Background: Tinnitus can be defined as a health condition characterized by the perception of sound, either in the head and/or ears, in the absence of any external acoustic stimulus. Perception is often quantified by self-report, or the use of patient reported outcome measures (PROMs). The purpose of this rapid review was to evaluate the level and quality of evidence regarding the use of serotonin and norepinephrine reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI), and tricyclic antidepressants as measured by tinnitus patient-reported outcome measures (PROMs) and/or Visual Analog Scales (VAS). Methods: The Cochrane Rapid Review guidelines were followed. The PICO mnemonic was used to “frame” the research question. The search strategy was developed and executed in three databases: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. Inclusion and exclusion criteria were established a priori. The search, identification, and selection process were plotted using the PRISMA Flow Diagram. Results were extracted to a custom form. Critical appraisal and risk of bias assessments were completed using standard critical appraisal tools. Results: Three hundred and seventy-five publications were identified and deduplicated, 286 were screened, 266 were deemed irrelevant. Twenty publications were identified for full text review. Seven randomized controlled trials (RCT) met the inclusion criteria and were assessed for design, quality, and bias. The level and quality of the RCT studies included were rated. Statistically significant benefits for amitriptyline, nortriptyline, fluoxetine with alprazolam, and sertraline were reported for tinnitus sufferers whereas fluoxetine alone, trazodone, vestipitant or vestipitant with paroxetine, or paroxetine alone did not demonstrate significant results. A meta-analysis was not completed due to the heterogeneity of studies. Conclusions: Despite promising results, there remains insufficient rigorous high-quality research evidence to indicate that antidepressants can effectively treat subjective tinnitus at this time.
Vos D, Nicholson D, Johnson M, Gottschalk D. The Effectiveness of Serotonin and Tricyclic Antidepressants in Tinnitus Management: A Rapid Review. The Internet Journal of Allied Health Sciences and Practice. 2023 Sep 21;21(4), Article 19.
Prisma (pdf format)
Figure 1 PRISMA Flow Diagram.jpg (84 kB)
Prisma (jpg format)
Vos et al (2023) Tinnitus Study 05.19.23 Revision #1 Final Draft Clean Copy.docx (530 kB)
PRISMA JPEG Revised.jpg (1016 kB)
Revised PRISMA JPEG