Antidepressant treatment of tinnitus patients. Interim report of a randomized clinical trial

Robert A Dobie, M. D. Sullivan, W. J. Katon, C. S. Sakai, J. Russo

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Previous studies have shown that severe tinnitus is associated with current major depression, and that tricyclic antidepressant therapy reduces tinnitus disability, at least compared to brief placebo treatment. We are completing a randomized clinical trial of nortriptyline, stratified by presence or absence of current major depression, in 100 patients with severe chronic tinnitus. Preliminary analysis of global outcome on the first 52 patients reveals that those receiving nortriptyline were more likely to feel that their drug had been helpful (74% vs. 36%, p < 0.01), but were equally likely to report that their tinnitus was improved (37% vs. 32%, NS). So far, neither audiometric nor self-report measures of tinnitus have demonstrated statistically significant differences between active drug and placebo. Simply administered visual rating scales, if externally-referenced, correlated better with global outcome than did the Iowa Tinnitus Handicap Questionnaire. As expected, nortriptyline was significantly superior to placebo with respect to reductions in the Hamilton Depression Scale, especially in depressed patients. Paradoxically, depressed patients reported more disability and loudness on all scales, but had lower 1 kHz tinnitus intensity matches and dynamic ranges. Our preliminary conclusions are that: 1) nortriptyline reduces depression in patients with severe tinnitus, 2) placebo effects are very important in the treatment of tinnitus, 3) depression may be associated with decreased tolerance for both internal and external sounds, and 4) it is still difficult to specify the appropriate measures of tinnitus loudness and disability for use in therapeutic trials.

Original languageEnglish (US)
Pages (from-to)242-247
Number of pages6
JournalActa Oto-Laryngologica
Volume112
Issue number2
StatePublished - 1992
Externally publishedYes

Fingerprint

Tinnitus
Antidepressive Agents
Randomized Controlled Trials
Nortriptyline
Therapeutics
Placebos
Placebo Effect
Tricyclic Antidepressive Agents
Therapeutic Uses
Pharmaceutical Preparations
Self Report

Keywords

  • antidepressant
  • depression
  • tinnitus

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Dobie, R. A., Sullivan, M. D., Katon, W. J., Sakai, C. S., & Russo, J. (1992). Antidepressant treatment of tinnitus patients. Interim report of a randomized clinical trial. Acta Oto-Laryngologica, 112(2), 242-247.

Antidepressant treatment of tinnitus patients. Interim report of a randomized clinical trial. / Dobie, Robert A; Sullivan, M. D.; Katon, W. J.; Sakai, C. S.; Russo, J.

In: Acta Oto-Laryngologica, Vol. 112, No. 2, 1992, p. 242-247.

Research output: Contribution to journalArticle

Dobie, RA, Sullivan, MD, Katon, WJ, Sakai, CS & Russo, J 1992, 'Antidepressant treatment of tinnitus patients. Interim report of a randomized clinical trial', Acta Oto-Laryngologica, vol. 112, no. 2, pp. 242-247.
Dobie RA, Sullivan MD, Katon WJ, Sakai CS, Russo J. Antidepressant treatment of tinnitus patients. Interim report of a randomized clinical trial. Acta Oto-Laryngologica. 1992;112(2):242-247.
Dobie, Robert A ; Sullivan, M. D. ; Katon, W. J. ; Sakai, C. S. ; Russo, J. / Antidepressant treatment of tinnitus patients. Interim report of a randomized clinical trial. In: Acta Oto-Laryngologica. 1992 ; Vol. 112, No. 2. pp. 242-247.
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