Uso do acamprosato no tratamento do zumbido: um estudo duplo-cego

Abstract

Nowadays, the treatment of tinnitus is still a great challenge for the otolaryngologists. Many facts remain unknown in its pathophysiology, leading to many different therapies, with irregular results. Acamprosate is a drug used in alcoholism treatment, due to its regulating effects in glutamatergic and GABA neurotransmission, and has never been used before in the treatment of tinnitus Aim: To evaluate efficacy and safety of the acamprosate in the treatment of sensorineural tinnitus. Study design: randomized clinical trial. Material and Method: 50 patients with sensorineural tinnitus were divided into two groups: 25 received acamprosate and 25 placebo, for a period of 3 months, in a prospective double-blind study, being analyzed for its efficacy and safety by the subjective score from 1 to 10 given by the patient. Results: We found a high index of success in the relief of tinnitus, about 86.9%. In 47.8% of the cases we found more than 50% relief. The incidence of side effects was low, 12%, all of them mild. Conclusion: Acamprosate, a drug used in the treatment of alcoholism, is a safe and successful alternative for sensorineural tinnitus' treatment.

Análise crítica dos métodos de mensuração do zumbido

“…This is the scale that has been more frequently used in Brazilian tinnitus studies 10,[12][13][14] . Actually, it is a visual graph used to determine the level of disturbance or discomfort caused by tinnitus, in a scale from 1 to 10.…”

“…It may be extremely subjective and influenced by environmental and psychosomatic factors. Many treatment results with medication and other means of treatment are disputed by the tinnitus measuring criteria employed 10,11 .…”

Effectiveness of Acamprosate for Tinnitus: A Systematic Review and Meta-Analysis of Clinical Trials

“…3 However, currently, no specific therapy has been recognized as satisfactory in all patients who suffer from tinnitus, and not even widely disseminated therapeutic options in the media and society, as for example the use of Ginkgo biloba4 extract and Zinc 5 showed efficacy in secondary studies with the best level of evidence available in the world literature. Azevedo & Figueiredo (2005) were pioneers in describing that the oral administration of acamprosate could be effective in the therapeutic approach of tinnitus. Since then, the world scientific community has slowly considered this possibility.…”

“…Since then, the world scientific community has slowly considered this possibility. 6 Tinnitus very possibly has its generator mechanism related to neurotransmitters and neurotransmission. In the auditory pathway afferent the presence of glutamate and gamma-aminobutyric acid (GABA) is well described, while in the efferent pathway, in addition to these, dopamine and acetylcholine are known.…”

Effect of Tinnitus Habituation Therapy on Auditory Abilities

“…12,13 Due to its complex, multiple, and not yet well-understood pathophysiology, several therapeutic modalities have been employed in the attempt to cure or even relieve and reduce the perception of tinnitus and hyperacusis. One of the strategies consists of tinnitus habituation therapy, 14 a treatment based on the neurophysiological model of tinnitus, described by Jastreboff in 1990. 15 In this model, the disorder is considered the result of a dynamic interaction between some centers of the central nervous system, including auditory and nonauditory pathways.…”