Objective To determine whether Ginkgo biloba is effective in treating tinnitus. Design Double blind, placebo controlled trial using postal questionnaires. Participants 1121 healthy people aged between 18 and 70 years with tinnitus that was comparatively stable; 978 participants were matched (489 pairs). Intervention 12 weeks' treatment with either 50 mg Ginkgo biloba extract LI 1370 three times daily or placebo. Main outcome measures Participants' assessment of tinnitus before, during, and after treatment. Questionnaires included items assessing perception of how loud and how troublesome tinnitus was. Changes in loudness were rated on a six point scale. Changes in how troublesome were rated on a five point scale. Results There were no significant differences in primary or secondary outcome measures between the groups. 34 of 360 participants receiving active treatment reported that their tinnitus was less troublesome after 12 weeks of treatment compared with 35 of 360 participants who took placebo. Conclusions 50 mg Ginkgo biloba extract LI 1370 given 3 times daily for 12 weeks is no more effective than placebo in treating tinnitus.
Thirty-one patients were drawn from a tinnitus clinic, screened for other medical problems and treated for 4 weeks with 30 mg nimodipine four times daily. Before and after treatment, the intensity of their tinnitus was assessed subjectively on a scale 1-10. Five patients reported to have a great improvement in their tinnitus whilst two claimed a worsening of the condition. Of the five positive responders, four were treated further with 30 mg nimodipine per day for 4 weeks and 60 mg per day for a further 4 weeks. During this treatment they were assessed more objectively by the determination of the minimal masking level using narrow band noise. There was a good correlation between the subjective and objective assessment of their responses.
Mice withdrawn from exposure for 14 days to ethanol inhalation showed the expected signs of ethanol withdrawal including convulsive behaviour. Injection of chlormethiazole (100 mg/kg) 5 h after the start of withdrawal, at the time that the convulsive behaviour was near maximal, resulted in the virtual disappearance of the withdrawal-induced behaviour within 30 min, with its reappearance by 60 min. A dose of chlormethiazole of 40 mg/kg was without effect. The time course of the effect of chlormethiazole (100 mg/kg) in the withdrawal test was similar to its effect in raising seizure threshold and decreasing locomotor activity. Chlormethiazole did not alter in vitro binding of [3H]-PN 200-110 to the dihydropyridine sensitive Ca2+ channel. Chlormethiazole, a drug used clinically to treat ethanol withdrawal, has therefore been shown to be effective in this animal model of withdrawal. Dihydropyridine calcium antagonists are also active in the model but chlormethiazole is likely to work by a different mechanism and it is suggested that this may be by increasing GABAergic function.
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