Orientamenti farmacologici nella terapia degli acufeni idiopatici cronici = Pharmacological trends in chronic idiopathic tinnitus

Therapeutic resources against chronic idiopathic tinnitus are still not specific. Only in rare circumstances is an etiologic approach feasible, mainly at the onset of the symptomatology. The neuronal pathways and the neurotransmitters involved in the onset and the maintenance of idiopathic tinnitus remain largerly unknown. In most cases the efficacy of the drugs lasts for a short period after their removal, and a complete and definitive remission of the symptomatology should be considered unusual. Concomitant indications to the administration of drugs, e.g. the coexistence within the tinnitus patient of a sensorineural hearing loss together with a depressive trait, increase the possibility to control the tinnitus through drugs: the main goal of the therapy is then the relief of the psychologic pain correlated to an irreversible audiologic disturbance. Pharmacological therapy needs to be strictly evaluated following the indications of each drug and the efficacy in the individual. Finally, because some of the effective drugs are themselves able to cause tinnitus, the improvement of the tinnitus should always be matched to the potential weight of this and of other side effects in the long period.