The medical treatment of tinnitus

Currently there are three methods of treating patients with intractable tinnitus, a physical one using masking (Vernon, 1977), a psychosomatic method using biofeedback (House et al., 1977), and a chemical treatment using intravenous lidocaine and the oral anticonvulsants--carbamazepine, primidone and lidocaine amine. The latter seems to be the most promising, being easier to use, less time-consuming, more accurate to assess, and relying less on the patient's active participation and intelligence. The only disadvantages of the chemical method are the serious side-effects of the drugs in use. This can be managed by careful administration of these drugs and monitoring of the patient. In the future, new anticonvulsants with fewer side-effects will certainly be produced. It may be that chemical treatment can be combined with the masking and/or the biofeedback methods with a synergistic result. Another possible use of carbamazepine is in the treatment of palatal myoclonus and other similar disorders. Further clinical studies are needed to corroborate this application of the treatment.