Tinnitus treatment by neurotransmitter modulation in high frequency sensorineural hearing loss using Acamprosate: A clinical experience

Abstract

Background: Sensorineural tinnitus is correlated to several inner ear and auditory pathway disorders. However, noxas originating from different auditory pathway levels may be similarly manifested in the auditory cortex. A likely candidate for these shared messengers are neurotransmitters. Two neurotransmitters have been described in the afferent auditory pathways: glutamate, which is excitatory, and GABA, which is inhibitory. Different studies have shown that sensorineural tinnitus is caused by an imbalance of these two neurotransmitters with an excitatory predominance. Acamprosate, a drug used in the treatment of alcoholism, might act modulating the balance glutamate-GABA. It could have a similar effect in the auditive afferent pathway. Only one research study on the use of acamprosate for tinnitus treatment has been published, which a result of over 80% of either relief or disappearance of tinnitus. Aim: To investigate the actual usefulness of Acamprosate in tinnitus treatments, since in the previously mentioned study the results were subjectively measured, with no follow up. Methods: Twenty patients treated with Acamprosate during a period of one month were studied; tinnitus psychoacoustic and psychoemotional assessment (THI) were carried out. Results: Out of twenty patients, in two tinnitus disappeared, in six, it was reduced in 5 or more dB and in these same patients THI improved in 50% or more. In 12 patients there was a very slight improvement or no changes at all. Conclusions: It would be possible to modulate successfully the neurotransmitters of the afferent auditory pathway in some patients suffering from severe tinnitus using Acamprosate. This is an original study with physiopathological bases, which offers new therapeutic perspectives.