Name of treatment	Anticonvulsants
Type of treatment	Pharmaceutical
Claims for treatment	Potentially suppress central auditory hyperactivity that may be related to tinnitus[1]. Anticonvulsants are believed to reduce tinnitus by augmenting the action or levels of neurotransmitters, or via blocking voltage gated sodium channels[1].
How treatment is delivered	Capsules or tablets.
Potential negative consequences	Common side effects from clinical trials included nausea, dizziness, headache, tiredness.[2]
Evidence offered:
Papers available	7 in the Cochrane review [2] 8 RCTs considered by the Clinical Practice Guideline [1].
Drugs mentioned in the literature	Gabapentin[3][4]; amino-oxyacetic acid[5]; lamotrigine (Lamictal)[6]; carbamazepine (Tegretol)[7][8]; flunarizine (Sibelium)[9].
Conclusions drawn	There is no evidence to show that anticonvulsants have a large positive effect in the treatment of tinnitus.[2] Carbamazepine and oxcarbazepine are not more effective than placebo in decreasing tinnitus severity.[10] Therapeutic use of these drugs for epilepsy may result in tinnitus and other auditory dysfunctions.[11]
Quality of evidence [12]	A
Does the BTA recommend this treatment?	No
BTA opinion on this treatment:	There is no evidence to show that anticonvulsants have an impact on tinnitus. Side effects were experienced by 18% of patients in the trials reviewed.[1]
Would the BTA support further studies into this treatment?	Yes, if high quality study
Verdict: Safety - is this treatment harmful?	Some potential for harm
Verdict: Efficacy - does this treatment work?	Evidence that they are not effective
Comments	Studies seldom used appropriate outcome measures and had high risk of bias

For further information

The BTA Tinnitus Support Team can answer your questions on any tinnitus related topics:

Telephone: 0800 018 0527
Web chat: - click on the icon
Email: [email protected]
Text/SMS: 07537 416841

We also offer a free tinnitus e-learning programme, Take on Tinnitus.

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tinnitus and ANTICONVULSANTS

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References

[1] Tunkel DE, Bauer CA, Sun GH, et al. Clinical Practice Guideline: Tinnitus. Otolaryngology–Head and Neck Surgery. 2014;151(2_suppl): S1-S40. doi:10.1177/0194599814545325

[2] Hoekstra CEL, Rynja SP, van Zanten GA, Rovers MM. Anticonvulsants for tinnitus. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD007960. DOI: 10.1002/14651858.CD007960.pub2.

[3] 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. European Archives of Oto‐Rhino‐Laryngology 2007;265(5):525‐30.

[4] 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;90:150-158.

[5] Reed HT, Meltzer J, Crews P, Norris CH, Quine DB. Guth PS. Amino oxyacetic acid as a palliative in tinnitus. Arch Otolaryngol. 1985; 111: 803-805

[6] Simpson JJ, Gilbert AM, Weiner GM, Davies WW. The assessment of lamotrigine, an antiepileptic drug, in the treatment of tinnitus. American Journal of Otology 1999;20:627‐31.

[7] Donaldson I. Tegretol: a double blind trial in tinnitus. Journal of Laryngology and Otology. 1981; 95: 947-951

[8] Hulshof JH, Vermeij P. The value of carbamazepine in the treatment of tinnitus. ORL: Journal of Oto‐Rhino‐Laryngology and Its Related Specialties 1985;47:262‐6

[9] Hulshof JH, Vermeij P. The value of flunarizine in the treatment of tinnitus. ORL: Journal of Oto‐Rhino‐Laryngology and Its Related Specialties 1986;48:33‐6.

[10] Gerami H, Saberi A, Nemati S, Kazemnejad E, Aghajanpour M. Effects of oxcarbazepine versus carbamazepine on tinnitus: A randomized double-blind placebo-controlled clinical trial. Iran J Neurol. 2012;11(3):106–110.

[11] Sherifa A Hamed (2017) The auditory and vestibular toxicities induced by antiepileptic drugs, Expert Opinion on Drug Safety, 16:11, 1281-1294, DOI: 10.1080/14740338.2017.1372420

[12] A = Systematic review/meta analysis. B = Randomised control studies. C = Cohort studies. D = Case control studies. E = case studies/reports. +/- to be used to indicate quality within bands

Author: Nic Wray

Version 2.0

Updated: 17 May 2022

To be reviewed: May 2025

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