 - 1993/10
N2 - Objective: To determine whether the antidepressant, nortriptyline, is effective for treatment of depression, tinnitusrelated disability, and tinnitus symptoms in patients with severe chronic tinnitus. Design: A 12-week, double-blind, randomized controlled trial. Setting: A university otolaryngology clinic. Patients: Ninety-two subjects with severe chronic tinnitus: 38 with current major depression and 54 with depressive symptoms and significant tinnitus-related disability. Intervention: Nortriptyline (maintained at 50 to 150 mg/mL for 6 weeks) or placebo. Main Outcome Measures: Hamilton Depression Rating Scale, Tinnitus Disability Measures, and Audiometric Measures. Results: Nortriptyline was superior to placebo by multivariate analysis of covariance for depression (10.6 vs 14.3 final Hamilton Depression score), for tinnitusrelated disability (1.8 vs 2.4 final MPI Tinnitus Interference), and tinnitus loudness (13.6 vs 20.0 dB final loudness match [in worst ear at tinnitus fequency]). When major depression and depressive symptoms groups were considered separately, nortriptyline was superior to placebo on these same measures but differences did not achieve statistical significance. Conclusions: The antidepressant nortriptyline decreases depression, functional disability, and tinnitus loudness associated with severe chronic tinnitus. What appears to be irreversible disability of otologic origin may, in part, be reversible disability of psychiatric origin.
AB - Objective: To determine whether the antidepressant, nortriptyline, is effective for treatment of depression, tinnitusrelated disability, and tinnitus symptoms in patients with severe chronic tinnitus. Design: A 12-week, double-blind, randomized controlled trial. Setting: A university otolaryngology clinic. Patients: Ninety-two subjects with severe chronic tinnitus: 38 with current major depression and 54 with depressive symptoms and significant tinnitus-related disability. Intervention: Nortriptyline (maintained at 50 to 150 mg/mL for 6 weeks) or placebo. Main Outcome Measures: Hamilton Depression Rating Scale, Tinnitus Disability Measures, and Audiometric Measures. Results: Nortriptyline was superior to placebo by multivariate analysis of covariance for depression (10.6 vs 14.3 final Hamilton Depression score), for tinnitusrelated disability (1.8 vs 2.4 final MPI Tinnitus Interference), and tinnitus loudness (13.6 vs 20.0 dB final loudness match [in worst ear at tinnitus fequency]). When major depression and depressive symptoms groups were considered separately, nortriptyline was superior to placebo on these same measures but differences did not achieve statistical significance. Conclusions: The antidepressant nortriptyline decreases depression, functional disability, and tinnitus loudness associated with severe chronic tinnitus. What appears to be irreversible disability of otologic origin may, in part, be reversible disability of psychiatric origin.
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U2 - 10.1001/archinte.1993.00410190091011
DO - 10.1001/archinte.1993.00410190091011
M3 - Article
C2 - 8215728
AN - SCOPUS:0027517875
VL - 153
SP - 2251
EP - 2259
JO - JAMA Internal Medicine
JF - JAMA Internal Medicine
SN - 2168-6106
IS - 19
ER -