Traditional medicine is rooted in pharmacologic therapy. Pharmacology is the use of chemical compounds to influence the behavior of a biological system. When these chemical compounds are used to treat an illness, we refer to it as "medication".
At NeuroMed, we often use medications as part of our treatment strategy. However, medications are only one part of our multimodal treatment approach to tinnitus care.
The following list includes some common pharmaceuticals we’ve employed in our treatment plans.
Nortriptyline is a tricyclic antidepressant that affects the neurotransmitters in the brain. This medicine has emerged as a cornerstone of our pharmaceutical approach. With an effectiveness rate of 75% to 80%, it has shown remarkable results in improving symptoms for ear-related disorders. We use a very low dose of the medication and titrate up for effect over the course of your treatment.
Beyond its primary use, nortriptyline addresses key neurobiological processes that can perpetuate tinnitus and other symptoms. So even though it is classified as an antidepressant, we do not use it this way. Rather, we use it to balance neurotransmitters in the brain and to facilitate the creation of healthy neural networks. It also helps with sleep regulation and reduces hormones associated with stress and anxiety in the brain.
Nortriptyline is a prescription medicine that comes as a capsule and an oral liquid and is taken orally. Note that this medication should be taken only as per the prescribed dosage and should not be stopped without consulting your provider.
Originally developed for seizure management, topiramate has proven its utility at low doses in addressing tinnitus and related neurological disorders.
Topiramate controls the spread of electrical activity, particularly for patients with lowered neurosensory thresholds. By doing so, it can target and alleviate symptoms such as tinnitus, headaches, dizziness, and chronic pain.
Topiramate is a prescription medicine that comes as a tablet, a sprinkle capsule (beads of medication that can be sprinkled on food), an extended-release (long-acting) capsule, and a solution (liquid) for oral consumption.
Note that this medication should be taken only as per the prescribed dosage and should not be stopped without consulting your provider.
Verapamil, initially intended as a blood pressure medication, has also been effective in treating tinnitus and migraine. Even patients without a history of high blood pressure can benefit from verapamil, as it doesn't substantially impact heart rate and blood pressure in all patients.
Our approach involves using very low doses, personalized to your needs, to manage your symptoms effectively.
Verapamil is a prescription medicine that comes as a tablet, an extended-release (long-acting) tablet, and an extended-release (long-acting) capsule and is taken orally. Please remember to consult your doctor before you stop taking this medication.
Gabapentin was originally developed to be an anti-seizure medication. However, it also treats other problems, including chronic tinnitus, vertigo, migraine, and other neurological issues.
At NeuroMed, we typically start with very low doses of Gabapentin, usually taken at night. This is because Gabapentin can induce sleepiness in some patients for a few days.
Gabapentin is a prescription medicine that comes as a capsule, a tablet, an extended-release (long-acting) tablet, and an oral solution (liquid) and is taken orally. Always remember to consult your doctor before you stop taking this medication.
Propranolol is a medication typically used to treat high blood pressure and is also FDA-approved for preventing migraine headaches. At NeuroMed, we use Propranolol together with other medications for the treatment of tinnitus that is associated with atypical migraine.
The drug acts as a beta-blocker by preventing the dilation of blood vessels and stabilizing serotonin levels. Propranolol can make your tinnitus and migraine symptoms shorter, less intense, and less frequent.
Propranolol comes as a tablet, solution (liquid), and as an extended-release (long-acting) capsule. It is taken orally. Do not stop taking propranolol without talking to your doctor.
Typically used to treat high blood pressure, Candesartan has also been found to be effective for migraine-related tinnitus. We use Candesartan in selected patients to treat tinnitus when it's associated with atypical forms of migraine.
Candesartan comes as a tablet and is taken orally. Do not stop taking candesartan without talking to your doctor.
Paroxetine, or Paxil, was originally designed as an anti-depressant. However, when prescribed in low doses, it is effective in treating headaches and migraine. We have successfully used Paroxetine for many patients with tinnitus and related neurological symptoms.
Again, the goal is not to treat depression, but to balance the neurotransmitter levels in the brain and facilitate positive changes to the neural networks that propagate tinnitus and it's related symptoms.
It impacts some patients by causing drowsiness, while others feel more alert when taking this medication. We typically ask patients to start taking the medication in the morning over a weekend so they can monitor its effect on them. If they feel drowsy after taking the drug, the dosage time is changed to nighttime.
Paroxetine comes as a tablet, a suspension (liquid), a controlled-release (long-acting) tablet, and a capsule and is taken orally. Do not stop taking Paroxetine without talking to your doctor.