gms | German Medical Science

Background: Improving oxygen and glucose supply, free radical scavenging and enhancing neuronal plasticity are treatment strategies pursued in chronic tinnitus.

Methods: In a double-blind trial 200 patients with chronic tinnitus were randomly assigned to EGb 761^® (240 mg/d) or pentoxifylline (1,200 mg/d) for 12 weeks. Treatment effects were assessed using the short form of the Tinnitus Questionnaire (Mini-TQ), 11-point box scales for loudness and annoyance, Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale (SDS).

Results: Improvements in the Mini-TQ were similar in both treatment groups (EGb 761^®: -1.5 [95%-CI: -2.2; -0.9]; pentoxifylline -2.0 [95%-CI: -2.7; -1.2]). A decrease by at least 25% of baseline scores in the Mini-TQ was seen in 44% of EGb 761^®-treated compared to 42% of pentoxifylline-treated patients. Comparable improvements in both treatment groups were found for the 11-point box scales loudness (EGb 761^®: -0.4 [-0.7; -0.1]; pentoxifylline: -0.4 [-0.7; -0.2]) and annoyance (-0.5 [-0.8; -0.2]; -0.6 [-0.8; -0.3]), HADS subscales anxiety (-1.3 [-1.8; -0.9]; -1.1 [-1.5; -0.6]) and depression (-0.4 [-0.9; 0.2]; -0.5 [-0.9; 0.0]), SDS (-1.7 [-2.7; -0.7]; -1.9 [-3.0; -0.7]). In patients with elevated depression scores treatment effects of EGb 761^® tended to be larger than in patients with low depression scores. More adverse events were reported under pentoxifylline (36 events in 27% of patients) compared to EGb 761^® treatment (20; 19%).

Conclusion: Although 77% of patients had tinnitus for at least 2 years, both treatments decreased tinnitus loudness, annoyance, psychological symptoms and disability within a short period. EGb 761^® was better tolerated than pentoxifylline and may have larger treatment effects in depressed patients.

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