'Ringing in the Ear' May Respond to Alcoholism Drug

But experts remain skeptical acamprosate will ease tinnitus

THURSDAY, Sept. 22, 2005 (HealthDay News) -- A drug used to treat alcoholism can help people with tinnitus, the "ringing in the ears" that can make life miserable, Brazilian researchers report.

Nearly 90 percent of a small group of people with tinnitus reported substantial relief after taking the drug acamprosate, according to otolaryngologists at the Federal University of Rio de Janeiro.

"In 47.8 percent of the cases, we found relief higher than 50 percent," they noted, adding that "the incidence of side effects was low."

The researchers attributed acamprosate's success to its effect on glutamate, an amino acid that stimulates activity of the nervous system. Their theory is that tinnitus is caused by disruptions in the same glutamate pathways that are involved in addiction to alcohol.

Acamprosate, marketed as Campral by Lipha Pharmaceuticals, Inc. of Lyon, France, is widely used in Europe and was approved last year by the Food and Drug Administration as a treatment for alcohol dependence.

The findings were to be presented at the American Academy of Otolaryngology's annual meeting, which starts Sept. 25 in Los Angeles.

The results and the theory behind them were viewed with caution by Robert L. Folmer, chief of clinical services at the tinnitus clinic of the Oregon Health Sciences University.

"Over the years, many different drug treatments have been tried for tinnitus," Folmer said. "The first reports are almost universally positive, but as time goes on you often don't hear about the drug being used again. I'm a bit skeptical about these early reports."

And it's likely that the drug is effective against tinnitus because it quiets activity of GABA, which stimulates activity of the nervous system, Folmer said. Many people with tinnitus have trouble sleeping, and acamprosate may help them by making them drowsy, he said.

"Other drugs that are antagonists to glutamate haven't worked out well," Folmer said.

Several weaknesses of the study were pointed out by two hearing experts at the University of Buffalo -- Robert F. Burkard, a professor in the department of communicative disorders and sciences and otolaryngology, and Richard Salvi, director of the university's Center for Hearing and Deafness. Salvi is also chairman of the American Tinnitus Association's scientific advisory committee.

There were only a few people in the study, with just 25 getting the drug, both experts pointed out. And "it is possible that patients could recognize when they were taking the drug due to its side effects," the two said in a joint statement.

In addition, "the metrics for assessing tinnitus improvement are not clearly described," they said, and "as with all drug studies, this needs to be replicated in other laboratories or clinical setting."

Despite all those caveats, "the results in the paper are encouraging," Salvi and Burkard said.

If acamprosate is effective for tinnitus, it would be a first, according to Folsom. "We don't recommend any medications because we haven't found any that are particularly effective," he said.

The Oregon clinic was the first of its kind "and so far we have found no quick fix," Folsom said. People who come to the clinic for help about tinnitus go through four hours of analysis to determine what might cause the problem, he said. If it is a byproduct of the hearing loss that comes with aging, nothing can be done about it. But in some other cases, sound generators put into the ear can make the ringing less bothersome.

More information

You can learn about that ringing in your ear from the American Tinnitus Association.

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